Province-Level Income Inequality and Health Outcomes in Canadian Adolescents

Objective To examine the effects of provincial income inequality (disparity between rich and poor), independent of provincial income and family socioeconomic status, on multiple adolescent health outcomes. Methods Participants (aged 12–17 years; N 11,899) were from the Canadian National Longitudinal Survey of Children and Youth. Parental education, household income, province income inequal-ity, and province mean income were measured. Health outcomes were measured across a number of do-mains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. Results Income inequality was associated with injuries, general physical symptoms, and limiting conditions, but not associated with most adolescent health outcomes and behaviors. Income inequality had a moderating effect on family socioeconomic status for limiting conditions, hyperactivity/inattention, and con-duct problems, but not for other outcomes. Conclusions Province-level income inequality was associated with some physical and mental health outcomes in adolescents, which has research and policy implications for this age-group. Key words adolescents; disparities; health behavior; mental health; public health. Countries with greater disparity between the rich and the poor—or greater income inequality—have been shown t