Effect of village income and household income on sanitation facilities, hygiene behaviours and child undernutrition during rapid economic growth in a rural cross-border area, Yunnan, China.

PubMed

Yang, C; Sangthong, R; Chongsuvivatwong, V; McNeil, E; Lu, L

2009-05-01

The study aimed to examine the effects of village income and household income on child nutrition status through basic sanitation and hygiene behaviours. A survey was conducted in a rural cross-border area of Yunnan, China. Data on village income in 2002-2006 and household income in 2002-2007 were obtained from an official report and a household survey respectively. Anthropometric measurement of the children aged 6 months to 5 years (n = 1801) was used to determine their nutrition status. Child caretakers were interviewed about household sanitation facilities and their hygiene behaviours using a structured questionnaire. Households with incomes below the national poverty line decreased from 22% in 2002 to less than 8% in 2007. The coverage of safe drinking water and water-sealed latrines gradually increased, but was still inadequate. The prevalence of stunting and underweight in children was 37% and 17.5% respectively. Village income had a greater positive effect than household income on exclusive breastfeeding, drinking boiled water, handwashing with soap, as well as reducing the prevalence of stunting. Village income at one lag year had the greatest effect on the availability of basic sanitation compared with other lag years, while household income had a small but significant effect through all lag years. Rapid economic growth is not always followed by improved child nutrition status. Village income has a greater effect than household income on sanitation facilities, hygiene behaviours of caretakers and child nutrition status.

[Household insecticides: pattern of use according to per capita income].

PubMed

Diel, Cristiane; Facchini, Luiz Augusto; Dall'Agnol, Marinel Mór

2003-02-01

Although insecticides are widely used in many countries, few studies of their use in households have been conducted. This study was carried out to describe the household use of insecticides according to per capita income. From October 1999 to January 2000, questionnaires on the use of household insecticides were applied to 2,039 households in the urban area of Pelotas, Brazil. Data was collected on income, use of insecticides in the 12 months prior to the interview, product type and chemical group of the insecticides found in the households and, mechanical protection used for insect control. Chi-square test for trends was used to assess relationships, prevalence rates and confidence intervals. Household insecticides were used in 89% of the households visited at least in one occasion in the 12 months prior to the interview. In 79% one or more units of insecticides were found in the household at the time of the interview. The most common types were aerosols and tablet refills for electric devices of the pyrethroid chemical group. Mechanical protection against insects was not widely used. Higher income households most frequently had insecticides in the form of pyrethroid aerosols while organophosphate sprays were more frequently found in lower income households.

Prevalence of Obesity Among Youths by Household Income and Education Level of Head of Household - United States 2011-2014.

PubMed

Ogden, Cynthia L; Carroll, Margaret D; Fakhouri, Tala H; Hales, Craig M; Fryar, Cheryl D; Li, Xianfen; Freedman, David S

2018-02-16

Obesity prevalence varies by income and education level, although patterns might differ among adults and youths (1-3). Previous analyses of national data showed that the prevalence of childhood obesity by income and education of household head varied across race/Hispanic origin groups (4). CDC analyzed 2011-2014 data from the National Health and Nutrition Examination Survey (NHANES) to obtain estimates of childhood obesity prevalence by household income (≤130%, >130% to ≤350%, and >350% of the federal poverty level [FPL]) and head of household education level (high school graduate or less, some college, and college graduate). During 2011-2014 the prevalence of obesity among U.S. youths (persons aged 2-19 years) was 17.0%, and was lower in the highest income group (10.9%) than in the other groups (19.9% and 18.9%) and also lower in the highest education group (9.6%) than in the other groups (18.3% and 21.6%). Continued progress is needed to reduce disparities, a goal of Healthy People 2020. The overall Healthy People 2020 target for childhood obesity prevalence is <14.5% (5).

Household income and risk-of-poverty of parents of long-term childhood cancer survivors.

PubMed

Mader, Luzius; Roser, Katharina; Baenziger, Julia; Tinner, Eva Maria; Scheinemann, Katrin; Kuehni, Claudia Elisabeth; Michel, Gisela

2017-08-01

Taking care of children diagnosed with cancer affects parents' professional life and may place the family at risk-of-poverty. We aimed to (i) compare the household income and risk-of-poverty of parents of childhood cancer survivors (CCS) to parents of the general population, and (ii) identify sociodemographic and cancer-related factors associated with risk-of-poverty. As part of the Swiss Childhood Cancer Survivor Study, we sent a questionnaire to parents of CCS aged 5-15 years, who survived ≥5 years after diagnosis. Information on parents of the general population came from the Swiss Household Panel (parents with ≥1 child aged 5-15 years). Risk-of-poverty was defined as having a monthly household income of <4,500 Swiss Francs (CHF) for single parents and <6,000 CHF for parent-couples. We used logistic regression to identify factors associated with risk-of-poverty. We included parents of 383 CCS and 769 control parent households. Parent-couples of CCS had a lower household income (P trend < 0.001) and were at higher risk-of-poverty (30.4% vs. 19.3%, P = 0.001) compared to control parent-couples. Household income and risk-of-poverty of single parents of CCS was similar to control single parents. Parents of CCS were at higher risk-of-poverty if they had only standard education (OR mother = 3.77 [where OR is odds ratio], confidence interval [CI]: 1.61-8.82; OR father = 8.59, CI: 4.16-17.72) and were from the German language region (OR = 1.99, CI: 1.13-3.50). We found no cancer-related risk factors. Parents of long-term CCS reported lower household income and higher risk-of-poverty than control parents. Support strategies may be developed to mitigate parents' risk-of-poverty in the long term, particularly among parents with lower education. © 2017 Wiley Periodicals, Inc.

Household income is associated with the risk of metabolic syndrome in a sex-specific manner.

PubMed

Dallongeville, Jean; Cottel, Dominique; Ferrières, Jean; Arveiler, Dominique; Bingham, Annie; Ruidavets, Jean Bernard; Haas, Bernadette; Ducimetière, Pierre; Amouyel, Philippe

2005-02-01

To assess the relationship between household income and metabolic syndrome in men and women. A total of 1,695 men and 1,664 women, aged 35-64 years, from three distinct geographical areas of France were investigated. Waist girth, plasma triglycerides, HDL cholesterol, glucose, and systolic blood pressure were used to define metabolic syndrome according to the National Cholesterol Education Program (NCEP)/Adult Treatment Panel III (ATPIII) guidelines. Household income, educational level, occupational category, working status, consumption of psychotropic drugs, accommodation status, household composition, physical activity at work and during leisure time, alcohol consumption, and smoking habits were recorded with a standardized questionnaire. There were 390 (23.0%) men and 381 (16.9%) women who satisfied NCEP/ATPIII criteria for metabolic syndrome. Household income (P < 0.0001) and consumption of psychotropic drugs (P = 0.0005) were associated with metabolic syndrome in women but not in men. In contrast, educational level, occupational category, working status, and accommodation status were associated with metabolic syndrome in both men and women. After adjustment on lifestyle variables, household income (interaction P < 0.004) remained inversely associated with metabolic syndrome in women but not in men. These data suggest that limited household income, which reflects a complex unfavorable social and economic environment, may increase the risk of metabolic syndrome in a sex-specific manner.

Impact of Community-Based HIV/AIDS Treatment on Household Incomes in Uganda

PubMed Central

Feulefack, Joseph F.; Luckert, Martin K.; Mohapatra, Sandeep; Cash, Sean B.; Alibhai, Arif; Kipp, Walter

2013-01-01

Though health benefits to households in developing countries from antiretroviral treatment (ART) programs are widely reported in the literature, specific estimates regarding impacts of treatments on household incomes are rare. This type of information is important to governments and donors, as it is an indication of returns to their ART investments, and to better understand the role of HIV/AIDS in development. The objective of this study is to estimate the impact of a community-based ART program on household incomes in a previously underserved rural region of Uganda. A community-based ART program, based largely on labor contributions from community volunteers, was implemented and evaluated. All households with HIV/AIDS patients enrolled in the treatment programme (n = 134 households) were surveyed five times; once at the beginning of the treatment and every three months thereafter for a period of one year. Data were collected on household income from cash earnings and value of own production. The analysis, using ordinary least squares and quantile regressions, identifies the impact of the ART program on household incomes over the first year of the treatment, while controlling for heterogeneity in household characteristics and temporal changes. As a result of the treatment, health conditions of virtually all patients improved, and household incomes increased by approximately 30% to 40%, regardless of household income quantile. These increases in income, however, varied significantly depending on socio-demographic and socio-economic control variables. Overall, results show large and significant impacts of the ART program on household incomes, suggesting large returns to public investments in ART, and that treating HIV/AIDS is an important precondition for development. Moreover, development programs that invest in human capital and build wealth are important complements that can increase the returns to ART programs. PMID:23840347

Household income and preschool attendance in china.

PubMed

Gong, Xin; Xu, Di; Han, Wen-Jui

2015-01-01

This article draws upon the literature showing the benefits of high-quality preschools on child well-being to explore the role of household income on preschool attendance for a cohort of 3- to 6-year-olds in China using data from the China Health and Nutrition Survey, 1991-2006. Analyses are conducted separately for rural (N = 1,791) and urban (N = 633) settings. Estimates from a probit model with rich controls suggest a positive association between household income per capita and preschool attendance in both settings. A household fixed-effects model, conducted only on the rural sample, finds results similar to, although smaller than, those from the probit estimates. Policy recommendations are discussed. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

Household responsibilities, income, and ambulatory blood pressure among working men and women

PubMed Central

Thurston, Rebecca C.; Sherwood, Andrew; Matthews, Karen A.; Blumenthal, James A.

2011-01-01

Objective To test the hypothesis that a greater perceived responsibility for household tasks and a greater number of hours spent doing these tasks would be associated with elevated ambulatory systolic (SBP) and diastolic blood pressure (DBP). The connection between job characteristics and cardiovascular outcomes has been widely studied. However, less is known about links between household work characteristics and cardiovascular health. Methods 113 employed unmedicated hypertensive men and women underwent one day of ambulatory blood pressure (ABP) monitoring. Participants provided information on 1) the number of hours spent doing and 2) their degree of responsibility for seven household tasks (child care, pet care, caring for ill/elderly, household chores, house/car repair, yardwork, finances). Associations between task hours and responsibility ratings in relation to SBP and DBP were estimated using generalized estimating equations, with covariates age, race, gender, body mass index, location, posture. Interactions with gender and socioeconomic position were assessed. Results A greater perceived responsibility for household tasks, but not the hours spent doing these tasks, was associated with higher ambulatory SBP (b(95% confidence interval (CI))=0.93(0.29–1.56), p=0.004) and DBP (b(95%CI)=0.30(0.10–0.51), p=0.003)). Significant interactions with income indicated that associations between household responsibilities and ABP were most pronounced among low income participants (SBP: b(95%CI)=1.40(0.58–2.21), p<0.001; DBP: b(95%CI)=0.48(0.18–0.78), p<0.01). The task most strongly associated with BP was household chores. No interactions with gender were observed. Conclusions Greater perceived responsibility for household tasks was associated with elevated ABP, particularly for lower income participants. Household obligations may have important implications for cardiovascular health, meriting further empirical attention. PMID:21217097

Demand for and utilization of dental services according to household income in the adult population in Norway.

PubMed

Grytten, Jostein; Holst, Dorthe; Skau, Irene

2012-08-01

The aim of this study was to describe the effect of income on demand and utilization of dental services according to household income in the adult population. The data were collected using a questionnaire, which was sent to a random sample of Norwegians aged 20 years or older living at home, 1861 persons in total. Demand was measured according to whether the person had been to the dentist during the last year. Utilization was measured as expenditure for dental treatment for those who had been to the dentist during the last year. The independent variables were the respondents' household income, age, gender, education, dental status and the mean fee for a dental consultation in the municipality. In the first stage, we carried out a logistic regression analysis of the log odds of having demanded dental services during the last year. In the second stage, we carried out a multiple regression analysis of expenditure for dental treatment for those who had been to the dentist during the last year. Altogether, 80% of the respondents had been to the dentist during the last year. Demand during the last year varied most according to dental status. There was little difference between men and women. The results of the logistic regression showed that the probability of having been to the dentist was 0.82 for those with a household income of €25 000 and 0.85 for those with a household income of €100 000. Mean expenditure for dental treatment was €355. There was no statistically significant relationship between household income and expenditure for dental treatment. Differences in demand for dental services according to household income are small, and there are no differences in utilization according to income. The findings are interesting, because in a population in which people have to pay almost all the costs for dental treatment themselves, one would expect the income differences in demand and utilization to be greater. © 2012 John Wiley & Sons A/S.

Mother and Grandmother Parenting in Low-Income Three-Generation Rural Households

PubMed Central

Barnett, Melissa A.

2009-01-01

This study draws data from the Family Life Project to examine parenting behaviors observed for 105 mothers and grandmothers raising an infant in rural low-income multigenerational households. Multilevel models are used to examine the relationships between maternal age and psychological distress and parenting of the infant by both generations. The findings indicate that young maternal age is a risk factor for less sensitive parenting in the presence of other risks, including psychological distress. Further, young maternal age is associated with negative parenting behaviors by grandmothers only. Grandmothers and mothers displayed similar levels of negative intrusive parenting, but different factors were linked to the observed parenting of each generation. These findings contribute to understanding the benefits and risks of three-generation households. PMID:19946461

Mother and Grandmother Parenting in Low-Income Three-Generation Rural Households

ERIC Educational Resources Information Center

Barnett, Melissa A.

2008-01-01

This study draws data from the Family Life Project to examine parenting behaviors observed for 105 mothers and grandmothers raising an infant in rural low-income multigenerational households. Multilevel models are used to examine the relationships between maternal age and psychological distress and parenting of the infant by both generations. The…

Trends in out-of-pocket health care expenditures in Canada, by household income, 1997 to 2009.

PubMed

Sanmartin, Claudia; Hennessy, Deirdre; Lu, Yuqian; Law, Michael Robert

2014-04-01

Canadian households are spending an increasing share of their household income on health care not covered by public plans. This study investigates trends in out-of-pocket expenditures for health care services and products by household income quintile from 1997 to 2009. Biennial estimates from the Survey of Household Spending between 1997 and 2009 were used to examine changes in out-of-pocket health care expenditures, by household income quintile. The statistical significance of these changes was assessed using linear and logistic regression. In 2009, the percentage of after-tax household income spent on health care among low-income households (5.7%) was nearly twice that of high-income households (2.6%). Approximately 40% of households in the two lowest income quintiles spent more than 5% of their total after-tax income on health care services and products, compared with 14% of households in the highest income quintile. The increase in spending between 1997 and 2009 was greatest for households in the lowest income quintile (63%). Out-of-pocket health care expenditures have increased for households in all income quintiles, but the relative increase was greatest among households in lower income quintiles.

The effect of alcohol consumption on household income in Ireland.

PubMed

Ormond, Gillian; Murphy, Rosemary

2016-11-01

This paper presents a study of the effects of alcohol consumption on household income in Ireland using the Slán National Health and Lifestyle Survey 2007 dataset, accounting for endogeneity and selection bias. Drinkers are categorised into one of four categories based on the recommended weekly drinking levels by the Irish Health Promotion Unit; those who never drank, non-drinkers, moderate and heavy drinkers. A multinomial logit OLS Two Step Estimate is used to explain individual's choice of drinking status and to correct for selection bias which would result in the selection into a particular category of drinking being endogenous. Endogeneity which may arise through the simultaneity of drinking status and income either due to the reverse causation between the two variables, income affecting alcohol consumption or alcohol consumption affecting income, or due to unobserved heterogeneity, is addressed. This paper finds that the household income of drinkers is higher than that of non-drinkers and of those who never drank. There is very little difference between the household income of moderate and heavy drinkers, with heavy drinkers earning slightly more. Weekly household income for those who never drank is €454.20, non-drinkers is €506.26, compared with €683.36 per week for moderate drinkers and €694.18 for heavy drinkers. Copyright © 2016 Elsevier Inc. All rights reserved.

Controlling urban air pollution caused by households: uncertainty, prices, and income.

PubMed

Chávez, Carlos A; Stranlund, John K; Gómez, Walter

2011-10-01

We examine the control of air pollution caused by households burning wood for heating and cooking in the developing world. Since the problem is one of controlling emissions from nonpoint sources, regulations are likely to be directed at household choices of wood consumption and combustion technologies. Moreover, these choices are subtractions from, or contributions to, the pure public good of air quality. Consequently, the efficient policy design is not independent of the distribution of household income. Since it is unrealistic to assume that environmental authorities can make lump sum income transfers part of control policies, efficient control of air pollution caused by wood consumption entails a higher tax on wood consumption and a higher subsidy for more efficient combustion technologies for higher income households. Among other difficulties, implementing a policy to promote the adoption of cleaner combustion technologies must overcome the seemingly paradoxical result that efficient control calls for higher technology subsidies for higher income households. Copyright © 2011 Elsevier Ltd. All rights reserved.

Low-income Children's participation in the National School Lunch Program and household food insufficiency.

PubMed

Huang, Jin; Barnidge, Ellen

2016-02-01

Assessing the impact of the National School Lunch Program (NSLP) on household food insufficiency is critical to improve the implementation of public food assistance and to improve the nutrition intake of low-income children and their families. To examine the association of receiving free/reduced-price lunch from the NSLP with household food insufficiency among low-income children and their families in the United States, the study used data from four longitudinal panels of the Survey of Income and Program Participation (SIPP; 1996, 2001, 2004, and 2008), which collected information on household food insufficiency covering both summer and non-summer months. The sample included 15, 241 households with at least one child (aged 5-18) receiving free/reduced-price lunch from the NSLP. A dichotomous measure describes whether households have sufficient food to eat in the observed months. Fixed-effects regression analysis suggests that the food insufficiency rate is .7 (95%CI: .1, 1.2) percentage points higher in summer months among NSLP recipients. Since low-income families cannot participate in the NSLP in summer when the school is not in session, the result indicates the NSLP participation is associated with a reduction of food insufficiency risk by nearly 14%. The NSLP plays a significant role to protect low-income children and their families from food insufficiency. It is important to increase access to school meal programs among children at risk of food insufficiency in order to ensure adequate nutrition and to mitigate the health problems associated with malnourishment among children. Copyright © 2015 Elsevier Ltd. All rights reserved.

Eat, Drink, Man, Woman: Gender, Income Share and Household Expenditure in South Africa

ERIC Educational Resources Information Center

Gummerson, Elizabeth; Schneider, Daniel

2013-01-01

This study examines how gendered household bargaining occurs in non-nuclear family households. We employ two South African data sets and use linear regression and household fixed effects to investigate the relationship between women's income shares and household expenditures. In married couple households, when women garner larger shares of income,…

Change in household income and risk for attention deficit hyperactivity disorder during childhood: A nationwide population-based cohort study.

PubMed

Choi, Young; Shin, Jaeyong; Cho, Kyoung Hee; Park, Eun-Cheol

2017-02-01

Childhood attention deficit hyperactivity disorder (ADHD) is reported to be more prevalent among socioeconomically disadvantaged groups in various countries. The effect of poverty on child development appears to depend on how long poverty lasts. The timing of poverty also seems to be important for childhood outcomes. Lifetime socioeconomic status may shape current health. Thus, we investigated the effects of household income changes from birth to 4 years on the occurrence of ADHD. Data were obtained from 18,029 participants in the Korean National Health Insurance cohort who were born in 2002 and 2003. All individuals were followed until December 2013 or the occurrence of ADHD, whichever came first. Household income trajectories were estimated using the national health insurance premium and the group-based model. Cox proportional hazard models were used to compare incidence rates between different income trajectory groups after adjustment for possible confounding risk factors. Of 18,029 participants, 554 subjects (3.1%) were identified as having ADHD by age 10 or 11. Seven household income trajectories within three categories were found. Children living in decreasing, consistently low, and consistently mid-low income households had an increased risk of ADHD compared to children who consistently lived in the mid-high household income group. Children who live in decreasing-income or consistently low-income households have a higher risk for ADHD. Promotion of targeted policies and priority support may help reduce ADHD in this vulnerable group. Copyright © 2016 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Understanding childhood obesity in America: linkages between household income, community resources, and children's behaviors.

PubMed

Eagle, Taylor F; Sheetz, Anne; Gurm, Roopa; Woodward, Alan C; Kline-Rogers, Eva; Leibowitz, Robert; Durussel-Weston, Jean; Palma-Davis, LaVaughn; Aaronson, Susan; Fitzgerald, Catherine M; Mitchell, Lindsey R; Rogers, Bruce; Bruenger, Patricia; Skala, Katherine A; Goldberg, Caren; Jackson, Elizabeth A; Erickson, Steven R; Eagle, Kim A

2012-05-01

Understanding childhood obesity's root causes is critical to the creation of strategies to improve our children's health. We sought to define the association between childhood obesity and household income and how household income and childhood behaviors promote childhood obesity. We assessed body mass index in 109,634 Massachusetts children, identifying the percentage of children who were overweight/obese versus the percentage of children in each community residing in low-income homes. We compared activity patterns and diet in 999 sixth graders residing in 4 Michigan communities with varying annual household income. In Massachusetts, percentage of overweight/obese by community varied from 9.6% to 42.8%. As household income dropped, percentage of overweight/obese children rose. In Michigan sixth graders, as household income goes down, frequency of fried food consumption per day doubles from 0.23 to 0.54 (P < .002), and daily TV/video time triples from 0.55 to 2.00 hours (P < .001), whereas vegetable consumption and moderate/vigorous exercise go down. The prevalence of overweight/obese children rises in communities with lower household income. Children residing in lower income communities exhibit poorer dietary and physical activity behaviors, which affect obesity. Copyright © 2012 Mosby, Inc. All rights reserved.

Relationship between catastrophic health expenditures and household incomes and expenditure patterns in South Korea.

PubMed

Kim, Younhee; Yang, Bongmin

2011-05-01

The compositions of health expenditures by households in South Korea with and without catastrophic health expenditures were compared. Also, relationships between catastrophic health expenditures and household incomes, and between such health expenditures and expenditure patterns were explored. Data from the 2006 South Korean Household Income & Expenditure Survey, a representative survey of 90,696 households were analyzed. We used a double-hurdle model to assess each income source and expenditure category. The independent variable was the presence of catastrophic health expenditure. After adjusting for household characteristics, the results showed that earned, business, and property incomes were significantly lower, but transfer and loan incomes were significantly higher in households with catastrophic health expenditures than in those without such health expenditures. All consumption categories, other than health expenditure, were significantly lower in households with catastrophic health expenditures than in those without catastrophic health expenditures. This suggests that households with catastrophic health expenditures faced challenges in offset by the potentially excessive health expenditure and may have been obliged to reduce consumption of other items. The expansion of insurance coverage and lowering of out-of-pocket rates in the South Korean Health Insurance benefits could be a necessary first step in protecting households from the occurrence of health related economic catastrophes. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Influence of maternal depression on household food insecurity for low-income families.

PubMed

Garg, Arvin; Toy, Sarah; Tripodis, Yorghos; Cook, John; Cordella, Nick

2015-01-01

To examine whether maternal depression predicts future household food insecurity for low-income families. This was a secondary data analysis using data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). The study cohort consisted of 2917 low-income mothers, defined as <185% federal poverty level, who were food secure at baseline. Maternal data collected when children were 9 and 24 months of age were used. Data at 9 months were considered baseline, and data at 24 months were considered follow-up. Baseline maternal depressive symptoms were measured by a 12-item abbreviated version of the Center for Epidemiologic Studies Depression Scale. Household food insecurity at follow-up was measured by the US Department of Agriculture Household Food Security Scale. At baseline, 16% of mothers were depressed (raw score >9). Most mothers were white, unemployed, and born in the United States. The majority received Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (86%); 39% received Supplemental Nutrition Assistance Program (SNAP). At follow-up, 11.8% of mothers reported household food insecurity. In multivariable analysis, maternal depression at baseline was significantly associated with food insecurity at follow-up (adjusted odds ratio 1.50; 95% confidence interval 1.06-2.12). Our results suggest that maternal depression is an independent risk factor for household food insecurity in low-income families with young children. Multidisciplinary interventions embedded within and outside the pediatric medical home should be developed to identify depressed mothers and link them to community-based mental health and food resources. Further longitudinal and interventional studies are needed to understand and address the complex relationship between poverty, maternal depression, social safety nets, and food insecurity. Copyright © 2015 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Young Adult Obesity and Household Income: Effects of Unconditional Cash Transfers†

PubMed Central

Akee, Randall; Simeonova, Emilia; Copeland, William; Angold, Adrian

2014-01-01

We investigate the effect of household cash transfers during childhood on young adult body mass indexes (BMI). The effects of extra income differ depending on the household’s initial socioeconomic status (SES). Children from the initially poorest households have a larger increase in BMI relative to children from initially wealthier households. Several alternative mechanisms are examined. Initial SES holds up as the most likely channel behind the heterogeneous effects of extra income on young adult BMI. (JEL D14, H23, H75, I12, J13, J15) PMID:24707346

Household and area income levels are associated with smoking status in the Korean adult population.

PubMed

Yun, Woo-Jun; Rhee, Jung-Ae; Kim, Sun A; Kweon, Sun-Seog; Lee, Young-Hoon; Ryu, So-Yeon; Park, Soon-Woo; Kim, Dong Hyun; Shin, Min-Ho

2015-01-31

Some previous studies have suggested that area-level characteristics have effects on smoking. The aim of this study was to evaluate the associations between household income and area income on smoking in Korean adults. This study was based on the Korean Community Health Survey (KCHS) performed in South Korea, between September and November 2009. In total, 222,242 subjects (103,124 men and 119,118 women) were included in the analysis. Information on smoking status was collected using a standardized questionnaire. Income status was determined by monthly household income. Household income was categorized as: <1 million won; <2 million won; <3 million won; and ≥3 million won. Area-level income categorized as quartiles. Data were analyzed using multilevel regression models. The analysis was conducted separately urban and rural, by sex. The lowest household income group had a higher risk of smoking than the highest household income group in both urban and rural areas for both men and women after adjusting for individual characteristics (urban men: odds ration [OR], 1.44; 95% confidence interval [CI], 1.36-1.53; rural men: OR, 1.33; 95% CI, 1.25-1.42; urban women: OR, 2.38; 95% CI, 2.06-2.76; rural women: OR, 1.51; 95% CI, 1.25-1.83). In men, the lowest area-level income group had a higher risk for smoking than the highest area-level income group in urban areas after adjusting for individual characteristics and household income (OR, 1.17; 95% CI, 1.02-1.33). In women, the lowest area-level income group had a lower risk for smoking than the highest area-level income group in rural areas after adjusting for individual characteristics and household income (OR, 0.52; 95% CI, 0.39-0.70). However, no association was observed between area-level income and smoking in rural areas for men or in urban areas for women. The results showed that smoking is strongly associated with household income status in both men and women, and area-level income is partly associated with smoking

Perceived Barriers to Savings among Low- to Moderate-Income Households that Do Not Save Regularly

ERIC Educational Resources Information Center

Mauldin, Teresa; Bowen, Cathy Faulcon; Cheang, Michael

2013-01-01

The study reported here examined the differences in barriers to savings among low- to moderate-income households who do not save regularly. Characteristics associated with individuals who perceived they could and could not save included age, presence of child under 18 years of age, and gender. Having no money left over, being late on bills and/or…

FOOD ACQUISITION AND INTRA-HOUSEHOLD CONSUMPTION PATTERNS: A STUDY OF LOW AND MIDDLE INCOME URBAN HOUSEHOLDS IN DELHI, INDIA.

PubMed

Pradhan, Mr; Taylor, Fc; Agrawal, S; Prabhakaran, D; Ebrahim, S

2013-12-01

Food habits and choices in India are shifting due to many factors: changing food markets, fast urbanization, food price inflation, uncertain food production and unequal distribution during the past decade. This study aims to explore food acquisition and intra-household consumption patterns in urban low and middle income (LMI) households in Delhi. Twenty households were randomly selected from the Center for Cardio-metabolic Risk Reduction in South Asia (CARRS) surveillance study. Data were derived from 20 questionnaires administered to women responsible for food preparation, four key-informant-interviews, and 20 in-depth interviews with household heads during September-November 2011. STATA and ATLAS.ti software were used for data analysis. Half of the households spent at least two-thirds of their income on food. The major expenditures were on vegetables (22% of total food expenditure), milk and milk products (16%), and cereal and related products (15%). Income, food prices, food preferences, and seasonal variation influenced food expenditure. Adults usually ate two to three times a day while children ate more frequently. Eating sequence was based on the work pattern within the household and cultural beliefs. Contrary to previous evidence, there was no gender bias in intra-household food distribution. Women considered food acquisition, preparation and distribution part of their self-worth and played a major role in food related issues in the household. Women's key roles in food acquisition, preparation and intra household food consumption should be considered in formulating food policies and programs.

FOOD ACQUISITION AND INTRA-HOUSEHOLD CONSUMPTION PATTERNS: A STUDY OF LOW AND MIDDLE INCOME URBAN HOUSEHOLDS IN DELHI, INDIA

PubMed Central

Pradhan, MR; Taylor, FC; Agrawal, S; Prabhakaran, D; Ebrahim, S

2014-01-01

Background Food habits and choices in India are shifting due to many factors: changing food markets, fast urbanization, food price inflation, uncertain food production and unequal distribution during the past decade. This study aims to explore food acquisition and intra-household consumption patterns in urban low and middle income (LMI) households in Delhi. Methods Twenty households were randomly selected from the Center for Cardio-metabolic Risk Reduction in South Asia (CARRS) surveillance study. Data were derived from 20 questionnaires administered to women responsible for food preparation, four key-informant-interviews, and 20 in-depth interviews with household heads during September-November 2011. STATA and ATLAS.ti software were used for data analysis. Results Half of the households spent at least two-thirds of their income on food. The major expenditures were on vegetables (22% of total food expenditure), milk and milk products (16%), and cereal and related products (15%). Income, food prices, food preferences, and seasonal variation influenced food expenditure. Adults usually ate two to three times a day while children ate more frequently. Eating sequence was based on the work pattern within the household and cultural beliefs. Contrary to previous evidence, there was no gender bias in intra-household food distribution. Women considered food acquisition, preparation and distribution part of their self-worth and played a major role in food related issues in the household. Conclusion Women’s key roles in food acquisition, preparation and intra household food consumption should be considered in formulating food policies and programs. PMID:25473147

The School Breakfast Program strengthens household food security among low-income households with elementary school children.

PubMed

Bartfeld, Judith S; Ahn, Hong-Min

2011-03-01

The School Breakfast Program is an important component of the nutritional safety net and has been linked to positive changes in meal patterns and nutritional outcomes. By offering a breakfast, which for low-income children is available either at no cost or reduced price, the program also has the potential to increase household food security. This study examined the relationship between availability of the School Breakfast Program and household food security among low-income third-grade students by using data from the Early Childhood Longitudinal Survey-Kindergarten Cohort. The primary sample included 3010 students. Availability of school breakfast was assessed by surveys of school administrators. Food security was assessed by parents' reports by using the standard 18-item food security scale and considering 2 different food security thresholds. A probit model was estimated to measure the relationship between school breakfast availability and household food security while controlling for a range of other characteristics. Access to school breakfast reduced the risk of marginal food insecurity but not the risk of food insecurity at the standard threshold. That is, the program appeared beneficial in offsetting food-related concerns among at-risk families, although not necessarily in alleviating food insecurity once hardships had crossed the food insecurity threshold. Increasing the availability of school breakfast may be an effective strategy to maintain food security among low-income households with elementary school children.

Household income and health problems during a period of labour-market change and widening income inequalities - a study among the Finnish population between 1987 and 2007.

PubMed

Aittomäki, Akseli; Martikainen, Pekka; Rahkonen, Ossi; Lahelma, Eero

2014-01-01

Income inequalities widened considerably from 1987 to 2007 in Finland. We compared the association between household income and health problems across three periods and in several different ways of modelling the dependence. Our aim was to find out whether the change in the distribution of income might have led to wider income-related inequalities in health problems. The data represent an 11-per-cent random sample of the Finnish population, and we restricted the analysed sample to those between 18 and 67 years of age and not in receipt of any pension in each of the three six-year periods examined (n between 280,106 and 291,198). The health outcome was sickness-allowance days compensated. Household-equivalent taxable income was applied with two different scale transformations: firstly, as real income adjusted for price level and secondly, as rank position on the income distribution. We used negative binomial regression models, with and without zero inflation, as well as decomposition analysis. We found that sickness-allowance days decreased with increasing income, while differences in the shape and magnitude of the association were found between the scales and the periods. During the study period the association strengthened considerably at both the lowest fifth and the top fifth of the rank scale, while the observed per-unit effect of real income changed less. Decomposition analysis suggested that slightly less than half of the observed increase in concentration of health problems at lower end of the rank scale could be accounted for by the change in real income distribution. The results indicate that widening differences in household consumption potential may have contributed to an intensified impact of household income on inequalities in health problems. Explaining the change only in terms of consumption potential, however, was problematic, and changes in the interdependence of labour-market advantage and health problems are likely to contribute as well. Copyright

Prevalence of Obesity Among Adults, by Household Income and Education - United States, 2011-2014.

PubMed

Ogden, Cynthia L; Fakhouri, Tala H; Carroll, Margaret D; Hales, Craig M; Fryar, Cheryl D; Li, Xianfen; Freedman, David S

2017-12-22

Studies have suggested that obesity prevalence varies by income and educational level, although patterns might differ between high-income and low-income countries (1-3). Previous analyses of U.S. data have shown that the prevalence of obesity varied by income and education, but results were not consistent by sex and race/Hispanic origin (4). Using data from the National Health and Nutrition Examination Survey (NHANES), CDC analyzed obesity prevalence among adults (aged ≥20 years) by three levels of household income, based on percentage (≤130%, >130% to ≤350%, and >350%) of the federal poverty level (FPL) and individual education level (high school graduate or less, some college, and college graduate). During 2011-2014, the age-adjusted prevalence of obesity among adults was lower in the highest income group (31.2%) than the other groups (40.8% [>130% to ≤350%] and 39.0% [≤130%]). The age-adjusted prevalence of obesity among college graduates was lower (27.8%) than among those with some college (40.6%) and those who were high school graduates or less (40.0%). The patterns were not consistent across all sex and racial/Hispanic origin subgroups. Continued progress is needed to achieve the Healthy People 2020 targets of reducing age-adjusted obesity prevalence to <30.5% and reducing disparities (5).

Does Household Income Matter for Children's Schooling? Evidence for Rural Sub-Saharan Africa

ERIC Educational Resources Information Center

Grimm, Michael

2011-01-01

Household income has been shown to matter for children's school enrolment, in particular in settings where households face tight liquidity constraints caused by the lack of insurance and limited possibilities to smooth consumption through credit and savings. However, so far only few studies have made an effort to quantify the income elasticity of…

Utilization of Selected Vitality Staple Foods by Low Income Households in Ebonyi State

ERIC Educational Resources Information Center

Igba, Chimezie Elizabeth; Okoro, M. O.

2015-01-01

The study focused on the utilization of selected vitality foods among low income household in Ebonyi State. Specifically the study aimed at identifying vitality foods that are available, accessible and utilized by low income household in state. Descriptive survey design was used for the study. The population of the study is 2,173,501 households…

Rooftop Solar Technical Potential for Low-to-Moderate Income (LMI) Households

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sigrin, Benjamin O

This report presents a first-of-kind assessment of the technical potential of rooftop solar for low and moderate-income households, as well as providing insight on the distribution of solar potential by tenure, income, and other building characteristics. We find that a substantial fraction of the national rooftop solar potential is located on LMI buildings and, for all incomes, a substantial fraction on multi-family and renter-occupied buildings. We also find that rooftop solar can significantly contribute to long-term penetration targets established by the U.S. DOE, though to do so requires deployment on multi-family and renter-occupied buildings. Traditional deployment models have insufficiently enabledmore » access to solar for these income groups and building types. Without innovation either in regulatory, market, or policy factors, a large fraction of the U.S. potential is unlikely to be addressed, as well as leading to inequalities in solar access. Ironically, potential electric bill savings from rooftop solar would have the greatest material impact on the lives of low-income households as compared to their high-income counterparts.« less

The relationship between employment status and self-rated health among wage workers in South Korea: the moderating role of household income.

PubMed

Lim, Hyejin; Kimm, Heejin; Song, In Han

2015-02-01

The purpose of the study reported in this article was to investigate the relationship between employment status and self-rated health (SRH) and the moderating effect of household income among wage workers in South Korea. This research analyzed the Korean Labor and Income Panel Study, 2005 to 2008. Of the 10,494 respondents participating in the survey during the period, a total of 1,548 people whose employment status had remained either precarious or nonprecarious were selected. A moderated multiple regression model was used to examine the main effect of employment status on SRH and the moderating effect of total household income on the relationship between employment status and SRH. Among 343 precarious workers and 1,205 nonprecarious workers, after controlling for gender, age, education, smoking, and drinking, employment status was associated with SRH of wage workers, and household income was found to have a moderating effect on SRH in that higher income buffers the link between unstable employment status and low SRH. Unstable employment, combined with low income, was significantly related to precarious wage workers' perceived health. To promote public health, efforts may be needed to secure not only people's employment, but also their income.

Impact of targeted beverage taxes on higher- and lower-income households.

PubMed

Finkelstein, Eric A; Zhen, Chen; Nonnemaker, James; Todd, Jessica E

2010-12-13

Sugar-sweetened beverage (SSB) taxes are increasingly being considered as a strategy for addressing the obesity epidemic. We sought to investigate the differential impact of targeted beverage taxes on higher- and lower-income households. This analysis relied on data from the 2006 Nielsen Homescan panel, which included a national sample of households that scan and transmit their store-bought food and beverage purchases weekly for a 12-month period. We assessed associations among beverage prices, energy intake, and weight using multivariate regression models. A 20% and 40% tax on carbonated SSBs only would reduce beverage purchases by a mean (SE) of 4.2 (1.6) and 7.8 (2.8) kcal/d per person, respectively. Extending the tax to all SSBs generates mean (SE) reductions of 7.0 (1.9) and 12.4 (3.4) kcal/d per person, respectively. Estimated mean (SE) weight losses resulting from a 20% and 40% tax on all SSBs are 0.32 (0.09) and 0.59 (0.16) kg/y per person, respectively. The 40% tax on SSBs, which costs a mean (SE) of $28.48 ($0.87) per household per year, would generate $2.5 billion ($77.5 million) in tax revenue, with the largest share coming from high-income households. Large taxes on SSBs have the potential to positively influence weight outcomes, especially for middle-income households. These taxes would also generate substantial revenue that could be used to fund obesity prevention programs or for other causes.

Household Income and Preschool Attendance in China

ERIC Educational Resources Information Center

Gong, Xin; Xu, Di; Han, Wen-Jui

2015-01-01

This article draws upon the literature showing the benefits of high-quality preschools on child well-being to explore the role of household income on preschool attendance for a cohort of 3-to 6-year-olds in China using data from the China Health and Nutrition Survey, 1991-2006. Analyses are conducted separately for rural (N = 1,791) and urban…

Sustainable income-generating projects for HIV-affected households in Zimbabwe: evidence from two high-density suburbs.

PubMed

Mutenje, Munyaradzi J; Nyakudya, Innocent W; Katsinde, Constance; Chikuvire, Tichaedza J

2007-04-01

An estimated 25% of the adults in urban areas of Zimbabwe are living as HIV-positive. In HIV-affected households the need for income increases with the demand for medicines, food and funeral costs. One way to mitigate this effect of the epidemic is by expanding micro enterprises that can enhance the livelihoods of urban households affected by HIV. To identify viable income-generating projects for such households, five possible projects facilitated by two HIV/AIDS support organisations were selected for assessment. These were: selling second-hand clothing, poultry-keeping and nutritional/herbal gardens, freezit-making, mobile kitchens, and payphone set-ups. A case study of 200 households benefiting from one of these projects was done in two high-density suburbs in the town of Bindura, northern Zimbabwe. Information was collected from each household four times per year, over four years (2001-2004). Information on the income generated from the micro enterprises was collected monthly during the period. Descriptive statistics were used to analyse household demographic data; income data was analysed using cost-benefit analysis and analysis of variance. The results show that all five income-generating projects were viable for these households, although some were not feasible for the most vulnerable HIV-affected households. Making more efficient use of micro enterprises can be a valuable part of mainstreaming HIV-affected people and households in urban areas, and so allow people living with HIV to have longer and more meaningful lives.

The effect of major income sources on rural household food (in)security: Evidence from Swaziland and implications for policy.

PubMed

Mabuza, Majola L; Ortmann, Gerald F; Wale, Edilegnaw; Mutenje, Munyaradzi J

2016-01-01

The aim of this article was to investigate the food (in)security effect of household income generated from major economic activities in rural Swaziland. From a sample of 979 households, the results of a multinomial treatment regression model indicated that gender of household head, labor endowment, education, size of arable land, and location significantly influenced the households' choice of primary economic activity. Further results suggested that off-farm-income-dependent households were less likely to be food insecure when compared with on-farm-income-dependent households. However, on-farm-income-dependent households had a better food security status than their counterparts who depended on remittances and nonfarm economic activities.

