TY - JOUR T1 - Shape of the association between income and mortality: a cohort study of Denmark, Finland, Norway and Sweden in 1995 and 2003 JF - BMJ Open JO - BMJ Open DO - 10.1136/bmjopen-2015-010974 VL - 6 IS - 12 SP - e010974 AU - Laust H Mortensen AU - Johan Rehnberg AU - Espen Dahl AU - Finn Diderichsen AU - Jon Ivar Elstad AU - Pekka Martikainen AU - David Rehkopf AU - Lasse Tarkiainen AU - Johan Fritzell Y1 - 2016/12/01 UR - http://bmjopen.bmj.com/content/6/12/e010974.abstract N2 - Objectives Prior work has examined the shape of the income–mortality association, but work has not compared gradients between countries. In this study, we focus on changes over time in the shape of income–mortality gradients for 4 Nordic countries during a period of rising income inequality. Context and time differentials in shape imply that the relationship between income and mortality is not fixed.Setting Population-based cohort study of Denmark, Finland, Norway and Sweden.Participants We collected data on individuals aged 25 or more in 1995 (n=12.98 million individuals, 0.84 million deaths) and 2003 (n=13.08 million individuals, 0.90 million deaths). We then examined the household size equivalised disposable income at the baseline year in relation to the rate of mortality in the following 5 years.Results A steep income gradient in mortality in men and women across all age groups except the oldest old in Denmark, Finland, Norway and Sweden. From the 1990s to 2000s mortality dropped, but generally more so in the upper part of the income distribution than in the lower part. As a consequence, the shape of the income gradient in mortality changed. The shift in the shape of the association was similar in all 4 countries.Conclusions A non-linear gradient exists between income and mortality in most cases and because of a more rapid mortality decline among those with high income the income gradient has become steeper over time. ER -