Ailing inequality: The impact of urban income inequality on the health of Canadians, 2001–2016

Abstract Previous research investigating the association between income inequality and health outcomes reported mixed results. Although there is extensive research on this topic, there is limited empirical evidence within Canada. This paper adds to previous Canadian research by testing the hypothesis that there is an association between urban income inequality and health. To do so, we combined information from the Canadian Census/National Household Survey and the Canadian Community Health Survey for the years 2001, 2006, 2011, and 2016, which yields on average more than 135,000 individual‐level respondents living in 126 urban areas. Using multilevel logistic regression models, we found that a one‐unit increase in the Gini coefficient is associated with an increased likelihood of poorer self‐rated health across all Census years (with ORs between 1.02 and 1.03; 95% CIs of 1.00–1.05), with the association appearing to be weaker in 2006. Income inequality has similar negative effects on self‐rated mental health, an association that is also consistent across the period of study. Additional analysis shows that the association between inequality and both health indicators is, however, sensitive to the choice of inequality measure. Future research in the Canadian context would benefit from longitudinal analysis.