Income Trends of Residential PV Adopters: An analysis of household-level income estimates [PowerPoint presentation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barbose, Galen L.; Darghouth, Naim R.; Hoen, Ben

The residential photovoltaic (PV) market has expanded rapidly over the past decade, but questions exist about how equitably that growth has occurred across income groups. Prior studies have investigated this question but are often limited by narrow geographic study regions, now-dated analysis timeframes, or coarse estimates of PV-adopter incomes. At the same time, a spate of new programs and initiatives, as well as innovations in business models and product design, have emerged in recent years with the aim of making solar more accessible and affordable to broader segments of the population. Yet, many of those efforts are proceeding without robustmore » underlying information about the income characteristics of recent residential PV adopters. This work aims to establish basic factual information about income trends among U.S. residential solar adopters, with some emphasis on low- and moderate-income (LMI) households. The analysis is unique in its relatively extensive coverage of the U.S. solar market, relying on Berkeley Lab’s Tracking the Sun dataset, which contains project-level data for the vast majority of all residential PV systems in the country (a subset of which are ultimately included in the analysis sample). This analysis is also unique in its use of household-level income estimates that provide a more-precise characterization of PV-adopter incomes than in most prior studies.« less

The relationship between household income and dietary intakes of 1-10 year old urban Malaysian.

PubMed

Mohd Shariff, Zalilah; Lin, Khor Geok; Sariman, Sarina; Lee, Huang Soo; Siew, Chin Yit; Mohd Yusof, Barakatun Nisak; Mun, Chan Yoke; Mohamad, Maznorila

2015-06-01

Diet plays an important role in growth and development of children. However, dietary intakes of children living in either rural or urban areas can be influenced by household income. This cross-sectional study examined energy, nutrient and food group intakes of 749 urban children (1-10 years old) by household income status. Children's dietary intakes were obtained using food recall and record for two days. Diet adequacy was assessed based on recommended intakes of energy and nutrients and food group servings. For toddlers, all nutrients except dietary fiber (5.5 g) exceeded recommended intakes. Among older children (preschoolers and school children), calcium (548 mg, 435 mg) and dietary fiber (7.4 g, 9.4 g) did not meet recommendations while percentage of energy from total fat and saturated fats exceeded 30% and 10%, respectively. The mean sodium intakes of preschoolers (1,684 mg) and school children (2,000 mg) were relatively high. Toddlers in all income groups had similar energy and nutrient intakes and percentages meeting the recommended intakes. However, low income older children had lowest intakes of energy (P < 0.05) and most nutrients (P < 0.05) and highest proportions that did not meet recommended energy and nutrient intakes. For all food groups, except milk and dairy products, all age groups had mean intakes below the recommended servings. Compared to middle and high income groups, low income preschoolers had the lowest mean intake of fruits (0.07 serving), meat/poultry (0.78 serving) and milk/dairy products (1.14 serving) while low income toddlers and school children had the least mean intake of fruits (0.09 serving) and milk/dairy products (0.54 serving), respectively. Low socioeconomic status, as indicated by low household income, could limit access to adequate diets, particularly for older children. Parents and caregivers may need dietary guidance to ensure adequate quantity and quality of home food supply and foster healthy eating habits in children.

Determinants of percent expenditure of household income due to childhood diarrhoea in rural Bangladesh.

PubMed

Das, J; Das, S K; Ahmed, S; Ferdous, F; Farzana, F D; Sarker, M H R; Ahmed, A M S; Chisti, M J; Malek, M A; Rahman, A; Faruque, A S G; Mamun, A A

2015-10-01

There is limited information on percent expenditure of household income due to childhood diarrhoea especially in rural Bangladesh. A total of 4205 children aged <5 years with acute diarrhoea were studied. Percent expenditure was calculated as total expenditure for the diarrhoeal episode divided by monthly family income, multiplied by 100. Overall median percent expenditure was 3·04 (range 0·01-94·35). For Vibrio cholerae it was 6·42 (range 0·52-82·85), for enterotoxigenic Escherichia coli 3·10 (range 0·22-91·87), for Shigella 3·17 (range 0·06-77·80), and for rotavirus 3·08 (range 0·06-48·00). In a multinomial logistic regression model, for the upper tertile of percent expenditure, significant higher odds were found for male sex, travelling a longer distance to reach hospital (⩾median of 4 miles), seeking care elsewhere before attending hospital, vomiting, higher frequency of purging (⩾10 times/day), some or severe dehydration and stunting. V. cholerae was the highest and rotavirus was the least responsible pathogen for percent expenditure of household income due to childhood diarrhoea.

Rural income transfer programs and rural household food security in Ethiopia.

PubMed

Uraguchi, Zenebe B

2012-01-01

Based on household food security surveys conducted in Ethiopia, this study seeks to understand the roles and limitations of income transfer projects as determinants of households’ food security. By covering the Food-For-Work Programs (FFWPs) and the Productive Safety Net Programs (PSNPs), the study shows that these programs served as temporary safety nets for food availability, but they were limited in boosting the dietary diversity of households and their coping strategies. Households which participated in the programs increased their supply of food as a temporary buffer to seasonal asset depletion. However, participation in the programs was marred by inclusion error (food-secure households were included) and exclusion error (food-insecure households were excluded). Income transfer projects alone were not robust determinants of household food security. Rather, socio-demographic variables of education and family size as well as agricultural input of land size were found to be significant in accounting for changes in households’ food security. The programs in the research sites were funded through foreign aid, and the findings of the study imply the need to reexamine the approaches adopted by bilateral donors in allocating aid to Ethiopia. At the same time the study underscores the need to improve domestic policy framework in terms of engendering rural local institutional participation in project management.

The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan.

PubMed

Ueda, P; Kondo, N; Fujiwara, T

2015-09-01

We hypothesized that children from lower income households and in households experiencing a negative income change in connection to the global economic crisis in 2008 would be at increased risk of adverse weight status during the subsequent years of economic downturn. Data were obtained from a nationwide longitudinal survey comprising all children born during 2 weeks of 2001. For 16,403 boys and 15,206 girls, information about anthropometric measurements and household characteristics was collected from 2001 to 2011 on multiple occasions. Interactions between the crisis onset (September 2008) and household income group, as well as the crisis onset and a >30% negative income change in connection to the crisis, were assessed with respect to risk of childhood over- and underweight. Adjusted for household and parental characteristics, boys and girls in the lower household income quartiles had a larger increase in risk of overweight after the crisis onset relative to their peers in the highest income group. (Odds ratio (95% confidence interval) for interaction term in boys=1.23 (1.02-1.24); girls=1.35 (1.23-1.49) comparing the lowest with the highest income group.) Among girls, an interaction between the crisis onset and a >30% negative change in household income with respect to risk of overweight was observed (odds ratio for interaction term=1.23 (1.09-1.38)). Girls from the highest income group had an increased risk of underweight after the crisis onset compared with girls from the lowest income group. Boys and girls from lower household income groups and girls from households experiencing a negative income change in connection to the global economic crisis in 2008, may be at increased risk of overweight. Vulnerability to economic uncertainty could increase risk of overweight in preadolescence.

The global economic crisis, household income and pre-adolescent overweight and underweight: a nationwide birth cohort study in Japan

PubMed Central

Ueda, P; Kondo, N; Fujiwara, T

2015-01-01

Background: We hypothesized that children from lower income households and in households experiencing a negative income change in connection to the global economic crisis in 2008 would be at increased risk of adverse weight status during the subsequent years of economic downturn. Methods: Data were obtained from a nationwide longitudinal survey comprising all children born during 2 weeks of 2001. For 16,403 boys and 15,206 girls, information about anthropometric measurements and household characteristics was collected from 2001 to 2011 on multiple occasions. Interactions between the crisis onset (September 2008) and household income group, as well as the crisis onset and a >30% negative income change in connection to the crisis, were assessed with respect to risk of childhood over- and underweight. Results: Adjusted for household and parental characteristics, boys and girls in the lower household income quartiles had a larger increase in risk of overweight after the crisis onset relative to their peers in the highest income group. (Odds ratio (95% confidence interval) for interaction term in boys=1.23 (1.02–1.24); girls=1.35 (1.23–1.49) comparing the lowest with the highest income group.) Among girls, an interaction between the crisis onset and a >30% negative change in household income with respect to risk of overweight was observed (odds ratio for interaction term=1.23 (1.09–1.38)). Girls from the highest income group had an increased risk of underweight after the crisis onset compared with girls from the lowest income group. Conclusions: Boys and girls from lower household income groups and girls from households experiencing a negative income change in connection to the global economic crisis in 2008, may be at increased risk of overweight. Vulnerability to economic uncertainty could increase risk of overweight in preadolescence. PMID:25982791

The effect of high medical expenses on household income in South Korea: a longitudinal study using propensity score matching.

PubMed

Choi, Jae Woo; Park, Eun Cheol; Yoo, Ki Bong; Lee, Sang Gyu; Jang, Sung In; Kim, Tae Hyun

2015-09-10

Almost 97% of the Korean population is covered by National Health Insurance and are entitled to receive the same level of insurance benefits, regardless of how much each enrollee contributes to the system. However, the percentage of out-of-pocket payments is still high. This study examines whether the incurrence of high medical expenses affects household income. We use the Korea Welfare Panel and select 4,962 households to measure repeatedly over 5 years. Using propensity score matching, we set households with medical expenses of three times the annual average as "occurrence households" while "non-occurrence households" are those below the cut-off but with all other factors, such as income, held constant. We analyze whether the income of occurrence households differs significantly from the comparison group using a linear mixed effect model. After the occurrence of high medical expenditure, occurrence households (n = 825) had US$ 1,737 less income than non-occurrence households. In addition, the income of households (n = 200) that incurred high medical costs repeatedly for 2 years was US$ 3,598 lower than the non-occurrence group. Although it is important for the government to focus on medical assistance for households that have medical expense burdens, it needs to consider providing income indemnity insurance to protect them.

Pathways between health, education and income in adolescence and adulthood.

PubMed

Callander, Emily J

2016-09-01

To quantify the impact of household income, and physical and mental health in adolescence on education attainment, household income and health status in adulthood. Path analysis and regression models using waves 1-12 of the Household, Income and Labour Dynamics in Australia survey. Individuals aged 17 or 18 in 2001, 52% were males (n=655) and 48% were female (52%). Of those participating in wave 1, five did not respond in wave 12. Education attainment, household income, physical and mental health at age 29/30. For females, physical health at age 17/18 was significantly related to level of education attainment at age 29/30 (standardised total effect 0.290, p<0.001), with this influence being greater in magnitude than that of household income at age 17/18 on level of education attainment at age 29/30 (standardised total effect 0.159, p=0.022). Females' physical health at age 17/18 was also significantly related to household income at age 29/30 (standardised total effect 0.09, p=0.018). Both adjusted for initial household income at age 17/18. For males, the total standardised total effect of physical health at age 17/18 had a greater impact than household income at age 17/18 on education attainment at age 29/30 (0.347, p<0.001 for physical health and 0.276, p<0.001 for household income). The OR of achieving a year 12 or higher level of education attainment was 4.72 (95% CI 1.43 to 15.58, p=0.0110) for females with good physical health at age 17/18 and 5.05 (95% CI 1.78 to 14.36, p=0.0024) for males, compared with those with poor physical health at age 17/18. As physical health in adolescence appears to have a stronger influence on education attainment in adulthood than household income, equity strategies for education attainment should also target those with poor health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Income inequality in uptake of voluntary versus organised breast cancer screening: evidence from the British Household Panel Survey.

PubMed

Carney, Patricia; O'Neill, Ciaran

2018-02-14

This paper measures income-related inequality in uptake of breast cancer screening among women before and after a policy change to extend the screening programme to women aged 65 to 70. Prior to programme expansion women aged 50 to 64 were invited for screening under the national cancer screening programme in England and Wales whereas women in the 65 to 70 age cohort could elect to be screened by personally organising a screen. This will give a deeper insight into the nature of inequality in screening and the impact of policies aimed at widening the access related to age on inequality of uptake. Taking advantage of this natural experiment, inequality is quantified across the different age cohorts and time periods with the use of concentration indices (CI). Using data from the British Household Panel Survey, information on screening attendance, equivalised household income and age was taken for the three years prior to the programme expansion and the three years immediately following the policy change. Results show that following the expansion, inequality significantly reduced for the 50-64 age group, prior to the expansion there was a pro-rich inequality in screening uptake. There is also evidence of a reduction in income inequality in screening uptake among those aged 65 to 70 and an increase in the number of women attending screening from this older age cohort. This indicates that an organised breast screening programme is likely to reduce income related inequality over a screening programme where women must organise their own screen. This is important when breast screening is one of the main methods used to detect breast cancer at an earlier stage which improves outcomes for women and reduces treatment costs.

Heat or eat: the Low Income Home Energy Assistance Program and nutritional and health risks among children less than 3 years of age.

PubMed

Frank, Deborah A; Neault, Nicole B; Skalicky, Anne; Cook, John T; Wilson, Jacqueline D; Levenson, Suzette; Meyers, Alan F; Heeren, Timothy; Cutts, Diana B; Casey, Patrick H; Black, Maureen M; Berkowitz, Carol

2006-11-01

Public funding for the Low Income Home Energy Assistance Program has never been sufficient to serve more than a small minority of income-eligible households. Low Income Home Energy Assistance Program funding has not increased with recent rapidly rising energy costs, harsh winter conditions, or higher child poverty rates. Although a national performance goal for the Low Income Home Energy Assistance Program is to increase the percentage of recipient households having > or = 1 member < or = 5 years of age, the association of income-eligible households' receipt of the Low Income Home Energy Assistance Program with indicators of well-being in young children has not been evaluated previously. The goal of the current study was to evaluate the association between a family's participation or nonparticipation in the Low Income Home Energy Assistance Program and the anthropometric status and health of their young children. In the ongoing Children's Sentinel Nutrition Assessment Project from June 1998 through December 2004, caregivers with children < 3 years of age in 2 emergency departments and 3 primary care clinics in 5 urban sites participated in cross-sectional surveys regarding household demographics, child's lifetime history of hospitalizations, and, for the past 12 months, household public assistance program participation and household food insecurity, measured by the US Food Security Scale. This scale, in accordance with established procedures, classifies households as food insecure if they report that they cannot afford enough nutritious food for all of the members to lead active, healthy lives. On the day of the interview, children's weight, length, and whether the children were admitted acutely to the hospital from the emergency departments were documented. The study sample consisted only of Low Income Home Energy Assistance Program income-eligible renter households without private insurance who also participated in > or = 1 other means-tested program. In this

Linear association between household income and metabolic control in children with insulin-dependent diabetes mellitus despite free access to health care.

PubMed

Deladoëy, Johnny; Henderson, Mélanie; Geoffroy, Louis

2013-05-01

In health care systems with a user fee, the impact of socioeconomic factors on pediatric insulin-dependent diabetes mellitus (IDDM) control could be due to the cost of accessing care. There is a linear association between household income and the average glycosylated hemoglobin (HbA1c) of children and adolescents with IDDM despite free access to health care. We used a linear regression model to examine the association between normalized average HbA1c of 1766 diabetic children (diagnosed at our institution from 1980 to 2011 before 17 years of age) and the median household income of their neighborhoods (obtained from Statistics Canada, 2006 Census data). We found a negative linear association (P < .001; r = -0.2) between the level of income and metabolic control assessed by HbA1c after controlling for sex, age at diagnosis, duration of diabetes, ethnicity, geographical factors, frequency of visits, current age (as a proxy for change in practice over time), and change of measurement methods of HbA1c across time. For every increase of $15,000 in annual income, HbA1c decreased by 0.1%. We report a linear association of household income with metabolic control of IDDM in childhood. Given that Canada has a system of free universal access to health care, confounding by access to care is unlikely. Considering the impact of poorly controlled IDDM in childhood on the development of long-term complications, our findings suggest that the higher complication rate found in adults of low socioeconomic status might originate from the poor control that they experienced in childhood. Support for the care of IDDM children from low-income neighborhoods should be increased.

Income-carbon footprint relationships for urban and rural households of Iskandar Malaysia

NASA Astrophysics Data System (ADS)

Majid, M. R.; Moeinzadeh, S. N.; Tifwa, H. Y.

2014-02-01

Iskandar Malaysia has a vision to achieve sustainable development and a low carbon society status by decreasing the amount of CO2 emission as much as 60% by 2025. As the case is in other parts of the world, households are suspected to be a major source of carbon emission in Iskandar Malaysia. At the global level, 72% of greenhouse gas emission is a consequence of household activities, which is influenced by lifestyle. Income is the most important indicator of lifestyle and consequently may influence the amount of households' carbon footprint. The main objective of this paper is to illustrate the carbon-income relationships in Iskandar Malaysia's urban and rural areas. Data were gathered through a questionnaire survey of 420 households. The households were classified into six categories based on their residential area status. Both direct and indirect carbon footprints of respondents were calculated using a carbon footprint model. Direct carbon footprint includes domestic energy use, personal travel, flight and public transportation while indirect carbon footprint is the total secondary carbon emission measurement such as housing operations, transportation operations, food, clothes, education, cultural and recreational services. Analysis of the results shows a wide range of carbon footprint values and a significance correlation between income and carbon footprint. The carbon footprints vary in urban and rural areas, and also across different urban areas. These identified carbon footprint values can help the authority target its carbon reduction programs.

Resource allocation decisions in low-income rural households.

PubMed

Franklin, D L; Harrell, M W

1985-05-01

This paper is based on the theory that a society's nutritional well-being is both a cause and a consequence of the developmental process within that society. An approach to the choices made by poor rural households regarding food acquisition and nurturing behavior is emerging from recent research based on the new economic theory of household production. The central thesis of this approach is that household decisions related to the fulfillment of basic needs are strongly determined by decisions on the allocation of time to household production activities. Summarized are the results of the estimation of a model of household production and consumption behavior with data from a cross-sectional survey of 30 rural communities in Veraguas Province, Panama. The struture of the model consists of allocation of resources to nurturing activities and to production activities. The resources to be allocated are time and market goods, and in theory, these are allocated according to relative prices. The empirical results of this study are generally consistent with the predictions of the neoclassical economic model of household resource allocation. The major conclusions that time allocations and market price conditions matter in the determination of well-being in low-income rural households and, importantly, that nurturing decisions significantly affect the product and factor market behavior of these households form the basis for a discussion on implucations for agricultural and rural development. Programs and policies that seek nutritional improvement should be determined with explicit recognition of the value of time and the importance of timing in the decisions of the poor.

Family income, food prices, and household purchases of fruits and vegetables in Brazil.

PubMed

Claro, Rafael Moreira; Monteiro, Carlos Augusto

2010-12-01

To analyze the influence of family income and food prices on the participation of fruits and vegetables in the food purchases of Brazilian households. Data analyzed refers to the Household Budget Survey conducted by the Instituto Brasileiro de Geografia e Estatística on a probabilistic sample of 48,470 Brazilian households between 2002 and 2003. Fruit and vegetable participation in total food purchases was expressed as a percentage of total calories purchased and as calories from fruit and vegetables adjusted for total calories purchased. A multiple regression analysis was employed to estimate elasticity coefficients, controlling for sociodemographic variables and price of other foods. Fruit and vegetable participation in total food purchases increased as the price of these foods decreased, or as income increased. A 1% decrease in the price of fruit and vegetables would increase their participation by 0.79%, whereas a 1% increase in family income would increase participation by 0.27%. The effect of income tended to be smaller among higher income strata. Reducing the price of fruit and vegetables, either by supporting their production or through fiscal measures, is a promising public policy instrument, capable of increasing the participation of these foods in the diet of the Brazilian population.

Accessibility of summer meals and the food insecurity of low-income households with children.

PubMed

Miller, Daniel P

2016-08-01

Almost no previous research has examined the impact of the US Department of Agriculture's (USDA) Summer Food Service Program and related Seamless Summer Option, which provide meals and snacks to low-income children over the summer. The present study investigated whether geographic accessibility of summer meals programme sites (a proxy for programme participation) was associated with food insecurity for low-income households. The study used data from the California Health Interview Survey (CHIS) and administrative data on summer meals sites in California. Geocoding was used to calculate driving time between CHIS households and nearby summer meals sites. Geographic accessibility was measured using a gravity model, which accounted for the spatially distributed supply of and demand for summer meals. Food insecurity and very low food security were measured using a standard six-item measure from the USDA. Low-income families with children (n 5394). A representative surveillance study of non-institutionalized households in California. Geographic accessibility was not associated with food insecurity. However, geographic accessibility was associated with a significantly lower probability of very low food security in the full sample and among households with younger children and those living in less urban areas. The USDA's summer meals programme may be effective at reducing the most severe form of food insecurity for low-income households with children. Expanding the number of summer meals sites, the number of meals served at sites and sites' hours of operation may be effective strategies to promote nutritional health over the summer months.

Distributional consequences of the transition from age-based to income-based prescription drug coverage in British Columbia, Canada.

PubMed

Hanley, Gillian E; Morgan, Steve; Hurley, Jeremiah; van Doorslaer, Eddy

2008-12-01

In May, 2003, British Columbia transitioned from an age-based public drug program, with public subsidy primarily based on age, to an age-irrelevant income-based drug program, in which public subsidy is based primarily on household income. As one of the specific aims of the policy change was to improve fairness by increasing the extent to which payment for drugs is based on ability to pay, we measure the progressivity of pharmaceutical financing before and after the policy change in BC using Kakwani indices. Our results suggest that pharmaceutical financing became less regressive after the policy change. However, this decrease in regressivity arose primarily because high-income seniors were making greater direct contributions to pharmaceutical financing and not because low-income households were making smaller direct contributions. Our results also suggest that if the public financing of pharmaceuticals were maintained or increased, a change from age-based to income-based eligibility can unambiguously improve equity in finance. As populations in developed countries age, governments will increasingly consider reforms to publicly financed health-care programs with age-based eligibility. In assessing policy options, financial equity is likely to be a key consideration. These results suggest that income-based pharmacare can improve financial equity especially when implemented with a commitment to maintain or increase public funding for prescription drugs.

Impacts of household income and economic recession on participation in colorectal cancer screening in Korea.

PubMed

Myong, Jun-Pyo; Kim, Hyoung-Ryoul

2012-01-01

To assess the impact of household income and economic recession on participation in CRC screening, we estimated annual participating proportions from 2007 to 2009 for different CRC screening modalities according to household income levels. A total of 8,042 subjects were derived from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV). Multivariate logistic regression analysis was used to estimate odds ratios and 95% confidence intervals for CRC screening with household income quartiles by gender in each year. People were less likely to attend a high-cost CRC screening such as a sigmoidoscopy or colonoscopy independent of the income quartile during the economic recession. Income disparities for participating in opportunistic cancer screening appear to have existed among both males and females during the three years (2007-2009), but were most distinctive in 2009. An increase in mortality of CRC can therefore be expected due to late detection in periods of economic crisis. Accordingly, the government should expand the coverage of CRC screening to prevent excess deaths by reducing related direct and indirect costs during the economic recession.

The Impact of Successful Cataract Surgery on Quality of Life, Household Income and Social Status in South India

PubMed Central

Fenwick, Eva; Balasubramaniam, Bharath; Ramani, Ramanathan V.; Holz, Frank G.; Gilbert, Clare E.

2012-01-01

Background To explore the hypothesis that sight restoring cataract surgery provided to impoverished rural communities will improve not only visual acuity and vision-related quality of life (VRQoL) but also poverty and social status. Methods Participants were recruited at outreach camps in Tamil Nadu, South India, and underwent free routine manual small incision cataract surgery (SICS) with intra-ocular lens (IOL) implantation, and were followed up one year later. Poverty was measured as monthly household income, being engaged in income generating activities and number of working household members. Social status was measured as rates of re-marriage amongst widowed participants. VRQoL was measured using the IND-VFQ-33. Associations were explored using logistic regression (SPSS 19). Results Of the 294 participants, mean age ± standard deviation (SD) 60±8 years, 54% men, only 11% remained vision impaired at follow up (67% at baseline; p<0.001). At one year, more participants were engaged in income generating activities (44.7% to 77.7%; p<0.001) and the proportion of households with a monthly income <1000 Rps. decreased from 50.5% to 20.5% (p<0.05). Overall VRQoL improved (p<0.001). Participants who had successful cataract surgery were less likely to remain in the lower categories of monthly household income (OR 0.05–0.22; p<0.02) and more likely to be engaged in income earning activities one year after surgery (OR 3.28; p = 0.006). Participants widowed at baseline who had successful cataract surgery were less likely to remain widowed at one year (OR 0.02; p = 0.008). Conclusion These findings indicate the broad positive impact of sight restoring cataract surgery on the recipients’ as well as their families’ lives. Providing free high quality cataract surgery to marginalized rural communities will not only alleviate avoidable blindness but also - to some extent - poverty in the long run. PMID:22952945

Work-family conflict and self-rated health among Japanese workers: How household income modifies associations.

PubMed

Kobayashi, Tomoko; Honjo, Kaori; Eshak, Ehab Salah; Iso, Hiroyasu; Sawada, Norie; Tsugane, Shoichiro

2017-01-01

To examine associations between work-family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011-2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work-family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04-2.97) for men and 3.54 (95% CI; 2.92-4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work-family conflict were likely to be more evident in the low income group only among women. Work-family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women.

Work–family conflict and self-rated health among Japanese workers: How household income modifies associations

PubMed Central

Kobayashi, Tomoko; Honjo, Kaori; Eshak, Ehab Salah; Iso, Hiroyasu; Sawada, Norie; Tsugane, Shoichiro

2017-01-01

To examine associations between work–family conflict and self-rated health among Japanese workers and to determine whether the associations differed by household income. Data was derived from the Japan Public Health Center-based Prospective Study for the Next Generation in Saku area in 2011–2012 (7,663 men and 7,070 women). Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health by work–family conflict consisting of two dimensions (work-to-family and family-to-work conflicts) were calculated by gender and household income. Multivariate ORs of high work-to-family and family-to-work conflicts for poor self-rated health were 2.46 (95% CI; 2.04–2.97) for men and 3.54 (95% CI; 2.92–4.30) for women, with reference to the low work-to-family and family-to-work conflicts (p-value for gender interaction = 0.02). Subgroup analysis indicated that health effects of work–family conflict were likely to be more evident in the low income group only among women. Work–family conflict was associated with poor self-rated health among middle-aged Japanese men and women; its health impact was relatively stronger among women, and particularly economically disadvantaged women. PMID:28207757

Fresh Fruit and Vegetable Purchases in an Urban Supermarket by Low-Income Households

ERIC Educational Resources Information Center

Phipps, Etienne J.; Stites, Shana D.; Wallace, Samantha L.; Braitman, Leonard E.

2013-01-01

Objective: To investigate the predictors of fresh fruit and vegetable purchases in a low-income population and identify subgroups in which interventions to increase such purchases might prove useful. Methods: Retrospective analysis of 209 shopping transactions from 30 households. Individual and household characteristics obtained from primary…

Pathways among Caregiver Education, Household Resources, and Infant Growth in 39 Low- and Middle-Income Countries.

PubMed

Bornstein, Marc H; Putnick, Diane L; Bradley, Robert H; Lansford, Jennifer E; Deater-Deckard, Kirby

2015-01-01

Caregiver education is known to relate to the growth of children, but possible mediation mechanisms of this association are poorly characterized and generally lack empirical support. We test whether instructional capital (caregiver education) leads to improved infant growth through availability of physical capital (household resources) across a wide swath of low- and middle-income countries (LMIC). Using the Multiple Indicator Cluster Survey (MICS3), we explore relations among caregiver education, household resources, and infant ( M age = .99 years) growth in 117,881 families living in 39 LMIC. Overall, household resources mediated 76% of the small association between caregiver education and infant growth. When disaggregated by countries characterized by low, medium, and high levels of human development (as indexed by average life expectancy, education, and gross domestic product), household resources mediated 48% to 78% of the association between caregiver education and infant growth. Caregiver education had effects on infant growth through household resources in countries characterized by low, medium, and high levels of human development; for girls and boys; and controlling for indexes of infant feeding and health.

Symposium on 'Intervention policies for deprived households' Policy initiatives to address low-income households' nutritional needs in the UK.

PubMed

Dowler, Elizabeth

2008-08-01

Members of low-income households in the UK are more likely to have patterns of food and nutrient intakes that are less inclined to lead to good health outcomes in the short and long term. Health inequalities, including the likelihood of child and adulthood obesity, have long been documented in the UK and show little sign of improving so far, despite 10 years of attention from a government that has committed itself to addressing them. Following the Acheson Inquiry into Inequalities in Health (1998) in England a number of initiatives to tackle inequalities in food and diet were established, both nationally and within the devolved nations of Scotland, Wales and Northern Ireland. Nevertheless, until recently, there has been no overall strategic policy addressing the food and nutritional needs of low-income households. The present paper reviews how the problems have been constructed and understood and how they have been addressed, briefly drawing on recent evaluations of food and nutrition policies in Scotland and Wales. The contemporary challenge is to frame cross-cutting policy initiatives that move beyond simple targeting and local actions, encompass a life-course approach and recognise both the diversity of households that fall into 'low-income' categories and the need for 'upstream' intervention.

Avertable Deaths Associated With Household Income in Virginia

PubMed Central

Jones, Resa M.; Johnson, Robert E.; Phillips, Robert L.; Oliver, M. Norman; Bazemore, Andrew; Vichare, Anushree

2010-01-01

Objectives. We estimated how many deaths would be averted if the entire population of Virginia experienced the mortality rates of the 5 most affluent counties or cities. Methods. Using census data and vital statistics for the years 1990 through 2006, we applied the mortality rates of the 5 counties/cities with the highest median household income to the populations of all counties and cities in the state. Results. If the mortality rates of the reference population had applied to the entire state, 24.3% of deaths in Virginia from 1990 through 2006 (range = 21.8%–28.1%) would not have occurred. An annual mean of 12 954 deaths would have been averted (range = 10 548–14 569), totaling 220 211 deaths from 1990 through 2006. In some of the most disadvantaged areas of the state, nearly half of deaths would have been averted. Conclusions. Favorable conditions that exist in areas with high household incomes exert a major influence on mortality rates. The corollary—that health suffers when society is exposed to economic stresses—is especially timely amid the current recession. Further research must clarify the extent to which individual-level factors (e.g., earnings, education, race, health insurance) and community characteristics can improve health outcomes. PMID:20167893

Why Does Disaster Recovery Work Influence Mental Health?: Pathways through Physical Health and Household Income.

PubMed

Lowe, Sarah R; Kwok, Richard K; Payne, Julianne; Engel, Lawrence S; Galea, Sandro; Sandler, Dale P

2016-12-01

Disaster recovery work increases risk for mental health problems, yet the mechanisms underlying this association are unclear. We explored links from recovery work to post-traumatic stress (PTS), major depression (MD), and generalized anxiety disorder (GAD) symptoms through physical health symptoms and household income in the aftermath of the Deepwater Horizon oil spill. As part of the NIEHS GuLF STUDY, participants (N = 10,141) reported on cleanup work activities, spill-related physical health symptoms, and household income at baseline, and mental health symptoms an average of 14.69 weeks (SD = 16.79) thereafter. Cleanup work participation was associated with higher physical health symptoms, which in turn were associated with higher PTS, MD, and GAD symptoms. Similar pattern of results were found in models including workers only and investigating the influence of longer work duration and higher work-related oil exposure on mental health symptoms. In addition, longer worker duration and higher work-related oil exposure were associated with higher household income, which in turn was associated with lower MD and GAD symptoms. These findings suggest that physical health symptoms contribute to workers' risk for mental health symptoms, while higher household income, potentially from more extensive work, might mitigate risk. © Society for Community Research and Action 2016.

[Health Care Insurance in France: its impact on income distribution between age and social groups].

PubMed

Fourcade, N; Duval, J; Lardellier, R

2013-08-01

Our study, based on microsimulation models, evaluates the redistributive impact of health care insurance in France on income distribution between age and social groups. This work sheds light on the debate concerning the respective role of the public health care insurance (PHI) and the private supplemental health care insurance (SHI) in France. The analysis points out that the PHI enables the lowest-income households and the pensioners a better access to health care than they would have had under a complete private SHI. Due to the progressivity of taxes, low-income households contribute less to the PHI and get higher benefits because of a weaker health. Pensioners have low contributions to public health care finance but the highest health care expenditures. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Household food insecurity and child health.

PubMed

Schmeer, Kammi K; Piperata, Barbara A

2017-04-01

Food insecurity, the lack of consistent access to sufficient quality and quantity of food, affects an estimated 800 million people around the world. Although household food insecurity is generally associated with poor child nutrition and health in the USA, we know less about household food insecurity and child health in developing countries. Particularly lacking is research assessing how associations between household food insecurity and children's health outcomes may differ by child age and among children beyond age 5 years in low-income settings. We use data from a population-based sample of households with children ages 3-11 years (N = 431) in León, Nicaragua to consider how household food insecurity is associated with three measures of child health: illness, anaemia and low height-for-age. Our results provide new evidence that even mild household food insecurity is detrimental to children's health; and that child age conditions the associations between household food insecurity and child health. We find that food insecurity is especially harmful to health during early childhood, but continues to have significant associations with health into middle childhood (up to ages 7-8 years). We discuss the potential implications of these results for future child health research and policies in low-income countries. © 2016 John Wiley & Sons Ltd. © 2016 John Wiley & Sons Ltd.

Rooftop Solar Technical Potential for Low-to-Moderate Income Households in the United States

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sigrin, Benjamin O; Mooney, Meghan E

This report presents a first-of-kind assessment of the technical potential of rooftop solar for low and moderate-income households, as well as providing insight on the distribution of solar potential by tenure, income, and other building characteristics. We find that a substantial fraction of the national rooftop solar potential is located on LMI buildings and, for all incomes, a substantial fraction on multi-family and renter-occupied buildings. We also find that rooftop solar can significantly contribute to long-term penetration targets established by the U.S. DOE, though to do so requires deployment on multi-family and renter-occupied buildings. Traditional deployment models have insufficiently enabledmore » access to solar for these income groups and building types. Without innovation either in regulatory, market, or policy factors, a large fraction of the U.S. potential is unlikely to be addressed, as well as leading to inequalities in solar access. Ironically, potential electric bill savings from rooftop solar would have the greatest material impact on the lives of low-income households as compared to their high-income counterparts.« less

Factors influencing householders' access to improved water in low-income urban areas of Accra, Ghana.

PubMed

Mahama, Ayisha Matuamo; Anaman, Kwabena Asomanin; Osei-Akoto, Isaac

2014-06-01

We analysed householders' access to improved water for drinking and other domestic uses in five selected low-income urban areas of Accra, Ghana using a survey of 1,500 households. Our definitions of improved water were different from those suggested by the World Health Organization (WHO). The results revealed that only 4.4% of the respondents had access to improved drinking water compared to 40.7% using the WHO definition. However, 88.7% of respondents had access to improved water for domestic uses compared to 98.3% using the WHO definition. Using logistic regression analysis, we established that the significant determinant of householders' access to improved drinking water was income. However, for access to improved water for other domestic uses, the significant factors were education, income and location of the household. Compared to migrants, indigenous people and people from mixed areas were less likely to have access to improved water for other domestic purposes. For the analysis using the WHO definitions, most of the independent variables were not statistically significant in determining householders' access, and those variables that were significant generated parameter estimates inconsistent with evidence from the literature and anecdotal evidence from officials of public health and water supply companies in Ghana.

Priority economic sector and household income in Indonesia (an analysis of input output)

NASA Astrophysics Data System (ADS)

Subanti, S.; Mulyanto; Hakim, A. R.; Mafruhah, I.; Hakim, I. M.

2018-03-01

This purpose of study aims to identify the roles of priority economic sectors on household incomes in Indonesia. Analyse in this paper used nine economic sectors, that representing result of classification from input output table. This study found that (1) priority economic sector are manufacturing sector & trade hotel and restaurant; (2) sector that have looking forward orientation included agriculture, mining & quarrying, and financial ownership & business services; and (3) electricity, gas, and water supply sector give the biggest impact to household income in Indonesia. The suggestion that policies aimed at increasing productivity and raising skills while encouraging individual participation in the formal labour market are essential.

Household food insecurity is associated with depressive symptoms among low-income pregnant Latinas

PubMed Central

Hromi-Fiedler, Amber; Bermúdez-Millán, Angela; Segura-Pérez, Sofia; Pérez-Escamilla, Rafael

2010-01-01

Latinas experience high rates of poverty, household food insecurity, and prenatal depression. To date, only one U.S. study has examined the relationship between household food insecurity and prenatal depression, yet it focused primarily on non-Latina white and non-Latina Black populations. Therefore, this study examined the independent association of household food insecurity with depressive symptoms among low-income pregnant Latinas. This cross-sectional study included 135 low income pregnant Latinas living in Hartford, Connecticut. Women were assessed at enrollment for household food security during pregnancy using an adapted and validated version of the U.S. Household Food Security Survey Module. Prenatal depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D). A cutoff of ≥ 21 was used to indicate elevated levels of prenatal depressive symptoms (EPDS). Multivariate backwards stepwise logistic regression was used to identify risk factors for EPDS. Almost one third of participants had EPDS. Women who were food insecure were more likely to experience EPDS compared to food secure women (OR=2.59; 95% CI=1.03–6.52). Being primiparous, experiencing heartburn and reporting poor/fair health during pregnancy, as well as having a history of depression were also independent risk factors for experiencing EPDS. Findings from this study suggest the importance of assessing household food insecurity when evaluating depression risk among pregnant Latinas. PMID:20735732

Food preparation supplies predict children's family meal and home-prepared dinner consumption in low-income households.

PubMed

Appelhans, Bradley M; Waring, Molly E; Schneider, Kristin L; Pagoto, Sherry L

2014-05-01

Frequent family meals and home food preparation are considered important for children's nutritional health and weight maintenance. This cross-sectional study tested whether these parent-driven behaviors are related to the availability of food preparation supplies in low-income urban households. Caregivers of children ages 6-13 provided information on family meal frequency, child consumption of home-prepared dinners, household food insecurity, and attitudes towards cooking. Researchers used a newly developed Food Preparation Checklist (FPC) to assess the availability of 41 food preparation supplies during a physical audit of the home environment. Caregivers and children provided anthropometric measurements and jointly reported on child dietary intake. In ordinal logistic regression models, greater home availability of food preparation supplies was associated with more frequent family meals and child consumption of home-prepared dinners. Associations were independent of household financial strain, food insecurity, caregiver attitudes toward cooking, and sociodemographic characteristics. Fewer food preparation supplies were available in households characterized by greater food insecurity, lower income, and negative caregiver attitudes towards cooking, but did not differ by child or caregiver weight status. As in prior studies, more frequent family meals and consumption of home-prepared dinners were associated with healthier child dietary intake in several areas. We conclude that food preparation supplies are often limited in the most socioeconomically disadvantaged households, and their availability is related to the frequency with which children consume family meals and home-prepared dinners. The potential role of food preparation supplies as contributors to socioeconomic disparities in child nutritional health and obesity deserves further study. Copyright © 2014 Elsevier Ltd. All rights reserved.

Household Risk and Child Sexual Abuse in a Low Income, Urban Sample of Women.

ERIC Educational Resources Information Center

Rowland, David L.; Zabin, Laurie S.; Emerson, Mark

2000-01-01

Explored the impact of household environment and childhood sexual abuse (CSA) on psychosocial development. Data on low-income, urban CSA victims, and non-CSA women indicated that household conditions indicative of parental dysfunction, antisocial behavior, and instability set the stage for CSA by interfering with parental protection. Victims'…

Household out-of-pocket medical expenditures and national health insurance in Taiwan: income and regional inequality

PubMed Central

Chu, Tu-Bin; Liu, Tsai-Ching; Chen, Chin-Shyan; Tsai, Yi-Wen; Chiu, Wen-Ta

2005-01-01

Background Unequal geographical distribution of medical care resources and insufficient healthcare coverage have been two long-standing problems with Taiwan's public health system. The implementation of National Health Insurance (NHI) attempted to mitigate the inequality in health care use. This study examines the degree to which Taiwan's National Health Insurance (NHI) has reduced out-of-pocket medical expenditures in households in different regions and varying levels of income. Methods Data used in this study were drawn from the 1994 and 1996 Surveys of Family Income and Expenditure. We pooled the data from 1994 and 1996 and included a year dummy variable (NHI), equal to 1 if the household data came from 1996 in order to assess the impact of NHI on household out-of-pocket medical care expenditures shortly after its implementation in 1995. Results An individual who was older, female, married, unemployed, better educated, richer, head of a larger family household, or living in the central and eastern areas was more likely to have greater household out-of-pocket medical expenditures. NHI was found to have effectively reduced household out-of-pocket medical expenditures by 23.08%, particularly for more affluent households. With the implementation of NHI, lower and middle income quintiles had smaller decreases in out-of-pocket medical expenditure. NHI was also found to have reduced household out-of-pocket medical expenditures more for households in eastern Taiwan. Conclusion Although NHI was established to create free medical care for all, further effort is needed to reduce the medical costs for certain disadvantaged groups, particularly the poor and aborigines, if equality is to be achieved. PMID:16137336

Household Income and Trajectories of Marital Satisfaction in Early Marriage

PubMed Central

Jackson, Grace L.; Krull, Jennifer L.; Bradbury, Thomas N.; Karney, Benjamin R.

