Explore national- and state-level data for hundreds of health, environmental and socioeconomic measures, including background information about each measure. Use features on this page to find measures; view subpopulations, trends and rankings; and download and share content.
North Carolina Value:
Ratio of median household income at the 80th percentile to median household income at the 20th percentile
North Carolina Rank:
Appears In:
Ratio of median household income at the 80th percentile to median household income at the 20th percentile
<= 4.34
4.35 - 4.53
4.54 - 4.70
4.71 - 5.07
>= 5.08
US Value: 4.92
Top State(s): Utah: 3.78
Bottom State(s): New York: 5.95
Definition: Ratio of median household income at the 80th percentile to median household income at the 20th percentile
Data Source and Years(s): U.S. Census Bureau, American Community Survey, 2022
Suggested Citation: America's Health Rankings analysis of U.S. Census Bureau, American Community Survey, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Research demonstrates an association between greater income disparity and worse population health in developed nations. Countries with greater income inequality have decreased life expectancy, educational attainment and social mobility, as well as increased rates of mental illness, obesity, infant mortality, teenage births, homicide and imprisonment. Income inequality creates chronic stress, which may contribute to poor health outcomes.
Income inequality has increased over the past 50 years in the United States, with the top 20% of earners receiving more than half of all U.S. income in 2022. The negative impacts of income inequality on the U.S. economy are expected to worsen in coming years, diminishing gross domestic product (GDP) growth.
The income inequality ratio, sometimes called the S80/S20 or quintile ratio, is the ratio of the average income of the top 20% (richest) to the bottom 20% (poorest) in a population. A high ratio indicates greater income inequality, while a ratio of 1 indicates total income equality. This ratio is one of the measures of income inequality used by the Organization of Economic Cooperation & Development (OECD) to track and compare human development worldwide.
Income inequality affects society as a whole. However, those with the lowest incomes suffer the most. Populations more affected by income inequality include:
Investing in education is an effective strategy to reduce income disparity. According to a 2019 study, if every state increased its population of college graduates by 1%, it would increase the national GDP by an estimated $103.5 billion. Another important area of focus for policymakers is redistributive tax policies, such as the earned income tax credit, which has been proven to reduce wealth disparities. The Peterson Institute for International Economics offers additional solutions from inequality experts for reducing income inequality, which include expanding tax policies, improving access to education and child care and increasing the federal minimum wage.
Bivens, Josh. “Inequality Is Slowing US Economic Growth.” Washington, D.C.: Economic Policy Institute, December 12, 2017. http://epi.org/136654.
“Chapter 7: Income and Wealth, by Income Tier.” In The Lost Decade of the Middle Class. Washington, D.C.: Pew Research Center, 2012. https://www.pewresearch.org/social-trends/2012/08/22/chapter-7-income-and-wealth-by-income-tier/.
Dorling, Danny. “The Mother of Underlying Causes - Economic Ranking and Health Inequality.” Social Science & Medicine 128 (March 2015): 327–30. https://doi.org/10.1016/j.socscimed.2015.01.008.
Guzman, Gloria, and Melissa Kollar. “Income in the United States: 2022.” Current Population Reports P60-279. Washington, D.C.: U.S. Census Bureau, September 2023. https://www.census.gov/content/dam/Census/library/publications/2023/demo/p60-279.pdf.
Holtz-Eakin, Douglas, and Tom Lee. “The Economic Benefits of Educational Attainment.” American Action Forum, June 4, 2019. https://www.americanactionforum.org/project/economic-benefits-educational-attainment/.
Hoynes, Hilary W., and Ankur J. Patel. “Effective Policy for Reducing Inequality? The Earned Income Tax Credit and the Distribution of Income.” Working Paper 21340. National Bureau of Economic Research, July 2015. https://doi.org/10.3386/w21340.
Kondo, Naoki, Rob M. van Dam, Grace Sembajwe, S. V. Subramanian, Ichiro Kawachi, and Zentaro Yamagata. “Income Inequality and Health: The Role of Population Size, Inequality Threshold, Period Effects and Lag Effects.” Journal of Epidemiology & Community Health 66, no. 6 (June 1, 2012): e11. https://doi.org/10.1136/jech-2011-200321.
Ma, Jennifer, Matea Pender, and Meredith Welch. “Education Pays 2019: The Benefits of Higher Education for Individuals.” Trends in Higher Education Series. College Board, 2019. https://research.collegeboard.org/pdf/education-pays-2019-full-report.pdf.
Pickett, Kate E., and Richard G. Wilkinson. “Income Inequality and Health: A Causal Review.” Social Science & Medicine 128 (March 2015): 316–26. https://doi.org/10.1016/j.socscimed.2014.12.031.
“Why Education Matters to Health: Exploring the Causes.” Issue Brief #2. Education and Health Initiative. Richmond, VA: The VCU Center on Society and Health and Robert Wood Johnson Foundation, April 2014. https://societyhealth.vcu.edu/media/society-health/pdf/test-folder/CSH-EHI-Issue-Brief-2.pdf.
Wilkinson, Richard G, and Kate E. Pickett. “Income Inequality and Population Health: A Review and Explanation of the Evidence.” Social Science & Medicine 62, no. 7 (April 1, 2006): 1768–84. https://doi.org/10.1016/j.socscimed.2005.08.036.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.