Wilkinson RG. Income, inequality and social cohesion. American Journal of Public Health 1997; 87: 1504-6

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Wilkinson asks if the relationships between income variables and mortality are really about what income buys? He reviews the examples of egalitarian societies that are thought to have better health because they are more socially cohesive. These include Roseto in Pennsylvania, Japan, and Britain during the two world wars. The recent studies on measures of social cohesion, and their links to mortality provide further support for this hypothesis. The strong relationship of health and income within societies contrasts with its lack among societies, where the association is health with income distribution. Social cohesion is seen to deteriorate within neighborhoods according to their degree of relative deprivation, assessed in relation to local standards, as well as to the wider society. He suggests that inequality is important in areas large enough to contain the salient social heterogeneity, but in small residential neighborhoods composed of one social stratum, the average income would matter more than the income distribution in suggesting the level of health enjoyed by that neighborhood.

Keywords

relative deprivation, health inequalities, income inequality, crime, homicide, neighborhoods, poverty, social capital, social cohesion,socioeconomic status