2016-01-01

Are the marriages of lower-income couples less satisfying than the marriages of more affluent couples? To address this question, we compared trajectories of marital satisfaction among couples with a wide range of household incomes. The marital satisfaction of 862 Black, White, and Latino newlywed spouses (N=431 couples) was assessed five times, each nine months apart, over the first four years of marriage. Lower-income couples did not have less satisfying marriages on average, nor did their satisfaction decline more steeply on average. However, they did experience (1) significantly greater fluctuations in marital satisfaction across assessments, and (2) significantly more variability between husbands and wives. If efforts to support the marriages of low-income couples are to address the unique characteristics of their marital development, these findings suggest that efforts to stabilize their marriages may be more effective than efforts to improve their satisfaction alone. PMID:28603296

Food insecurity and the relationship between household income and children's health and nutrition in Brazil.

PubMed

Reis, Mauricio

2012-04-01

Empirical evidence indicates that children living in wealthier households have better health. Food insecurity could be related to lack of adequate nutrition experienced by poor children and may be pointed out as one of the possible explanations for this relationship. This paper investigates the association between food insecurity and children's health and nutrition and the role of the former in the child health income gradient. Using data from the 2006 Brazilian Demographic and Health Survey, the results show that children living in households with food insecurity have worse nutrition and health indicators. In addition, the relationship between household income and many children's health and nutrition measures weakens but remains significant when controlling for food insecurity. Copyright © 2011 John Wiley & Sons, Ltd.

Income, Age and Financial Satisfaction

ERIC Educational Resources Information Center

Hsieh, Chang-Ming

2003-01-01

Although the effects of income and age on subjective well-being have been widely studied, research on the effects of income and age on financial satisfaction, a major life domain to which income has direct relevance, remains limited. Analyzing data from the General Social Surveys, this article empirically examined the effects of income and age on…

How Does Household Income Affect Child Personality Traits and Behaviors?†

PubMed Central

Akee, Randall; Copeland, William; Costello, E. Jane; Simeonova, Emilia

2018-01-01

We examine the effects of a quasi-experimental unconditional household income transfer on child emotional and behavioral health and personality traits. Using longitudinal data, we find that there are large beneficial effects on children’s emotional and behavioral health and personality traits during adolescence. We find evidence that these effects are most pronounced for children who start out with the lowest initial endowments. The income intervention also results in improvements in parental relationships which we interpret as a potential mechanism behind our findings. PMID:29568124

Are low-to-middle-income households experiencing food insecurity in Victoria, Australia? An examination of the Victorian Population Health Survey, 2006-2009.

PubMed

Kleve, Sue; Davidson, Zoe E; Gearon, Emma; Booth, Sue; Palermo, Claire

2017-07-01

Food insecurity affects health and wellbeing. Little is known about the relationship between food insecurity across income levels. This study aims to investigate the prevalence and frequency of food insecurity in low-to-middle-income Victorian households over time and identify factors associated with food insecurity in these households. Prevalence and frequency of food insecurity was analysed across household income levels using data from the cross-sectional 2006-09 Victorian Population Health Surveys (VPHS). Respondents were categorised as food insecure, if in the last 12 months they had run out of food and were unable to afford to buy more. Multivariable logistic regression was used to describe factors associated with food insecurity in low-to-middle-income households (A$40000-$80000 in 2008). Between 4.9 and 5.5% for total survey populations and 3.9-4.8% in low-to-middle-income respondents were food insecure. Food insecurity was associated with limited help from friends, home ownership status, inability to raise money in an emergency and cost of some foods. Food insecurity exists in households beyond those on a very low income. Understanding the extent and implications of household food insecurity across all income groups in Australia will inform effective and appropriate public health responses.

Household food (in)security and nutritional status of urban poor children aged 6 to 23 months in Kenya.

PubMed

Mutisya, Maurice; Kandala, Ngianga-Bakwin; Ngware, Moses Waithanji; Kabiru, Caroline W

2015-10-13

Millions of people in low and low middle income countries suffer from extreme hunger and malnutrition. Research on the effect of food insecurity on child nutrition is concentrated in high income settings and has produced mixed results. Moreover, the existing evidence on food security and nutrition in children in low and middle income countries is either cross-sectional and/or is based primarily on rural populations. In this paper, we examine the effect of household food security status and its interaction with household wealth status on stunting among children aged between 6 and 23 months in resource-poor urban setting in Kenya. We use longitudinal data collected between 2006 and 2012 from two informal settlements in Nairobi, Kenya. Mothers and their new-borns were recruited into the study at birth and followed prospectively. The analytical sample comprised 6858 children from 6552 households. Household food security was measured as a latent variable derived from a set of questions capturing the main domains of access, availability and affordability. A composite measure of wealth was calculated using asset ownership and amenities. Nutritional status was measured using Height-for-Age (HFA) z-scores. Children whose HFA z-scores were below -2 standard deviation were categorized as stunted. We used Cox regression to analyse the data. The prevalence of stunting was 49 %. The risk of stunting increased by 12 % among children from food insecure households. When the joint effect of food security and wealth status was assessed, the risk of stunting increased significantly by 19 and 22 % among children from moderately food insecure and severely food insecure households and ranked in the middle poor wealth status. Among the poorest and least poor households, food security was not statistically associated with stunting. Our results shed light on the joint effect of food security and wealth status on stunting. Study findings underscore the need for social protection policies to

Risk for household safety hazards: Socioeconomic and sociodemographic factors.

PubMed

Mayes, Sunnye; Roberts, Michael C; Stough, Cathleen Odar

2014-12-01

Many unintentional injuries to young children occur in the home. The current study examines the relation between family socioeconomic and sociodemographic factors and risk factors for home injury. Presence of household hazards was examined in 80 families with toddler-aged children. Parental ability to identify household hazards in pictures was also assessed. ANOVAs and Pearson product-moment correlations examined the relationship between presence of household hazards, knowledge to identify hazards, and factors of yearly family income, parental age, parental education, parental marital status, child ethnicity, and the number of children living in the home. A greater number of hazards were found in the homes of both the lowest and highest income families, but poorer knowledge to identify household hazards was found only among parents of the lowest income families and younger parents. Across family socioeconomic status, parent knowledge of hazards was related to observed household hazards. The relationship between family income and risk for injury is complex, and children of both lower and higher SES families may be at risk for injury. While historically particular focus has been placed on risk for injury among children in low income families, injury prevention efforts should target reducing presence of household hazards in both high and low SES families. Copyright © 2014 National Safety Council and Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.

Impact of gender participation in non-farming activities on household income and poverty levels in Pakistan.

PubMed

Ali, Akhter; Erenstein, Olaf; Rahut, Dil Bahadur

2015-01-01

In the rural areas of Pakistan, the majority of farm households have small landholdings of less than 2 hectares. Both male and females are engaged in farming and non-farming activities. However, in Pakistan the gender-wise participation in farming activities is not much documented. The main objective of the current study is to estimate the impact of male and female participation in non-farming activities on a household's income level and poverty status in Pakistan. The current study is based on a cross-sectional data set collected from 325 households through a purposive random sampling technique. A detailed comprehensive questionnaire was prepared for data collection. The data were analyzed by employing the propensity score matching approach. The empirical results indicate that both male and female participation in non-farming activities has a positive impact on household welfare in Pakistan by raising income levels and thus contributing to poverty reduction. However, the impact is greater when the males of a household take part in these activities rather than the females. In the past only a few studies have focused on gender-based participation in non-farming activities. The non-farming sector is an important one in rural areas, especially in developing countries like Pakistan. More opportunities need to be created for both men and women in rural areas of Pakistan to find off-farm work, in order to increase household income and reduce poverty levels.

Predictors of high out-of-pocket healthcare expenditure: an analysis using Bangladesh household income and expenditure survey, 2010.

PubMed

Molla, Azaher Ali; Chi, Chunhuei; Mondaca, Alicia Lorena Núñez

2017-01-31

Predictors of high out-of-pocket household healthcare expenditure are essential for creating effective health system finance policy. In Bangladesh, 63.3% of health expenditure is out-of-pocket and born by households. It is imperative to know what determines household health expenditure. This study aims to investigate the predicting factors of high out-of-pocket household healthcare expenditure targeting to put forward policy recommendations on equity in financial burden. Bangladesh household income and expenditure survey 2010 provides data for this study. Predictors of high out-of-pocket household healthcare expenditure were analyzed using multiple linear regressions. We have modeled non-linear relationship using logarithmic form of linear regression. Heteroscedasticity and multicollinearity were checked using Breusch-Pagan/Cook-Weishberg and VIF tests. Normality of the residuals was checked using Kernel density curve. We applied required adjustment for survey data, so that standard errors and parameters estimation are valid. Presence of chronic disease and household income were found to be the most influential and statistically significant (p < 0.001) predictors of high household healthcare expenditure. Households in rural areas spend 7% less than urban dwellers. The results show that a 100% increase in female members in a family leads to a 2% decrease in household health expenditure. Household income, health shocks in families, and family size are other statistically significant predictors of household healthcare expenditure. Proportion of elderly and under-five members in the family show some positive influence on health expenditure, though statistically nonsignificant. The findings call for emphasizing prevention of chronic diseases, as it is a strong predictor of household health expenditure. Innovative insurance scheme needs to be devised to prevent household from being impoverished due to health shocks in the family. Policy makers are urged to design an

Impact of average household income and damage exposure on post-earthquake distress and functioning: A community study following the February 2011 Christchurch earthquake.

PubMed

Dorahy, Martin J; Rowlands, Amy; Renouf, Charlotte; Hanna, Donncha; Britt, Eileen; Carter, Janet D

2015-08-01

Post-traumatic stress, depression and anxiety symptoms are common outcomes following earthquakes, and may persist for months and years. This study systematically examined the impact of neighbourhood damage exposure and average household income on psychological distress and functioning in 600 residents of Christchurch, New Zealand, 4-6 months after the fatal February, 2011 earthquake. Participants were from highly affected and relatively unaffected suburbs in low, medium and high average household income areas. The assessment battery included the Acute Stress Disorder Scale, the depression module of the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7), along with single item measures of substance use, earthquake damage and impact, and disruptions in daily life and relationship functioning. Controlling for age, gender and social isolation, participants from low income areas were more likely to meet diagnostic cut-offs for depression and anxiety, and have more severe anxiety symptoms. Higher probabilities of acute stress, depression and anxiety diagnoses were evident in affected versus unaffected areas, and those in affected areas had more severe acute stress, depression and anxiety symptoms. An interaction between income and earthquake effect was found for depression, with those from the low and medium income affected suburbs more depressed. Those from low income areas were more likely, post-earthquake, to start psychiatric medication and increase smoking. There was a uniform increase in alcohol use across participants. Those from the low income affected suburb had greater general and relationship disruption post-quake. Average household income and damage exposure made unique contributions to earthquake-related distress and dysfunction. © 2014 The British Psychological Society.

System Dynamics Modeling of Households' Electricity Consumption and Cost-Income Ratio: a Case Study of Latvia

NASA Astrophysics Data System (ADS)

Bariss, Uldis; Bazbauers, Gatis; Blumberga, Andra; Blumberga, Dagnija

2017-11-01

Increased energy efficiency of the building sector is high on the list of priorities for energy policy since better energy efficiency would help to reduce impact on climate change and increase security of energy supply. One aim of the present study was to find a relative effect of growth of demand for energy services due to changes in income, energy consumption per unit of demand due to technological development, changes in electricity price and household income on household electricity consumption in Latvia. The method applied included system dynamics modeling and data from a household survey regarding the relationship between electricity saving activities and the electricity cost-income ratio. The results revealed that, in direct contrast to the expected, a potential reduction of the electricity consumption is rather insensitive to electricity price and electricity cost-income ratio, and that the efficiency of technologies could be the main drivers for future electricity savings. The results suggest that support to advancement of technologies and faster replacement of inefficient ones rather than influencing the energy price could be effective energy policy measures. The model, developed in the study could be used in similar assessments in other countries.

Economic impacts of health shocks on households in low and middle income countries: a review of the literature

PubMed Central

2014-01-01

Poor health is a source of impoverishment among households in low -and middle- income countries (LMICs) and a subject of voluminous literature in recent years. This paper reviews recent empirical literature on measuring the economic impacts of health shocks on households. Key inclusion criteria were studies that explored household level economic outcomes (burden of out-of-pocket (OOP) health spending, labour supply responses and non-medical consumption) of health shocks and sought to correct for the likely endogeneity of health shocks, in addition to studies that measured catastrophic and impoverishment effects of ill health. The review only considered literature in the English language and excluded studies published before 2000 since these have been included in previous reviews. We identified 105 relevant articles, reports, and books. Our review confirmed the major conclusion of earlier reviews based on the pre-2000 literature - that households in LMICs bear a high but variable burden of OOP health expenditure. Households use a range of sources such as income, savings, borrowing, using loans or mortgages, and selling assets and livestock to meet OOP health spending. Health shocks also cause significant reductions in labour supply among households in LMICs, and households (particularly low-income ones) are unable to fully smooth income losses from moderate and severe health shocks. Available evidence rejects the hypothesis of full consumption insurance in the face of major health shocks. Our review suggests additional research on measuring and harmonizing indicators of health shocks and economic outcomes, measuring economic implications of non-communicable diseases for households and analyses based on longitudinal data. Policymakers need to include non-health system interventions, including access to credit and disability insurance in addition to support formal insurance programs to ameliorate the economic impacts of health shocks. PMID:24708831

Economic impacts of health shocks on households in low and middle income countries: a review of the literature.

PubMed

Alam, Khurshid; Mahal, Ajay

2014-04-03

Poor health is a source of impoverishment among households in low -and middle- income countries (LMICs) and a subject of voluminous literature in recent years. This paper reviews recent empirical literature on measuring the economic impacts of health shocks on households. Key inclusion criteria were studies that explored household level economic outcomes (burden of out-of-pocket (OOP) health spending, labour supply responses and non-medical consumption) of health shocks and sought to correct for the likely endogeneity of health shocks, in addition to studies that measured catastrophic and impoverishment effects of ill health. The review only considered literature in the English language and excluded studies published before 2000 since these have been included in previous reviews. We identified 105 relevant articles, reports, and books. Our review confirmed the major conclusion of earlier reviews based on the pre-2000 literature--that households in LMICs bear a high but variable burden of OOP health expenditure. Households use a range of sources such as income, savings, borrowing, using loans or mortgages, and selling assets and livestock to meet OOP health spending. Health shocks also cause significant reductions in labour supply among households in LMICs, and households (particularly low-income ones) are unable to fully smooth income losses from moderate and severe health shocks. Available evidence rejects the hypothesis of full consumption insurance in the face of major health shocks. Our review suggests additional research on measuring and harmonizing indicators of health shocks and economic outcomes, measuring economic implications of non-communicable diseases for households and analyses based on longitudinal data. Policymakers need to include non-health system interventions, including access to credit and disability insurance in addition to support formal insurance programs to ameliorate the economic impacts of health shocks.

Perceived Income Adequacy Among Older Adults in 12 Countries: Findings From the Survey of Health, Ageing, and Retirement in Europe

PubMed Central

Litwin, Howard; Sapir, Eliyahu V.

2009-01-01

Purpose: To validate a survey research measure of subjective income, as measured by perceived income adequacy, in an international context. Design and Methods: The study population comprised persons aged 50 years and older in 12 countries from the Survey of Health, Ageing and Retirement in Europe (n = 28,939). Perceived difficulty in making ends meet was regressed on sociodemographic variables, economic indicators, health status measures, and expectations regarding one's financial future. Country differences were also controlled. Results: The findings confirm a multidimensional explanation of perceived income adequacy but also point to the primacy of objective economic indicators in predicting household financial distress. Respondents aged 80 years and older report less financial difficulty. Poor health status and pessimistic financial expectations also predict greater household financial distress but to a lesser degree. Implications: Self-rated economic status is a robust indicator of financial capacity in older age and can be used by practitioners to gain meaningful information. However, practitioners should keep in mind that the oldest-old may underestimate financial difficulties. PMID:19386829

Does modifying the household food budget predict changes in the healthfulness of purchasing choices among low- and high-income women?

PubMed

Inglis, Victoria; Ball, Kylie; Crawford, David

2009-04-01

Food cost has a strong influence on food purchases and given that persons of low income often have more limited budgets, healthier foods may be overlooked in favour of more energy-dense lower-cost options. The aim of this study was to investigate whether modifications to the available household food budget led to changes in the healthfulness of food purchasing choices among women of low and high income. A quasi-experimental design was used which included a sample of 74 women (37 low-income women and 37 high-income women) who were selected on the basis of their household income and sent an itemised shopping list in order to calculate their typical weekly household shopping expenditure. The women were also asked to indicate those foods they would add to their list if they were given an additional 25% of their budget to spend on food and those foods they would remove if they were restricted by 25% of their budget. When asked what foods they would add with a larger household food budget, low-income women chose more foods from the 'healthier' categories whereas high-income women chose more foods from the less 'healthier' categories. However, making the budgets of low- and high-income women more 'equivalent' did not eradicate income differences in overall healthfulness of food purchasing choices. This study highlights the importance of cost when making food purchasing choices among low- and high-income groups. Public health strategies aimed at reducing income inequalities in diet might focus on promoting healthy diets that are low cost.

The stability of income inequality in Brazil, 2006-2012: an estimate using income tax data and household surveys.

PubMed

Medeiros, Marcelo; de Souza, Pedro Herculano Guimarães Ferreira; de Castro, Fábio Ávila

2015-04-01

the level and evolution of income inequality among adults in Brazil between 2006 and 2012. to calculate the level of inequality, its trend over the years and the share of income growth appropriated by different social groups. We combined tax data from the Annual Personal Income Tax Returns (Declaração Anual de Ajuste do Imposto de Renda da Pessoa Física - DIRPF) and the Brazilian National Household Survey (Pesquisa Nacional por Amostra de Domicílios - PNAD) to construct a complete distribution of total income among adults in Brazil. We applied Pareto interpolations to income tax tabulations to arrive at the distribution within income groups. We tested the results, comparing the PNAD to the Brazilian Consumption and Expenditure Survey (Pesquisa de Orçamentos Familiares - POF) and to data from the Census Subsample Survey (Census. We found evidence that income inequality in Brazil is higher than previously thought and that it remained stable between 2006 and 2012; in making these findings, we thus diverged from most studies on the dynamics of inequality in Brazil.. There was income growth, but the top incomes have appropriated most of this growth.

Social Security and the Retirement and Savings Behavior of Low Income Households1

PubMed Central

van der Klaauw, Wilbert; Wolpin, Kenneth I.

2011-01-01

In this paper, we develop and estimate a model of retirement and savings incorporating limited borrowing, stochastic wage offers, health status and survival, social security benefits, Medicare and employer provided health insurance coverage, and intentional bequests. The model is estimated on sample of relatively poor households from the first three waves of the Health and Retirement Study (HRS), for whom we would expect social security income to be of particular importance. The estimated model is used to simulate the responses to changes in social security rules, including changes in benefit levels, in the payroll tax, in the social security earnings tax and in early and normal retirement ages. Welfare and budget consequences are estimated. PMID:21566719

The impact of out-of-pocket payments for dental care on household finances in low and middle income countries.

PubMed

Bernabé, Eduardo; Masood, Mohd; Vujicic, Marko

2017-01-23

Dental care is extremely costly and beyond most people means in developing countries. The primary aim of this study was to determine the impact of out-of-pocket payments for dental care on household finances in 40 low and middle income countries. A second aim was to compare the burden of payments for dental care with that for other health services. We used data from 174,257 adults, aged 18 years and above, who reported their total and itemized household expenditure in the past four weeks as part of the World Health Surveys. The financial burden on households was measured using the catastrophic health expenditure (CHE) and impoverishment approaches. A household was classified as facing CHE if it spent 40% or more of its capacity to pay, and as facing impoverishment if it fell below the country-specific poverty line after spending on health care was subtracted from household expenditure. The odds of experiencing CHE and impoverishment due to expenditure on dental care were estimated from two-level logistic regression models, controlling for various individual- and country-level covariates. Households that paid for dental care had 1.88 (95% Confidence Interval: 1.78-1.99) greater odds of incurring CHE and 1.65 (95% CI: 1.52-1.80) greater odds of facing impoverishment, after adjustment for covariates. Furthermore, the impact of paying for dental care was lower than that for medications or drugs, inpatient care, outpatient care and laboratory tests but similar to that of health care products, traditional medicine and other health services. Households with recent dental care spending were more likely to use a large portion of their disposable income and fall below the poverty line. Policy makers ought to consider including dental care as part of universal health care and advocate for the inclusion of dental care coverage in health insurance packages.

Relationship Between Catastrophic Health Expenditures and Income Quintile Decline

PubMed Central

Kang, Jeong-Hee; Kim, Chul-Woung

2018-01-01

Objectives The aims of this study were to investigate the proportion of households facing catastrophic health expenditures based on household income quintiles, and to analyze the relationship between expenditures and household income quintile decline. Methods Study data were obtained from an annually conducted survey of the 2012–2013 Korean health panel. There were 12,909 subjects aged 20–64 years from economically active households, whose income quintile remained unchanged or declined by more than one quintile from 2012 to 2013. Logistic regression analysis was performed to determine whether catastrophic health expenditures in 2012 were related to more than one quintile income decline in 2013. Results Households facing catastrophic health expenditures of ≥ 40%, ≥ 30%, and ≥ 10% of a household’s capacity to pay, were 1.58 times (p < 0.003), 1.75 times (p < 0.000), and 1.23 times (p < 0.001) more likely to face a decline in income quintile, respectively. Conclusion Over a 1 year period, the proportion of households facing more than one quintile income decline was 16.4%, while 2.1% to 2.5% of households in Korea faced catastrophic health expenditures. Catastrophic health expenditure experienced in 2012 was significantly associated with income quintile decline 1 year later. Therefore, lowering the proportion of households with catastrophic health expenditure may reduce the proportion of households with income quintiles decline. PMID:29740531

Assessing the relevance of neighbourhood characteristics to the household food security of low-income Toronto families.

PubMed

Kirkpatrick, Sharon I; Tarasuk, Valerie

2010-07-01

Although the sociodemographic characteristics of food-insecure households have been well documented, there has been little examination of neighbourhood characteristics in relation to this problem. In the present study we examined the association between household food security and neighbourhood features including geographic food access and perceived neighbourhood social capital. Cross-sectional survey and mapping of discount supermarkets and community food programmes. Twelve high-poverty neighbourhoods in Toronto, Ontario, Canada. Respondents from 484 low-income families who had children and who lived in rental accommodations. Food insecurity was pervasive, affecting two-thirds of families with about a quarter categorized as severely food insecure, indicative of food deprivation. Food insecurity was associated with household factors including income and income source. However, food security did not appear to be mitigated by proximity to food retail or community food programmes, and high rates of food insecurity were observed in neighbourhoods with good geographic food access. While low perceived neighbourhood social capital was associated with higher odds of food insecurity, this effect did not persist once we accounted for household sociodemographic factors. Our findings raise questions about the extent to which neighbourhood-level interventions to improve factors such as food access or social cohesion can mitigate problems of food insecurity that are rooted in resource constraints. In contrast, the results reinforce the importance of household-level characteristics and highlight the need for interventions to address the financial constraints that underlie problems of food insecurity.

The relation between household income and surgical outcome in the Dutch setting of equal access to and provision of healthcare.

PubMed

Ultee, Klaas H J; Tjeertes, Elke K M; Bastos Gonçalves, Frederico; Rouwet, Ellen V; Hoofwijk, Anton G M; Stolker, Robert Jan; Verhagen, Hence J M; Hoeks, Sanne E

2018-01-01

The impact of socioeconomic disparities on surgical outcome in the absence of healthcare inequality remains unclear. Therefore, we set out to determine the association between socioeconomic status (SES), reflected by household income, and overall survival after surgery in the Dutch setting of equal access and provision of care. Additionally, we aim to assess whether SES is associated with cause-specific survival and major 30-day complications. Patients undergoing surgery between March 2005 and December 2006 in a general teaching hospital in the Netherlands were prospectively included. Adjusted logistic and cox regression analyses were used to assess the independent association of SES-quantified by gross household income-with major 30-day complications and long-term postoperative survival. A total of 3929 patients were included, with a median follow-up of 6.3 years. Low household income was associated with worse survival in continuous analysis (HR: 1.05 per 10.000 euro decrease in income, 95% CI: 1.01-1.10) and in income quartile analysis (HR: 1.58, 95% CI: 1.08-2.31, first [i.e. lowest] quartile relative to the fourth quartile). Similarly, low income patients were at higher risk of cardiovascular death (HR: 1.26 per 10.000 decrease in income, 95% CI: 1.07-1.48, first income quartile: HR: 3.10, 95% CI: 1.04-9.22). Household income was not independently associated with cancer-related mortality and major 30-day complications. Low SES, quantified by gross household income, is associated with increased overall and cardiovascular mortality risks among surgical patients. Considering the equality of care provided by this study setting, the associated survival hazards can be attributed to patient and provider factors, rather than disparities in healthcare. Increased physician awareness of SES as a risk factor in preoperative decision-making and focus on improving established SES-related risk factors may improve surgical outcome of low SES patients.

Estimating the Number of Low-Income Americans Exposed to Household Air Pollution from Burning Solid Fuels

PubMed Central

Rogalsky, Derek K.; Mendola, Pauline; Metts, Tricia A.

2014-01-01

Background: Exposure to household air pollution (HAP) from inefficient biomass and coal stoves kills nearly 4 million people every year worldwide. HAP is an environmental risk associated with poverty that affects an estimated 3 billion people mostly in low- and middle-income countries. Objectives: Our goal was to estimate the number of low-income Americans exposed to potentially health-damaging concentrations of HAP. Methods: We mapped county-level data for the percentage of households using wood, coal, and/or coke as their primary heating fuel along with percent of the population below the federal poverty level. Using U.S. Census data and the likelihood of fugitive emissions as reported in the literature, we estimated the number of low-income Americans potentially exposed to HAP. Results: Solid fuel is the primary heating source for > 2.5 million U.S. households, or 6.5 million people. The mapping exercise showed several rural areas, primarily in the northern and western regions, that have high levels of solid-fuel use and poverty. We then identified 117 counties with high co-incident poverty and solid-fuel use as high-priority counties for research into potential health risks from HAP. We estimate that between 500,000 and 600,000 low-income people in the United States are likely exposed to HAP from burning solid fuels within their homes. Conclusion: HAP occurs within the United States and should be further investigated for adverse health risks, especially among those living in areas with rural poverty. Citation: Rogalsky DK, Mendola P, Metts TA, Martin WJ II. 2014. Estimating the number of low-income Americans exposed to household air pollution from burning solid fuels. Environ Health Perspect 122:806–810; http://dx.doi.org/10.1289/ehp.1306709 PMID:24833615

Determinants of Household Use of Selected Energy Star Appliances

EIA Publications

2016-01-01

The main objective of this paper is to test a series of hypotheses regarding the influences of household characteristics (such as education, age, sex, race, income, and size of household), building characteristics (such as age, ownership, and type), and electricity prices on the use of ENERGY STAR appliances.

Poverty Levels and Debt Indicators among Low-Income Households before and after the Great Recession

ERIC Educational Resources Information Center

Kim, Kyoung Tae; Wilmarth, Melissa J.; Henager, Robin

2017-01-01

This study analyzed the debt profile of low-income households before and after the Great Recession using the 2007, 2010, and 2013 Survey of Consumer Finances (SCF). We used Heckman selection models to investigate three debt characteristics: (a) the amount of debt, (b) debt-to-income ratio, and (c) debt delinquency. Before and after the Great…

Trends in racial/ethnic and income disparities in foods and beverages consumed and purchased from stores among US households with children, 2000-2013.

PubMed

Ng, Shu Wen; Poti, Jennifer M; Popkin, Barry M

2016-09-01

It is unclear whether racial/ethnic and income differences in foods and beverages obtained from stores contribute to disparities in caloric intake over time. We sought to determine whether there are disparities in calories obtained from store-bought consumer packaged goods (CPGs), whether brands (name brands compared with private labels) matter, and if disparities have changed over time. We used NHANES individual dietary intake data among households with children along with the Nielsen Homescan data on CPG purchases among households with children. With NHANES, we compared survey-weighted energy intakes for 2003-2006 and 2009-2012 from store and nonstore sources by race/ethnicity [non-Hispanic whites (NHWs), non-Hispanic blacks (NHBs), and Hispanic Mexican-Americans) and income [≤185% federal poverty line (FPL), 186-400% FPL, and >400% FPL]. With the Nielsen data, we compared 2000-2013 trends in calories purchased from CPGs (obtained from stores) across brands by race/ethnicity (NHW, NHB, and Hispanic) and income. We conducted random-effect models to derive adjusted trends and differences in calories purchased (708,175 observations from 64,709 unique households) and tested whether trends were heterogeneous by race/ethnicity or income. Store-bought foods and beverages represented the largest component of dietary intake, with greater decreases in energy intakes in nonstore sources for foods and in store sources for beverages. Beverages from stores consistently decreased in all subpopulations. However, in adjusted models, reductions in CPG calories purchased in 2009-2012 were slower for NHB and low-income households than for NHW and high-income households, respectively. The decline in calories from name-brand food purchases was slower among NHB, Hispanic, and lowest-income households. NHW and high-income households had the highest absolute calories purchased in 2000. Across 2 large data sources, we found decreases in intake and purchases of beverages from stores

Household Food Security and Fruit and Vegetable Intake among Low-Income Fourth-Graders

ERIC Educational Resources Information Center

Grutzmacher, Stephanie; Gross, Susan

2011-01-01

Objective: To examine the relationship between household food security and children's and parents' fruit, vegetable, and breakfast consumption and fruit and vegetable availability. Design: Cross-sectional study using matched parent-child surveys. Setting: Title I elementary schools in Maryland. Participants: Ninety-two low-income parent-child…

After Mexico Implemented a Tax, Purchases of Sugar-Sweetened Beverages Decreased and Water Increased: Difference by Place of Residence, Household Composition, and Income Level.

PubMed

Colchero, M Arantxa; Molina, Mariana; Guerrero-López, Carlos M

2017-08-01

Background: In January 2014, Mexico implemented a tax on sugar-sweetened beverage (SSB) purchases of 1 peso/L. Objective: We examined the heterogeneity of changes in nonalcoholic beverage (SSB and bottled water) purchases after the tax was implemented by household income, urban and rural strata, and household composition. Methods: We used 4 rounds of the National Income and Expenditure Surveys: 2008, 2010, 2012, and 2014. Changes in purchases in per capita liters per week were estimated with the use of 2-part models to adjust for nonpurchases. We compared absolute and relative differences between adjusted changes in observed purchases in 2014 with expected purchases in 2014 based on prior trends (2008-2012). The models were adjusted for sociodemographic characteristics of the households, place of residence, and lagged gross domestic product per capita. Results: We found a 6.3% reduction in the observed purchases of SSBs in 2014 compared with the expected purchases in that same year based on trends from 2008 to 2012. These reductions were higher among lower-income households, residents living in urban areas, and households with children. We also found a 16.2% increase in water purchases that was higher in low- and middle-income households, in urban areas, and among households with adults only. Conclusions: SSB purchases decreased and water purchases increased after an SSB tax was imposed in Mexico. The magnitude of these changes was greater in lower-income and urban households. © 2017 American Society for Nutrition.

Determinants of Thailand household healthcare expenditure: the relevance of permanent resources and other correlates.

PubMed

Okunade, Albert A; Suraratdecha, Chutima; Benson, David A

2010-03-01

Several papers in the leading health economics journals modeled the determinants of healthcare expenditure using household survey or family budgets data of developed countries. Past work largely used self-reported current income as the core determinant, whereas the theoretically correct concept of household resource constraint is permanent or long-run income (á lá Milton Friedman). This paper strives to rectify the theoretical oversight of using current income by augmenting the model with household asset. Using longitudinal data, we constructed 'wealth index' as a distinct covariate to capture the households' tendency to liquidate assets when defraying necessary healthcare liabilities after exhausting cash incomes. (Current income and assets together capture the household expanded resource base). Using 98 632 household observations from Thailand Socio-Economic Surveys (1994-2000 biennial data cycles) we found, using a double-hurdle model with dependent errors, that out-of-pocket healthcare spending behaves as a technical necessity across income quintiles and household sizes. Pre-1997 economic shock income elasticities are smaller than the post-shock estimates across income quintiles for large and small households. Proximity to death, median age, and assets are also among other significant determinants. Our novel findings extend the theoretical consistency of a multi-level decision model in household healthcare expenditure in the developing Asian country context. (c) 2009 John Wiley & Sons, Ltd.

Trends in racial/ethnic and income disparities in foods and beverages consumed and purchased from stores among US households with children, 2000–201312

PubMed Central

Poti, Jennifer M; Popkin, Barry M

2016-01-01

Background: It is unclear whether racial/ethnic and income differences in foods and beverages obtained from stores contribute to disparities in caloric intake over time. Objective: We sought to determine whether there are disparities in calories obtained from store-bought consumer packaged goods (CPGs), whether brands (name brands compared with private labels) matter, and if disparities have changed over time. Design: We used NHANES individual dietary intake data among households with children along with the Nielsen Homescan data on CPG purchases among households with children. With NHANES, we compared survey-weighted energy intakes for 2003–2006 and 2009–2012 from store and nonstore sources by race/ethnicity [non-Hispanic whites (NHWs), non-Hispanic blacks (NHBs), and Hispanic Mexican-Americans) and income [≤185% federal poverty line (FPL), 186–400% FPL, and >400% FPL]. With the Nielsen data, we compared 2000–2013 trends in calories purchased from CPGs (obtained from stores) across brands by race/ethnicity (NHW, NHB, and Hispanic) and income. We conducted random-effect models to derive adjusted trends and differences in calories purchased (708,175 observations from 64,709 unique households) and tested whether trends were heterogeneous by race/ethnicity or income. Results: Store-bought foods and beverages represented the largest component of dietary intake, with greater decreases in energy intakes in nonstore sources for foods and in store sources for beverages. Beverages from stores consistently decreased in all subpopulations. However, in adjusted models, reductions in CPG calories purchased in 2009–2012 were slower for NHB and low-income households than for NHW and high-income households, respectively. The decline in calories from name-brand food purchases was slower among NHB, Hispanic, and lowest-income households. NHW and high-income households had the highest absolute calories purchased in 2000. Conclusions: Across 2 large data sources, we found

Household food insecurity is associated with anemia in adult Mexican women of reproductive age.

PubMed

Fischer, Nils C; Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Méndez-Gómez-Humarán, Ignacio; Pérez-Escamilla, Rafael

2014-12-01

Anemia is a major cause of maternal mortality. Household food insecurity (HFI) may increase the risk of anemia among women of reproductive age although this hypothesis remains largely untested in representative samples from low- and middle-income countries. Our objective was to investigate the association of HFI with anemia in a nationally representative, cross-sectional sample of Mexican women of reproductive age (12-49 y old). We tested the association between HFI and anemia among 16,944 women of reproductive age using the multiple logistic regression among adolescent (12-20 y) and adult women (21-49 y). HFI was measured with the use of the Latin American and Caribbean Food Security Scale. Hemoglobin was measured with capillary hemoglobin with the use of HemoCue photometer (HemoCue, Inc.) and anemia was defined with the use of WHO standards. The association of HFI and anemia was not significant (P > 0.05) for adolescent women (12-20 y), whereas in adult women (21-49 y), the adjusted odds of having anemia were 31-43% higher among those living in mild to severely food insecure households than adult women residing in food secure households (P < 0.05). HFI is associated with anemia among adult Mexican women. Programs that reduce HFI may also be effective at reducing the risk of anemia among Mexican women. © 2014 American Society for Nutrition.

Household disrepair and the mental health of low-income urban women.

PubMed

Burdette, Amy M; Hill, Terrence D; Hale, Lauren

2011-02-01

We employ longitudinal survey data from the Welfare, Children, and Families project (1999, 2001) to examine the effects of household disrepair (e.g., living with leaky structures, busted plumbing, broken windows, and pests) on psychological distress among low-income urban women with children. Building on previous research, we adjust for related housing concepts, neighborhood disorder, financial hardship, and a host of relevant background factors. We also formally test the mediating influences of social support and self-esteem. Our cross-sectional analysis indicated that household disrepair is positively associated with recent symptoms of psychological distress. Our longitudinal change score analysis demonstrates two important patterns. First, women living with household disrepair at baseline are not necessarily vulnerable to increases in symptoms of psychological distress over the 2-year study period. Second, women who report an increase in disrepair over the study period are also likely to report a concurrent increase in symptoms of distress. Although social support and self-esteem favor mental health in our cross-sectional and longitudinal analyses, these psychosocial resources fail to mediate or explain the association between disrepair and distress.

Perceived benefits and challenges for low-income mothers of having family meals with preschool-aged children: childhood memories matter.

PubMed

Malhotra, Khushi; Herman, Allison N; Wright, Gretchen; Bruton, Yasmeen; Fisher, Jennifer O; Whitaker, Robert C

2013-11-01

Eating regular family meals is associated with a lower risk of obesity among preschool-aged children. Children in lower-income households are at higher risk for obesity, but there is little information about their mothers' perceptions of family meals, and such information could improve nutrition counseling. To identify the perceived benefits and challenges of having family meals, four focus groups were conducted with 20 mothers of preschool-aged children living in low-income households in Philadelphia, PA. Three authors independently analyzed verbatim transcripts using an inductive method of open coding, and themes were established by consensus among all authors. Of the 20 mothers, 18 were black, 11 had education beyond high school, and 12 were living with an adult partner or husband. Mothers' strong childhood memories of mealtimes, both negative and positive, motivated them to have family meals because of the opportunities afforded by mealtimes to build strong relationships with their children. However, mothers also described needing help, especially from other household adults, in preparing meals and establishing calm and order with their children during mealtimes. To identify what motivates the mothers of low-income, preschool-aged children to have family meals, registered dietitians can benefit from asking about the mothers' own childhood experiences of family meals. Studies are needed to examine whether such an approach to identifying maternal motivations, when combined with practical advice about overcoming challenges with meal preparation and managing children's mealtime behavior, could lead to more frequent and nutritious family meals in this population. Copyright © 2013 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Common mental disorders, neighbourhood income inequality and income deprivation: small-area multilevel analysis.

PubMed

Fone, David; Greene, Giles; Farewell, Daniel; White, James; Kelly, Mark; Dunstan, Frank

2013-04-01

Common mental disorders are more prevalent in areas of high neighbourhood socioeconomic deprivation but whether the prevalence varies with neighbourhood income inequality is not known. To investigate the hypothesis that the interaction between small-area income deprivation and income inequality was associated with individual mental health. Multilevel analysis of population data from the Welsh Health Survey, 2003/04-2010. A total of 88,623 respondents aged 18-74 years were nested within 50,587 households within 1887 lower super output areas (neighbourhoods) and 22 unitary authorities (regions), linked to the Gini coefficient (income inequality) and the per cent of households living in poverty (income deprivation). Mental health was measured using the Mental Health Inventory MHI-5 as a discrete variable and as a 'case' of common mental disorder. High neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods after adjusting for individual and household risk factors (parameter estimate +0.70 (s.e. = 0.33), P = 0.036; odds ratio (OR) for common mental disorder case 0.92, 95% CI 0.88-0.97). Income inequality at regional level was significantly associated with poorer mental health (parameter estimate -1.35 (s.e. = 0.54), P = 0.012; OR = 1.13, 95% CI 1.04-1.22). The associations between common mental disorders, income inequality and income deprivation are complex. Income inequality at neighbourhood level is less important than income deprivation as a risk factor for common mental disorders. The adverse effect of income inequality starts to operate at the larger regional level.

