Kaufman, Jay S. (2005). Income Inequality and Reproductive Outcomes--That Model Is Best Which Models the Least. International Journal of Epidemiology, 34(4)
One thing that most of us have figured out by now is that when it comes to health outcomes, it is not good to be poor. Furthermore, in a racially stratified society, it is generally not good for one's health to be a member of the racial group that isn't advantaged in the social hierarchy. All this has been known for a long time, but what social epidemiologists have managed to do quite successfully of late is to suggest new ways of classifying places that are independently predictive of risk for adverse outcomes, conditional on those previously defined individual-level classifications. One of the most successful of these new constructs is income inequality, which can be operationalized with any of a variety of metrics for the spread of individual incomes in a defined geographic area. The association between income inequality and various health outcomes, adjusted for absolute income, has been a dominant trope in social epidemiology for over a decade now,1 so it is natural that authors would begin to extend this to more and more health outcomes, including reproductive outcomes like preterm birth and post-neonatal mortality.2 Since the perinatal period is presumably a sensitive one with respect to environmental and psychosocial influences, it makes perfect sense that we should hypothesize a patterning of birth outcomes along this dimension, even net individual-level status or average income of the clusters.
International Journal of Epidemiology
Kaufman, Jay S.