Income inequality and population health: a political-economic research agenda.

There is more than 30 years of research on relationships between income inequality and population health. In this article, we propose a research agenda with five recommendations for future research to refine existing knowledge and examine new questions. First, we recommend that future research prioritise analyses with broader time horizons, exploring multiple temporal aspects of the relationship. Second, we recommend expanding research on the effect of public expenditures on the inequality-health relationship. Third, we introduce a new area of inquiry focused on interactions between social mobility, income inequality and population health. Fourth, we argue the need to examine new perspectives on 21st century capitalism, specifically the population health impacts of inequality in income from capital (especially housing), in contrast to inequality in income from labour. Finally, we propose that this research broaden beyond all-cause mortality, to cause-specific mortality, avoidable mortality and subcategories thereof. We believe that such a research agenda is important for policy to respond to the changes following the COVID-19 pandemic.

Do health trajectories predict neighborhood outcomes? Evidence of health selection in a diverse sample of U.S. adults.

Across the United States, residents of lower income neighborhoods evince poorer health, on average, than residents of more affluent areas. Studies aiming to explain this pattern have focused largely on the effects of neighborhood characteristics on residents' health, often overlooking the possibility that the reverse causal process-that a person's health impacts where they live, or "health selection into neighborhoods"-also plays a role. We investigated processes of health selection using the Panel Study of Income Dynamics, a longitudinal survey of U.S. households. Using ordinary least squares linear regression, we estimated the effect of householders' self-rated health on their neighborhood socioeconomic status (SES, the Census tract-level family poverty rate) in 2013, adjusting for neighborhood SES and health in 2001 as well as sociodemographic characteristics and residential mobility. Poorer health was associated with residence in higher poverty neighborhoods overall. Stratified models indicated that while health selection was observed across both race/ethnicity and class boundaries, the relationship between poor health and neighborhood poverty was stronger among non-Hispanic Black respondents, those with low income, and respondents who either moved moderate distances or did not move at all during the study period. We conclude with a call for future work exploring the mechanisms leading those in worse health to reside in higher poverty neighborhoods, and for public health policies that seek not only to improve health supporting conditions in economically disadvantaged neighborhoods, but that also support the economic and social needs of residents struggling with health problems.

Opioid Prescribing Rates by Congressional Districts, United States, 2016.

OBJECTIVES: To determine the extent to which opioid prescribing rates vary across US congressional districts. METHODS: In an observational cross-sectional framework using secondary data, we constructed 2016 congressional district-level opioid prescribing rate estimates using a population-weighted methodology. RESULTS: High prescribing rate districts were concentrated in the South, Appalachia, and the rural West. Low-rate districts were concentrated in urban centers. CONCLUSIONS: In the midst of an opioid overdose crisis, we identified congressional districts of particular concern for opioid prescription saturation. Public Health Implications. The congressional district geography represents a policy-relevant boundary and a politically important level at which to monitor the crisis and determine program funding. Furthermore, in the context of the opioid crisis, knowing how congressional districts rank across the country and in states is useful in the creation of policies targeted to areas in need.