The association between ownership of common household devices and obesity and diabetes in high, middle and low income countries

PubMed Central

Lear, Scott A.; Teo, Koon; Gasevic, Danijela; Zhang, Xiaohe; Poirier, Paul P.; Rangarajan, Sumathy; Seron, Pamela; Kelishadi, Roya; Tamil, Azmi Mohd; Kruger, Annamarie; Iqbal, Romaina; Swidan, Hani; Gómez-Arbeláez, Diego; Yusuf, Rita; Chifamba, Jephat; Kutty, V. Raman; Karsidag, Kubilay; Kumar, Rajesh; Li, Wei; Szuba, Andrzej; Avezum, Alvaro; Diaz, Rafael; Anand, Sonia S.; Rosengren, Annika; Yusuf, Salim

2014-01-01

Background: Household devices (e.g., television, car, computer) are common in high income countries, and their use has been linked to obesity and type 2 diabetes mellitus. We hypothesized that device ownership is associated with obesity and diabetes and that these effects are explained through reduced physical activity, increased sitting time and increased energy intake. Methods: We performed a cross-sectional analysis using data from the Prospective Urban Rural Epidemiology study involving 153 996 adults from high, upper-middle, lower-middle and low income countries. We used multilevel regression models to account for clustering at the community and country levels. Results: Ownership of a household device increased from low to high income countries (4% to 83% for all 3 devices) and was associated with decreased physical activity and increased sitting, dietary energy intake, body mass index and waist circumference. There was an increased odds of obesity and diabetes with the ownership of any 1 household device compared to no device ownership (obesity: odds ratio [OR] 1.43, 95% confidence interval [CI] 1.32–1.55; diabetes: OR 1.38, 95% CI 1.28–1.50). Ownership of a second device increased the odds further but ownership of a third device did not. Subsequent adjustment for lifestyle factors modestly attenuated these associations. Of the 3 devices, ownership of a television had the strongest association with obesity (OR 1.39, 95% CI 1.29–1.49) and diabetes (OR 1.33, 95% CI 1.23–1.44). When stratified by country income level, the odds of obesity and diabetes when owning all 3 devices was greatest in low income countries (obesity: OR 3.15, 95% CI 2.33–4.25; diabetes: OR 1.97, 95% CI 1.53–2.53) and decreased through country income levels such that we did not detect an association in high income countries. Interpretation: The ownership of household devices increased the likelihood of obesity and diabetes, and this was mediated in part by effects on physical

Short-term and long-term associations between household wealth and physical growth: a cross-comparative analysis of children from four low- and middle-income countries.

PubMed

Krishna, Aditi; Oh, Juhwan; Lee, Jong-koo; Lee, Hwa-Young; Perkins, Jessica M; Heo, Jongho; Ro, Young Sun; Subramanian, S V

2015-01-01

Stunting, a form of anthropometric failure, disproportionately affects children in developing countries with a higher burden on children living in poverty. How early life deprivation affects physical growth over various life stages is less well-known. We investigate the short- and long-run associations between household wealth in early life with physical growth in childhood in four low- and middle-income countries to understand the persistent implications of early life conditions of poverty and resource constraints on physical growth. Longitudinal study of eight cohorts of children in four countries - Ethiopia, India, Peru, and Vietnam (n=10,016) - ages 6 months to 15 years, using data from the Young Lives project, 2002-2009. Physical growth outcomes are standardized height-for-age z-scores (HAZ) and stunting. The key exposure is household wealth measured at baseline using a wealth index, an asset-based indicator. Covariates include child's age and sex, caregiver's educational status, household size, and place of residence. Baseline wealth index is significantly associated with higher physical growth rates as suggested by higher HAZ and lower odds of stunting. We found these associations in all four countries, for younger and older cohorts and for children who experienced changes in living standards. For the older cohort, despite the timing of the first survey at age 7-8 years, which is beyond the critical period of 1,000 days, there are lasting influences of early poverty, even for those who experienced changes in wealth. Household wealth in early life matters for physical growth with conditions of poverty and deprivation influencing growth faltering even beyond the 1,000 days window. The influences of early childhood poverty, so prevalent among children in low- and middle-income countries, must be addressed by policies and programs targeting early life but also focusing on older children experiencing growth faltering.

Livestock and livelihoods of smallholder cattle-owning households in Cambodia: the contribution of on-farm and off-farm activities to income and food security.

PubMed

Ashley, Katherine; Harrison, Holly; Chan, Phalleap Hok; Sothoeun, Suon; Young, James Robert; Windsor, Peter Andrew; Bush, Russell David

2018-05-23

The majority of smallholder farming households in Cambodia are rurally based and rely on agriculture to support their livelihoods. However, in recent years, growth in the agriculture sector has stagnated with farmers facing several challenges including declining prices for traditional crops and irregular rainfall patterns. This has led to a need for farmers to diversify income sources with livestock promoted as a more viable livelihood activity, particularly the raising of cattle and poultry. However, uncertain profitability of livestock activities is a common perception by smallholders, especially where animals have not been traditionally viewed as a primary income source. To address this, information is required which compares the income and expenses associated with livestock raising to other on-farm activities and off-farm sources. This study reports on a survey of livelihood survey of 17 male and 21 female representatives of 20 households owning cattle in Cambodia, comparing the associated income and expenses of the various livelihood activities in the 12-month period from January to December 2016. Combined total household income from both on-farm and off-farm sources ranged from USD875 to 17730 with an average of USD6779, representing 51% and 49% from on-farm and off-farm activities, respectively. Cattle raising was the most common source of on-farm income (85%), contributing USD1064 and representing 22% of total household income. General household expenses, such as food and transportation (including expenses associated with off-farm employment), represented the majority of total household expenses (79%). Gross profit calculations indicated higher values for pig raising (USD1841.79), cattle (USD950.80) and non-rice crops (USD884) whilst the highest gross margin value was recorded for cattle (89.33%) followed by vegetables (85.27%) and non-rice crops (83.08%). Whilst wet season and dry season rice returned a negative gross profit value of USD197.27 and USD90

Factors associated with women's and children's body mass indices by income status.

PubMed

Lin, B H; Huang, C L; French, S A

2004-04-01

To describe associations between eating behaviors, dietary intake, physical activity, attitudes toward diet and health, sociodemographic variables and body mass index (BMI) among women and children, and differences by household income. Data from the 1994-1996 Continuing Survey of Food Intakes by Individuals (CSFII) and the Diet and Health Knowledge Survey (DHKS) were examined using multivariate regression to estimate the associations between BMI and behavioral and environmental variables among women and children. CSFII 1994-1996 is representative of the US population. DHKS surveyed CSFII respondents 20 y of age and over. Our samples consisted of 2419 adult women and 1651 school-age children. CSFII respondents reported 24 h recalls of all food intakes on 2 nonconsecutive days and their personal and household characteristics, including self-reported height and weight. DHKS collected data on knowledge and attitudes toward dietary guidance and health from CSFII adult respondents. Significant correlations between women's BMI and age, race, dietary patterns, TV watching, and smoking was observed among women from both low- and high-income households. Beverage consumption, eating out, the importance of maintaining healthy weight, and exercise were correlated with BMI only among women from high-income households. Among children, age, race, income, and mother's BMI were significantly correlated with child BMI. Among women, the associations between some behavioral and environmental factors and BMI differ by household income. Intervention programs need to target specific eating and physical activity behaviors to promote a healthy body weight.

Higher food prices may threaten food security status among American low-income households with children.

PubMed

Zhang, Qi; Jones, Sonya; Ruhm, Christopher J; Andrews, Margaret

2013-10-01

Children in food-insecure households are more likely to experience poorer health function and worse academic achievement. To investigate the relation between economic environmental factors and food insecurity among children, we examined the relation between general and specific food prices (fast food, fruits and vegetables, beverages) and risk of low (LFS) and very low food security (VLFS) status among low-income American households with children. Using information for 27,900 child-year observations from the Early Childhood Longitudinal Study-Kindergarten Class of 1998-1999 linked with food prices obtained from the Cost of Living Data of the Council for Community and Economic Research, formerly known as the American Chamber of Commerce Researchers' Association, fixed effects models were estimated within stratified income groups. Higher overall food prices were associated with increased risk of LFS and VLFS (coefficient = 0.617; P < 0.05). Higher fast food and fruit and vegetable prices also contributed to higher risk of food insecurity (coefficient = 0.632, P < 0.01 for fast food; coefficient = 0.879, P < 0.01 for fruits and vegetables). However, increasing beverage prices, including the prices of soft drinks, orange juice, and coffee, had a protective effect on food security status, even when controlling for general food prices. Thus, although food price changes were strongly related to food security status among low-income American households with children, the effects were not uniform across types of food. These relations should be accounted for when implementing policies that change specific food prices.

The direct impact of landslides on household income in tropical regions: A case study from the Rwenzori Mountains in Uganda.

PubMed

Mertens, K; Jacobs, L; Maes, J; Kabaseke, C; Maertens, M; Poesen, J; Kervyn, M; Vranken, L

2016-04-15

Landslides affect millions of people worldwide, but theoretical and empirical studies on the impact of landslides remain scarce, especially in Sub-Saharan Africa. This study proposes and applies a method to estimate the direct impact of landslides on household income and to investigate the presence of specific risk sharing and mitigation strategies towards landslides in a tropical and rural environment. An original cross-sectional household survey is used in combination with geographical data to acquire detailed information on livelihoods and on hazards in the Rwenzori mountains, Uganda. Ordinary least square regressions and probit estimations with village fixed effects are used to estimate the impact of landslides and the presence of mitigation strategies. Geographical information at household level allows to disentangle the direct impact from the indirect effects of landslides. We show that the income of affected households is substantially reduced during the first years after a landslide has occurred. We find that members of recently affected households participate more in wage-employment or in self-employed activities, presumably to address income losses following a landslide. Yet, we see that these jobs do not provide sufficient revenue to compensate for the loss of income from agriculture. Given that landslides cause localized shocks, finding a significant direct impact in our study indicates that no adequate risk sharing mechanisms are in place in the Rwenzori sub-region. These insights are used to derive policy recommendations for alleviating the impact of landslides in the region. By quantifying the direct impact of landslides on household income in an agricultural context in Africa this study draws the attention towards a problem that has been broadly underestimated so far and provides a sound scientific base for disaster risk reduction in the region. Both the methodology and the findings of this research are applicable to other tropical regions with high

Determinants of Sugar-Sweetened Beverage Consumption among Low-Income Children: Are There Differences by Race/Ethnicity, Age, and Sex?

PubMed

Tasevska, Natasha; DeLia, Derek; Lorts, Cori; Yedidia, Michael; Ohri-Vachaspati, Punam

2017-12-01

Understanding determinants of high consumption of sugar-sweetened beverages (SSBs), a highly prevalent obesogenic behavior, will help build effective customized public health interventions. Our aim was to identify child and parent lifestyle and household demographic factors predictive of high SSB consumption frequency in children from low-income, ethnically diverse communities that may help inform public health interventions. We used a cross-sectional telephone household survey. Participants were 717 boys and 686 girls aged 3 to 18 years old from the New Jersey Childhood Obesity Study living in five low-income cities (Camden, New Brunswick, Newark, Trenton, and Vineland). The adult most knowledgeable about household food shopping completed a questionnaire over the telephone inquiring about their and their child's dietary and physical activity habits, and household-, parent-, and child-level demographics. Child's SSB consumption frequency was measured. Multivariate ordered logit models were designed to investigate a variety of variables hypothesized to affect the frequency of SSB consumption. Exploratory stratified analyses by race, sex, and age were also conducted. Eight percent of our study participants never consumed SSBs, 45% consumed SSBs at least once per day, and 23% consumed twice or more per day. SSB consumption was higher among children 12 to 18 years vs 3 to 5 years (P<0.0001), of non-Hispanic black vs non-Hispanic white race/ethnicity (P=0.010), who were moderate fast food consumers vs never consumers (P=0.003), and those whose parents were high vs low SSB consumers (P<0.0001). Living in a non-English-speaking household (P=0.030), having a parent with a college or higher education vs less than high school (P=0.003), and having breakfast 6 to 7 days/wk vs never to 2 days/wk or less were associated with lower SSB consumption (P=0.001). We identified a number of household-, parent-, and child-level predictors of SSB consumption, which varied by race, sex

Disparities in children's vocabulary and height in relation to household wealth and parental schooling: A longitudinal study in four low- and middle-income countries.

PubMed

Reynolds, Sarah A; Andersen, Chris; Behrman, Jere; Singh, Abhijeet; Stein, Aryeh D; Benny, Liza; Crookston, Benjamin T; Cueto, Santiago; Dearden, Kirk; Georgiadis, Andreas; Krutikova, Sonya; Fernald, Lia C H

2017-12-01

Children from low socio-economic status (SES) households often demonstrate worse growth and developmental outcomes than wealthier children, in part because poor children face a broader range of risk factors. It is difficult to characterize the trajectories of SES disparities in low- and middle-income countries because longitudinal data are infrequently available. We analyze measures of children's linear growth (height) at ages 1, 5, 8 and 12y and receptive language (Peabody Picture Vocabulary Test) at ages 5, 8 and 12y in Ethiopia, India, Peru and Vietnam in relation to household SES, measured by parental schooling or household assets. We calculate children's percentile ranks within the distributions of height-for-age z-scores and of age- and language-standardized receptive vocabulary scores. We find that children in the top quartile of household SES are taller and have better language performance than children in the bottom quartile; differences in vocabulary scores between children with high and low SES are larger than differences in the height measure. For height, disparities in SES are present by age 1y and persist as children age. For vocabulary, SES disparities also emerge early in life, but patterns are not consistent across age; for example, SES disparities are constant over time in India, widen between 5 and 12y in Ethiopia, and narrow in this age range in Vietnam and Peru. Household characteristics (such as mother's height, age, and ethnicity), and community fixed effects explain most of the disparities in height and around half of the disparities in vocabulary. We also find evidence that SES disparities in height and language development may not be fixed over time, suggesting opportunities for policy and programs to address these gaps early in life.

Households across all income quintiles, especially the poorest, increased animal source food expenditures substantially during recent Peruvian economic growth.

PubMed

Humphries, Debbie L; Behrman, Jere R; Crookston, Benjamin T; Dearden, Kirk A; Schott, Whitney; Penny, Mary E

2014-01-01

Relative to plant-based foods, animal source foods (ASFs) are richer in accessible protein, iron, zinc, calcium, vitamin B-12 and other nutrients. Because of their nutritional value, particularly for childhood growth and nutrition, it is important to identify factors influencing ASF consumption, especially for poorer households that generally consume less ASFs. To estimate differential responsiveness of ASF consumption to changes in total household expenditures for households with different expenditures in a middle-income country with substantial recent income increases. The Peruvian Young Lives household panel (n = 1750) from 2002, 2006 and 2009 was used to characterize patterns of ASF expenditures. Multivariate models with controls for unobserved household fixed effects and common secular trends were used to examine nonlinear relationships between changes in household expenditures and in ASF expenditures. Households with lower total expenditures dedicated greater percentages of expenditures to food (58.4% vs.17.9% in 2002 and 24.2% vs. 21.5% in 2009 for lowest and highest quintiles respectively) and lower percentages of food expenditures to ASF (22.8% vs. 33.9% in 2002 and 30.3% vs. 37.6% in 2009 for lowest and highest quintiles respectively). Average percentages of overall expenditures spent on food dropped from 47% to 23.2% between 2002 and 2009. Households in the lowest quintiles of expenditures showed greater increases in ASF expenditures relative to total consumption than households in the highest quintiles. Among ASF components, meat and poultry expenditures increased more than proportionately for households in the lowest quintiles, and eggs and fish expenditures increased less than proportionately for all households. Increases in household expenditures were associated with substantial increases in consumption of ASFs for households, particularly households with lower total expenditures. Increases in ASF expenditures for all but the top quintile of

Using direct observations on multiple occasions to measure household food availability among low-income Mexicano residents in Texas colonias

PubMed Central

2010-01-01

Background It has been recognized that the availability of foods in the home are important to nutritional health, and may influence the dietary behavior of children, adolescents, and adults. It is therefore important to understand food choices in the context of the household setting. Considering their importance, the measurement of household food resources becomes critical. Because most studies use a single point of data collection to determine the types of foods that are present in the home, which can miss the change in availability within a month and when resources are not available, the primary objective of this pilot study was to examine the feasibility and value of conducting weekly in-home assessments of household food resources over the course of one month among low-income Mexicano families in Texas colonias. Methods We conducted five in-home household food inventories over a thirty-day period in a small convenience sample; determined the frequency that food items were present in the participating households; and compared a one-time measurement with multiple measurements. After the development and pre-testing of the 252-item culturally and linguistically- appropriate household food inventory instrument that used direct observation to determine the presence and amount of food and beverage items in the home (refrigerator, freezer, pantry, elsewhere), two trained promotoras recruited a convenience sample of 6 households; administered a baseline questionnaire (personal info, shopping habits, and food security); conducted 5 in-home assessments (7-day interval) over a 30-day period; and documented grocery shopping and other food-related activities within the previous week of each in-home assessment. All data were collected in Spanish. Descriptive statistics were calculated for mean and frequency of sample characteristics, food-related activities, food security, and the presence of individual food items. Due to the small sample size of the pilot data, the Friedman

Common mental disorders, neighbourhood income inequality and income deprivation: small-area multilevel analysis

PubMed Central

Fone, David; Greene, Giles; Farewell, Daniel; White, James; Kelly, Mark; Dunstan, Frank

2013-01-01

Background Common mental disorders are more prevalent in areas of high neighbourhood socioeconomic deprivation but whether the prevalence varies with neighbourhood income inequality is not known. Aims To investigate the hypothesis that the interaction between small-area income deprivation and income inequality was associated with individual mental health. Method Multilevel analysis of population data from the Welsh Health Survey, 2003/04–2010. A total of 88 623 respondents aged 18–74 years were nested within 50 587 households within 1887 lower super output areas (neighbourhoods) and 22 unitary authorities (regions), linked to the Gini coefficient (income inequality) and the per cent of households living in poverty (income deprivation). Mental health was measured using the Mental Health Inventory MHI-5 as a discrete variable and as a ‘case’ of common mental disorder. Results High neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods after adjusting for individual and household risk factors (parameter estimate +0.70 (s.e. = 0.33), P = 0.036; odds ratio (OR) for common mental disorder case 0.92, 95% CI 0.88–0.97). Income inequality at regional level was significantly associated with poorer mental health (parameter estimate -1.35 (s.e. = 0.54), P = 0.012; OR = 1.13, 95% CI 1.04–1.22). Conclusions The associations between common mental disorders, income inequality and income deprivation are complex. Income inequality at neighbourhood level is less important than income deprivation as a risk factor for common mental disorders. The adverse effect of income inequality starts to operate at the larger regional level. PMID:23470284

Estimated Participation and Hours in Early Care and Education by Type of Arrangement and Income at Ages 2 to 4 in 2010

ERIC Educational Resources Information Center

Barnett, Steve; Nores, Milagros

2012-01-01

This working paper estimates participation in early childhood education (ECE) programs by child's age, program setting, family income level, and child's household language. To produce the best possible estimates of participation, the authors combined information from multiple data sets. In 2010, approximately 6.6 million between the ages of 2 and…

Critical factors for active transportation to school among low-income and minority students. Evidence from the 2001 National Household Travel Survey.

PubMed

McDonald, Noreen C

2008-04-01

Walking to school may be an important source of daily physical activity in children's lives, and government agencies are supporting programs to encourage walking to school (e.g., Safe Routes to School and the CDC's KidsWalk programs). However, little research has looked at differences in behavior across racial/ethnic and income groups. This cross-sectional study used data from the 2001 National Household Travel Survey to document rates of walking and biking to school among low-income and minority youth in the U.S. (N=14,553). Binary models of the decision to use active transport to school were developed to simultaneously adjust for trip, individual, household, and neighborhood correlates. All analyses were conducted in 2007. The data showed that low-income and minority groups, particularly blacks and Hispanics, use active travel modes to get to school at much higher rates than whites or higher-income students. However, racial variation in travel patterns is removed by controlling for household income, vehicle access, distance between home and school, and residential density. Active transportation to school may be an important strategy to increase and maintain physical activity levels for low-income and minority youth. Current policy interventions such as Safe Routes to School have the opportunity to provide benefits for low-income and minority students who are the most likely to walk to school.

Parents' Incomes and Children's Outcomes: A Quasi-Experiment.

PubMed

Akee, Randall K Q; Copeland, William E; Keeler, Gordon; Angold, Adrian; Costello, Elizabeth J

2010-01-01

We examine the role that an exogenous increase in household income due to a government transfer unrelated to household characteristics plays in children's long run outcomes. Children in affected households have higher levels of education in their young adulthood and a lower incidence of criminality for minor offenses. Effects differ by initial household poverty status. An additional $4000 per year for the poorest households increases educational attainment by one year at age 21 and reduces having ever committed a minor crime by 22% at ages 16-17. Our evidence suggests that improved parental quality is a likely mechanism for the change.

High vulnerability to household food insecurity in a sample of Canadian renter households in government-subsidized housing.

PubMed

Fafard St-Germain, Andrée-Anne; Tarasuk, Valerie

2017-06-16

To determine the prevalence and severity of household food insecurity and examine household material circumstances related to food insecurity in a sample of renter households in government-subsidized housing. Cross-sectional data from the 2010 Survey of Household Spending were used to determine the food insecurity status of 455 renter households living in the 10 provinces and receiving a government housing subsidy. Multivariable logistic regressions were conducted to examine the relationship between household characteristics describing material circumstances and food insecurity. One in two households was food insecure. Marginal, moderate and severe food insecurity affected 9.0%, 23.3% and 18.5% of households respectively. Household economic resources, as captured with after-tax income, after-rent income, or total expenditure, had an independent, inverse relationship with food insecurity. Among the other characteristics examined, more adults or children in the household, presence of a member with disability, and receipt of social assistance increased the odds of food insecurity, but receipt of social assistance lost statistical significance when controlling for total expenditure. Presence of a senior in the household was independently associated with lower odds of food insecurity. Our findings suggest that more effective income-based interventions are needed to address food insecurity among low-income households receiving government housing subsidies. A better integration of housing and income-based policies is necessary to support household food security among government-subsidized renter households.

Healthy Habits, Happy Homes: randomized trial to improve household routines for obesity prevention among preschool-aged children.

PubMed

Haines, Jess; McDonald, Julia; O'Brien, Ashley; Sherry, Bettylou; Bottino, Clement J; Schmidt, Marie Evans; Taveras, Elsie M

2013-11-01

Racial/ethnic and socioeconomic disparities exist across risk factors for childhood obesity. To examine the effectiveness of a home-based intervention to improve household routines known to be associated with childhood obesity among a sample of low-income, racial/ethnic minority families with young children. Randomized trial. The intervention was delivered in the families' homes. The study involved 121 families with children aged 2 to 5 years who had a television (TV) in the room where he or she slept; 111 (92%) had 6-month outcome data (55 intervention and 56 control). The mean (SD) age of the children was 4.0 (1.1) years; 45% were overweight/obese. Fifty-two percent of the children were Hispanic, 34% were black, and 14% were white/other. Nearly 60% of the families had household incomes of $20,000 or less. The 6-month intervention promoted 4 household routines, family meals, adequate sleep, limiting TV time, and removing the TV from the child's bedroom, using (1) motivational coaching at home and by phone, (2) mailed educational materials, and (3) text messages. Control subjects were mailed materials focused on child development. Change in parent report of frequency of family meals (times/wk), child sleep duration (hours/d), child weekday and weekend day TV viewing (hours/d), and the presence of a TV in the room where the child slept from baseline to 6 months. A secondary outcome was change in age- and sex-adjusted body mass index (calculated as weight in kilograms divided by height in meters squared). Compared with control subjects, intervention participants had increased sleep duration (0.75 hours/d; 95% CI, 0.06 to 1.44; P = .03), greater decreases in TV viewing on weekend days (-1.06 hours/d; 95% CI, -1.97 to -0.15; P = .02), and decreased body mass index (-0.40; 95% CI, -0.79 to 0.00; P = .05). No significant intervention effect was found for the presence of a TV in the room where the child slept or family meal frequency. Our results suggest that promoting

Labour market income inequality and mortality in North American metropolitan areas.

PubMed

Sanmartin, C; Ross, N A; Tremblay, S; Wolfson, M; Dunn, J R; Lynch, J

2003-10-01

To investigate relations between labour market income inequality and mortality in North American metropolitan areas. An ecological cross sectional study of relations between income inequality and working age (25-64 years) mortality in 53 Canadian (1991) and 282 US (1990) metropolitan areas using four measures of income inequality. Two labour market income concepts were used: labour market income for households with non-trivial attachment to the labour market and labour market income for all households, including those with zero and negative incomes. Relations were assessed with weighted and unweighted bivariate and multiple regression analyses. US metropolitan areas were more unequal than their Canadian counterparts, across inequality measures and income concepts. The association between labour market income inequality and working age mortality was robust in the US to both the inequality measure and income concept, but the association was inconsistent in Canada. Three of four inequality measures were significantly related to mortality in Canada when households with zero and negative incomes were included. In North American models, increases in earnings inequality were associated with hypothetical increases in working age mortality rates of between 23 and 33 deaths per 100 000, even after adjustment for median metropolitan incomes. This analysis of labour market inequality provides more evidence regarding the robust nature of the relation between income inequality and mortality in the US. It also provides a more refined understanding of the nature of the relation in Canada, pointing to the role of unemployment in generating Canadian metropolitan level health inequalities.

Family Income at the Bottom and at the Top: Income Sources and Family Characteristics

PubMed Central

Raffalovich, Lawrence E.; Monnat, Shannon M.; Tsao, Hui-shien

2009-01-01

Attention has recently been focused on wealth as a source of long-term economic security and on wealth ownership as a crucial aspect of the racial economic divisions in the United States. This literature, however has been concerned primarily with the wealth gap between poor and middle-class families, and between the white and black middle class. In this paper, we investigate the incomes of families at the top and bottom of the family income distribution. We examine the sources of income and the demographic characteristics of these high-income and low-income families using family level data from the 1988-2003 Current Population Surveys. We find that, at the bottom of the distribution, transfer income is the major income source; in particular, income from social security, supplemental security, and public assistance. At the top, employment income is the largest component of family income. Non-white, female, and non-married householders are disproportionately located at the bottom of the family income distribution. These families consist of both young and old adults, with high-school educations or less, in low-level service occupations. Many are disabled, many are retired. Householders at the top of the income distribution are typically male, white, and married. Householders and spouses at the top are typically middle-age, with college educations, employed in professional service and managerial occupations. We find that wealth is not an important source of income for families at the highest percentiles. The highest income families during this period in the U.S. were not a “property elite”: their income is mostly from employment. We speculate, however, that they will join the “property elite” later in the life-course as they retire and receive income from their investments. PMID:20161570

Family Income at the Bottom and at the Top: Income Sources and Family Characteristics.

PubMed

Raffalovich, Lawrence E; Monnat, Shannon M; Tsao, Hui-Shien

2009-12-01

Attention has recently been focused on wealth as a source of long-term economic security and on wealth ownership as a crucial aspect of the racial economic divisions in the United States. This literature, however has been concerned primarily with the wealth gap between poor and middle-class families, and between the white and black middle class. In this paper, we investigate the incomes of families at the top and bottom of the family income distribution. We examine the sources of income and the demographic characteristics of these high-income and low-income families using family level data from the 1988-2003 Current Population Surveys.We find that, at the bottom of the distribution, transfer income is the major income source; in particular, income from social security, supplemental security, and public assistance. At the top, employment income is the largest component of family income. Non-white, female, and non-married householders are disproportionately located at the bottom of the family income distribution. These families consist of both young and old adults, with high-school educations or less, in low-level service occupations. Many are disabled, many are retired. Householders at the top of the income distribution are typically male, white, and married. Householders and spouses at the top are typically middle-age, with college educations, employed in professional service and managerial occupations.We find that wealth is not an important source of income for families at the highest percentiles. The highest income families during this period in the U.S. were not a "property elite": their income is mostly from employment. We speculate, however, that they will join the "property elite" later in the life-course as they retire and receive income from their investments.

Inequalities in self-rated health in Japan 1986-2007 according to household income and a novel occupational classification: national sampling survey series.

PubMed

Hiyoshi, Ayako; Fukuda, Yoshiharu; Shipley, Martin J; Brunner, Eric J

2013-11-01

Japan, for the past two decades, has seen economic stagnation and substantial social change. We examined whether health inequalities increased over this period. Using eight triennial waves of a series of large nationally representative surveys between 1986 and 2007 (n=398 303), temporal trends in relative and slope indices of inequality (RII, SII, respectively) were tested based on self-rated health in relation to theory-based social class and household income. Age-standardised prevalence of self-rated fair or poor health showed V-shaped time trends in both sexes with the lowest prevalence in early/mid-1990s. In 1986, RII and SII in household social class and income were significant for both sexes. In men, RII and SII according to income showed significant narrowing of temporal trends in poor health (-1.4% and -0.1% annually, respectively), but these were stable in women. After multilevel multiple imputation for missing income data, the findings in men were not altered but narrowing trends became evident and significant in women (-1% and -0.1% annually, respectively). Inequality indices for social class remained constant over the study period in both sexes. Relative and absolute health inequalities for social class and income based on self-rated fair or poor health narrowed or remained stable between 1986 and 2007, despite the economic stagnation and adverse social changes. Overall population health across socioeconomic groups initially improved but then worsened. The positive finding regarding the health inequality trend seen in the Japanese context is informative for the wider international community during this period of economic uncertainty.

Estimates of Year-to-Year Volatility in Earnings and in Household Incomes from Administrative,Survey, and Matched Data

ERIC Educational Resources Information Center

Dahl, Molly; DeLeire, Thomas; Schwabish, Jonathan A.

2011-01-01

We document trends in the volatility in earnings and household incomes between 1985 and 2005 in three different data sources: administrative earnings records, the Survey of Income and Program Participation (SIPP) matched to administrative earnings records, and SIPP survey data. In all data sources, we find a substantial amount of year-to-year…

Household food insecurity is not associated with BMI for age or weight for height among Brazilian children aged 0-60 months.

PubMed

Kac, Gilberto; Schlüssel, Michael M; Pérez-Escamilla, Rafael; Velásquez-Melendez, Gustavo; da Silva, Antônio Augusto Moura

2012-01-01

We examined the association between Household Food Insecurity (HFI), weight for height z-score (WHZ) and Body Mass Index for age z-score (BMI-Z) in a representative sample of children 0-60 months of age (n = 3,433) in five Brazilian geographical regions. Data were derived from the 2006-07 Brazilian Demographic and Health Survey. HFI was measured with the Brazilian Food Insecurity Scale. Associations were estimated using multiple linear regression models (β coefficients and 95% CI) taking into account the complex sampling design. Interaction terms between HFI and geographical region and HFI and child sex and child age were assessed. The weighted prevalence of any level of HFI was 48.6%. Severe food insecurity was more prevalent among children from the North region (16.8%), born from mothers with <4 years of schooling (15.9%) and those from families with ≥3 children (18.8%). The interaction between HFI and geographical region was non-significant for BMI-Z (P = 0.119) and WHZ (P = 0.198). Unadjusted results indicated that HFI was negatively associated with BMI-Z (moderate to severe HFI: β = -0.19, 95% CI: -0.35 - -0.03, P = 0.047), and WHZ (moderate to severe HFI: β = -0.26, 95% CI: -0.42 - -0.09, P = 0.009). Estimates lost significance after adjustments for key confounders such as mothers' skin color, mothers' years of schooling, place of household, household income quartiles, mothers' smoking habit, mothers' marital status, number of children 0-60 months in the household, and birth order. HFI is unrelated to weight outcomes among Brazilian children 0-60 months.

Sociodemographic patterns of household water-use costs in Puerto Rico.

PubMed

Yu, Xue; Ghasemizadeh, Reza; Padilla, Ingrid; Meeker, John D; Cordero, Jose F; Alshawabkeh, Akram

2015-08-15

Variability of household water-use costs across different sociodemographic groups in Puerto Rico is evaluated using census microdata from the Integrated Public Use Microdata Series (IPUMS). Multivariate analyses such as multiple linear regression (MLR) and factor analysis (FA) are used to classify, extract and interpret the household water-use costs. The FA results suggest two principal varifactors in explaining the variability of household water-use costs (64% in 2000 and 50% in 2010), which are grouped into a soft coefficient (social, economic and demographic characteristics of household residents, i.e., age, size, income, education) and a hard coefficient (dwelling conditions, i.e., number of rooms, units in the building, building age). The demographic profile of a high water-use household in Puerto Rico tends to be that of renters, people who live in larger or older buildings, people living in metro areas, or those with higher education level and higher income. The findings and discussions from this study will help decision makers to plan holistic and integrated water management to achieve water sustainability. Copyright © 2015 Elsevier B.V. All rights reserved.

Sociodemographic patterns of household water-use costs in Puerto Rico

PubMed Central

Yu, Xue; Ghasemizadeh, Reza; Padilla, Ingrid; Meeker, John D.; Cordero, Jose F.; Alshawabkeh, Akram

2015-01-01

Variability of household water-use costs across different sociodemographic groups in Puerto Rico is evaluated using census microdata from the Integrated Public Use Microdata Series (IPUMS). Multivariate analyses such as Multiple Linear Regression (MLR) and Factor Analysis (FA) are used to classify, extract and interpret the household water-use costs. The FA results suggest two principal varifactors in explaining the variability of household water-use costs (64% in 2000 and 50% in 2010), which are grouped into a soft coefficient (social, economic and demographic characteristics of household residents, i.e. age, size, income, education) and a hard coefficient (dwelling conditions, i.e. number of rooms, units in the building, building age). The demographic profile of a high water-use household in Puerto Rico tends to be that of renters, people who live in larger or older buildings, people living in metro areas, or those with higher education level and higher income. The findings and discussions from this study will help decision makers to plan holistic and integrated water management to achieve water sustainability. PMID:25897735

Parents’ Incomes and Children's Outcomes: A Quasi-Experiment

PubMed Central

Akee, Randall K.Q.; Copeland, William E.; Keeler, Gordon; Angold, Adrian; Costello, Elizabeth J.

2009-01-01

We examine the role that an exogenous increase in household income due to a government transfer unrelated to household characteristics plays in children's long run outcomes. Children in affected households have higher levels of education in their young adulthood and a lower incidence of criminality for minor offenses. Effects differ by initial household poverty status. An additional $4000 per year for the poorest households increases educational attainment by one year at age 21 and reduces having ever committed a minor crime by 22% at ages 16−17. Our evidence suggests that improved parental quality is a likely mechanism for the change. PMID:20582231

Child, Household, and Caregiver Characteristics Associated with Hospitalization for Influenza Among Children 6–59 Months of Age

PubMed Central

2014-01-01

Background: Young children are at increased risk of severe outcomes from influenza illness, including hospitalization. We conducted a case-control study to identify risk factors for influenza-associated hospitalizations among children in US Emerging Infections Program sites. Methods: Cases were children 6–59 months of age hospitalized for laboratory-confirmed influenza infections during 2005–2008. Age- and zip-code-matched controls were enrolled. Data on child, caregiver and household characteristics were collected from parents and medical records. Conditional logistic regression was used to identify independent risk factors for hospitalization. Results: We enrolled 290 (64%) of 454 eligible cases and 1089 (49%) of 2204 eligible controls. Risk for influenza hospitalization increased with maternal age <26 years [odds ratio (OR): 1.8, 95% confidence interval (CI): 1.1–2.9]; household income below the poverty threshold (OR: 2.2, 95% CI: 1.4–3.6); smoking by >50% of household members (OR: 2.9, 95% CI: 1.4–6.6); lack of household influenza vaccination (OR: 1.8, 95% CI: 1.2–2.5) and presence of chronic illnesses, including hematologic/oncologic (OR: 11.8, 95% CI: 4.5–31.0), pulmonary (OR: 2.9, 95% CI: 1.9–4.4) and neurologic (OR: 3.8, 95% CI: 1.6–9.2) conditions. Full influenza immunization decreased the risk among children 6–23 months of age (OR: 0.5, 95% CI: 0.3–0.9) but not among those 24–59 months of age (OR: 1.5, 95% CI: 0.8–3.0; P value for difference = 0.01). Conclusions: Chronic illnesses, young maternal age, poverty, household smoking and lack of household influenza vaccination increased the risk of influenza hospitalization. These characteristics may help providers to identify young children who are at greatest risk for severe outcomes from influenza illness. PMID:24642518

Household food insecurity is positively associated with depression among low-income supplemental nutrition assistance program participants and income-eligible nonparticipants.

PubMed

Leung, Cindy W; Epel, Elissa S; Willett, Walter C; Rimm, Eric B; Laraia, Barbara A

2015-03-01

Food insecurity is associated with adverse mental health outcomes. Given that federal food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP), aim to alleviate food insecurity, there may be heterogeneity in the association between food insecurity and depression by SNAP participation status. With the use of data from the 2005-2010 NHANES, we examined the associations between household food security and depression and whether these differed by SNAP participation. The study population was restricted to 3518 adults with household incomes ≤130% of the federal poverty level. Food insecurity was assessed with the 18-item US Household Food Security Survey Module; a score of ≥3 was considered food insecure. Depression was assessed with the 9-item Patient Health Questionnaire and was defined as a score of ≥10. Multivariate logistic regression models examined the associations between food insecurity and depression, adjusting for sociodemographic and health characteristics. The overall prevalence of depression was 9.3%, ranging from 6.7% among SNAP nonparticipants to 12.8% among SNAP participants. For every depressive symptom, there was a dose-response relation, such that a higher prevalence was observed with worsening food insecurity. After multivariate adjustment, food insecurity was positively associated with depression (P-trend < 0.0001), but SNAP participation modified this relation (P-interaction = 0.03). Among low-income, eligible nonparticipants, very low food security was significantly associated with higher odds of depression (OR: 5.10; 95% CI: 3.09, 8.41). Among SNAP participants, very low food security was also associated with higher odds of depression but at a lower magnitude (OR: 2.21; 95% CI: 1.54, 3.17). The complex relation between food insecurity and mental health may vary on the basis of SNAP participation status. Programmatic efforts to address the risk of depression among their beneficiaries may positively affect the

Households across All Income Quintiles, Especially the Poorest, Increased Animal Source Food Expenditures Substantially during Recent Peruvian Economic Growth

PubMed Central

Humphries, Debbie L.; Behrman, Jere R.; Crookston, Benjamin T.; Dearden, Kirk A.; Schott, Whitney; Penny, Mary E.

2014-01-01

Background Relative to plant-based foods, animal source foods (ASFs) are richer in accessible protein, iron, zinc, calcium, vitamin B-12 and other nutrients. Because of their nutritional value, particularly for childhood growth and nutrition, it is important to identify factors influencing ASF consumption, especially for poorer households that generally consume less ASFs. Objective To estimate differential responsiveness of ASF consumption to changes in total household expenditures for households with different expenditures in a middle-income country with substantial recent income increases. Methods The Peruvian Young Lives household panel (n = 1750) from 2002, 2006 and 2009 was used to characterize patterns of ASF expenditures. Multivariate models with controls for unobserved household fixed effects and common secular trends were used to examine nonlinear relationships between changes in household expenditures and in ASF expenditures. Results Households with lower total expenditures dedicated greater percentages of expenditures to food (58.4% vs.17.9% in 2002 and 24.2% vs. 21.5% in 2009 for lowest and highest quintiles respectively) and lower percentages of food expenditures to ASF (22.8% vs. 33.9% in 2002 and 30.3% vs. 37.6% in 2009 for lowest and highest quintiles respectively). Average percentages of overall expenditures spent on food dropped from 47% to 23.2% between 2002 and 2009. Households in the lowest quintiles of expenditures showed greater increases in ASF expenditures relative to total consumption than households in the highest quintiles. Among ASF components, meat and poultry expenditures increased more than proportionately for households in the lowest quintiles, and eggs and fish expenditures increased less than proportionately for all households. Conclusions Increases in household expenditures were associated with substantial increases in consumption of ASFs for households, particularly households with lower total expenditures. Increases in ASF

Short-term and long-term associations between household wealth and physical growth: a cross-comparative analysis of children from four low- and middle-income countries

PubMed Central

Krishna, Aditi; Oh, Juhwan; Lee, Jong-koo; Lee, Hwa-Young; Perkins, Jessica M.; Heo, Jongho; Ro, Young Sun; Subramanian, S.V.

