Inequality in the Face of Death: The Income Gradient in Mortality of the Spanish Pre-Recession Working-Age Population

Int J Environ Res Public Health. 2021 Nov 25;18(23):12379. doi: 10.3390/ijerph182312379.

Abstract

The purpose of this paper is to evaluate the association between socioeconomic status (SES) and mortality over a three-year period for working-age Spaniards (2007-2009), paying particular attention to the effect of income level. The analysis is relatively new in Spain, and the studies are limited. Neither income nor wealth are included in existing Spanish mortality studies. The main reason for this limitation is the nature of the data sets used, mainly Census Records. We overcome this problem by using data on 693,994 individuals taken from a Social Security sampling and used to estimate the probabilities of death for each income decile and the mortality rate ratios in three different models: (1) using only income, controlled by age and sex, (2) adding socio-economic and geographical variables, and (3) adding level of education. However, the data used here also have some limitations. They do not include government employees, the military or the Department of Justice personnel, whose exclusion we believe causes an under-representation of highly educated people in our sample. The results confirm that there is a non-linear relationship between mortality and income. This non-linear relationship implies that income redistribution resulting from progressive taxation systems could lead to higher reductions in mortality for low-income groups than the reductions induced in the mortality of the high-income population, thus reducing overall mortality.

Keywords: determinants of health; income; mortality rate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • European People / statistics & numerical data
  • Health Status Disparities*
  • Healthcare Disparities
  • Humans
  • Income / statistics & numerical data
  • Mortality* / trends
  • Poverty / statistics & numerical data
  • Social Class*
  • Socioeconomic Factors
  • Spain / epidemiology

Supplementary concepts

  • Spaniard people