Poverty has long been recognized as a contributor to death and disease, but several recent trends have generated an increased focus on the link between income and health. First, income inequality in the United States has increased dramatically in recent decades, while health indicators have plateaued, and life expectancy differences by income have grown. Second, there is growing scholarly and public recognition that many nonclinical factors—education, employment, race, ethnicity, and geography—influence health outcomes. Third, health care payment and delivery system reforms have encouraged an emphasis on addressing social determinants of health, including income.
In this brief, we review the evidence supporting the income-health relationship and the likely mechanisms through which income affects health. We then discuss the growing importance of this association, given widening income inequality, and discuss policy levers that might help reduce income-related health disparities. (author abstract)