2015-01-01

Background Stunting, a form of anthropometric failure, disproportionately affects children in developing countries with a higher burden on children living in poverty. How early life deprivation affects physical growth over various life stages is less well-known. Objective We investigate the short- and long-run associations between household wealth in early life with physical growth in childhood in four low- and middle-income countries to understand the persistent implications of early life conditions of poverty and resource constraints on physical growth. Design Longitudinal study of eight cohorts of children in four countries – Ethiopia, India, Peru, and Vietnam (n=10,016) – ages 6 months to 15 years, using data from the Young Lives project, 2002–2009. Physical growth outcomes are standardized height-for-age z-scores (HAZ) and stunting. The key exposure is household wealth measured at baseline using a wealth index, an asset-based indicator. Covariates include child's age and sex, caregiver's educational status, household size, and place of residence. Results Baseline wealth index is significantly associated with higher physical growth rates as suggested by higher HAZ and lower odds of stunting. We found these associations in all four countries, for younger and older cohorts and for children who experienced changes in living standards. For the older cohort, despite the timing of the first survey at age 7–8 years, which is beyond the critical period of 1,000 days, there are lasting influences of early poverty, even for those who experienced changes in wealth. Conclusions Household wealth in early life matters for physical growth with conditions of poverty and deprivation influencing growth faltering even beyond the 1,000 days window. The influences of early childhood poverty, so prevalent among children in low- and middle-income countries, must be addressed by policies and programs targeting early life but also focusing on older children experiencing growth

Area-level income inequality and oral health among Australian adults—A population-based multilevel study

PubMed Central

2018-01-01

Background A lack of evidence exists on the association between area-level income inequality and oral health within Australia. This study examined associations between area-level income inequality and oral health outcomes (inadequate dentition (<21 teeth) and poor self-rated oral health) among Australian adults. Variations in the association between area-level income inequality and oral health outcomes according to area-level mean income were also assessed. Finally, household-income gradients in oral health outcomes according to area-level income inequality were compared. Methods For the analyses, data on Australian dentate adults (n = 5,165 nested in 435 Local Government Areas (LGAs)) was obtained from the National Dental Telephone Interview Survey-2013. Multilevel multivariable logistic regression models with random intercept and fixed slopes were fitted to test associations between area-level income inequality and oral health outcomes, examine variations in associations according to area-level mean income, and examine variations in household-income gradients in outcomes according to area-level income inequality. Covariates included age, sex, LGA-level mean weekly household income, geographic remoteness and household income. Results LGA-level income inequality was not associated with poor self-rated oral health and inversely associated with inadequate dentition (OR: 0.64; 95% CI: 0.48, 0.87) after adjusting for covariates. Inverse association between income inequality and inadequate dentition at the individual level was limited to LGAs within the highest tertile of mean weekly household income. Household income gradients in both outcomes showed poorer oral health at lower levels of household income. The household income gradients for inadequate dentition varied according to the LGA-level income inequality. Conclusion Findings suggest that income inequality at the LGA-level in Australia is not positively associated with poorer oral health outcomes. Inverse

Area-level income inequality and oral health among Australian adults-A population-based multilevel study.

PubMed

Singh, Ankur; Harford, Jane; Antunes, José Leopoldo Ferreira; Peres, Marco A

2018-01-01

A lack of evidence exists on the association between area-level income inequality and oral health within Australia. This study examined associations between area-level income inequality and oral health outcomes (inadequate dentition (<21 teeth) and poor self-rated oral health) among Australian adults. Variations in the association between area-level income inequality and oral health outcomes according to area-level mean income were also assessed. Finally, household-income gradients in oral health outcomes according to area-level income inequality were compared. For the analyses, data on Australian dentate adults (n = 5,165 nested in 435 Local Government Areas (LGAs)) was obtained from the National Dental Telephone Interview Survey-2013. Multilevel multivariable logistic regression models with random intercept and fixed slopes were fitted to test associations between area-level income inequality and oral health outcomes, examine variations in associations according to area-level mean income, and examine variations in household-income gradients in outcomes according to area-level income inequality. Covariates included age, sex, LGA-level mean weekly household income, geographic remoteness and household income. LGA-level income inequality was not associated with poor self-rated oral health and inversely associated with inadequate dentition (OR: 0.64; 95% CI: 0.48, 0.87) after adjusting for covariates. Inverse association between income inequality and inadequate dentition at the individual level was limited to LGAs within the highest tertile of mean weekly household income. Household income gradients in both outcomes showed poorer oral health at lower levels of household income. The household income gradients for inadequate dentition varied according to the LGA-level income inequality. Findings suggest that income inequality at the LGA-level in Australia is not positively associated with poorer oral health outcomes. Inverse association between income inequality and

Monetary and nonmonetary household consumption of health services and the role of insurance benefits: An analysis of the Mexico's National Household Income and Expenditure Survey.

PubMed

Serván-Mori, Edson; Wirtz, Veronika J

2018-05-23

To study the monetary and nonmonetary consumption of healthcare services at household level in Mexico and the magnitude of the contribution of public programs. By using the National Household Income and Expenditure Survey 2012, we performed a cross-sectional and observational analysis of actual household consumption of health services by insurance type (no insurance, social security, Seguro Popular (SP)). Household consumption was divided into 2 categories: consumption related to "monetary" expenditure in health care and "nonmonetary" consumption in health care by the household. Nonmonetary included self-consumption or gifts received from other households and institutional contributions such as government payments or private organization transfers. In SP households, monetary and nonmonetary consumption of health services represented the highest proportion of available household expenditure (11.2%) compared to uninsured (8.4%) and social security (5.9%) households. The prevalence of outpatient consultation and medicine use is the highest among the health service consumption categories regardless of insurance status. Distribution of nonmonetary versus monetary consumption of health services was pro-poor: The poorer the households, the larger the proportion of nonmonetary consumption. The higher probability of receiving nonmonetary resources as a component of health service consumption in SP households is likely to increase the affordability to health services and likely to reduce healthcare expenditures. Future research should focus on the type of nonmonetary consumption of health services at household level to better understand financial protection and access to health care in Mexico. Copyright © 2018 John Wiley & Sons, Ltd.

Socioeconomic status and COPD among low- and middle-income countries.

PubMed

Grigsby, Matthew; Siddharthan, Trishul; Chowdhury, Muhammad Ah; Siddiquee, Ali; Rubinstein, Adolfo; Sobrino, Edgardo; Miranda, J Jaime; Bernabe-Ortiz, Antonio; Alam, Dewan; Checkley, William

2016-01-01

Socioeconomic status (SES) is a strong social determinant of health. There remains a limited understanding of the association between SES and COPD prevalence among low- and middle-income countries where the majority of COPD-related morbidity and mortality occurs. We examined the association between SES and COPD prevalence using data collected in Argentina, Bangladesh, Chile, Peru, and Uruguay. We compiled lung function, demographic, and SES data from three population-based studies for 11,042 participants aged 35-95 years. We used multivariable alternating logistic regressions to study the association between COPD prevalence and SES indicators adjusted for age, sex, self-reported daily smoking, and biomass fuel smoke exposure. Principal component analysis was performed on monthly household income, household size, and education to create a composite SES index. Overall COPD prevalence was 9.2%, ranging from 1.7% to 15.4% across sites. The adjusted odds ratio of having COPD was lower for people who completed secondary school (odds ratio [OR] =0.73, 95% CI 0.55-0.98) and lower with higher monthly household income (OR =0.96 per category, 95% CI 0.93-0.99). When combining SES factors into a composite index, we found that the odds of having COPD was greater with lower SES (interquartile OR =1.23, 95% CI 1.05-1.43) even after controlling for subject-specific factors and environmental exposures. In this analysis of multiple population-based studies, lower education, lower household income, and lower composite SES index were associated with COPD. Since household income may be underestimated in population studies, adding household size and education into a composite index may provide a better surrogate for SES.

Geographical Mobility, Income, Life Satisfaction and Family Size Preferences: An Empirical Study on Rural Households in Shaanxi and Henan Provinces in China.

PubMed

Chen, Jiangsheng; Yang, Hong

Employing data from the China rural-urban mobility survey conducted in 2010, this study investigates the influence of family demographic characteristics on the income, life satisfaction, and potential for rural-urban mobility at the rural household level of two provinces of China: Shaanxi and Henan. A larger labor force in a rural household was found to reduce a family's ability or inclination to move to a city. The findings reveal that family size negatively affects the average income per family member and reduces the marginal income of the labor force and that minor children can improve the life satisfaction of family members. We conclude that a larger family size does not translate to more benefits for a rural household. Family size preference is found to be a reflection of parents' concerns about elderly care and is deemed to be unfavorable for urbanization in P. R. China.

Heterogeneity in hedonic modelling of house prices: looking at buyers' household profiles

NASA Astrophysics Data System (ADS)

Kestens, Yan; Thériault, Marius; Des Rosiers, François

2006-03-01

This paper introduces household-level data into hedonic models in order to measure the heterogeneity of implicit prices regarding household type, age, educational attainment, income, and the previous tenure status of the buyers. Two methods are used for this purpose: a first series of models uses expansion terms, whereas a second series applies Geographically Weighted Regressions. Both methods yield conclusive results, showing that the marginal value given to certain property specifics and location attributes do vary regarding the characteristics of the buyer’s household. Particularly, major findings concern the significant effect of income on the location rent as well as the premium paid by highly-educated households in order to fulfil social homogeneity.

Nutritional Outcomes Related to Household Food Insecurity among Mothers in Rural Malaysia

PubMed Central

Ihab, A.N.; Manan, W.M. Wan; Suriati, W.N. Wan; Zalilah, M.S.; Rusli, A. Mohamed

2013-01-01

During the past two decades, the rates of food insecurity and obesity have risen. Although a relationship between these two seemingly-paradoxical states has not been repeatedly seen in men, research suggests that a correlation between them exists in women. This study examines nutritional outcomes of household food insecurity among mothers in rural Malaysia. A cross-sectional survey of low-income households was conducted, and 223 households with mothers aged 18–55 years, who were non-lactating, non-pregnant, and had at least one child aged 2–12 years, were purposively selected. A questionnaire was administered that included the Radimer/Cornell Scale, items about sociodemographic characteristics, and anthropometric measurements. Of the households, 16.1% were food-secure whereas 83.9% experienced some kind of food insecurity: 29.6% of households were food-insecure, 19.3% contained individuals who were food-insecure, and 35.0% fell into the ‘child hunger’ category. The result reported that household-size, total monthly income, income per capita, and food expenditure were significant risk factors of household food insecurity. Although there was a high prevalence of overweight and obese mothers (52%) and 47.1% had at-risk waist-circumference (≥80 cm), no significant association was found between food insecurity, body mass index, and waist-circumference. In conclusion, the rates of household food insecurity and overweight and obesity were high in the study population, although they are looking paradoxical. Longitudinal studies with larger sample-sizes are recommended to further examine the relationship between food insecurity and obesity. PMID:24592589

Healthy eating behaviors and the cognitive environment are positively associated in low-income households with young children.

PubMed

Pieper, Joy Rickman; Whaley, Shannon E

2011-08-01

The purpose of this research was to examine relationships between eating behaviors and the cognitive environment in primarily Hispanic low-income households with young children receiving WIC benefits in Los Angeles County. Survey data were collected from 3645 low-income families with children age 12-65 mo in Los Angeles County. Eating behaviors were measured through questions about fruit, vegetable, milk, soft drink, and fast food intake. The cognitive environment was evaluated through questions on the home literacy environment (HLE), reading frequency, and preschool enrollment. All healthy eating behaviors measured were significantly and positively associated with reading frequency and HLE scores after adjustment for confounders. HLE and reading frequency scores were 18% and 14% higher, respectively, in children eating two or more servings of fruit per day and 12% and 9% higher, respectively, in children eating three or more servings of vegetables per day. Preschool enrollment was not significantly associated with any eating behavior. Outcomes varied by language-ethnic groups and child sex. Results suggest that healthy eating behaviors are positively associated with stronger cognitive environments in low-income Hispanic families with young children. Interventions to prevent childhood obesity in this group may therefore benefit from including a home literacy component. Copyright © 2011 Elsevier Ltd. All rights reserved.

Organized Sports and Unstructured Active Play as Physical Activity Sources in Children From Low-Income, Chicago Households.

PubMed

Appelhans, Bradley M; Li, Hong

2016-08-01

This study tested associations of organized sports participation and unstructured active play with overall moderate and vigorous physical activity (MVPA) in low-income children and examined factors associated with participation frequency. Research staff visited 88 low-income Chicago households with children ages 6-13 years. MVPA was assessed through 7-day accelerometry. Researchers documented the home availability of physical activity equipment. Caregivers reported on child participation in organized sports and unstructured active play, family support for physical activity, perceived neighborhood safety, and access to neighborhood physical activity venues. Despite similar participation in organized sports and unstructured active play, boys accumulated more MVPA than girls. MVPA was predicted by an interaction between gender and unstructured active play. Boys accumulated 23-45 additional minutes of weekday MVPA and 53-62 additional minutes of weekend MVPA through unstructured active play, with no such associations in girls. Higher reported neighborhood safety and family support for physical activity were associated with engagement in unstructured active play for both genders, and with participation in organized sports for girls. Physical activity interventions for low-income, urban children should emphasize unstructured active play, particularly in boys. Fostering family support for physical activity and safe play environments may be critical intervention components.

A multilevel analysis of individual, household, and neighborhood correlates of intimate partner violence among low-income pregnant women in Jefferson county, Alabama.

PubMed

Li, Qing; Kirby, Russell S; Sigler, Robert T; Hwang, Sean-Shong; Lagory, Mark E; Goldenberg, Robert L

2010-03-01

We examined individual, household, and neighborhood correlates of intimate partner violence (IPV) before and during pregnancy. We used multilevel modeling to investigate IPV among 2887 pregnant women in 112 census tracts who sought prenatal care in 8 public clinics in Jefferson County, Alabama, from 1997 through 2001. Data were collected from the Perinatal Emphasis Research Center project, the 2000 Census, and the local Sheriff and Police Departments Uniform Crime Reports for 1997 through 2001. Participants were predominantly young, African American, on Medicaid, and residents of low-income neighborhoods. The prevalence of past-year male partner-perpetrated physical or sexual violence was 7.4%. Neighborhood residential stability, women performing most of the housework (lack of involvement among partners), being unmarried (being in an uncommitted relationship), and alcohol use were positively associated with elevated IPV risk. Significant protective factors for IPV included older age at first vaginal intercourse and a greater sense of mastery (e.g., the perception of oneself as an effective person). Both neighborhood contextual and individual and household compositional effects are associated with IPV among low-income pregnant women. The results imply that combined interventions to improve neighborhood conditions and strengthen families may effectively reduce IPV.

Does household composition explain welfare regime poverty risks for older adults and other household members?

PubMed

Tai, Tsui-o; Treas, Judith

2009-11-01

This cross-national study examines the poverty of older adults and their household members and relates the risk of poverty to macrolevel state approaches to welfare as well as to microlevel composition of households. Data on individuals in households with older adults for 22 countries come from the Luxembourg Income Survey. Robust cluster analysis relates the risk of poverty to the type of state welfare regime; the characteristics of the household head (age, gender, marital status, and education); as well as the household's numbers of earners, older adults, and children. Persons in households with older adults are significantly less likely to be poor in countries with social democratic and conservative welfare regimes than in Taiwan, an exemplar of limited social welfare programs. Controlling for country differences in household composition increases the differences in poverty risks. Living with fewer children, more older adults, and more earners lowers the risk of poverty, as does having a married and better educated household head. Countries with more generous social welfare provisions have lower risks of poverty despite having household characteristics that are comparatively unfavorable. As Taiwan demonstrates, household composition, particularly a reliance on multigenerational households, compensates for limited state welfare programs.

Adolescent mothers leaving multigenerational households.

PubMed

Oberlander, Sarah E; Shebl, Fatma M; Magder, Laurence S; Black, Maureen M

2009-01-01

This study examined how the developmental processes of autonomy and relatedness are related to changes in the residential status of 181 first-time, adolescent, urban, low-income, African American mothers over the first 24 months postpartum. Although adolescent mothers were eager to live independently, few made a clear transition out of the multigenerational household; 56% lived in the household of origin continuously (IN), 21% left and never returned (OUT), and 23% had multiple moves in and out of the household (IN/OUT). Older adolescent maternal age, less supportive adolescent mother-grandmother relations, and high household density were associated with leaving the household of origin. The IN/OUT group had difficulty adopting the roles of adult and parent. Helping adolescent mothers and grandmothers negotiate roles to reduce conflict may promote autonomy and relatedness, allowing mothers to learn parenting skills, qualify for public assistance, and continue their education.

Quality of life of middle-aged adults in single households in South Korea.

PubMed

Song, Hyun Jin; Park, Susan; Kwon, Jin-Won

2018-04-18

The number of single households has increased worldwide with middle-aged people in such households indicating the highest increase. However, there is a lack of studies on the topic. This study estimated the quality of life (QOL) by household type for middle-aged Korean adults. We used the Korea National Health and Nutrition Examination Survey data from 2007 to 2015. QOL was analyzed using EQ-5D 3-level, and demographic and health-related variables were included as confounders. The households were divided into single household, married couple without child, other one-generation, married couple with child, single parent with child, other two-generation, and three-generation. Logistic regression using level, strata, and sample weight of data was performed based on average QOL. This study included 18,147 responders aged 45-64 years, with single households constituting 5.7%. Single households having average or less QOL were 48.4%, with men and women constituting 40.1 and 53.3%, respectively. After adjusting socioeconomic factors and health-related factors, the odds ratio (OR) of single households was 1.375 (95% CI 1.122-1.684) compared to the three-generation group. According to the sex, the OR of single households with men was higher (OR 1.552, 95% CI 1.121-2.149). However, no significance was found in women. The study results revealed that middle-aged people in single households had low QOL than those in multi-person households. The trend was significantly observable in men than in women. Because middle-aged adults might transform into elderly with low QOL, program development and social support for middle-aged adults in single households should be provided.

Income in the United States: 2002. Current Population Reports. Consumer Income.

ERIC Educational Resources Information Center

DeNavas-Walt, Carmen; Cleveland, Robert W.; Webster, Bruce H., Jr.

Using data from the 2003 Current Population Survey Annual Social and Economic Supplement, this study found that real median household money income declined by 1.1 percent between 2001-2002 to $42,409. Real median household income was unchanged between 2001-2002 for three of four alternative income definitions. The fourth, real median household…

The Quality of Life of Hong Kong's Poor Households in the 1990s: Levels of Expenditure, Income Security and Poverty

ERIC Educational Resources Information Center

Wong, Hung

2005-01-01

This paper examines the changes in the quality of life of poor households in Hong Kong in the late 1990s by analyzing their levels of expenditure, income security and poverty before and after 1997. Though there have been significant increases in the levels of expenditure among CSSA recipients, the expenditure among these poorest households in Hong…

Housing, income inequality and child injury mortality in Europe: a cross-sectional study.

PubMed

Sengoelge, M; Hasselberg, M; Ormandy, D; Laflamme, L

2014-03-01

Child poverty rates are compared throughout Europe to monitor how countries are caring for their children. Child poverty reduction measures need to consider the importance of safe living environments for all children. In this study we investigate how European country-level economic disparity and housing conditions relate to one another, and whether they differentially correlate with child injury mortality. We used an ecological, cross-sectional study design of 26 European countries of which 20 high-income and 6 upper-middle-income. Compositional characteristics of the home and its surroundings were extracted from the 2006 European Union Income Social Inclusion and Living Conditions Database (n = 203,000). Mortality data of children aged 1-14 years were derived from the World Health Organization Mortality Database. The main outcome measure was age standardized cause-specific injury mortality rates analysed by income inequality and housing and neighbourhood conditions. Nine measures of housing and neighbourhood conditions highly differentiating European households at country level were clustered into three dimensions, labelled respectively housing, neighbourhood and economic household strain. Income inequality significantly and positively correlated with housing strain (r = 0.62, P = 0.001) and household economic strain (r = 0.42, P = 0.009) but not significantly with neighbourhood strain (r = 0.34, P = 0.087). Child injury mortality rates correlated strongly with both country-level income inequality and housing strain, with very small age-specific differences. In the European context housing, neighbourhood and household economic strains worsened with increasing levels of income inequality. Child injury mortality rates are strongly and positively associated with both income inequality and housing strain, suggesting that housing material conditions could play a role in the association between income inequality and child health. © 2013 John Wiley & Sons Ltd.

[Intra-household distribution of energy and macronutrients in Colombian households].

PubMed

Ardila, Víctor A; Prada, Gloria E; Herrán, Oscar F

2013-01-01

Knowing the intra-household distribution of dietary intake is useful to establish food policy. To estimate the intra-household distribution of energy and macronutrients by kinship in Colombian households. We applied two recalls of dietary intake for the last 24 hours (R24H) in 1,505 subjects living in 432 households. Usual intake was calculated for each subject, aggregated for each household and calculated the share (%) for each of its members. Participation data was adjusted in linear models for age, gender, body mass index, energy requirement, socioeconomic levels, education and household size. The head of the household participates on average in 27.4% (95% CI: 26.5 to 28.2) of the total energy, without sex differences or if they contribute to the household income or not. The participation of unrelated subjects was 30.3% (95% CI: 25.3 to 35.3), and 26.0% (95% CI: 22.7 to 29.3) of the siblings of the head of the household, which is equivalent to that of the head of the household. By adjusting participation, the grandson becomes important with 29.8% (95% CI: 27.4 to 30.9). Men participate more than women (p<0.05). Even in smaller households, participation is lower if the economic level is low and they are receiving food aids (p<0.05). In the context of the structures of power and authority, the need for a cultural intervention with nutritional purposes to modify the principles of contribution, necessity, equity and demand emerges. Inequality is evident in the distribution.

Are food and beverage purchases in households with preschoolers changing?: a longitudinal analysis from 2000 to 2011.

PubMed

Ford, Christopher N; Ng, Shu Wen; Popkin, Barry M

2014-09-01

U.S. dietary studies from 2003 to 2010 show decreases in children's caloric intake. We examined purchases of consumer packaged foods/beverages in the U.S. between 2000 and 2011 among households with children aged 2-5 years. To describe changes in consumer packaged goods (CPG) purchases between 2000 and 2011 after adjusting for economic indicators, and explore differences by race, education, and household income level. CPG purchase data were obtained for 42,753 U.S. households with one or more child aged 2-5 years using the Nielsen Homescan Panel. Top sources of purchased calories were grouped, and random effects regression was used to model the relationship between calories purchased from each group and race, female head of household education, and household income. Models adjusted for household composition, market-level unemployment rate, prices, and quarter, with Bonferroni correction for multiple comparisons (α=0.05). Between 2000 and 2011, adjusted total calories purchased from foods (-182 kcal/day) and beverages (-100 kcal/day) declined significantly. Decreases in purchases of milk (-40 kcal); soft drinks (-27 kcal/day); juice and juice drinks (-24 kcal/day); grain-based desserts (-24 kcal/day); savory snacks (-17 kcal/day); and sweet snacks and candy (-13 kcal/day) were among the major changes. Changes in CPG purchases differed significantly by race, female head of household education, and household income. Trends in CPG purchases suggest that solid fats and added sugars are decreasing in the food supply of U.S. preschoolers. Pronounced differences by race, education, and household income persist. Published by Elsevier Inc.

Household food group expenditure patterns are associated with child anthropometry at ages 5, 8 and 12 years in Ethiopia, India, Peru and Vietnam.

PubMed

Humphries, Debbie L; Dearden, Kirk A; Crookston, Benjamin T; Woldehanna, Tassew; Penny, Mary E; Behrman, Jere R

2017-08-01

Population-level analysis of dietary influences on nutritional status is challenging in part due to limitations in dietary intake data. Household expenditure surveys, covering recent household expenditures and including key food groups, are routinely conducted in low- and middle-income countries. These data may help identify patterns of food expenditure that relate to child growth. We investigated the relationship between household food expenditures and child growth using factor analysis. We used data on 6993 children from Ethiopia, India, Peru and Vietnam at ages 5, 8 and 12y from the Young Lives cohort. We compared associations between household food expenditures and child growth (height-for-age z scores, HAZ; body mass index-for-age z scores, BMI-Z) using total household food expenditures and the "household food group expenditure index" (HFGEI) extracted from household expenditures with factor analysis on the seven food groups in the child dietary diversity scale, controlling for total food expenditures, child dietary diversity, data collection round, rural/urban residence and child sex. We used the HFGEI to capture households' allocations of their finances across food groups in the context of local food pricing, availability and pReferences RESULTS: The HFGEI was associated with significant increases in child HAZ in Ethiopia (0.07), India (0.14), and Vietnam (0.07) after adjusting for all control variables. Total food expenditures remained significantly associated with increases in BMI-Z for India (0.15), Peru (0.11) and Vietnam (0.06) after adjusting for study round, HFGEI, dietary diversity, rural residence, and whether the child was female. Dietary diversity was inversely associated with BMI-Z in India and Peru. Mean dietary diversity increased from age 5y to 8y and decreased from age 8y to 12y in all countries. Household food expenditure data provide insights into household food purchasing patterns that significantly predict HAZ and BMI-Z. Including food

Inequality in income and mortality in the United States: analysis of mortality and potential pathways.

PubMed

Kaplan, G A; Pamuk, E R; Lynch, J W; Cohen, R D; Balfour, J L

1996-04-20

To examine the relation between health outcomes and the equality with which income is distributed in the United States. The degree of income inequality, defined as the percentage of total household income received by the less well off 50% of households, and changes in income inequality were calculated for the 50 states in 1980 and 1990. These measures were then examined in relation to all cause mortality adjusted for age for each state, age specific deaths, changes in mortalities, and other health outcomes and potential pathways for 1980, 1990, and 1989-91. Age adjusted mortality from all causes. There was a significant correlation (r = -0.62 [corrected], P < 0.001) between the percentage of total household income received by the less well off 50% in each state and all cause mortality, unaffected by adjustment for state median incomes. Income inequality was also significantly associated with age specific mortalities and rates of low birth weight, homicide, violent crime, work disability, expenditures on medical care and police protection, smoking, and sedentary activity. Rates of unemployment, imprisonment, recipients of income assistance and food stamps, lack of medical insurance, and educational outcomes were also worse as income inequality increased. Income inequality was also associated with mortality trends, and there was a suggestion of an impact of inequality trends on mortality trends. Variations between states in the inequality of the distribution of income are significantly associated with variations between states in a large number of health outcomes and social indicators and with mortality trends. These differences parallel relative investments in human and social capital. Economic policies that influence income and wealth inequality may have an important impact on the health of countries.

Socioeconomic disparities in osteoporosis prevalence: different results in the overall Korean adult population and single-person households.

PubMed

Kim, Jungmee; Lee, Joongyub; Shin, Ju-Young; Park, Byung-Joo

2015-03-01

The present study was conducted in order to examine the association between socioeconomic status (SES) and osteoporosis prevalence in Korea and to assess whether different associations are found in single-person households. A cross-sectional population-based study was conducted using the Korea National Health and Nutrition Examination Survey, from 2008 to 2011. The study subjects were people aged ≥ 50 years with osteoporosis as defined by bone mineral density. Multivariate logistic models were used to estimate prevalence odds ratios (pORs) and 95% confidence intervals (CIs). Gender differences in the likelihood of osteoporosis were analyzed based on household income, education level, and residential area. There were 8221 osteoporosis patients aged ≥ 50 years, of whom 927 lived in single-person households. There was a gender-specific association between osteoporosis prevalence and all three SES factors that we analyzed: income, education, and residential area. After adjusting for age, SES, and health behaviors, including body mass index (BMI), low household income was only significantly associated with osteoporosis in men, whereas education level had an inverse relationship with osteoporosis only in women (p = 0.01, p < 0.001, respectively). However, after controlling for age and BMI, rural residency was only associated with osteoporosis in women living in single-person households (pOR, 1.59; 95% CI, 1.05 to 2.43). The Korean adult population showed a gender-specific relationship between SES and osteoporosis prevalence, with a different pattern found in single-person households.

Health Behaviors of Cancer Survivors in Nationwide Cross-Sectional Survey in Korea: Higher Alcohol Drinking, Lower Smoking, and Physical Inactivity Pattern in Survivors with Higher Household Income.

PubMed

Park, Boyoung; Kong, Sun-Young; Kim, Jeongseon; Kim, Yeol; Park, In Hae; Jung, So-Youn; Lee, Eun Sook

2015-08-01

This study investigated the prevalence of smoking, alcohol consumption, and physical activity in cancer survivors and examined the sociodemographic factors affecting these health-related behaviors.We used data from the 4th and 5th Korean National Health and Nutrition Examination Survey conducted between 2007 and 2012, which identified 1153 cancer cases and 36,451 people without a history of cancer ≥20 years of age. We used a structured questionnaire to obtain information concerning cancer diagnosis, health-related behaviors, and sociodemographic characteristics.The proportion of cancer survivors who were current drinkers, heavy drinkers, current smokers, or engaged in physical activity were 49.1, 9.0, 9.2, or 50.7%, respectively. Compared with people with no history of cancer, cancer survivors were less likely to be current drinkers (odds ratio [OR] = 0.45; 95% confidence interval [CI] 0.36-0.56), heavy drinkers (OR = 0.53; 95% CI 0.36-0.78), current smokers (OR = 0.37; 95% CI 0.24-0.55), or physically inactive (OR = 0.77; 95% CI 0.63-0.95). Cancer survivors with higher household incomes had higher odds of current drinking and heavy drinking (P trend = 0.039 and 0.033, respectively) and were less likely to be current smokers or physically inactive (P trend = 0.016 and 0.046, respectively). Age, sex, sites of cancer, and the time since diagnosis affected the health behaviors in cancer survivors. Furthermore, we confirmed that these unhealthy behaviors are interrelated.We found that household income had a bidirectional effect on health behaviors and confirmed an aggregation of unhealthy lifestyles. Identification of survivors vulnerable to unhealthy lifestyles, focusing on household income level would allow intervention programs to be more effective.

Push or Pull: Changes in the Relative Risk and Growth of Entrepreneurship Among Older Households.

PubMed

Weller, Christian E; Wenger, Jeffrey B; Lichtenstein, Benyamin; Arcand, Carolyn

2018-03-19

Amid insufficient retirement savings and the growing need to work longer, it is important to understand why self-employment, especially entrepreneurship, has grown among older households. Older households may have been pushed into entrepreneurship by the growing risks of wage-and-salary employment as wages and jobs have become less stable. Alternatively, older households may have been pulled into entrepreneurship as the associated risks have declined, for instance, due to greater opportunities to diversify income away from risky business income. We examine the economic causes of the rise in entrepreneurship among older households. We use summary statistics and multinomial logit regressions to analyze the link between economic pressures in wage-and-salary employment, financial strength of entrepreneurship, and the presence and change of entrepreneurship among older households-aged 50 years or older. We use household data from the Federal Reserve's Survey of Consumer Finances from 1989 to 2013. We find little support for the claim that increased economic pressures are correlated with rising entrepreneurship. Instead, our results suggest that the growth of older entrepreneurship is coincident with increasing access to dividend and interest income. We also find some evidence that access to Social Security and other annuity benefits increases the likelihood of self-employment. Implications: Entrepreneurship among older households increasingly correlates with income diversification. Policymakers interested in encouraging more entrepreneurship among older households could consider increased access to income diversification through social insurance.

Correlates of household smoking bans in low-income families of children with and without asthma.

PubMed

Wamboldt, Frederick S; Balkissoon, Ronald C; Rankin, Allison E; Szefler, Stanley J; Hammond, S Katharine; Glasgow, Russell E; Dickinson, W Perry

2008-03-01

Exposure to secondhand smoke (SHS) harms all children's health, especially children with asthma. Yet, children with asthma are as likely to live with smokers as healthy children. Household smoking bans are being advocated to reduce children's harm from SHS. To measure the effect of household smoking bans on child SHS exposure and to examine correlates of strict smoking bans in a low-income, diverse sample, 91 children with asthma were matched to 91 healthy children. All had at least one smoker living in their homes. Nicotine dosimeters, child cotinine assays, and maternal reports quantified child SHS exposures. Maternal reports of household smoking rules, behaviors, and beliefs, and other family characteristics were also gathered. The presence of a strict household smoking ban vastly reduced children's SHS exposures and was associated with fewer cigarettes smoked by the mother and by other family members, the belief that SHS was a personal health risk, having children with asthma, and living in a single-family home. Many children are exposed to high levels of SHS at home. Strict household smoking bans greatly decrease, but do not eliminate children's SHS exposure. Even in disadvantaged families, mutable factors were associated with strict smoking bans. Increased dissemination and use of established public health strategies are needed to reduce children's SHS exposures.

Income inequality, parental socioeconomic status, and birth outcomes in Japan.

PubMed

Fujiwara, Takeo; Ito, Jun; Kawachi, Ichiro

2013-05-15

The purpose of this study was to investigate the impact of income inequality and parental socioeconomic status on several birth outcomes in Japan. Data were collected on birth outcomes and parental socioeconomic status by questionnaire from Japanese parents nationwide (n = 41,499) and then linked to Gini coefficients at the prefectural level in 2001. In multilevel analysis, z scores of birth weight for gestational age decreased by 0.018 (95% confidence interval (CI): -0.029, -0.006) per 1-standard-deviation (0.018-unit) increase in the Gini coefficient, while gestational age at delivery was not associated with the Gini coefficient. For dichotomous outcomes, mothers living in prefectures with middle and high Gini coefficients were 1.24 (95% CI: 1.05, 1.47) and 1.23 (95% CI: 1.02, 1.48) times more likely, respectively, to deliver a small-for-gestational-age infant than mothers living in more egalitarian prefectures (low Gini coefficients), although preterm births were not significantly associated with income distribution. Parental educational level, but not household income, was significantly associated with the z score of birth weight for gestational age and small-for-gestational-age status. Higher income inequality at the prefectural level and parental educational level, rather than household income, were associated with intrauterine growth but not with shorter gestational age at delivery.

Similarities and differences between families who have frequent and infrequent family meals: A qualitative investigation of low-income and minority households.

PubMed

Berge, Jerica M; Draxten, Michelle; Trofholz, Amanda; Hanson-Bradley, Carrie; Justesen, Kathryn; Slattengren, Andrew

2018-04-01

Numerous quantitative studies have examined the association between family meal frequency and child/adolescent weight and weight-related behaviors. However, limited qualitative research has been conducted to identify mealtime characteristics (e.g., child behavior during meals, rules/expectations, family dynamics) that occur during family meals that may explain why some families engage in frequent family meals and others do not. This is particularly important within racially/ethnically diverse households, as these demographic groups are at higher risk for weight-related problems. The current study aimed to identify similarities and differences in mealtime characteristics between households that have frequent and infrequent family meals within a low-income and minority population. This qualitative study included 118 parents who participated in Family Meals, LIVE!, a mixed-methods, cross-sectional study. Parents (90% female; mean age = 35) were racially/ethnically diverse (62% African American, 19% White, 4% Native American, 4% Asian, 11% Mixed/Other) and from low-income (73% < $35,000/yr.) households. Data were analyzed using inductive content analysis. Results indicated some similar mealtime characteristics (i.e., picky eating, involving family members in meal preparation) between households having frequent and infrequent family meals. Additionally, several differences in mealtime characteristics were identified between households having frequent (i.e., importance of family meals, flexibility in the definition of family meals, family meal rules, no pressure-to-eat feeding practices) versus infrequent family meals (i.e., pressure-to-eat parent feeding practices, family meals are dinner meals only, and difficult meal time behaviors). Study findings may be useful for developing intervention targets for low-income and racially/ethnically diverse households so more families can benefit from the protective nature of family meals. Copyright © 2018 Elsevier Ltd

INCOME INCONGRUITY, RACE AND PRETERM BIRTH

EPA Science Inventory

Previous research with vital records finds income incongruity associated with adverse birth outcomes. We examined the effects of negative income incongruity (reporting lower household income than the census tract median household income) on preterm birth (PTB <37 weeks completed ...

The Urban Household in the 1980s: A Demographic and Economic Perspective. Revised.

ERIC Educational Resources Information Center

Muller, Thomas; And Others

This report focuses on demographic and economic changes affecting urban households during the 1980s. Statistics regarding birth, fertility and mortality rates, marriage and divorce, and household formation are presented. Metropolitan and interregional trends in mobility are examined by racial, income and age groups. Growth rates of the national…

Household income determines access to specialized pediatric chronic pain treatment in Germany.

PubMed

Ruhe, Ann-Kristin; Wager, Julia; Hirschfeld, Gerrit; Zernikow, Boris

2016-04-21

Families with lower socioeconomic status (SES) often face problems with gaining access to health care services. Information is scarce on the relationship between SES and health care delivery for children suffering from chronic pain. Families presenting to a specialized pain center (N = 1,001) provided information on 'household income, 'parental education' and 'occupation' to aid the evaluation of their SES. To assess whether the SES of the clinical sample is representative of the general population, it was compared to data from a community sample (N = 14,558). For the clinical sample, travel distance to the clinic was described in relation to the 75% catchment area. Multiple logistic regression was used to analyze the association between SES and the journey from outside the catchment area. The SES was significantly higher in the clinical sample than in the community sample. Within the clinical sample, the distance traveled to the pain center increased with increasing SES. The 75% catchment area was 143 miles for families with the highest SES and 78 miles for the lowest SES. 'Household income' predicted travel distance (OR 1.32 (1.12-1.56)). Education and occupational status were not significant predictors of travel from outside the catchment area. In Germany, specialized care for children with chronic pain is subject to disparities in access. Future activities should focus on identifying barriers to access and seeking to prevent inequalities in specialized pediatric health care delivery. Increasing the number of specialized treatment facilities could improve access to specialized pediatric pain treatment, regardless of socioeconomic determinants.

Lower Education and Household Income Contribute to Advanced Disease, Less Treatment Received and Poorer Prognosis in Patients with Hepatocellular Carcinoma.

PubMed

Shen, Yuan; Guo, Hui; Wu, Tao; Lu, Qiang; Nan, Ke-Jun; Lv, Yi; Zhang, Xu-Feng

2017-01-01

Understanding the ways in which socioeconomic status affects prognosis of hepatocellular carcinoma (HCC) is important for building up strategies eliminating the inequalities in cancer diagnosis and treatments among different groups, which, remains undetermined. In the present study, 1485 newly diagnosed HCC patients with complete demographic and clinical data were included. Socioeconomic data, including education, annual household income and residency was also reported by patients or families. In the present study, less educated patients were older, more female involved, poorly paid, more living in rural places, had more advanced tumor burden, received less curative and loco-regional therapies, and thus showed poorer short-term and long-term outcomes (in total or after surgical resection) than the highly educated. Patients with lower income were less educated, less treated, and more likely to live in rural places, had more advanced stages of HCC and thus poorer long-term survival (in total or after surgical resection) than higher income groups. In Cox regression analysis, lower household income was independently associated with poorer outcome (HR=1.2, 95% CI: 1.0-1.4, p =0.036). These results indicate that education and income are critically associated with early diagnosis, treatments and prognosis of HCC. Much more efforts should be taken to support the patients with less education and lower income to improve the outcomes of HCC.

Income-related and educational inequality in small-for-gestational age and preterm birth in Denmark and Finland 1987-2003.

PubMed

Mortensen, Laust H; Lauridsen, Jørgen T; Diderichsen, Finn; Kaplan, George A; Gissler, Mika; Andersen, Anne-Marie N

2010-02-01

In this paper, we examine income- and education-related inequality in small-for-gestational age (SGA) and preterm birth in Denmark and Finland from 1987 to 2003 using concentration indexes (CIXs). From the national medical birth registries we gathered information on all births from 1987 to 2003. Information on highest completed maternal education and household income in the year preceding birth of the offspring was obtained for 1,012,400 births in Denmark and 499,390 in Finland. We then calculated CIXs for income- and education-related inequality in SGA and preterm birth. The mean household income-related inequality in SGA was -0.04 (95% confidence interval: -0.05, -0.04) in Denmark and -0.03 (-0.04, -0.02) in Finland. The maternal education-related inequality in SGA was -0.08 (-0.10, -0.06) in Denmark and -0.07 (-0.08, -0.06) in Finland. The income-related inequality in preterm birth was -0.03 (-0.03, -0.02) in Denmark and -0.03 (-0.04, -0.02) in Finland. The education-related inequality in preterm birth was -0.05 (-0.07, -0.04) in Denmark and -0.04 (-0.05, -0.03) in Finland. In Denmark, the income-related and education-related inequity in SGA increased over time. In Finland, the income-related inequality in SGA birth increased slightly, while education-related inequalities remained stable. Inequalities in preterm birth decreased over time in both countries. Denmark and Finland are examples of nations with free prenatal care and publicly financed obstetric care of high quality. During the period of study there were macroeconomic shocks affecting both countries. However, only small income- and education-related inequalities in SGA and preterm births during the period were observed.

Federal Income Tax Cuts and Low-Income Families.

ERIC Educational Resources Information Center

Sammartino, Frank J.

This report identifies overall tax burdens faced by low income families, explaining how those burdens would change if certain types of federal income tax cuts were enacted. Using detailed household-level data on incomes and taxes, the report shows how federal income and payroll taxes differ for low income families and how these families benefit…

Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso.

PubMed Central

Su, Tin Tin; Kouyaté, Bocar; Flessa, Steffen

2006-01-01

OBJECTIVE: To quantify the extent of catastrophic household health care expenditure and determine the factors responsible for it in Nouna District, Burkina Faso. METHODS: We used the Nouna Health District Household Survey to collect data on 800 households during 2000-01 for our analysis. The determinants of household catastrophic expenditure were identified by multivariate logistic regression method. FINDINGS: Even at very low levels of health care utilization and modest amount of health expenditure, 6-15% of total households in Nouna District incurred catastrophic health expenditure. The key determinants of catastrophic health expenditure were economic status, household health care utilization especially for modern medical care, illness episodes in an adult household member and presence of a member with chronic illness. CONCLUSION: We conclude that the poorest members of the community incurred catastrophic health expenses. Setting only one threshold/cut-off value to determine catastrophic health expenses may result in inaccurate estimation leading to misinterpretation of important factors. Our findings have important policy implications and can be used to ensure better access to health services and a higher degree of financial protection for low-income groups against the economic impact of illness. PMID:16501711

Effects of low income on infant health.

