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March 2004 (Volume 82)
Quarterly Article
John Lynch
George Davey Smith
Sam Harper
Marianne Hillemeier
Nancy Ross
George A. Kaplan
Michael Wolfson
Sep 23, 2026
Sep 22, 2026
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This article reviews 98 aggregate and multilevel studies examining the associations between income inequality and health. Overall, there seems to be little support for the idea that income inequality is a major, generalizable determinant of population health differences within or between rich countries. Income inequality may, however, directly influence some health outcomes, such as homicide in some contexts. The strongest evidence for direct health effects is among states in the United States, but even that is somewhat mixed. Despite little support for a direct effect of income inequality on health per se, reducing income inequality by raising the incomes of the most disadvantaged will improve their health, help reduce health inequalities, and generally improve population health.
Author(s): John Lynch; George Davey Smith; Sam Harper; Marianne Hillemeier; Nancy Ross; George A. Kaplan; Michael Wolfson
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Volume 82, Issue 1 (pages 5–99) DOI: 10.1111/j.0887-378X.2004.00302.x Published in 2004