This week’s Too Much includes an in depth look at a new meta-analysis about the impact of a society’s income inequality on that society’s citizen’s health. It’s a puzzle that apparently epidemiologists have been working on for a while but it was fairly recently brought to the forefront again when a comparison between the US and European countries showed that the US fares worse even though we spend a lot more on health care (I’ll see if I can dig up that article again…). Nothing seemed to explain the discrepancy, though, it’s obvious that the reporting ignored consistent findings that showed that the income gap seems to be a strong contender. According to the new meta-analysis:

The results suggest a modest adverse effect of income inequality on health, although the population impact might be larger if the association is truly causal. The results also support the threshold effect hypothesis, which posits the existence of a threshold of income inequality beyond which adverse impacts on health begin to emerge.

The US has clearly passed that threshold. Most of the extra mortality occurs in the US, the country with the widest income gap. How much of an impact?

Of the deaths the new BMJ study ties to inequality, almost 900,000 came in the United States.

Too Much last week asked a leading U.S. epidemiologist, Dr. Stephen Bezruchka of the University of Washington School of the Public Health, to place that calculation in perspective.

“We can say,” he noted, “that one in four deaths can be attributed to our high rates of income inequality.”

That’s about three times the number of deaths attributed to smoking… An editorial in the British Medical Journal gives more background.

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