PubMed

Séguin, Louise; Xu, Qian; Potvin, Louise; Zunzunegui, Maria-Victoria; Frohlich, Katherine L

2003-06-10

Few population-based studies have analyzed the link between poverty and infant morbidity. In this study, we wanted to determine whether inadequate income itself has an impact on infant health. We interviewed 2223 mothers of 5-month-old children participating in the 1998 phase of the Quebec Longitudinal Study of Child Development to determine their infant's health and the sociodemographic characteristics of the household (including household income, breast-feeding and the smoking habits of the mother). Data on the health of the infants at birth were taken from medical records. We examined the effects of household income using Statistics Canada definitions of sufficient (above the low-income threshold), moderately inadequate (between 60% and 99% of the low-income threshold) and inadequate (below 60% of the low-income threshold) income on the mother's assessment of her child's overall health, her report of her infant's chronic health problems and her report of the number of times, if any, her child had been admitted to hospital since birth. In the analysis, we controlled for factors known to affect infant health: infant characteristics and neonatal health problems, the mother's level of education, the presence or absence of a partner, the duration of breast-feeding and the mother's smoking status. Compared with infants in households with sufficient incomes, those in households with lower incomes were more likely to be judged by their mothers to be in less than excellent health (moderately inadequate incomes: adjusted odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.1; very inadequate incomes: adjusted OR 1.8, 95% CI 1.3-2.6). Infants in households with moderately inadequate incomes were more likely to have been admitted to hospital (adjusted OR 1.8, 95% CI 1.2-2.6) than those in households with sufficient incomes, but the same was not true of infants in households with very inadequate incomes (adjusted OR 0.7, 95% CI 0.4-1.2). Household income did not

Income, neighborhood stressors, and harsh parenting: test of moderation by ethnicity, age, and gender.

PubMed

Barajas-Gonzalez, R Gabriela; Brooks-Gunn, Jeanne

2014-12-01

Family and neighborhood influences related to low-income were examined to understand their association with harsh parenting among an ethnically diverse sample of families. Specifically, a path model linking household income to harsh parenting via neighborhood disorder, fear for safety, maternal depressive symptoms, and family conflict was evaluated using cross-sectional data from 2,132 families with children ages 5-16 years from Chicago. The sample was 42% Mexican American, 41% African American, and 17% European American. Results provide support for a family process model where a lower income-to-needs ratio is associated with higher reports of neighborhood disorder, greater fear for safety, and more family conflict, which is in turn, associated with greater frequency of harsh parenting. Our tests for moderation by ethnicity/immigrant status, child gender, and child age (younger child vs. adolescent) indicate that although paths are similar for families of boys and girls, as well as for families of young children and adolescents, there are some differences by ethnic group. Specifically, we find the path from neighborhood disorder to fear for safety is stronger for Mexican American (United States born and immigrant) and European American families in comparison with African American families. We also find that the path from fear for safety to harsh parenting is significant for European American and African American families only. Possible reasons for such moderated effects are considered.

Socioeconomic Disparities in Osteoporosis Prevalence: Different Results in the Overall Korean Adult Population and Single-person Households

PubMed Central

Kim, Jungmee; Lee, Joongyub; Shin, Ju-Young; Park, Byung-Joo

2015-01-01

Objectives: The present study was conducted in order to examine the association between socioeconomic status (SES) and osteoporosis prevalence in Korea and to assess whether different associations are found in single-person households. Methods: A cross-sectional population-based study was conducted using the Korea National Health and Nutrition Examination Survey, from 2008 to 2011. The study subjects were people aged ≥ 50 years with osteoporosis as defined by bone mineral density. Multivariate logistic models were used to estimate prevalence odds ratios (pORs) and 95% confidence intervals (CIs). Gender differences in the likelihood of osteoporosis were analyzed based on household income, education level, and residential area. Results: There were 8221 osteoporosis patients aged ≥ 50 years, of whom 927 lived in single-person households. There was a gender-specific association between osteoporosis prevalence and all three SES factors that we analyzed: income, education, and residential area. After adjusting for age, SES, and health behaviors, including body mass index (BMI), low household income was only significantly associated with osteoporosis in men, whereas education level had an inverse relationship with osteoporosis only in women (p=0.01, p<0.001, respectively). However, after controlling for age and BMI, rural residency was only associated with osteoporosis in women living in single-person households (pOR, 1.59; 95% CI, 1.05 to 2.43). Conclusions: The Korean adult population showed a gender-specific relationship between SES and osteoporosis prevalence, with a different pattern found in single-person households. PMID:25857646

20 CFR 416.1133 - What is a pro rata share of household operating expenses.

Code of Federal Regulations, 2010 CFR

2010-04-01

... operating expenses. 416.1133 Section 416.1133 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Income In-Kind Support and Maintenance § 416... receiving in-kind support and maintenance from anyone else in the household. The one-third reduction...

Individual and household-level socioeconomic position is associated with harmful alcohol consumption behaviours among adults.

PubMed

Giskes, Katrina; Turrell, Gavin; Bentley, Rebecca; Kavanagh, Anne

2011-06-01

To examine associations between individual-, household- and neighbourhood-level socioeconomic position (SEP) and harmful alcohol consumption. Adults aged 18-76 residing in 50 neighbourhoods in Melbourne completed a postal questionnaire (n= 2349, 58.7% response rate). Alcohol-related behaviours were classified by risk of short- and long-term harm. Individual-, household- and neighbourhood-level SEP were ascertained by education, household income and proportion of low-income households, respectively. The association were examined by multi-level logistic regression. Participants lower education or household income were less likely to consume alcohol frequently compared to their more-advantaged counterparts. Lower-educated men were more likely to be at risk of short-term harm [OR 1.75 (1.23 - 2.48)]. Low-income women were less likely to be at risk of short-term harm [OR 0.44 (0.23 - 0.81)]. Neighbourhood disadvantage was not associated with alcohol consumption. Men and women from socioeconomically advantaged backgrounds were more frequent consumers of alcohol, whereas their disadvantaged counterparts drank less frequently but in greater quantities on each drinking occasion. Socioeconomic disadvantage at the individual and household levels may be an important determinant of alcohol consumption among Australian adults. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Rural Income and Forest Reliance in Highland Guatemala

NASA Astrophysics Data System (ADS)

Prado Córdova, José Pablo; Wunder, Sven; Smith-Hall, Carsten; Börner, Jan

2013-05-01

This paper estimates rural household-level forest reliance in the western highlands of Guatemala using quantitative methods. Data were generated by the way of an in-depth household income survey, repeated quarterly between November 2005 and November 2006, in 11 villages ( n = 149 randomly selected households). The main sources of income proved to be small-scale agriculture (53 % of total household income), wages (19 %) and environmental resources (14 %). The latter came primarily from forests (11 % on average). In the poorest quintile the forest income share was as high as 28 %. All households harvest and consume environmental products. In absolute terms, environmental income in the top quintile was 24 times higher than in the lowest. Timber and poles, seeds, firewood and leaf litter were the most important forest products. Households can be described as `regular subsistence users': the share of subsistence income is high, with correspondingly weak integration into regional markets. Agricultural systems furthermore use important inputs from surrounding forests, although forests and agricultural uses compete in household specialization strategies. We find the main household determinants of forest income to be household size, education and asset values, as well as closeness to markets and agricultural productivity. Understanding these common but spatially differentiated patterns of environmental reliance may inform policies aimed at improving livelihoods and conserving forests.

Household energy consumption in the United States, 1987 to 2009: Socioeconomic status, demographic composition, and energy services profiles

NASA Astrophysics Data System (ADS)

Kemp, Robert J.

This dissertation examines household energy consumption in the United States over the period of 1987 to 2009, specifically focusing on the role of socioeconomic status, demographic composition, and energy services profiles. The dissertation makes use of four cross-sections from the Residential Energy Consumption Survey data series to examine how household characteristics influence annual energy consumption overall, and by fuel type. Chapter 4 shows that household income is positively related to energy consumption, but more so for combustible fuel consumption than for electricity consumption. Additionally, results for educational attainment suggest a less cross-sectional association and more longitudinal importance as related to income. Demographic composition matters, as predicted by the literature; household size and householder age show predicted effects, but when considered together, income explains any interaction between age and household size. Combustible fuels showed a far greater relationship to housing unit size and income, whereas electricity consumption was more strongly related to educational attainment, showing important differences in the associations by fuel type. Taken together, these results suggest a life course-based model for understanding energy consumption that may be strongly linked to lifestyles. Chapter 5 extends the findings in Chapter 4 by examining the patterning of physical characteristics and behaviors within households. The chapter uses Latent Class Analysis to examine a broad set of energy significant behaviors and characteristics to discover five unique energy services profiles. These profiles are uniquely patterned across demographic and socioeconomic compositions of households and have important effects on energy consumption. These profiles are likely byproducts of the lifestyles in which the household takes part, due to factors such as their socioeconomic status and household demographic composition. Overall, the dissertation

New Haven, Connecticut: Targeting Low-Income Household Energy Savings (City Energy: From Data to Decisions)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Strategic Priorities and Impact Analysis Team, Office of Strategic Programs

This fact sheet "New Haven, Connecticut: Targeting Low-Income Household Energy Savings" explains how the City of New Haven used data from the U.S. Department of Energy's Cities Leading through Energy Analysis and Planning (Cities-LEAP) and the State and Local Energy Data (SLED) programs to inform its city energy planning. It is one of ten fact sheets in the "City Energy: From Data to Decisions" series.

Maternal Income during Pregnancy is Associated with Chronic Placental Inflammation at Birth.

PubMed

Keenan-Devlin, Lauren S; Ernst, Linda M; Ross, Kharah M; Qadir, Sameen; Grobman, William A; Holl, Jane L; Crockett, Amy; Miller, Gregory E; Borders, Ann E B

2017-08-01

Objective  This study aims to examine whether maternal household income is associated with histological evidence of chronic placental inflammation. Study Design  A total of 152 participants completed surveys of household income and consented to placenta collection at delivery and postpartum chart review for birth outcomes. Placental inflammatory lesions were evaluated via histological examination of the membranes, basal plate, and villous parenchyma by a single, experienced pathologist. Associations between household income and the presence of inflammatory lesions were adjusted for known perinatal risk factors. Results  Overall, 45% of participants reporting household income below $30,000/y had chronic placental inflammation, compared with 25% of participants reporting income above $100,000 annually (odds ratio [OR] = 4.23, 95% confidence interval [CI] = 1.25, 14.28; p  = 0.02). Middle-income groups showed intermediate rates of chronic inflammatory lesions, at 40% for those reporting $30,000 and 50,000 (OR = 3.60, 95% CI = 1.05, 12.53; p  = 0.04) and 38% for those reporting $50,000 to 100,000 (OR = 1.57, 95% CI = 0.60, 4.14; p  = 0.36). Results remained significant after adjustment for maternal age, race, and marital status. Conclusion  Chronic placental inflammation is associated with maternal household income. Greater occurrence of placental lesions in low-income mothers may arise from a systemic inflammatory response to social and physical environmental factors. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

INCOME INCONGRUITY, RACE AND PRETERM BIRTH (PTB)

EPA Science Inventory

Previous research using birth records has found income incongruity associated with adverse birth outcomes. The effects of negative income incongruity (reporting lower household income than the census tract median household income) on PTB (<37 weeks completed gestation) are examin...

Are food and beverage purchases in households with preschoolers changing? A longitudinal analysis from 2000–2011

PubMed Central

Ford, Christopher N.; Ng, Shu Wen; Popkin, Barry M.

2014-01-01

Background US dietary studies from 2003–2010 show decreases in children’s caloric intake. We examine purchases of consumer-packaged foods/beverages in the US between 2000- and 2011 among households with children ages 2–5y. Objectives Describe changes in consumer-packaged goods purchases between 2000 and 2011 after adjusting for economic indicators, and explore differences by race, education, and household income level. Methods Consumer-packaged goods purchases data were obtained for 42,753 US households with ≥1 child aged 2–5y using the Nielsen Homescan Panel. Top sources of calories purchased were grouped, and random effects regression was used to model the relationship between calories purchased from each food/beverage group and race, female head of household education, and household income. Models adjusted for household composition, market-level unemployment rate, prices, and quarter. Bonferroni correction was used to adjust for multiple comparisons (α=0.05). Results Between 2000 and 2011, adjusted total calories purchased from foods (−182 kcal/d) and beverages (−100 kcal/d) declined significantly. Decreases in purchases of milk (−40 kcal), soft drinks (−27 kcal/d), juice and juice drinks (−24 kcal/d), grain-based desserts (−24 kcal/d), savory snacks (−17 kcal/d), and sweet snacks and candy (−13 kcal/d) were among the major changes observed. There were significant differences by race, female head of household education, and household income for changes in consumer-packaged food and beverage purchases between 2000 and 2011. Conclusions Trends in consumer-packaged goods purchases suggest that solid fats and added sugars are decreasing in the food ply of US preschool children. Yet, pronounced differences by race, education, and household income persist. PMID:25049217

Energy Efficiency Financing for Low- and Moderate-Income Households: Current State of the Market, Issues, and Opportunities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Leventis, Greg; Kramer, Chris; Schwartz, Lisa

Ensuring that low- and moderate-income (LMI) households have access to energy efficiency is equitable, provides energy savings as a resource to meet energy needs, and can support multiple policy goals, such as affordable energy, job creation, and improved public health. Although the need is great, many LMI households may not be able to afford efficiency improvements or may be inhibited from adopting efficiency for other reasons. Decision-makers across the country are currently exploring the challenges and potential solutions to ramping up adoption of efficiency in LMI households, including the use of financing. The report’s objective is to offer state andmore » local policymakers, state utility regulators, program administrators, financial institutions, consumer advocates and other LMI stakeholders with an understanding of: -The relationship between LMI communities and financing for energy efficiency, including important considerations for its use such as consumer protections -The larger programmatic context of grant-based assistance and other related resources supporting LMI household energy efficiency -Lessons learned from existing energy efficiency financing programs serving LMI households -Financing products used by these programs and their relative advantages and disadvantages in addressing barriers to financing or to energy efficiency uptake for LMI households« less

Cigarette smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity.

PubMed

Townsend, J; Roderick, P; Cooper, J

1994-10-08

To assess effects of price, income, and health publicity on cigarette smoking by age, sex, and socioeconomic group. Econometric multiple regression analysis of data on cigarette smoking from the British general household survey. Random sample of adult population in Britain interviewed for biennial general household surveys 1972-90. Changes in cigarette consumption and prevalence of smoking. Price elasticities of demand for cigarettes (percentage change in cigarette consumption for a 1% change in price) were significant at -0.5 (95% confidence interval -0.8 to -0.1) for men and -0.6 (-0.9 to -0.3) for women, were highest in socioeconomic group V (-1.0 for men and -0.9 for women), and lowest (not significantly different from zero) in socioeconomic groups I and II. The gradient in price elasticities by socioeconomic group was significant for men (F = 5.6, P = 0.02) and for women (F = 6.1, P = 0.02). Price was a significant factor in cigarette consumption by age for women in every age group and for men aged 25-34. Cigarette consumption by young men aged 16-34 increased with income. There was a significant decrease in smoking over time by women in socioeconomic groups I and II and by men in all age and social groups except socioeconomic group V attributable to health publicity. Price significantly affected smoking prevalence in socioeconomic group V (-0.6 for men and -0.5 for women) and for all women (-0.2). Men and women in lower socioeconomic groups are more responsive than are those in higher socioeconomic groups to changes in the price of cigarettes and less to health publicity. Women of all ages, including teenagers, appear to have been less responsive to health publicity than have men but more responsive to price. Response to health publicity decreased linearly with age. Real price increases in cigarettes could narrow differences between socioeconomic groups in smoking and the related inequalities in health, but specific measures would be necessary to ameliorate

Poverty and health-related quality of life of people living in Hong Kong: comparison of individuals from low-income families and the general population.

PubMed

Lam, Cindy Lo Kuen; Guo, Vivian Yawei; Wong, Carlos King Ho; Yu, Esther Yee Tak; Fung, Colman Siu Cheung

2017-06-01

To assess health-related quality of life (HRQOL) among Chinese adults from low-income households in Hong Kong, and to explore any threshold of household income that impaired HRQOL. A cross-sectional analysis was conducted on 298 adults from low-income families when they enrolled into a cohort study between 2012 and 2014. HRQOL was measured by the 12-item Short-Form Health Survey-version 2 (SF-12v2). Their mean SF-12v2 subscale and summary scores were compared with those of 596 age-sex-matched subjects randomly selected from a database of 2763 adults from the Hong Kong general population (ratio = 1:2). Multiple linear regressions were conducted to determine any association between monthly household income and HRQOL. Subjects from low-income households had significantly lower SF-12v2 bodily pain, general health, vitality and physical component summary (PCS) scores than the age-sex matched subjects from the general population. Subgroup analysis showed that a household income <50% of the median monthly household income in Hong Kong (HK$10 000 ≈ US$1290, i.e. poverty line in Hong Kong) was independently associated with poorer PCS and mental component summary (MCS) scores after adjustment for socio-demographics and co-morbidities. Chinese adults from low-income households had poorer HRQOL, and <50% of the median monthly household income seems to be the threshold for impairment of both physical and mental HRQOL. The findings support the current definition of the poverty line. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Household and community income, economic shocks and risky sexual behavior of young adults: evidence from the Cape Area Panel Study 2002 and 2005.

PubMed

Dinkelman, Taryn; Lam, David; Leibbrandt, Murray

2007-11-01

To describe recent trends in adolescent sexual behavior in Cape Town, South Africa, and to determine whether household and community poverty and negative economic shocks predict risky sexual behavior. Matched survey data on 2993 African and coloured youth from the Cape Area Panel Study 2002 and 2005. Sexual debut, multiple sexual partners in past year, condom use at last sex, measured in 2002 and 2005. We tested for changes over time in reported sexual behavior and estimate multivariate probit models to measure the association between 2002 individual, household and community characteristics and 2005 sexual behavior. There was a statistically significant increase in condom use and a decrease in the incidence of multiple sexual partners between 2002 and 2005 for young women aged 17-22 years. Young women in households with 10% higher income were 0.53% less likely to debut sexually by 2005; young men in communities with a 10% higher poverty rate were 5% less likely to report condom use at last sex. Negative economic shocks are associated with a 0.04% increase in the probability of multiple partnerships for young women. Education is positively correlated with sexual debut for young women and with multiple partnerships for both sexes. Trends in sexual behavior between 2002 and 2005 indicate significant shifts towards safer practices. There is little evidence of a relationship between negative economic shocks, household and community poverty, and risky behavior. We hypothesize that the unexpected positive relationship between education and sexual debut may be driven by peer effects in schools with substantial age mixing.

[Family care for the aged in multigenerational households (author's transl)].

PubMed

Klusmann, D; Lüders, I; Bruder, J; Lauter, H

1981-09-01

Multigenerational household with widowed elderly above the age of 70 have been studied by interviewing the aged person and his/her daughter/daughter in law. The sample is described according to household composure and some sociodemographic characteristics. Data analysis focused on the relationship between variables in the elderly person and variables in the daughter/daughter in law. Psychic and somatic well-being in the relatives can be predicted by the degree of competence/dependency in the aged family member, but less so with a general health assessment. Organic brain conditions in the aged parents seem to have most adverse effects on the daughter/daughter in law when they are of a moderate degree.

Rural income and forest reliance in highland Guatemala.

PubMed

Prado Córdova, José Pablo; Wunder, Sven; Smith-Hall, Carsten; Börner, Jan

2013-05-01

This paper estimates rural household-level forest reliance in the western highlands of Guatemala using quantitative methods. Data were generated by the way of an in-depth household income survey, repeated quarterly between November 2005 and November 2006, in 11 villages (n = 149 randomly selected households). The main sources of income proved to be small-scale agriculture (53 % of total household income), wages (19 %) and environmental resources (14 %). The latter came primarily from forests (11 % on average). In the poorest quintile the forest income share was as high as 28 %. All households harvest and consume environmental products. In absolute terms, environmental income in the top quintile was 24 times higher than in the lowest. Timber and poles, seeds, firewood and leaf litter were the most important forest products. Households can be described as 'regular subsistence users': the share of subsistence income is high, with correspondingly weak integration into regional markets. Agricultural systems furthermore use important inputs from surrounding forests, although forests and agricultural uses compete in household specialization strategies. We find the main household determinants of forest income to be household size, education and asset values, as well as closeness to markets and agricultural productivity. Understanding these common but spatially differentiated patterns of environmental reliance may inform policies aimed at improving livelihoods and conserving forests.

Household computer and Internet access: The digital divide in a pediatric clinic population

PubMed Central

Carroll, Aaron E.; Rivara, Frederick P.; Ebel, Beth; Zimmerman, Frederick J.; Christakis, Dimitri A.

2005-01-01

Past studies have noted a digital divide, or inequality in computer and Internet access related to socioeconomic class. This study sought to measure how many households in a pediatric primary care outpatient clinic had household access to computers and the Internet, and whether this access differed by socio-economic status or other demographic information. We conducted a phone survey of a population-based sample of parents with children ages 0 to 11 years old. Analyses assessed predictors of having home access to a computer, the Internet, and high-speed Internet service. Overall, 88.9% of all households owned a personal computer, and 81.4% of all households had Internet access. Among households with Internet access, 48.3% had high speed Internet at home. There were statistically significant associations between parental income or education and home computer ownership and Internet access. However, the impact of this difference was lessened by the fact that over 60% of families with annual household income of $10,000–$25,000, and nearly 70% of families with only a high-school education had Internet access at home. While income and education remain significant predictors of household computer and internet access, many patients and families at all economic levels have access, and might benefit from health promotion interventions using these modalities. PMID:16779012

Income and Well-Being: Relative Income and Absolute Income Weaken Negative Emotion, but Only Relative Income Improves Positive Emotion.

PubMed

Yu, Zonghuo; Chen, Li

2016-01-01

Whether relative income or absolute income could affect subjective well-being has been a bone of contention for years. Life satisfaction and the relative frequency of positive and negative emotions are parts of subjective well-being. According to the prospect theory, hedonic adaptation helps to explain why positive emotion is often so hard to be maintained, and negative emotion wouldn't be easy to be eliminated. So we expect the relationship between income and positive emotion is different from that between income and negative emotion. Given that regional reference is the main comparison mechanism, effects of regional average income on regional average subjective well-being should be potentially zero if only relative income matters. Using multilevel analysis, we tested the hypotheses with a dataset of 30,144 individuals from 162 counties in China. The results suggested that household income at the individual level is associated with life satisfaction, happiness and negative emotions. On the contrary, at a county level, household income is only associated with negative emotion. In other words, happiness and life satisfaction was only associated with relative income, but negative emotion was associated with relative income and absolute income. Without social comparison, income doesn't improve happiness, but it could weaken negative emotion. Therefore, it is possible for economic growth to weaken negative emotion without improving happiness. These findings also contribute to the current debate about the "Esterling paradox."

Food crop production, nutrient availability, and nutrient intakes in Bangladesh: exploring the agriculture-nutrition nexus with the 2010 Household Income and Expenditure Survey.

PubMed

Fiedler, John L

2014-12-01

Systematic collection of national agricultural data has been neglected in many low- and middle-income countries for the past 20 years. Commonly conducted nationally representative household surveys collect substantial quantities of highly underutilized food crop production data. To demonstrate the potential usefulness of commonly available household survey databases for analyzing the agriculture-nutrition nexus. Using household data from the 2010 Bangladesh Household Income and Expenditure Survey, the role and significance of crop selection, area planted, yield, nutrient production, and the disposition of 34 food crops in affecting the adequacy of farming households' nutrient availability and nutrient intake status are explored. The adequacy of each farming household's available energy, vitamin A, calcium, iron, and zinc and households' apparent intakes and intake adequacies are estimated. Each household's total apparent nutrient intake adequacies are estimated, taking into account the amount of each crop that households consume from their own production, together with food purchased or obtained from other sources. Even though rice contains relatively small amounts of micronutrients, has relatively low nutrient density, and is a relatively poor source of nutrients compared with what other crops can produce on a given tract of land, because so much rice is produced in Bangladesh, it is the source of 90% of the total available energy, 85% of the zinc, 67% of the calcium, and 55% of the iron produced by the agricultural sector. The domination of agriculture and diet by rice is a major constraint to improving nutrition in Bangladesh. Simple examples of how minor changes in the five most common cropping patterns could improve farming households' nutritional status are provided. Household surveys' agricultural modules can provide a useful tool for better understanding national nutrient production realities and possibilities.

A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China.

PubMed

Guerchet, Maëlenn M; Guerra, Mariella; Huang, Yueqin; Lloyd-Sherlock, Peter; Sosa, Ana Luisa; Uwakwe, Richard; Acosta, Isaac; Ezeah, Peter; Gallardo, Sara; Liu, Zhaorui; Mayston, Rosie; Montes de Oca, Veronica; Wang, Hong; Prince, Martin J

2018-01-01

While links between disability and poverty are well established, there have been few longitudinal studies to clarify direction of causality, particularly among older adults in low and middle income countries. We aimed to study the effect of care dependence among older adult residents on the economic functioning of their households, in catchment area survey sites in Peru, Mexico and China. Households were classified from the evolution of the needs for care of older residents, over two previous community surveys, as 'incident care', 'chronic care' or 'no care', and followed up three years later to ascertain economic outcomes (household income, consumption, economic strain, satisfaction with economic circumstances, healthcare expenditure and residents giving up work or education to care). Household income did not differ between household groups. However, income from paid work (Pooled Count Ratio pCR 0.88, 95% CI 0.78-1.00) and government transfers (pCR 0.80, 95% CI 0.69-0.93) were lower in care households. Consumption was 12% lower in chronic care households (pCR 0.88, 95% CI 0.77-0.99). Household healthcare expenditure was higher (pCR 1.55, 95% CI 1.26-1.90), and catastrophic healthcare spending more common (pRR 1.64, 95% CI 1.64-2.22) in care households. While endogeneity cannot be confidently excluded as an explanation for the findings, this study indicates that older people's needs for care have a discernable impact on household economics, controlling for baseline indicators of long-term economic status. Although living, typically, in multigenerational family units, older people have not featured prominently in global health and development agendas. Population ageing will rapidly increase the number of households where older people live, and their societal significance. Building sustainable long-term care systems for the future will require some combination of improved income security in old age; incentivisation of informal care through compensation for direct and

Children with Special Health Care Needs, Supplemental Security Income, and Food Insecurity.

PubMed

Rose-Jacobs, Ruth; Fiore, Jennifer Goodhart; de Cuba, Stephanie Ettinger; Black, Maureen; Cutts, Diana B; Coleman, Sharon M; Heeren, Timothy; Chilton, Mariana; Casey, Patrick; Cook, John; Frank, Deborah A

2016-01-01

To assess food insecurity in low-income households with young children with/without special health care needs (SHCN) and evaluate relationships between child Supplemental Security Income (SSI) receipt and food insecurity. A cross-sectional survey (2013-2015) of caregivers was conducted at 5 medical centers. Eligibility included index child age <48 months without private health insurance and a caregiver fluent in English or Spanish. Interviews included sociodemographics, 5-item Children with Special Health Care Needs Screener, 18-item US Food Security Survey Module, household public assistance program participation, and child SSI receipt. Household and child food insecurity, each, were evaluated using multivariable logistic regression models. Of 6724 index children, 81.5% screened negative for SHCN, 14.8% positive for SHCN (no SSI), and 3.7% had SHCN and received SSI. After covariate control, households, with versus without a child with SHCN, were more likely to experience household (Adjusted odds ratios [AOR] 1.24, 95% confidence intervals [CI], 1.03-1.48) and child (AOR 1.35, 95% CI, 1.11-1.63) food insecurity. Among households with children with SHCN, those with children receiving, versus not receiving SSI, were more likely to report household (AOR 1.42, 95% CI, 0.97-2.09) but not child food insecurity. Low-income households with young children having SHCN are at risk for food insecurity, regardless of child SSI receipt and household participation in other public assistance programs. Policy recommendations include reevaluation of assistance programs' income and medical deduction criteria for households with children with SHCN to decrease the food insecurity risk faced by these children and their families.

Household Crowding During Childhood and Long-Term Education Outcomes.

PubMed

Lopoo, Leonard M; London, Andrew S

2016-06-01

Household crowding, or having more household members than rooms in one's residence, could potentially affect a child's educational attainment directly through a number of mechanisms. We use U.S. longitudinal data from the Panel Study of Income Dynamics to derive new measures of childhood crowding and estimate negative associations between crowding during one's high school years and, respectively, high school graduation by age 19 and maximum education at age 25. These negative relationships persist in multivariate models in which we control for the influence of a variety of factors, including socioeconomic status and housing-cost burden. Given the importance of educational attainment for a range of midlife and later-life outcomes, this study suggests that household crowding during one's high school years is an engine of cumulative inequality over the life course.

Associations between smoking behaviors and financial stress among low-income smokers.

PubMed

Widome, Rachel; Joseph, Anne M; Hammett, Patrick; Van Ryn, Michelle; Nelson, David B; Nyman, John A; Fu, Steven S

2015-01-01

Many American households struggle to bring in sufficient income to meet basic needs related to nutrition, housing, and healthcare. Nicotine addiction and consequent expenditures on cigarettes may impose extra financial strain on low-income households. We examine how cigarette use behaviors relate to self-reported financial stress/strain among low-income smokers. At baseline in 2011/12, OPT-IN recruited adult smokers age 18-64 from the administrative databases of the state-subsidized Minnesota Health Care Programs (N = 2406). We tested whether nicotine dependency, type of cigarettes used, and smoking intensity were associated with self-reported difficulty affording food, healthcare, housing, and living within one's income. All regression models were adjusted for race, education, income, age, and gender. Difficulty living on one's income (77.4%), paying for healthcare (33.6%), paying for housing (38.4%), and paying for food (40.8%) were common conditions in this population. Time to first cigarette and cigarettes smoked per day predicted financial stress related to affording food, housing, and living within one's income (all p < 0.05). For instance, those whose time to first cigarette was greater than 60 minutes had about half the odds of reporting difficulty paying for housing compared to those who had their first cigarette within five minutes of waking (adjusted odds ratio = 0.55 [95% CI: 0.41, 0.73]). Type of cigarette used was not associated with any type of financial stress/strain. Smoking and particularly heavy smoking may contribute in an important way to the struggles that low-income households with smokers face in paying for necessities.

Social determinants of household food expenditure in Australia: the role of education, income, geography and time.

PubMed

Venn, Danielle; Dixon, Jane; Banwell, Cathy; Strazdins, Lyndall

2018-04-01

To examine socio-economic status (SES) and time-related factors associated with less healthy food purchases in Australia. Data were from the 2009/10 Household Expenditure Survey (HES) conducted by the Australian Bureau of Statistics. Regression analysis was used to examine the associations between the proportion of the household food budget spent on various food types (processed and unprocessed foods, foods purchased from takeaways and restaurants) and SES and time constraint variables. Australia, 2009-2010. Nationally representative sample of Australian households. Household income seems to be the most important correlate with food expenditure patterns once other SES indicators are controlled for. Time constraints appear to explain some, but not all, of the adjusted SES gradients in food expenditure. Comparing home food consumption categories (processed and unprocessed foods) with foods purchased away from home (takeaway and restaurant foods) shows that wealthier, more highly educated and least disadvantaged households spend relatively less of their total food budget on processed and unprocessed foods prepared at home and more on foods purchased away from home at restaurants. Simple SES gradients in dietary behaviour are influenced by correlations between different SES indicators and between SES and time constraints. Examining these factors separately obscures some of the possible causal effects of disadvantage on healthy eating. When formulating policy responses to unhealthy diets, policy makers should consider alternative sources of disadvantage, including time pressure.

Schooling of Girls and Boys in A West African Country: The Effects of Parental Education, Income, and Household Structure.

ERIC Educational Resources Information Center

Glick, Peter; Sahn, David E.

2000-01-01

Investigates gender differences in determinants of three schooling indicators (grade attainment, current enrollment, and withdrawal from school) in a poor urban area in Guinea. Raising household income leads to greater investments in girls' schooling. Improving fathers' education benefits both sexes' education; improving mothers' education…

Seasonality, household food security, and nutritional status in Dinajpur, Bangladesh.

PubMed

Hillbruner, Chris; Egan, Rebecca

2008-09-01

The influence of seasonality on food security and nutritional status is widely accepted. However, research has typically focused on rural households and has not explored the specific mechanisms underlying seasonal effects. To investigate the role of seasonality in determining the food security and nutritional status of low-income urban households and to isolate specific pathways through which seasonality has its impact. Secondary panel data from CARE/IFPRI were utilized. Three rounds of data were collected from approximately 600 households in low-income areas of Dinajpur, Bangladesh, from 2002 through 2003, twice during the monsoon season and once in the dry season. Household-level surveys collected data on income and expenditure, employment, urban agriculture, health, and assets. Height and weight measurements were taken from children between the ages of 6 and 72 months. Paired t-tests and logistic fixed-effects modeling were then used to explore the role of seasonality. The prevalence rates of food insecurity, wasting, and inadequate growth were all significantly higher during the monsoon season as compared with the dry season. Dietary diversity and lost work due to the weather were identified as specific pathways through which season affected household food security. However, mechanisms hypothesized to contribute to seasonal declines in nutritional status, such as child illness, were not found to be significant. Season had a significant effect on both food security and nutritional status in Dinajpur, with households consistently worse off during the monsoon season. Initiatives to promote food market development, support employment during the hunger season, and prevent seasonal declines in nutritional status should be implemented.

Associations of occupational, transportation, household and leisure-time physical activity patterns with metabolic risk factors among middle-aged adults in a middle-income country.

PubMed

Chu, Anne H Y; Moy, Foong Ming

2013-01-01

This study investigates physical activity in different domains and its association with metabolic risk factors among middle-aged adults. The study was performed in Kuala Lumpur, Malaysia from August 2010-August 2011. Body mass index (BMI), waist circumference, systolic/diastolic blood pressure, and fasting blood glucose/lipid profile were measured in 686 Malay participants (mean age 45.9 ± 6.5 years). Self-reported physical activity was obtained with the validated IPAQ (Malay version) and categorized into low-, moderate- and high-activity levels across occupational, transportation, household and leisure-time domains. Participants spent most of their time on household (567.5, 95% CI: 510-630 MET-minutes/week) and occupational activities (297, 95% CI: 245-330 MET-minutes/week). After adjusted for gender and smoking, participants with low-activity levels in occupational, transport and household domains were associated with significantly higher odds for metabolic syndrome (2.02, 95% CI: 1.33-3.05; 1.49, 95% CI: 1.01-2.21; 1.96, 95% CI: 1.33-2.91). Significantly higher odds for obesity and abdominal obesity were consistently reported among those with low-activity levels across all four domains. High-activity levels in occupational, transportation and household domains were each negatively associated with metabolic syndrome among our cohort. Increase participation of physical activity across all four domains (including leisure-time activity) should be encouraged. Copyright © 2012 Elsevier Inc. All rights reserved.

Household Food Insecurity May Predict Underweightand Wasting among Children Aged 24-59 Months.

PubMed

Abdurahman, Ahmed A; Mirzaei, Khadijeh; Dorosty, Ahmed Reza; Rahimiforoushani, A; Kedir, Haji

2016-01-01

The aim of this study was to examine the association between household food insecurity and nutritional status among children aged 24-59 months in Haromaya District. Children (N = 453) aged 24-59 months were recruited in a community-based cross-sectional survey with a representative sample of households selected by a multistage sampling procedure in Haromaya District. Household Food Insecurity Access Scale and anthropometry were administered. Multinomial logistic regression models were applied to select variables that are candidate for multivariable model. The prevalences of stunting, underweight, and wasting among children aged 24-59 months were 61.1%, 28.1%, and 11.8%, respectively. The mean household food insecurity access scale score was 3.34, and 39.7% of households experienced some degree of food insecurity. By logistic regression analysis and after adjusting for the confounding factors, household food insecurity was significantly predictive of underweight (AOR = 2.48, CI = 1.17-5.24, p = .05) and chronic energy deficiency (AOR = 0.47, CI = 0.23-0.97, p = .04) and marginally significant for wasting (AOR = 0.53, CI = 0.27-1.03, p = .06). It is concluded that household food security improves child growth and nutritional status.

Respiratory risks from household air pollution in low and middle income countries

PubMed Central

Gordon, Stephen B; Bruce, Nigel G; Grigg, Jonathan; Hibberd, Patricia L; Kurmi, Om P; Lam, Kin-bong Hubert; Mortimer, Kevin; Asante, Kwaku Poku; Balakrishnan, Kalpana; Balmes, John; Bar-Zeev, Naor; Bates, Michael N; Breysse, Patrick N; Buist, Sonia; Chen, Zhengming; Havens, Deborah; Jack, Darby; Jindal, Surinder; Kan, Haidong; Mehta, Sumi; Moschovis, Peter; Naeher, Luke; Patel, Archana; Perez-Padilla, Rogelio; Pope, Daniel; Rylance, Jamie; Semple, Sean; Martin, William J

2016-01-01

A third of the world’s population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5–4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean

Respiratory risks from household air pollution in low and middle income countries.

PubMed

Gordon, Stephen B; Bruce, Nigel G; Grigg, Jonathan; Hibberd, Patricia L; Kurmi, Om P; Lam, Kin-bong Hubert; Mortimer, Kevin; Asante, Kwaku Poku; Balakrishnan, Kalpana; Balmes, John; Bar-Zeev, Naor; Bates, Michael N; Breysse, Patrick N; Buist, Sonia; Chen, Zhengming; Havens, Deborah; Jack, Darby; Jindal, Surinder; Kan, Haidong; Mehta, Sumi; Moschovis, Peter; Naeher, Luke; Patel, Archana; Perez-Padilla, Rogelio; Pope, Daniel; Rylance, Jamie; Semple, Sean; Martin, William J

2014-10-01

A third of the world's population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5-4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy

Household sanitation is associated with lower risk of bacterial and protozoal enteric infections, but not viral infections and diarrhoea, in a cohort study in a low-income urban neighbourhood in Vellore, India.

PubMed

Berendes, David; Leon, Juan; Kirby, Amy; Clennon, Julie; Raj, Suraja; Yakubu, Habib; Robb, Katharine; Kartikeyan, Arun; Hemavathy, Priya; Gunasekaran, Annai; Roy, Sheela; Ghale, Ben Chirag; Kumar, J Senthil; Mohan, Venkata Raghava; Kang, Gagandeep; Moe, Christine

2017-09-01

This study examined associations between household sanitation and enteric infection - including diarrhoeal-specific outcomes - in children 0-2 years of age in a low-income, dense urban neighbourhood. As part of the MAL-ED study, 230 children in a low-income, urban, Indian neighbourhood provided stool specimens at 14-17 scheduled time points and during diarrhoeal episodes in the first 2 years of life that were analysed for bacterial, parasitic (protozoa and helminths) and viral pathogens. From interviews with caregivers in 100 households, the relationship between the presence (and discharge) of household sanitation facilities and any, pathogen-specific, and diarrhoea-specific enteric infection was tested through mixed-effects Poisson regression models. Few study households (33%) reported having toilets, most of which (82%) discharged into open drains. Controlling for season and household socio-economic status, the presence of a household toilet was associated with lower risks of enteric infection (RR: 0.91, 95% CI: 0.79-1.06), bacterial infection (RR: 0.87, 95% CI: 0.75-1.02) and protozoal infection (RR: 0.64, 95% CI: 0.39-1.04), although not statistically significant, but had no association with diarrhoea (RR: 1.00, 95% CI: 0.68-1.45) or viral infections (RR: 1.12, 95% CI: 0.79-1.60). Models also suggested that the relationship between household toilets discharging to drains and enteric infection risk may vary by season. The presence of a household toilet was associated with lower risk of bacterial and protozoal enteric infections, but not diarrhoea or viral infections, suggesting the health effects of sanitation may be more accurately estimated using outcome measures that account for aetiologic agents. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

Household characteristics for older adults and study background from SAGE Ghana Wave 1.

