Abstract
OBJECTIVESPrevious research has found that greater income inequality is related to problematic alcohol use across a variety of geographical areas in the USA and New York City (NYC). Those studies used self-reported data to assess alcohol use. This study examined the relationship between within-neighborhood income inequality and alcohol-related emergency department (ED) visits.METHODSThe study outcome was the alcohol-related ED visit rate per 10,000 persons between 2010 and 2014, using data obtained from the New York Statewide Planning and Research Cooperative System. The main predictor of interest was income inequality, measured using the Gini coefficient from the American Community Survey (2010-2014) at the public use microdata area (PUMA) level (n=55) in NYC. Variables associated with alcohol-related ED visits in bivariate analyses were considered for inclusion in a multivariable model.RESULTSThere were 420,568 alcohol-related ED visits associated with a valid NYC address between 2010 and 2014. The overall annualized NYC alcohol-related ED visit rate was 100.7 visits per 10,000 persons. The median alcohol ED visit rate for NYC PUMAs was 88.0 visits per 10,000 persons (interquartile range [IQR], 64.5 to 133.5), and the median Gini coefficient was 0.48 (IQR, 0.45 to 0.51). In the multivariable model, a higher neighborhood Gini coefficient, a lower median age, and a lower percentage of male residents were independently associated with the alcohol-related ED visit rate.CONCLUSIONSThis study found that higher neighborhood income inequality was associated with higher neighborhood alcohol-related ED visit rates. The precise mechanism of this relationship is not understood, and further investigation is warranted to determine temporality and to assess whether the results are generalizable to other locales.
Highlights
Poverty is associated with poor health outcomes, including diabetes, coronary heart disease, and mortality [1]
2019, Korean Society of Epidemiology is thought to be mediated through material deprivation, including lack of health resources, which can manifest as limited access to health care services, difficulty paying for food and housing, and differences in the quality of the social and physical environment [2]
The results of this study are consistent with the findings of other research studies, which have explored the relationship between income inequality and problematic alcohol use [13,14,15,16]
Summary
Poverty is associated with poor health outcomes, including diabetes, coronary heart disease, and mortality [1]. The relationship between poverty and health has been well studied, the relationship between income inequality and health is less thoroughly understood. Studies have found that income inequality is associated with greater mortality, lower selfrated health, and other poor health outcomes [3,4,5]. Health outcomes related to neighborhood economic status may vary by race and ethnicity [8,9]
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