PubMed

Biritwum, Richard B; Mensah, George; Minicuci, Nadia; Yawson, Alfred E; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

2013-06-11

Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub-Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18-49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of drinking water, with the lowest at

Household characteristics for older adults and study background from SAGE Ghana Wave 1

PubMed Central

Biritwum, Richard B.; Mensah, George; Minicuci, Nadia; Yawson, Alfred E.; Naidoo, Nirmala; Chatterji, Somnath; Kowal, Paul

2013-01-01

Background Globally, the population aged 60 years and older is projected to reach 22% by 2050. In sub-Saharan Africa, this figure is projected to exceed 8%, while in Ghana, the older adult population will reach 12% by 2050. The living arrangements and household characteristics are fundamental determinants of the health and well-being of this population, data sources about which are increasingly available. Methods The World Health Organization's Study on global AGEing and adult health (SAGE) Wave 1 was conducted in China, Ghana, India, Russian Federation, Mexico, and South Africa between 2007 and 2010. SAGE Ghana Wave 1 was implemented in 2007/08 using face-to-face interviews in a nationally representative sample of persons aged 50-plus, along with a smaller cohort aged 18–49 years for comparison purposes. Household information included a household roster including questions about health insurance coverage for all household members, household and sociodemographic characteristics, status of the dwelling, and economic situation. Re-interviews were done in a random 10% of the sample and proxy interviews done where necessary. Verbal autopsies were conducted for deaths occurring in older adult household members in the 24 months prior to interview. Results The total household population was 27,270 from 5,178 households. The overall household response rate was 86% and household cooperation rate was 98%. Thirty-four percent of household members were under 15 years of age while 8.3% were aged 65-plus years. Households with more than 11 members were more common in rural areas (57.2%) and in the highest income quintile (30.6%). Household members with no formal education formed 24.7% of the sample, with Northern and Upper East regions reaching more than 50%. Only 26.8% of the household members had insurance coverage. Households with hard floors ranged from 25.7% in Upper West to 97.7% in Ashanti region. Overall, 84.9% of the households had access to improved sources of

Investigating the Effects of Community-Based Interventions on Mathematics Achievement of Girls from Low-Income Households in Kenya

ERIC Educational Resources Information Center

Hungi, Njora; Ngware, Moses

2017-01-01

This paper uses difference-in-difference and multivariate analyses procedures to examine the effects of two community-based intervention packages on mathematics achievement of primary school girls from low-income urban households in Kenya. The data involved in this study were collected between 2013 and 2015 from 748 12-19 years old primary school…

A post-crisis assessment of retirement income adequacy for Baby Boomers and Gen Xers.

PubMed

VanDerhei, Jack

2011-02-01

DETERMINING THOSE "AT RISK" OF INSUFFICIENT RETIREMENT INCOME: The analysis in this paper was designed to answer two questions: 1) What percentage of U.S. households became "at risk" of insufficient retirement income as a result of the financial market and real estate crisis in 2008 and 2009? 2) Of those who are at risk, what additional savings do they need to make each year until retirement age to make up for their losses from the crisis? The results are from the 2010 EBRI Retirement Security Projection Model by the Employee Benefit Research Institute. Range at risk: The percentage of households that would not have been "at risk" without the 2008-2009 crisis but that ended up "at risk" varies from a low of 3.8 percent to a high of 14.3 percent. 50-50 chance of adequacy: Looking at all Early Boomer households that would need to save an additional amount (over and above the savings already factored into the baseline model), the median percentage of additional compensation for these households desiring a 50 percent probability of retirement income adequacy would be 3.0 percent of compensation each year until retirement age to account for the financial and housing market crisis in 2008 and 2009. 90 percent chance of adequacy: Looking at all Early Boomer households that would need to save an additional amount (over and above the savings already factored into the baseline model), the median percentage of additional compensation for these households desiring a 90 percent probability of retirement income adequacy would be 4.3 percent of compensation. Range of adequacy: Looking only at Early Boomer households that would need to save an additional amount (over and above the savings already factored into the baseline model), that had account balances in defined contribution plans and IRAs as well as exposure to the real estate crisis in 2008 and 2009 shows a median percentage for of 5.6 percent for a 50 percent probability and 6.7 percent for a 90 percent probability of

Association of Household Food Insecurity with the Mental and Physical Health of Low-Income Urban Ecuadorian Women with Children

PubMed Central

Armijos, Rodrigo X.; Racines, Marcia; Cevallos, William; Castro, Nancy P.

2016-01-01

Chronic physical and mental health conditions account for a rising proportion of morbidity, mortality, and disability in the Americas region. Household food insecurity (HFI) has been linked to chronic disease in US and Canadian women but it is uncertain if the same is true for low- and middle-income Latin American countries in epidemiologic transition. We conducted a survey to investigate the association of HFI with the physical and mental health of 794 women with children living in low-income Quito, Ecuador, neighborhoods. Data were collected on HFI and health indicators including self-reported health (SF-1), mental health (MHI-5), blood pressure, and self-reported mental and physical health complaints. Fasting blood glucose and lipids were measured in a subsample. The multivariate analyses revealed that HFI was associated with poorer self-rated health, low MHI-5 scores, and mental health complaints including stress, depression, and ethnospecific illnesses. It was also associated with chest tightness/discomfort/pain, dental disease, and gastrointestinal illness but not other conditions. The findings suggest that improving food security in low-income households may help reduce the burden of mental distress in women with children. The hypothesized link with diabetes and hypertension may become more apparent as Ecuador moves further along in the epidemiologic transition. PMID:27752266

Association of Household Food Insecurity with the Mental and Physical Health of Low-Income Urban Ecuadorian Women with Children.

PubMed

Weigel, M Margaret; Armijos, Rodrigo X; Racines, Marcia; Cevallos, William; Castro, Nancy P

2016-01-01

Chronic physical and mental health conditions account for a rising proportion of morbidity, mortality, and disability in the Americas region. Household food insecurity (HFI) has been linked to chronic disease in US and Canadian women but it is uncertain if the same is true for low- and middle-income Latin American countries in epidemiologic transition. We conducted a survey to investigate the association of HFI with the physical and mental health of 794 women with children living in low-income Quito, Ecuador, neighborhoods. Data were collected on HFI and health indicators including self-reported health (SF-1), mental health (MHI-5), blood pressure, and self-reported mental and physical health complaints. Fasting blood glucose and lipids were measured in a subsample. The multivariate analyses revealed that HFI was associated with poorer self-rated health, low MHI-5 scores, and mental health complaints including stress, depression, and ethnospecific illnesses. It was also associated with chest tightness/discomfort/pain, dental disease, and gastrointestinal illness but not other conditions. The findings suggest that improving food security in low-income households may help reduce the burden of mental distress in women with children. The hypothesized link with diabetes and hypertension may become more apparent as Ecuador moves further along in the epidemiologic transition.

Exploring household income as a predictor of psychological well-being among long-term colorectal cancer survivors.

PubMed

Lundy, J Jason; Coons, Stephen Joel; Wendel, Christopher; Hornbrook, Mark C; Herrinton, Lisa; Grant, Marcia; Krouse, Robert S

2009-03-01

The purpose of this analysis was to determine the unique contribution of household income to the variance explained in psychological well-being (PWB) among a sample of colorectal cancer (CRC) survivors. This study is a secondary analysis of data collected as part of the Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors Study, which included CRC survivors with (cases) and without (controls) ostomies. The dataset included socio-demographic, health status, and health-related quality of life (HRQOL) information. HRQOL was assessed with the modified City of Hope Quality of Life (mCOH-QOL)-Ostomy questionnaire and SF-36v2. To assess the relationship between income and PWB, a hierarchical linear regression model was constructed combining data from both cases and controls. After accounting for the proportion of variance in PWB explained by the other independent variables in the model, the additional variance explained by income was significant (R (2) increased from 0.228 to 0.250; P = 0.006). Although the study design does not allow causal inference, these results demonstrate a significant relationship between income and PWB in CRC survivors. The findings suggest that for non-randomized group comparisons of HRQOL, income should, at the very least, be included as a control variable in the analysis.

Daily Travel by Persons with Low Income

DOT National Transportation Integrated Search

1997-10-26

Persons in households with low incomes are much less likely to have a vehicle, largely in part because a greater proportion of their income is spent on shelter and food. About a quarter (26%) of low income households do not have a car, compared to 4%...

Income differentials in functional disability in old age: relative risks of onset, recovery, decline, attrition and mortality.

PubMed

Broese van Groenou, Marjolein I; Deeg, Dorly J H; Penninx, Brenda W J H

2003-04-01

Socioeconomic status (SES) differences in health decline in late life may be underestimated, because the relatively higher risks of attrition of lower-SES persons are seldom taken into account. This longitudinal study aimed at comparing income differences in the course of disability, non-mortality attrition and mortality in older adults. A sample population of 3107 older adults who participated in the 1992/1993 baseline of the Longitudinal Aging Study Amsterdam was examined regarding changes in functional disability in 1998/1999. SES was indicated by household income. Multinomial regression analyses revealed that, for men without disability at baseline, the relative rate for attrition was four times higher and the mortality rate was twice as high for low-income vs high-income persons. For non-disabled women, the relative risk for the onset of disability was nearly twice as high for low-income vs high-income persons. For both men and women, these risks decreased only slightly when behavioral and psychosocial risk factors were taken into account. Among persons with disability at baseline, the relative risks for attrition (for women) and mortality (for men) were twice as high for low-income persons, but no income differences were found with respect to recovery and decline. Adjustment for risk factors decreased the relative risks for attrition and mortality to a non-significant level. Income inequality in health in late life is to a large degree explained by the higher incidence of disability among lower-status women and by the higher attrition and mortality risks among lower-status men.

Association of Income Inequality With Pediatric Hospitalizations for Ambulatory Care-Sensitive Conditions.

PubMed

Bettenhausen, Jessica L; Colvin, Jeffrey D; Berry, Jay G; Puls, Henry T; Markham, Jessica L; Plencner, Laura M; Krager, Molly K; Johnson, Matthew B; Queen, Mary Ann; Walker, Jacqueline M; Latta, Grant M; Riss, Robert R; Hall, Matt

2017-06-05

The level of income inequality (ie, the variation in median household income among households within a geographic area), in addition to family-level income, is associated with worsened health outcomes in children. To determine the influence of income inequality on pediatric hospitalization rates for ambulatory care-sensitive conditions (ACSCs) and whether income inequality affects use of resources per hospitalization for ACSCs. This retrospective, cross-sectional analysis used the 2014 State Inpatient Databases of the Healthcare Cost and Utilization Project of 14 states to evaluate all hospital discharges for patients aged 0 to 17 years (hereafter referred to as children) from January 1 through December 31, 2014. Using the 2014 American Community Survey (US Census), income inequality (Gini index; range, 0 [perfect equality] to 1.00 [perfect inequality]), median household income, and total population of children aged 0 to 17 years for each zip code in the 14 states were measured. The Gini index for zip codes was divided into quartiles for low, low-middle, high-middle, and high income inequality. Rate, length of stay, and charges for pediatric hospitalizations for ACSCs. A total of 79 275 hospitalizations for ACSCs occurred among the 21 737 661 children living in the 8375 zip codes in the 14 included states. After adjustment for median household income and state of residence, ACSC hospitalization rates per 10 000 children increased significantly as income inequality increased from low (27.2; 95% CI, 26.5-27.9) to low-middle (27.9; 95% CI, 27.4-28.5), high-middle (29.2; 95% CI, 28.6-29.7), and high (31.8; 95% CI, 31.2-32.3) categories (P < .001). A significant, clinically unimportant longer length of stay was found for high inequality (2.5 days; 95% CI, 2.4-2.5 days) compared with low inequality (2.4 days; 95% CI, 2.4-2.5 days; P < .001) zip codes and between charges ($765 difference among groups; P < .001). Children living in areas of high income

A cohort study of the effects of older adult care dependence upon household economic functioning, in Peru, Mexico and China

PubMed Central

Guerchet, Maëlenn M.; Guerra, Mariella; Huang, Yueqin; Lloyd-Sherlock, Peter; Sosa, Ana Luisa; Uwakwe, Richard; Acosta, Isaac; Ezeah, Peter; Gallardo, Sara; Liu, Zhaorui; Mayston, Rosie; Montes de Oca, Veronica; Wang, Hong

2018-01-01

Background While links between disability and poverty are well established, there have been few longitudinal studies to clarify direction of causality, particularly among older adults in low and middle income countries. We aimed to study the effect of care dependence among older adult residents on the economic functioning of their households, in catchment area survey sites in Peru, Mexico and China. Methods Households were classified from the evolution of the needs for care of older residents, over two previous community surveys, as ‘incident care’, ‘chronic care’ or ‘no care’, and followed up three years later to ascertain economic outcomes (household income, consumption, economic strain, satisfaction with economic circumstances, healthcare expenditure and residents giving up work or education to care). Results Household income did not differ between household groups. However, income from paid work (Pooled Count Ratio pCR 0.88, 95% CI 0.78–1.00) and government transfers (pCR 0.80, 95% CI 0.69–0.93) were lower in care households. Consumption was 12% lower in chronic care households (pCR 0.88, 95% CI 0.77–0.99). Household healthcare expenditure was higher (pCR 1.55, 95% CI 1.26–1.90), and catastrophic healthcare spending more common (pRR 1.64, 95% CI 1.64–2.22) in care households. Conclusions While endogeneity cannot be confidently excluded as an explanation for the findings, this study indicates that older people’s needs for care have a discernable impact on household economics, controlling for baseline indicators of long-term economic status. Although living, typically, in multigenerational family units, older people have not featured prominently in global health and development agendas. Population ageing will rapidly increase the number of households where older people live, and their societal significance. Building sustainable long-term care systems for the future will require some combination of improved income security in old age

A multilevel analysis of socioeconomic (small area) differences in household food purchasing behaviour.

PubMed

Turrell, G; Blakely, T; Patterson, C; Oldenburg, B

2004-03-01

To examine the association between area and individual level socioeconomic status (SES) and food purchasing behaviour. The sample comprised 1000 households and 50 small areas. Data were collected by face to face interview (66.4% response rate). SES was measured using a composite area index of disadvantage (mean 1026.8, SD = 95.2) and household income. Purchasing behaviour was scored as continuous indices ranging from 0 to 100 for three food types: fruits (mean 50.5, SD = 17.8), vegetables (61.8, 15.2), and grocery items (51.4, 17.6), with higher scores indicating purchasing patterns more consistent with dietary guideline recommendations. Brisbane, Australia, 2000. Persons responsible for their household's food purchasing. Controlling for age, gender, and household income, a two standard deviation increase on the area SES measure was associated with a 2.01 unit increase on the fruit purchasing index (95% CI -0.49 to 4.50). The corresponding associations for vegetables and grocery foods were 0.60 (-1.36 to 2.56) and 0.94 (-1.35 to 3.23). Before controlling for household income, significant area level differences were found for each food, suggesting that clustering of household income within areas (a composition effect) accounted for the purchasing variability between them. Living in a socioeconomically advantaged area was associated with a tendency to purchase healthier food, however, the association was small in magnitude and the 95% CI for area SES included the null. Although urban areas in Brisbane are differentiated on the basis of their socioeconomic characteristics, it seems unlikely that where you live shapes your procurement of food over and above your personal characteristics.

Very Low Food Security in US Households Is Predicted by Complex Patterns of Health, Economics, and Service Participation.

PubMed

Choi, Seul Ki; Fram, Maryah S; Frongillo, Edward A

2017-10-01

Background: Very low food security (VLFS) happens at the intersection of nuanced and complex patterns of risk characteristics across multiple domains. Little is known about the idiosyncratic situations that lead households to experience VLFS. Objective: We used classification and regression tree (CART) analysis, which can handle complex combinations of predictors, to identify patterns of characteristics that distinguish VLFS households in the United States from other households. Methods: Data came from 3 surveys, the 2011-2014 National Health Interview Survey (NHIS), the 2005-2012 NHANES, and the 2002-2012 Current Population Survey (CPS), with sample participants aged ≥18 y and households with income <300% of the federal poverty line. Survey participants were stratified into households with children, adult-only households, and older-adult households (NHIS, CPS) or individuals aged 18-64 y and individuals aged ≥65 y (NHANES). Household food security was measured with the use of the 10-item US Adult Food Security Scale. Variables from multiple domains, including sociodemographic characteristics, health, health care, and participation in social welfare and food assistance programs, were considered as predictors. The 3 data sources were analyzed separately with the use of CART analysis. Results: Household experiences of VLFS were associated with different predictors for different types of households and often occurred at the intersection of multiple characteristics spanning unmet medical needs, poor health, disability, limitation, depressive symptoms, low income, and food assistance program participation. These predictors built complex trees with various combinations in different types of households. Conclusions: This study showed that multiple characteristics across multiple domains distinguished VLFS households. Flexible and nonlinear methods focusing on a wide range of risk characteristics should be used to identify VLFS households and to inform policies and

How Do Cooks Actually Cook Vegetables? A Field Experiment With Low-Income Households.

PubMed

Clarke, Peter; Evans, Susan H

2016-01-01

Vegetables in the diet contribute to disease prevention. However, low-income households underconsume fresh vegetables, perhaps because of cost and of unavailability at nearby stores. A third reason may lurk behind those barriers: cooks' unfamiliarity with various and appealing ways to prepare vegetables. To illuminate that possibility and to suggest interventions that could be designed more effectively to boost vegetable consumption, this study took the novel step of providing ample, if temporary, supplies of a fresh vegetable to random sets of clients of food pantries. A week later, telephone interviews obtained details about preparations of meals and snacks that household cooks had made with their unexpected bounty. Among the experiment's 10 vegetables, some were used twice as often as others. Even more striking, cooks practiced a narrow repertoire of preparation methods, dominated by boiling and steaming, across most of the vegetables. Fats and salt were often added to boiled and steamed preparations. Implications are drawn to suggest kinds of recipes-pairings of vegetables and of vegetables with underused means of preparation-that could expand cooks' repertoires and add variety in flavors, appearances of dishes, meal textures, and aromas. © 2015 Society for Public Health Education.

Income and Social Rank Influence UK Children's Behavioral Problems: A Longitudinal Analysis.

PubMed

Garratt, Elisabeth A; Chandola, Tarani; Purdam, Kingsley; Wood, Alex M

2017-07-01

Children living in low-income households face elevated risks of behavioral problems, but the impact of absolute and relative income to this risk remains unexplored. Using the U.K. Millennium Cohort Study data, longitudinal associations between Strengths and Difficulties Questionnaire scores and absolute household income, distance from the regional median and mean income, and regional income rank were examined in 3- to 12-year-olds (n = 16,532). Higher absolute household incomes were associated with lower behavioral problems, while higher income rank was associated with lower behavioral problems only at the highest absolute incomes. Higher absolute household incomes were associated with lower behavioral problems among children in working households, indicating compounding effects of income and socioeconomic advantages. Both absolute and relative incomes therefore appear to influence behavioral problems. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

Prevalence and intensity of catastrophic health care expenditures in Iran from 2008 to 2015: a study on Iranian household income and expenditure survey.

PubMed

Yazdi-Feyzabadi, Vahid; Bahrampour, Mina; Rashidian, Arash; Haghdoost, Ali-Akbar; Akbari Javar, Mohammadreza; Mehrolhassani, Mohammad Hossein

2018-04-13

Households exposure to catastrophic health expenditure is a valuable measure to monitor financial protection in health sector payments. The present study had two aims: first, to estimate the prevalence and intensity of catastrophic health expenditures (CHE) in Iran. Second, to investigate main factors that influence the probability of CHE. CHE is defined as an occasion in which a household's out-of-pocket (OOP) spending exceeds 40% of the total income that remains after subtraction of living expenses. This study used the data from eight national repeated cross-sectional surveys on households' income and expenditure. The proportion of households facing CHE, as a prevalence measure, was estimated for rural and urban areas. The intensity of CHE was also calculated using overshoot and mean positive overshoot (MPO) measures. The factors affecting the CHE were also analyzed using logistic random effects regression model. We also used ArcMap 10.1 to display visually disparities across the country. An increasing number of Iranians has been subject to catastrophic health care costs over the study period in both rural and urban areas (CHE = 2.57% in 2008 and 3.25% in 2015). In the same period, the overshoot of CHE and the mean positive overshoot ranged from 0.26% to 0.65% and from 12.26% to 20.86%, respectively. The average absolute monetary value of OOP spending per month has been low in rural areas over the years, but the prevalence of CHE has been higher than urban areas. Generally put, rural settlement, higher income, receiving inpatient and outpatient services, and existence of elderly people in the household led to increase in CHE prevalence (p < 0.05). Interestingly, provinces with more limited geographical and cultural accessibility had the lowest CHE. According to the findings, Iran's healthcare system has failed to realize the aim of five-year national development plan regarding CHE prevalence (1% CHE prevalence according to the plan). Therefore, revision

[Offered income, salary expectations, and the economic activity of married women: an analytic model].

PubMed

Lollivier, S

1984-06-01

This study uses data from tax declarations for 40,000 French households for 1975 to propose a model that permits quantification of the effects of certain significant factors on the economic activity of married women. The PROBIT model of analysis of variance was used to determine the specific effect of several variables, including age of the woman, number of children under 25 years of age in the household, the age of the youngest child, husband's income and socioprofessional status, wife's level and type of education, size of community of residence and region of residence. The principal factors influencing activity rates were found to be educational level, age, and to those of childless women, but activity rates dropped by about 30% for mothers of 2 and even more for mothers of 3 or more children. Influence of the place of residence and the husband's income were associated with lesser disparities. The reasons for variations in female labor force participation can be viewed as analogous to a balance. Underlying factors can increase or decrease the income the woman hopes to earn (offered income) as well as the minimum income for which she will work (required salary). A TOBIT model was constructed in which income was a function of age, education, geographic location, and number of children, and salary required was a function of the variables related to the husband including income and socioprofessional status. For most of the effects considered, the observed variation in activity rates resulted from variations in offered income. The husband's income influences only the desired salary. The offered income decreases and the required salary increases when the number of children is 2 or more, reducing the rate of activity. More educated women have slightly greater salary expectations, but command much higher salaries, resulting in an increased rate of professional activity.

Exploring household income as a predictor of psychological well-being among long-term colorectal cancer survivors

PubMed Central

Coons, Stephen Joel; Wendel, Christopher; Hornbrook, Mark C; Herrinton, Lisa; Grant, Marcia; Krouse, Robert S

2009-01-01

Purpose The purpose of this analysis was to determine the unique contribution of household income to the variance explained in psychological well-being (PWB) among a sample of colorectal cancer (CRC) survivors. Methods This study is a secondary analysis of data collected as part of the Health-Related Quality of Life in Long-Term Colorectal Cancer Survivors Study, which included CRC survivors with (cases) and without (controls) ostomies. The dataset included socio-demographic, health status, and health-related quality of life (HRQOL) information. HRQOL was assessed with the modified City of Hope Quality of Life (mCOH-QOL)-Ostomy questionnaire and SF-36v2. To assess the relationship between income and PWB, a hierarchical linear regression model was constructed combining data from both cases and controls. Results After accounting for the proportion of variance in PWB explained by the other independent variables in the model, the additional variance explained by income was significant (R2 increased from 0.228 to 0.250; p = 0.006). Conclusions Although the study design does not allow causal inference, these results demonstrate a significant relationship between income and PWB in CRC survivors. The findings suggest that for non-randomized group comparisons of HRQOL, income should, at the very least, be included as a control variable in the analysis. PMID:19132550

Province-Level Income Inequality and Health Outcomes in Canadian Adolescents

PubMed Central

McGrath, Jennifer J.

2015-01-01

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 inequality, and province mean income were measured. Health outcomes were measured across a number of domains, 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 conduct 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. PMID:25324533

The effects of household income distribution on stroke prevalence and its risk factors of high blood pressure and smoking: a cross-sectional study in Saskatchewan, Canada.

PubMed

Bird, Yelena; Lemstra, Mark; Rogers, Marla

2017-03-01

Stroke is a major chronic disease and a common cause of adult disability and mortality. Although there are many known risk factors for stroke, lower income is not one that is often discussed. To determine the unadjusted and adjusted association of income distribution on the prevalence of stroke in Saskatchewan, Canada. Information was collected from the Canadian Community Health Survey conducted by Statistics Canada for 2000-2008. In total, 178 variables were analysed for their association with stroke. Prior to statistical adjustment, stroke was seven times more common for lower income residents than higher income residents. After statistical adjustment, only four covariates were independently associated with stroke prevalence, including having high blood pressure (odds ratio (OR) = 2.62; 95% confidence interval (CI) = 2.12-3.24), having a household income below CAD$30,000 per year (OR = 2.49; 95% CI = 1.88-3.29), being a daily smoker (OR = 1.36; 95% CI = 1.16-1.58) and being physically inactive (OR = 1.27; 95% CI = 1.13-1.43). After statistical adjustment, there were five covariates independently associated with high blood pressure prevalence, including having a household income below CAD$30,000 per year (OR = 1.52; 95% CI = 1.41-1.63). After statistical adjustment, there were five covariates independently associated with daily smoking prevalence, including having a household income below CAD$30,000 per year (OR = 1.29; 95% CI = 1.25-1.33). Knowledge of disparities in the prevalence, severity, disability and mortality of stroke is critically important to medical and public health professionals. Our study found that income distribution was strongly associated with stroke, its main disease intermediary - high blood pressure - and its main risk factor - smoking. As such, income is an important variable worthy of public debate as a modifiable risk factor for stroke.

Association between household food access insecurity and nutritional status indicators among children aged <5 years in Nepal: results from a national, cross-sectional household survey.

PubMed

Sreeramareddy, Chandrashekhar T; Ramakrishnareddy, N; Subramaniam, Mayoori

2015-11-01

To examine the association between household food insecurity score and Z-scores of childhood nutritional status indicators. Population-based, cross-sectional survey, Nepal Demographic and Health Survey 2011. A nationally representative sample of 11 085 households selected by a two-stage, stratified cluster sampling design to interview eligible men and women. Children (n 2591) aged 0-60 months in a sub-sample of households selected for men's interview. Prevalence of moderate and severe household food insecurity was 23·2% and 19·0%, respectively, for children aged 0-60 months. Weighted prevalence rates for stunting (height-for-age Z-score (HAZ) <-2), wasting (weight-for-height Z-score (WHZ) <-2) and underweight (weight-for-age Z-score (WAZ) <-2) were 41·6% (95% CI 38·9, 44·3%), 11·5% (95% CI 9·8, 13·2%) and 30·1% (95% CI 27·5, 32·8%), respectively. Prevalences of stunting, severe stunting (HAZ<-3) and underweight by level of household food insecurity were statistically significant (P<0·001). By multiple linear regression analyses and after adjustment for sociodemographic, child and environmental factors, household food access insecurity score was associated with HAZ (β=-0·02, P=0·01) and WAZ (β=-0·01, P=0·01) but was not associated with WHZ and BMI-for-age Z-score. A 10-point increase in household food access insecurity score was associated with a decrease in HAZ of 0·2 (95% CI 0·05, 0·39) and decrease in WAZ of 0·1 (95% CI 0·03, 0·27). Our results from a nationally representative sample confirm the previously reported association of household food insecurity with stunting and underweight. Community nutrition interventions may use household food insecurity scales for identifying those households where children may be at risk of growth faltering.

Firearm ownership in households with children.

PubMed

Drongowski, R A; Smith, S J; Coran, A G; Cullen, M L

1998-04-01

Increased morbidity and mortality rates in children injured by firearms has been well documented during this past decade. The aim of this study was to determine the socioeconomic factors affecting firearm ownership in families with children living in suburban/rural versus inner-city environments, and to identify predictors of firearm ownership in these families. Parents of children less than 19 years old seen in a suburban (n = 751) or inner-city hospital (n = 406) anonymously completed a questionnaire regarding firearm ownership. Firearm ownership was 54% in rural locations, versus 18% among inner-city residents (P< .05). Firearm ownership in white households was 45% versus 20% in African-American households (P< .05). Mean number of all types of firearms in white households was 3.38 versus 1.78 in black households (P< .001). Firearm ownership was 19% in the less than $20,000 income bracket, significantly lower than households with greater incomes, and was significantly lower in households in which parents had the least education (19.7%) versus those with college degrees (38.5%; P< .05). Firearm owners of rifles and shotguns significantly more often cited hunting, collection, and target shooting as reasons for owning firearms, in contrast to revolver owners who cited protection and collection as reasons for firearm ownership (P < .05). Firearm ownership is higher in rural, caucasian versus inner-city African-American residents and is significantly less in households with lower income and educational levels. Significant predictors for firearm ownership were number of parents in households, educational level of parents, and population of residence.

Revealing the unequal household health footprints in China

NASA Astrophysics Data System (ADS)

Zhao, H.; Li, X.; Zhang, Q.

2017-12-01

Household consumption scale and patterns varies among rural and urban, rich and poor households across regions and nations, these bring uneven direct and indirect production related pollutant emissions and related health footprint. Here, by integrating four stat-of-the-art social-economical and physical models, we quantify PM2.5 related health burden from consumption of 12 income groups for rural and urban households in seven regions of China. We show that, despite earn and spend far less than urban residents, rural households show similar health footprints (3.4×10-4 deaths per capita) with that of urban (3.2×10-4 deaths per capita), primarily because 50% of its consumption related deaths were contributed by the less controlled direct biofuel consumption emissions. Income or expenditure is a main contributor of household health footprints, national averagely, the highest income brackets in rural and urban is 1.8 and 3.4 times of their lowest income groups, respectively. From regions perspective, the household in east coast regions show higher footprint than that of central and western regions, and part of their footprint were occurred in central and west regions through trade or atmospheric transportation. Our results indicate that urbanization will not solve the pollution effects, and efforts to reduce the household health impact should focus on the mitigation of the biofuel consumption emissions in rural area and encourage sustainable consumption in urban area.

Minority and poor households: patterns of travel and transportation fuel use

DOE Office of Scientific and Technical Information (OSTI.GOV)

Millar, M.; Morrison, R.; Vyas, A.

1986-05-01

This report documents the travel behavior and transportation fuel use of minority and poor households in the US, using information from numerous national-level sources. The resulting data base reveals distinctive patterns of household vehicle availability and use, travel, and fuel use and enables us to relate observed differences between population groups to differences in their demographic characteristics and in the attributes of their household vehicles. When income and residence location are controlled, black (and to a lesser extent, Hispanic and poor) households have fewer vehicles regularly available than do comparable white or nonpoor households; moreover, these vehicles are older andmore » larger and thus have significantly lower fuel economy. The net result is that average black, Hispanic, and poor households travel fewer miles per year but use more fuel than do average white and nonpoor households. Certain other findings - notably, that of significant racial differences in vehicle availability and use by low-income households - challenge the conventional wisdom that such racial variations arise solely because of differences in income and residence location. Results of the study suggest important differences - primarily in the yearly fluctuation of income - between black and white low-income households even when residence location is controlled. These variables are not captured by cross-sectional data sets (either the national surveys used in our analysis or the local data sets that are widely used for urban transportation planning).« less

Income Affluence in Poland

ERIC Educational Resources Information Center

Brzezinski, Michal

2010-01-01

This paper examines the evolution of income affluence (richness) in Poland during 1998-2007. Using household survey data, the paper estimates several statistical indices of income affluence including income share of the top percentiles, population share of individuals receiving incomes higher than the richness line, and measures that take into…

Effect of national wealth on BMI: An analysis of 206,266 individuals in 70 low-, middle- and high-income countries

PubMed Central

Reidpath, Daniel D.

2017-01-01

Background This study explores the relationship between BMI and national-wealth and the cross-level interaction effect of national-wealth and individual household-wealth using multilevel analysis. Methods Data from the World Health Survey conducted in 2002–2004, across 70 low-, middle- and high-income countries was used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as outcome variable. The potential determinants of individual-level BMI were participants’ sex, age, marital-status, education, occupation, household-wealth and location(rural/urban) at the individual-level. The country-level factors used were average national income (GNI-PPP) and income inequality (Gini-index). A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries was fitted, treating BMI as a continuous outcome. Results The weighted mean BMI and standard-error of the 206,266 people from 70-countries was 23.90 (4.84). All the low-income countries were below the 25.0 mean BMI level and most of the high-income countries were above. All wealthier quintiles of household-wealth had higher scores in BMI than lowest quintile. Each USD10000 increase in GNI-PPP was associated with a 0.4 unit increase in BMI. The Gini-index was not associated with BMI. All these variables explained 28.1% of country-level, 4.9% of individual-level and 7.7% of total variance in BMI. The cross-level interaction effect between GNI-PPP and household-wealth was significant. BMI increased as the GNI-PPP increased in first four quintiles of household-wealth. However, the BMI of the wealthiest people decreased as the GNI-PPP increased. Conclusion Both individual-level and country-level factors made an independent contribution to the BMI of the people. Household-wealth and national-income had significant interaction effects. PMID:28662041

Effect of national wealth on BMI: An analysis of 206,266 individuals in 70 low-, middle- and high-income countries.

PubMed

Masood, Mohd; Reidpath, Daniel D

2017-01-01

This study explores the relationship between BMI and national-wealth and the cross-level interaction effect of national-wealth and individual household-wealth using multilevel analysis. Data from the World Health Survey conducted in 2002-2004, across 70 low-, middle- and high-income countries was used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as outcome variable. The potential determinants of individual-level BMI were participants' sex, age, marital-status, education, occupation, household-wealth and location(rural/urban) at the individual-level. The country-level factors used were average national income (GNI-PPP) and income inequality (Gini-index). A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries was fitted, treating BMI as a continuous outcome. The weighted mean BMI and standard-error of the 206,266 people from 70-countries was 23.90 (4.84). All the low-income countries were below the 25.0 mean BMI level and most of the high-income countries were above. All wealthier quintiles of household-wealth had higher scores in BMI than lowest quintile. Each USD10000 increase in GNI-PPP was associated with a 0.4 unit increase in BMI. The Gini-index was not associated with BMI. All these variables explained 28.1% of country-level, 4.9% of individual-level and 7.7% of total variance in BMI. The cross-level interaction effect between GNI-PPP and household-wealth was significant. BMI increased as the GNI-PPP increased in first four quintiles of household-wealth. However, the BMI of the wealthiest people decreased as the GNI-PPP increased. Both individual-level and country-level factors made an independent contribution to the BMI of the people. Household-wealth and national-income had significant interaction effects.

Earned Income Credit Utilization by Welfare Recipients: A Case Study of Minnesota's Earned Income Credit Program

ERIC Educational Resources Information Center

Hirasuna, Donald P.; Stinson, Thomas F.

2007-01-01

This paper examines utilization of a state earned income credit by AFDC and TANF recipients. Although utilization percentages are increasing, we find that among TANF recipients in 1999, 45.7 percent of all households and 34.8 percent of eligible households did not receive the state earned income credit. Moreover, we find that utilization may…

Illness, death, and macronutrients: adequacy of rural Mozambican household production of macronutrients in the face of HIV/AIDS.

PubMed

Donovan, Cynthia; Massingue, Jaquelino

2007-06-01

As the public sector and civil society develop intervention programs to deal with the HIV/ AIDS epidemic, there has been an increasing emphasis on the relationship between nutrition and the disease. Drug interventions may be ineffective, and the progression from HIV infection to full-blown AIDS may be accelerated without adequate nutrition. Mozambique is still fighting an increasing prevalence rate of HIV including in rural areas. Rural households in Mozambique rely heavily on their own agricultural production for the basic macronutrients. To evaluate the extent to which household agricultural production of basic staples meets overall household needs for major macronutrients, comparing households affected and not directly affected by HIV/ AIDS and other major illnesses over two time periods. Methods. This research analyzes nationally representative panel data from rural household surveys conducted in 2002 and 2005 to evaluate whether households that have suffered the chronic illness or illness-related death of prime-age adult members (15 to 49 years of age) are more vulnerable to macronutrient gaps. Households in the South and in the North with a male illness or death in 2002 produced significantly less macronutrients from crops in 2005 than nonaffected households. These households also had significantly lower income per adult equivalent. Mortality or illness from HIV/AIDS affects the ability of agricultural households dependent on own-food production to produce macronutrients. Interventions to improve access to food may be needed for affected households, particularly in light of their inability to recover over time. More analysis is needed to understand income sources, crop diversification, and access to macronutrients through the market.

Human Health and Economic Impacts of Ozone Reductions by Income Group.

PubMed

Saari, Rebecca K; Thompson, Tammy M; Selin, Noelle E

2017-02-21

Low-income households may be disproportionately affected by ozone pollution and ozone policy. We quantify how three factors affect the relative benefits of ozone policies with household income: (1) unequal ozone reductions; (2) policy delay; and (3) economic valuation methods. We model ozone concentrations under baseline and policy conditions across the full continental United States to estimate the distribution of ozone-related health impacts across nine income groups. We enhance an economic model to include these impacts across household income categories, and present its first application to evaluate the benefits of ozone reductions for low-income households. We find that mortality incidence rates decrease with increasing income. Modeled ozone levels yield a median of 11 deaths per 100 000 people in 2005. Proposed policy reduces these rates by 13%. Ozone reductions are highest among low-income households, which increases their relative welfare gains by up to 4% and decreases them for the rich by up to 8%. The median value of reductions in 2015 is either $30 billion (in 2006 U.S. dollars) or $1 billion if reduced mortality risks are valued with willingness-to-pay or as income from increased life expectancy. Ozone reductions were relatively twice as beneficial for the lowest- compared to the highest-income households. The valuation approach affected benefits more than a policy delay or differential ozone reductions with income.

Using rewards-based incentives to increase purchase of fruit and vegetables in lower-income households: design and start-up of a randomized trial.

PubMed

Phipps, Etienne J; Wallace, Samantha L; Stites, Shana D; Uplinger, Nadine; Brook Singletary, S; Hunt, Lacy; Axelrod, Saul; Glanz, Karen; Braitman, Leonard E

2013-05-01

To report the design and baseline results of a rewards-based incentive to promote purchase of fruit and vegetables by lower-income households. A four-phase randomized trial with wait-listed controls. In a pilot study, despite inadequate study coupon use, purchases of fresh fruit (but not vegetables) increased, but with little maintenance. In the present study, credits on the study store gift card replace paper coupons and a tapering phase is added. The primary outcome is the number of servings of fresh and frozen fruit and vegetables purchased per week. A large full-service supermarket located in a predominantly minority community in Philadelphia, Pennsylvania, USA. Fifty-eight households, with at least one child living in the home. During the baseline period, households purchased an average of 3·7 servings of fresh vegetables and an average of less than 1 serving of frozen vegetables per week. Households purchased an average of 1·9 servings of fresh fruit per week, with little to no frozen fruit purchases. Overall, the range of fresh and frozen produce purchased during this pre-intervention period was limited. At baseline, produce purchases were small and of limited variety. The study will contribute to understanding the impact of financial incentives on increasing the purchases of healthier foods by lower-income populations.

A survey of recycling behaviour in households in Dhaka, Bangladesh.

PubMed

Afroz, Rafia; Hanaki, Keisuke; Tuddin, Rabaah; Ayupp, Kartinah; Ayup, Kartinah

2010-06-01

This paper examines the factors that might influence recycling behaviour of the households in Dhaka city, Bangladesh. Information on recycling activity, socio-economic characteristics, and attitudes of the households towards recycling were obtained from interviews with 456 households in Dhaka. Logistic regression analysis was used to determine the dominant factors that might influence the recycling behaviour of the households. The results showed that environmental consciousness, the availability of storage space, and age (25-35 years) are significant positive predictors of recycling behaviour (at the 1% level). Another variable Income 2 (TK3,000-15,000) is also positively correlated with recycling (at the 5% level). Establishment of a recycling programme could be an effective strategy in implementing sustainable waste management in Bangladesh. For this strategy to succeed, however, active partnership between households and the waste management service department is required. The households' attitudes toward recycling should, therefore, be taken into consideration as should the results of this study, which are important indicators of households' positive attitudes toward sustainable waste management in Dhaka.

Household income disparities in fruit and vegetable consumption by state and territory: results of the 2009 Behavioral Risk Factor Surveillance System.

PubMed

Grimm, Kirsten A; Foltz, Jennifer L; Blanck, Heidi M; Scanlon, Kelley S

2012-12-01

Few studies take into account the influence of family size on household resources when assessing income disparities in fruit and vegetable (F/V) consumption. Poverty income ratio (PIR) is a measure that utilizes both reported income and household size. We sought to examine state-specific disparities in meeting Healthy People 2010 objectives for F/V consumption by percent PIR. This analysis included 353,005 adults in 54 states and territories reporting data to the 2009 Behavioral Risk Factor Surveillance System in the United States. Percent PIR was calculated using the midpoint of self-reported income range and family size. The prevalences consuming at least two fruits and at least three vegetables per day were examined by percent PIR (<130% [greatest poverty], 130% to <200%, 200% to <400%, and ≥ 400% [least poverty]). The percent of adults consuming vegetables at least three times daily was significantly lower (21.3%) among those living at greatest poverty (<130% PIR) compared with 30.7% among those with least poverty (≥ 400% PIR). Daily consumption of vegetables at least three times was significantly lower among those with greatest poverty in a majority of states and territories surveyed (43 of 54). The overall percent of adults consuming fruits at least 2 times daily was also lower among those living at greatest vs least poverty, but the difference was smaller (32.0% vs 34.2%), with 14 states reporting a difference that was significantly lower among those with greatest poverty. Our study revealed that in 2009 a significantly lower proportion of US adults living at greatest poverty consumed fruits at least two times daily or vegetables at least three times daily compared with those with the least poverty, with greater disparity in vegetable intake. Policy and environmental strategies for increased affordability, access, availability, and point-of-decision information are approaches that may help disparate households purchase and consume F/V. Published by

Comparison of two cash transfer strategies to prevent catastrophic costs for poor tuberculosis-affected households in low- and middle-income countries: An economic modelling study.

PubMed

Rudgard, William E; Evans, Carlton A; Sweeney, Sedona; Wingfield, Tom; Lönnroth, Knut; Barreira, Draurio; Boccia, Delia

2017-11-01

Illness-related costs for patients with tuberculosis (TB) ≥20% of pre-illness annual household income predict adverse treatment outcomes and have been termed "catastrophic." Social protection initiatives, including cash transfers, are endorsed to help prevent catastrophic costs. With this aim, cash transfers may either be provided to defray TB-related costs of households with a confirmed TB diagnosis (termed a "TB-specific" approach); or to increase income of households with high TB risk to strengthen their economic resilience (termed a "TB-sensitive" approach). The impact of cash transfers provided with each of these approaches might vary. We undertook an economic modelling study from the patient perspective to compare the potential of these 2 cash transfer approaches to prevent catastrophic costs. Model inputs for 7 low- and middle-income countries (Brazil, Colombia, Ecuador, Ghana, Mexico, Tanzania, and Yemen) were retrieved by literature review and included countries' mean patient TB-related costs, mean household income, mean cash transfers, and estimated TB-specific and TB-sensitive target populations. Analyses were completed for drug-susceptible (DS) TB-related costs in all 7 out of 7 countries, and additionally for drug-resistant (DR) TB-related costs in 1 of the 7 countries with available data. All cost data were reported in 2013 international dollars ($). The target population for TB-specific cash transfers was poor households with a confirmed TB diagnosis, and for TB-sensitive cash transfers was poor households already targeted by countries' established poverty-reduction cash transfer programme. Cash transfers offered in countries, unrelated to TB, ranged from $217 to $1,091/year/household. Before cash transfers, DS TB-related costs were catastrophic in 6 out of 7 countries. If cash transfers were provided with a TB-specific approach, alone they would be insufficient to prevent DS TB catastrophic costs in 4 out of 6 countries, and when increased enough

Assets and Income: Disability-Based Disparities in the United States

ERIC Educational Resources Information Center

Parish, Susan L.; Grinstein-Weiss, Michal; Yeo, Yeong Hun; Rose, Roderick A.; Rimmerman, Arie

2010-01-01

The authors analyzed data from the 2001 Survey of Income and Program Participation (SIPP) to determine the extent of a disability-based net worth and income gap among U.S. households. The sample included 4,154 households with an adult with disabilities and 12,365 households without an adult with disabilities. Households with an adult with…

Province-level income inequality and health outcomes in Canadian adolescents.

PubMed

Quon, Elizabeth C; McGrath, Jennifer J

2015-03-01

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. 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 inequality, and province mean income were measured. Health outcomes were measured across a number of domains, including self-rated health, mental health, health behaviors, substance use behaviors, and physical health. 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 conduct problems, but not for other outcomes. 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. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Household location choices: implications for biodiversity conservation.

PubMed

Peterson, M Nils; Chen, Xiaodong; Liu, Jianguo

2008-08-01

Successful conservation efforts require understanding human behaviors that directly affect biodiversity. Choice of household location represents an observable behavior that has direct effects on biodiversity conservation, but no one has examined the sociocultural predictors of this choice relative to its environmental impacts. We conducted a case study of the Teton Valley of Idaho and Wyoming (U.S.A.) that (1) explored relationships between sociodemographic variables, environmental attitudes, and the environmental impact of household location choices, (2) assessed the potential for small household sizes in natural areas to multiply the environmental impacts of household location decisions, and (3) evaluated how length of residency predicted the environmental attitudes of people living in natural areas. We collected sociodemographic data, spatial coordinates, and land-cover information in a survey of 416 households drawn from a random sample of Teton Valley residents (95% compliance rate). Immigrants (respondents not born in the study area) with the lowest education levels and least environmentally oriented attitudes lived in previously established residential areas in disproportionately high numbers, and older and more educated immigrants with the most environmentally oriented attitudes lived in natural areas in disproportionately high numbers. Income was not a significant predictor of household location decisions. Those living in natural areas had more environmental impact per person because of the location and because small households (<3 people/household) were 4 times as likely in natural areas as large households. Longer residency in natural areas predicted less environmentally oriented attitudes, suggesting that living in natural areas does not foster more concern for nature. Because populaces are rapidly aging, growing more educated, and potentially growing more environmentally oriented, these patterns are troubling for biodiversity conservation. Our results

Income Transfers and Assets of the Poor. Revised. Discussion Paper.

ERIC Educational Resources Information Center

Ziliak, James P.

Contrary to the predictions of the standard life-cycle model, many low lifetime-income households accumulate little wealth relative to their incomes compared to households with high lifetime income. This paper uses data from the Panel Study of Income Dynamics and a correlated random-effects generalized model of moments estimator to decompose the…

The Association of Health and Income in the Elderly: Experience from a Southern State of Brazil

PubMed Central

Fillenbaum, Gerda G.; Blay, Sergio L.; Pieper, Carl F.; King, Katherine E.; Andreoli, Sergio B.; Gastal, Fábio L.

2013-01-01

Objectives In high income, developed countries, health status tends to improve as income increases, but primarily through the 50th-66th percentile of income. It is unclear whether the same limitation holds in middle income countries, and for both general assessments of health and specific conditions. Methods Data were obtained from Brazil, a middle income country. In-person interviews with a representative sample of community residents age ≥60 (N=6963), in the southern state of Rio Grande do Sul, obtained information on demographic characteristics including household income and number of persons supported, general health status (self-rated health, functional status), depression, and seven physician-diagnosed, self-reported health conditions. Analyses used household income (adjusted for number supported and economies of scale) together with higher order income terms, and controlled for demographics and comorbidities, to ascertain nonlinearity between income and general and specific health measures. Results In fully controlled analyses income was associated with general measures of health (linearly with self-rated health, nonlinearly with functional status). For specific health measures there was a consistent linear association with depression, pulmonary disorders, renal disorders, and sensory impairment. For musculoskeletal, cardiovascular (negative association), and gastrointestinal disorders this association no longer held when comorbidities were controlled. There was no association with diabetes. Conclusion Contrary to findings in high income countries, the association of household-size-adjusted income with health was generally linear, sometimes negative, and sometimes absent when comorbidities were controlled. PMID:24058505

Household Costs of Leprosy Reactions (ENL) in Rural India

PubMed Central

Chandler, David J.; Hansen, Kristian S.; Mahato, Bhabananda; Darlong, Joydeepa; John, Annamma; Lockwood, Diana N. J.

2015-01-01

Background Erythema nodosum leprosum (ENL) is a common immune-mediated complication of lepromatous (LL) and borderline lepromatous (BL) leprosy. Most patients experience chronic or multiple acute ENL over many years during an economically active period of their lives. Understanding the economic burden of ENL is essential to provide effective patient support, yet this area has not been investigated. Methods Ninety-one patients with LL or BL leprosy attending a leprosy hospital in Purulia district of West Bengal, India, were interviewed using a structured questionnaire. Cases (n = 53) were identified as those who had one or more episodes of ENL within the last 3 years. Controls (n = 38) had LL or BL leprosy but no history of ENL. Data were collected on household income, direct and indirect costs, and coping strategies. Findings The total household cost was Rs 1543 per month or 27.9% (IQR 13.2-52.6) of monthly household income for cases, and Rs 237 per month or 4.9% (IQR 1.7-13.4) of monthly household income for controls. Indirect costs accounted for 65% of total household costs for cases. Direct costs accounted for the remaining 35% of household costs, and resulted almost entirely from treatment-seeking in the private sector. Total household costs exceeded 40% of household income for 37.7% of cases (n = 20) and 2.6% of controls (n = 1) [1 USD = 59 INR]. Interpretation Households affected by ENL face significant economic burden and are at risk of being pushed further into poverty. Health policy should acknowledge the importance of private sector provision and the significant contribution to total household costs of lost productivity (indirect cost). Further work is needed to explore this area and identify solutions. PMID:25590638

Income and Expenditures of Families with a Baby.

ERIC Educational Resources Information Center

Lino, Mark

1991-01-01

Studies real household income after the birth of a baby reporting median child care expenses were zero in first and $6 in fourth quarter; mean expenses in fourth quarter were $210. Fertility rate of women aged 18-44 without high school education who had baby in 1988 was 87, compared to 63 for women with college degree. (LB)

Type and extent of trans-disciplinary co-operation to improve food security, health and household environment in low and middle income countries: systematic review.

PubMed

Gaihre, Santosh; Kyle, Janet; Semple, Sean; Smith, Jo; Subedi, Madhu; Marais, Debbi

2016-10-18

Although linkages have been found between agricultural interventions and nutritional health, and the development of clean fuels and improved solid fuel stoves in reducing household air pollution and adverse health effects, the extent of the potential of combined household interventions to improve health, nutrition and the environment has not been investigated. A systematic review was conducted to identify the extent and type of community-based agricultural and household interventions aimed at improving food security, health and the household environment in low and middle income countries. A systematic search of Ovid MEDLINE, PUBMED, EMBASE and SCOPUS databases was performed. Key search words were generated reflecting the "participants, interventions, comparators, outcomes and study design" approach and a comprehensive search strategy was developed following "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" recommendations. Any community-based agricultural and/or household interventions were eligible for inclusion if the focus was to improve at least one of the outcome measures of interest. All relevant study designs employing any of these interventions (alone/in combination) were included if conducted in Low and middle income countries. Review articles, and clinical and occupational studies were excluded. A total of 123 studies were included and grouped into four intervention domains; agricultural (n = 27), air quality (n = 34), water quality (n = 32), and nutritional (n = 30). Most studies were conducted in Asia (39.2 %) or Africa (34.6 %) with the remaining 26.1 % in Latin America. Very few studies (n = 11) combined interventions across more than one domain. The majority of agricultural and nutritional studies were conducted in Africa and Asia, whereas the majority of interventions to improve household air quality were conducted in Latin America. It is clear that very little trans-disciplinary research has been done with

Catastrophic health expenditures and its inequality in elderly households with chronic disease patients in China.

PubMed

Wang, Zhonghua; Li, Xiangjun; Chen, Mingsheng

2015-01-20

Although numerous studies examine catastrophic health expenditures (CHE) worldwide, most focus on whole populations rather than specific vulnerable groups. This study analyzes the extent, associated factors and inequality of CHE in elderly household with chronic disease patients in China. Data were obtained from a nationally representative elderly household survey-the China Health and Retirement Longitudinal Study-that was conducted by the National School of Development of Peking University in 2011. An elderly household with chronic disease patients is defined by ≥ 1 chronic disease patient who is ≥ 45 years of age. CHE was measured according to the proportion of out-of-pocket health payments to non-food household expenditures. The associated factors of CHE were estimated using ordinary least square and logistic regression modeling. CHE inequality was measured according to the concentration index (CI) and its decomposition. CHE incidence and intensity were relatively high among elderly households with chronic disease patients. The main associated factors of CHE include household size, having members > 65 years, having members with ≥ 2 chronic diseases, per capita income, and elderly household members demonstrating healthcare-seeking behaviors. Healthcare insurance did not significantly affect CHE risk. Disproportionate concentration of CHE was noted among elderly households, and poor elderly households demonstrated a higher probability of experiencing CHE. Factors such as household size, per capita income, having members > 65 years, and having members with ≥ 2 chronic diseases are major and positive contributors to CHE inequality. Some inpatient and outpatient services are negatively contributed to CHE inequality,suggesting that the unequal usage of such services reduces CHE inequality among elderly households with chronic disease patients. Policy efforts should focus on improving financial protection and relieving the economic

The distribution of income is worse than you think: Including pollution impacts into measures of income inequality.

PubMed

Muller, Nicholas Z; Matthews, Peter Hans; Wiltshire-Gordon, Virginia

2018-01-01

This paper calculates the distribution of an adjusted measure of income that deducts damages due to exposure to air pollution from reported market income in the United States from 2011 to 2014. The Gini coefficient for this measure of adjusted income is 0.682 in 2011, as compared to 0.482 for market income. By 2014, we estimate that the Gini for adjusted income fell to 0.646, while the market income Gini did not appreciably change. The inclusion of air pollution damage acts like a regressive tax: with air pollution, the bottom 20% of households lose roughly 10% of the share of income, while the top 20% of households gain 10%. We find that, unlike the case for market income, New England is not the most unequal division with respect to adjusted income. Further, the difference between adjusted income for white and Hispanics is smaller than expected. However, the gap in augmented income between whites and African-Americans is widening.

Socio-economic status and body mass index in low-income Mexican adults

PubMed Central

Fernald, Lia

2007-01-01

The study reported here explored the associations of body mass index (BMI), socio-economic status (SES), and beverage consumption in a very low income population. A house-to-house survey was conducted in 2003 of 12,873 Mexican adults. The sample was designed to be representative of the poorest communities in seven of Mexico’s thirty-one states. Greater educational attainment was significantly associated with higher BMI and a greater prevalence of overweight (25≤BMI<30) and obesity (30≤BMI) in men and women. The combined prevalence of overweight and obesity was over 70% in women over the median age of 35.4 years old with at least some primary education compared with a prevalence of 45% in women below the median age with no education. BMI was positively correlated with five of the six SES variables in both sexes: education, occupation, quality of housing conditions, household assets, and subjective social status. BMI and household income were significantly correlated in women but not in men. In the model including all SES variables, education, occupation, housing conditions and household assets all contributed independently and significantly to BMI, and household income and subjective social status did not. Increased consumption of alcoholic and carbonated sugar beverages was associated with higher SES and higher BMI in men and women. Thus, in spite of the narrow range of socio-economic variability in this population, the increased consumption of high calorie beverages may explain the positive relationship between SES and BMI. The positive associations between SES and BMI in this low-income, rural population are likely to be related to the changing patterns of food availability, food composition, consumption patterns and cultural factors. Contextually sensitive population-level interventions are critically needed to address obesity and overweight in poor populations, particularly in older women. PMID:17368895

The relationship between dietary patterns, body mass index percentile, and household food security in young urban children.

PubMed

Trapp, Christine M; Burke, Georgine; Gorin, Amy A; Wiley, James F; Hernandez, Dominica; Crowell, Rebecca E; Grant, Autherene; Beaulieu, Annamarie; Cloutier, Michelle M

2015-04-01

The relationship between food insecurity and child obesity is unclear. Few studies have examined dietary patterns in children with regard to household food security and weight status. The aim of this study was to examine the association between household food security, dietary intake, and BMI percentile in low-income, preschool children. Low-income caregivers (n=222) with children ages 2-4 years were enrolled in a primary-care-based obesity prevention/reversal study (Steps to Growing Up Healthy) between October 2010 and December 2011. At baseline, demographic data, household food security status (US Household Food Security Instrument) and dietary intake (Children's Dietary Questionnaire; CDQ) were collected. BMI percentile was calculated from anthropometric data. Participating children were primarily Hispanic (90%), Medicaid insured (95%), 50% female, 35±8.7 months of age (mean±standard deviation), 19% overweight (BMI 85th-94th percentile), and 29% obese (≥95th percentile). Thirty-eight percent of interviews were conducted in Spanish. Twenty-five percent of households reported food insecurity. There was no association between household food insecurity and child BMI percentile. Dietary patterns of the children based on the CDQ did not differ by household food security status. Food group subscale scores (fruit and vegetable, fat from dairy, sweetened beverages, and noncore foods) on the CDQ did not differ between normal weight and overweight/obese children. Maternal depression and stress did not mediate the relationship between household food insecurity and child weight status. Hispanic children were more likely to be overweight or obese in both food-secure and food-insecure households. Household food insecurity was not associated with child BMI percentile in this study. Dietary intake patterns of children from food-insecure households were not different compared to those from food-secure households.

Three Essays Examining Household Energy Demand and Behavior

NASA Astrophysics Data System (ADS)

Murray, Anthony G.

This dissertation consists of three essays examining household energy decisions and behavior. The first essay examines the adoption of energy efficient Energy Star home appliances by U.S. households. Program effectiveness requires that consumers be aware of the labeling scheme and also change their purchase decisions based on label information. The first essay examines the factors associated with consumer awareness of the Energy Star label of recently purchased major appliances and the factors associated with the choice of Energy Star labeled appliances. The findings suggest that eliminating identified gaps in Energy Star appliance adoption would result in house electricity cost savings of $164 million per year and associated carbon emission reductions of about 1.1 million metric tons per year. The second essay evaluates household energy security and the effectiveness of the Low-Income Home Energy Assistance Program (LIHEAP), the single largest energy assistance program available to poor households within the United States. Energy security is conceptually akin to the well-known concept of food security. Rasch models and household responses to energy security questions in the 2005 Residential Energy Consumption Survey are used to generate an energy insecurity index that is consistent with those found in the food insecurity literature. Participating in LIHEAP is found to significantly reduce household energy insecurity score in the index. Further, simulations show that the elimination of the energy assistance safety net currently available to households increases the number of energy insecure house- holds by over 16 percent. The third essay develops a five equation demand system to estimate household own-price, cross-price and income elasticities between electricity, natural gas, food at home, food away from home, and non-durable commodity groups. Household cross-price elasticities between energy and food commodities are of particular importance. Energy price shocks

Measuring the Return on Household Enterprise: What Matters Most for Whom?

PubMed Central

Samphantharak, Krislert; Townsend, Robert M.

2011-01-01

Return on assets (ROA) from household enterprise is crucial for understanding the well-being and productivity of households in developing economies. Yet the definition and measurement of household enterprise ROA remain inconsistent or unclear. We illustrate potential measurement problems with examples from various actual surveys. We then take advantage of a detailed integrated household survey to perform a robustness analysis, acting as if we had gathered less data than was actually the case, to see what matters and for whom. The three issues that matter most for accurate measurement of household enterprise ROA are the choice of accrual versus cash basis of income, the treatment of household’s own labor in enterprise income, and the treatment of non-factor income. Also, this sensitivity matters most for a relatively poor region dominated by crop cultivation relative to a richer region with non-farm enterprises. Though the choice between accrued income and cash income matters less when the frequency of the data declines, there remains high sensitivity in longer-term and annualized data. We conclude the paper by providing recommendations on how to improve the survey questionnaires for more accurate measurement in field research. PMID:22523446

Availability and affordability of cardiovascular disease medicines and their effect on use in high-income, middle-income, and low-income countries: an analysis of the PURE study data.

PubMed

Khatib, Rasha; McKee, Martin; Shannon, Harry; Chow, Clara; Rangarajan, Sumathy; Teo, Koon; Wei, Li; Mony, Prem; Mohan, Viswanathan; Gupta, Rajeev; Kumar, Rajesh; Vijayakumar, Krishnapillai; Lear, Scott A; Diaz, Rafael; Avezum, Alvaro; Lopez-Jaramillo, Patricio; Lanas, Fernando; Yusoff, Khalid; Ismail, Noorhassim; Kazmi, Khawar; Rahman, Omar; Rosengren, Annika; Monsef, Nahed; Kelishadi, Roya; Kruger, Annamarie; Puoane, Thandi; Szuba, Andrzej; Chifamba, Jephat; Temizhan, Ahmet; Dagenais, Gilles; Gafni, Amiram; Yusuf, Salim

2016-01-02

WHO has targeted that medicines to prevent recurrent cardiovascular disease be available in 80% of communities and used by 50% of eligible individuals by 2025. We have previously reported that use of these medicines is very low, but now aim to assess how such low use relates to their lack of availability or poor affordability. We analysed information about availability and costs of cardiovascular disease medicines (aspirin, β blockers, angiotensin-converting enzyme inhibitors, and statins) in pharmacies gathered from 596 communities in 18 countries participating in the Prospective Urban Rural Epidemiology (PURE) study. Medicines were considered available if present at the pharmacy when surveyed, and affordable if their combined cost was less than 20% of household capacity-to-pay. We compared results from high-income, upper middle-income, lower middle-income, and low-income countries. Data from India were presented separately given its large, generic pharmaceutical industry. Communities were recruited between Jan 1, 2003, and Dec 31, 2013. All four cardiovascular disease medicines were available in 61 (95%) of 64 urban and 27 (90%) of 30 rural communities in high-income countries, 53 (80%) of 66 urban and 43 (73%) of 59 rural communities in upper middle-income countries, 69 (62%) of 111 urban and 42 (37%) of 114 rural communities in lower middle-income countries, eight (25%) of 32 urban and one (3%) of 30 rural communities in low-income countries (excluding India), and 34 (89%) of 38 urban and 42 (81%) of 52 rural communities in India. The four cardiovascular disease medicines were potentially unaffordable for 0·14% of households in high-income countries (14 of 9934 households), 25% of upper middle-income countries (6299 of 24,776), 33% of lower middle-income countries (13,253 of 40,023), 60% of low-income countries (excluding India; 1976 of 3312), and 59% households in India (9939 of 16,874). In low-income and middle-income countries, patients with previous

Are the Chinese Saving for Old Age?: The Relationship between Future Pension Benefits of 45-60 Years Old Chinese and Current Household Expenditures.

PubMed

van Dullemen, C E; Nagel, I; de Bruijn, J M G

2017-01-01

Worldwide, older people's support used to be the adult children's responsibility. In China, two generations after introducing the one-child policy in the late 70-ies, this becomes an increasingly demanding obligation. The Chinese government took the responsibility to mitigating old- age poverty risks and realized unprecedented progress in pension coverage. At the same time, the household savings increased to about 30 % of disposable income. Built on previous research on the politics of ageing, this study analyses households responses to the established governmental and firm pension programs as well as to the New Rural Pension Scheme (NRPS), introduced in 2009. The central question is: will participation in the established and new pension programs lead to higher current Chinese household expenditures and therefore to lower savings? The China Health and Retirement Longitudinal Study (CHARLS) dataset of 2011 offered the opportunity to study the influence of the recently introduced NRPS. We find that Chinese households with members between 45 and 60 years who expect future benefits of NRPS do not have higher expenditures than those not covered by NRPS. For the participants in the established, mostly urban pension programs a correlation was found with higher current expenditures (28 % more spending on basic needs, 80 % more on luxury) However, further analysis shows that this correlation cannot be interpreted as a causal relationship. This implies that coverage by pensions, be it in urban or rural programs, does not determine higher current expenditures and lower savings.

Do agreements between adolescent and parent reports on family socioeconomic status vary with household financial stress?

PubMed

Pu, Christy; Huang, Nicole; Chou, Yiing-Jenq

2011-04-19

Many studies compared the degree of concordance between adolescents' and parents' reports on family socioeconomic status (SES). However, none of these studies analyzed whether the degree of concordance varies by different levels of household financial stress. This research examines whether the degree of concordance between adolescents' and parent reports for the three traditional SES measures (parental education, parental occupation and household income) varied with parent-reported household financial stress and relative standard of living. 2,593 adolescents with a mean age of 13 years, and one of their corresponding parents from the Taiwan Longitudinal Youth Project conducted in 2000 were analyzed. Consistency of adolescents' and parents' reports on parental educational attainment, parental occupation and household income were examined by parent-reported household financial stress and relative standard of living. Parent-reported SES variables are closely associated with family financial stress. For all levels of household financial stress, the degree of concordance between adolescent's and parent's reports are highest for parental education (κ ranging from 0.87 to 0.71) followed by parental occupation (κ ranging from 0.50 to 0.34) and household income (κ ranging from 0.43 to 0.31). Concordance for father's education and parental occupation decreases with higher parent-reported financial stress. This phenomenon was less significant for parent-reported relative standard of living. Though the agreement between adolescents' and parents' reports on the three SES measures is generally judged to be good in most cases, using adolescents reports for family SES may still be biased if analysis is not stratified by family financial stress.

The global impact of income inequality on health by age: an observational study.

PubMed

Dorling, Danny; Mitchell, Richard; Pearce, Jamie

2007-10-27

To explore whether the apparent impact of income inequality on health, which has been shown for wealthier nations, is replicated worldwide, and whether the impact varies by age. Observational study. 126 countries of the world for which complete data on income inequality and mortality by age and sex were available around the year 2002 (including 94.4% of world human population). Data on mortality were from the World Health Organization and income data were taken from the annual reports of the United Nations Development Programme. Mortality in 5-year age bands for each sex by income inequality and income level. At ages 15-29 and 25-39 variations in income inequality seem more closely correlated with mortality worldwide than do variations in material wealth. This relation is especially strong among the poorest countries in Africa. Mortality is higher for a given level of overall income in more unequal nations. Income inequality seems to have an influence worldwide, especially for younger adults. Social inequality seems to have a universal negative impact on health.

Income inequality and socioeconomic gradients in mortality.

PubMed

Wilkinson, Richard G; Pickett, Kate E

2008-04-01

We investigated whether the processes underlying the association between income inequality and population health are related to those responsible for the socioeconomic gradient in health and whether health disparities are smaller when income differences are narrower. We used multilevel models in a regression analysis of 10 age- and cause-specific US county mortality rates on county median household incomes and on state income inequality. We assessed whether mortality rates more closely related to county income were also more closely related to state income inequality. We also compared mortality gradients in more- and less-equal states. Mortality rates more strongly associated with county income were more strongly associated with state income inequality: across all mortality rates, r= -0.81; P=.004. The effect of state income inequality on the socioeconomic gradient in health varied by cause of death, but greater equality usually benefited both wealthier and poorer counties. Although mortality rates with steep socioeconomic gradients were more sensitive to income distribution than were rates with flatter gradients, narrower income differences benefit people in both wealthy and poor areas and may, paradoxically, do little to reduce health disparities.

Comparison of two cash transfer strategies to prevent catastrophic costs for poor tuberculosis-affected households in low- and middle-income countries: An economic modelling study

PubMed Central

Lönnroth, Knut; Boccia, Delia

2017-01-01

Background Illness-related costs for patients with tuberculosis (TB) ≥20% of pre-illness annual household income predict adverse treatment outcomes and have been termed “catastrophic.” Social protection initiatives, including cash transfers, are endorsed to help prevent catastrophic costs. With this aim, cash transfers may either be provided to defray TB-related costs of households with a confirmed TB diagnosis (termed a “TB-specific” approach); or to increase income of households with high TB risk to strengthen their economic resilience (termed a “TB-sensitive” approach). The impact of cash transfers provided with each of these approaches might vary. We undertook an economic modelling study from the patient perspective to compare the potential of these 2 cash transfer approaches to prevent catastrophic costs. Methods and findings Model inputs for 7 low- and middle-income countries (Brazil, Colombia, Ecuador, Ghana, Mexico, Tanzania, and Yemen) were retrieved by literature review and included countries' mean patient TB-related costs, mean household income, mean cash transfers, and estimated TB-specific and TB-sensitive target populations. Analyses were completed for drug-susceptible (DS) TB-related costs in all 7 out of 7 countries, and additionally for drug-resistant (DR) TB-related costs in 1 of the 7 countries with available data. All cost data were reported in 2013 international dollars ($). The target population for TB-specific cash transfers was poor households with a confirmed TB diagnosis, and for TB-sensitive cash transfers was poor households already targeted by countries’ established poverty-reduction cash transfer programme. Cash transfers offered in countries, unrelated to TB, ranged from $217 to $1,091/year/household. Before cash transfers, DS TB-related costs were catastrophic in 6 out of 7 countries. If cash transfers were provided with a TB-specific approach, alone they would be insufficient to prevent DS TB catastrophic costs in 4

Population Income and Longitudinal Trends in Living Kidney Donation in the United States

PubMed Central

Dong, Jianghu; Gill, John

2015-01-01

Living kidney donation is declining in the United States. We examined longitudinal trends in living donation as a function of median household income and donor relation to assess the effect of financial barriers on donation in a changing economic environment. The zip code–level median household income of all 71,882 living donors was determined by linkage to the 2000 US Census. Longitudinal changes in the rate of donation were determined in income quintiles between 1999 and 2004, when donations were increasing, and between 2005 and 2010, when donations were declining. Rates were adjusted for population differences in age, sex, race, and ESRD rate using multilevel linear regression models. Between 1999 and 2004, the rate of growth in living donation per million population was directly related to income, increasing progressively from the lowest to highest income quintile, with annualized changes of 0.55 (95% confidence interval [95% CI], 0.14 to 1.05) for Q1 and 1.77 (95% CI, 0.66 to 2.77) for Q5 (P<0.05). Between 2005 and 2010, donation declined in Q1, Q2, and Q3; was stable in Q4; and continued to grow in Q5. Longitudinal changes varied by donor relationship, and the association of income with longitudinal changes also varied by donor relationship. In conclusion, changes in living donation in the past decade varied by median household income, resulting in increased disparities in donation between low- and high-income populations. These findings may inform public policies to support living donation during periods of economic volatility. PMID:25035519

Factors associated with household food security of participants of the MANA food supplement program in Colombia.

PubMed

Hackett, Michelle; Melgar-Quiñonez, Hugo; Taylor, Christopher A; Alvarez Uribe, Martha Cecilia

2010-03-01

The objective of this study was to explore demographic and economic characteristics associated with household food security of 2,784 low-income households with pre-school aged children receiving food supplements from the Colombian Plan for Improving Food and Nutrition in Antioquia - MANA (Mejoramiento Alimentario y Nutricional de Antioquia) in the Department of Antioquia, Colombia. Included in the study was a 12-item household food security survey was collected from a cross-sectional, stratified random sample of MANA participants in which households were characterized as food secure, mildly food insecure, moderately food insecure, and severely food insecure. It was hypothesized that household food security status would be strongly associated with demographic characteristics, food expenditure variables, and food supplement consumption by children in MANA. Food insecure households were characterized by more members, older parents, and lower income (p < 0.0001). Rural residence and female head of households had higher rates of food insecurity (p < 0.01). Food insecure households had the lowest monthly expenditures food (p < 0.0001). Severely food insecure households saved the highest percentage of per capita food expenditure from consuming MANA supplements (p < 0.0001), similarly, MANA food supplement intakes were greatest in households reporting the most food insecurity (p < 0.001). The results of this study are important to describe characteristics of the population benefiting from the MANA nutrition intervention by their unique level of household food security status.

Shopping for fruits and vegetables. Food and retail qualities of importance to low-income households at the grocery store.

PubMed

Webber, Caroline B; Sobal, Jeffery; Dollahite, Jamie S

2010-04-01

Purchasing fruits and vegetables is an integral part of managing food consumption and dietary quality. This study examined how low-income adults who had primary responsibility for household food purchases considered retail produce decisions. We used a qualitative research approach based on grounded theory and an ecological conceptual framework. Twenty-eight low-income rural, village, and inner city heads of households in upstate New York, USA, were selected by purposive and theoretical sampling and interviewed about fruit and vegetable shopping habits, attitudes toward local food stores, and where and how they would prefer to buy produce. Analyses revealed their concerns were organized around five themes: store venue; internal store environment; product quality; product price; relationships with the stores. An unanticipated finding was the differing social relations that appear to exist between participant consumers, store employees and management, and the store itself as a representation of the larger retail food system. Attitudes toward retail food stores in this study are described as passive or fatalistic indifference, supportive, opportunistic, and confrontational (change agents). These attitudes are related to how shoppers considered retail fruit and vegetable choice, access, and availability. These findings suggest ways to individualize nutrition education and consumer education messages. Copyright 2009 Elsevier Ltd. All rights reserved.

Influence of sociodemographic characteristics on different dimensions of household food insecurity in Montevideo, Uruguay.

PubMed

Rossi, Máximo; Ferre, Zuleika; Curutchet, María Rosa; Giménez, Ana; Ares, Gastón

2017-03-01

To determine the factor structure of the Latin American & Caribbean Household Food Security Scale (ELCSA) and to study the influence of sociodemographic characteristics on each of the identified dimensions in Montevideo, Uruguay. Cross-sectional survey with a representative sample of urban households. Household food insecurity was measured using the ELCSA. The percentage of respondents who gave affirmative responses for each of the items of the ELCSA was determined. Exploratory factor analysis was carried out to determine the ELCSA's factor structure. A probit model was used to determine the impact of some individual and household sociodemographic characteristics on the identified dimensions of food insecurity. Metropolitan area centred on Montevideo, the capital city of Uruguay, April-September 2014. Adults aged between 18 and 93 years (n 742). The percentage of affirmative responses to the items of the ELCSA ranged from 4·4 to 31·7 %. Two factors were identified in the exploratory factor analysis performed on data from households without children under 18 years old, whereas three factors were identified for households with children. The identified factors were associated with different severity levels of food insecurity. Likelihood of experiencing different levels of food insecurity was affected by individual characteristics of the respondent as well as characteristics of the household. The influence of sociodemographic variables varied among the ELCSA dimensions. Household income had the largest influence on all dimensions, which indicates a strong relationship between income and food insecurity.

Age at immigration and the incomes of older immigrants, 1994-2010.

PubMed

O'Neil, Kevin; Tienda, Marta

2015-03-01

Seniors comprise a growing proportion of new U.S. immigrants. We investigate whether late-age immigrants are disadvantaged in older age relative to those arriving earlier in life, based on income, reliance on public benefits, and access to public medical insurance. We test whether the 1996 welfare reform law altered the relationships between age at immigration and these outcomes. Immigrants aged 65 and older in the 1994-2010 Current Population Surveys were classified by age at immigration. Median and logistic regressions are used to estimate the association between age at immigration and several outcomes and to test whether these associations differ for arrivals before and after welfare reform. Late-age immigration is strongly associated with lower personal income, lower rates of Medicare and Social Security receipt, and higher participation in Supplemental Security Income (SSI) and Medicaid. Arrival after 1996 is associated with lower rates of SSI, Medicaid, and Medicare receipt. The association between late-age immigration and income is stronger for post-1996 arrivals relative to earlier arrivals, whereas that between late-age immigration and Medicaid is weaker, suggesting that the penalty conferred by late-age immigration grew after reform. Late-age immigrants face formidable economic disadvantages exacerbated by exclusion from public benefits, with implications for immigration, health care, and welfare policy. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The High Cost of Free Tuberculosis Services: Patient and Household Costs Associated with Tuberculosis Care in Ebonyi State, Nigeria

PubMed Central

Ukwaja, Kingsley N.; Alobu, Isaac; lgwenyi, Chika; Hopewell, Philip C.

2013-01-01

Objective Poverty is both a cause and consequence of tuberculosis. The objective of this study is to quantify patient/household costs for an episode of tuberculosis (TB), its relationships with household impoverishment, and the strategies used to cope with the costs by TB patients in a resource-limited high TB/HIV setting. Methods A cross-sectional study was conducted in three rural hospitals in southeast Nigeria. Consecutive adults with newly diagnosed pulmonary TB were interviewed to determine the costs each incurred in their care-seeking pathway using a standardised questionnaire. We defined direct costs as out-of-pocket payments, and indirect costs as lost income. Results Of 452 patients enrolled, majority were male 55% (249), and rural residents 79% (356), with a mean age of 34 (±11.6) years. Median direct pre-diagnosis/diagnosis cost was $49 per patient. Median direct treatment cost was $36 per patient. Indirect pre-diagnostic and treatment costs were $416, or 79% of total patient costs, $528. The median total cost of TB care per household was $592; corresponding to 37% of median annual household income pre-TB. Most patients reported having to borrow money 212(47%), sell assets 42(9%), or both 144(32%) to cope with the cost of care. Following an episode of TB, household income reduced increasing the proportion of households classified as poor from 54% to 79%. Before TB illness, independent predictors of household poverty were; rural residence (adjusted odds ratio [aOR] 2.8), HIV-positive status (aOR 4.8), and care-seeking at a private facility (aOR 5.1). After TB care, independent determinants of household poverty were; younger age (≤35 years; aOR 2.4), male gender (aOR 2.1), and HIV-positive status (aOR 2.5). Conclusion Patient and household costs for TB care are potentially catastrophic even where services are provided free-of-charge. There is an urgent need to implement strategies for TB care that are affordable for the poor. PMID:24015293

The high cost of free tuberculosis services: patient and household costs associated with tuberculosis care in Ebonyi State, Nigeria.

PubMed

Ukwaja, Kingsley N; Alobu, Isaac; Lgwenyi, Chika; Hopewell, Philip C

2013-01-01

Poverty is both a cause and consequence of tuberculosis. The objective of this study is to quantify patient/household costs for an episode of tuberculosis (TB), its relationships with household impoverishment, and the strategies used to cope with the costs by TB patients in a resource-limited high TB/HIV setting. A cross-sectional study was conducted in three rural hospitals in southeast Nigeria. Consecutive adults with newly diagnosed pulmonary TB were interviewed to determine the costs each incurred in their care-seeking pathway using a standardised questionnaire. We defined direct costs as out-of-pocket payments, and indirect costs as lost income. Of 452 patients enrolled, majority were male 55% (249), and rural residents 79% (356), with a mean age of 34 (± 11.6) years. Median direct pre-diagnosis/diagnosis cost was $49 per patient. Median direct treatment cost was $36 per patient. Indirect pre-diagnostic and treatment costs were $416, or 79% of total patient costs, $528. The median total cost of TB care per household was $592; corresponding to 37% of median annual household income pre-TB. Most patients reported having to borrow money 212(47%), sell assets 42(9%), or both 144(32%) to cope with the cost of care. Following an episode of TB, household income reduced increasing the proportion of households classified as poor from 54% to 79%. Before TB illness, independent predictors of household poverty were; rural residence (adjusted odds ratio [aOR] 2.8), HIV-positive status (aOR 4.8), and care-seeking at a private facility (aOR 5.1). After TB care, independent determinants of household poverty were; younger age (≤ 35 years; aOR 2.4), male gender (aOR 2.1), and HIV-positive status (aOR 2.5). Patient and household costs for TB care are potentially catastrophic even where services are provided free-of-charge. There is an urgent need to implement strategies for TB care that are affordable for the poor.

45 CFR 1305.4 - Age of children and family income eligibility.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Age of children and family income eligibility... FAMILIES, HEAD START PROGRAM ELIGIBILITY, RECRUITMENT, SELECTION, ENROLLMENT AND ATTENDANCE IN HEAD START § 1305.4 Age of children and family income eligibility. (a) To be eligible for Head Start services, a...

Early Childhood Household Smoke Exposure Predicts Less Task-Oriented Classroom Behavior at Age 10.

PubMed

Pagani, Linda S; Fitzpatrick, Caroline

2016-10-01

Secondhand tobacco smoke is considered a developmental neurotoxicant especially given underdeveloped vital systems in young children. An ecological test of its negative influence on brain development can be made by examining the prospective association between early childhood household smoke exposure and later classroom behavior. Using a longitudinal birth cohort, we examined the unique contribution of household tobacco smoke exposure to children's subsequent classroom engagement at age 10. From child ages 1.5 to 7 years, parents of 2,055 participants from the Quebec Longitudinal Study of Child Development reported on household smoking by themselves and other home occupants. At age 10, fourth-grade teachers reported on the child's classroom engagement. In terms of prevalence, 58% of parents reported that their children were never exposed to smoke in the home, while 34% and 8% of children were exposed to transient and continuous household smoke, respectively. Compared with never exposed children, those who were exposed to transient and continuous household smoke scored 13% and 9% of a standard deviation lower on classroom engagement in fourth grade, standardized B = -.128 (95% confidence interval = -.186, -.069) and standardized B = -.093 (95% confidence interval = -.144, -.043), respectively. Compared with their never exposed peers, children exposed to transient and continuous early childhood household smoke showed proportionately less classroom engagement, which reflects task-orientation, following directions, and working well autonomously and with others. This predisposition poses risks for high school dropout, which from a population health perspective is closely linked with at-risk lifestyle habits and unhealthy outcomes. © 2015 Society for Public Health Education.

Household pesticide contamination from indoor pest control applications in urban low-income public housing dwellings: a community-based participatory research.

PubMed

Lu, Chensheng; Adamkiewicz, Gary; Attfield, Kathleen R; Kapp, Michaela; Spengler, John D; Tao, Lin; Xie, Shao Hua

2013-02-19

We designed this community-based participatory research (CBPR) project aiming to generate evidence-based research results to encourage residents living in urban low-income public housing dwellings engaging in a community-wide integrated pest management (IPM) program with the intention to improve their health and quality of life, as well as household conditions. We enrolled 20 families and their children in this study in which we utilized environmental exposure assessment (surface wipe and indoor air) tools to quantitatively assessing residential pesticide exposure in young children before the implementation of an IPM program. We analyzed those samples for 19 organophosphate (OP) and pyrethroid pesticides. The most commonly detected pesticides were pyrethroids, particularly permethrin and cypermethrin with average concentrations of 2.47 and 3.87 μg/m(2), respectively. In many dwellings, we detected OPs, which are no longer available on the market; however, their levels are significantly lower than those of pyrethroids. None of the 20 families was free from pesticide contamination in their households, and pesticides were commonly detected in living room and children's bedroom. The correlation among household hygienic conditions, the sighting of live pests/pest debris, and the degree of indoor pesticide contamination highlights the failure of conventional chemical-based applications for pest controls. The results from the current study, as well as other recent studies, conducted in low-income public housing, child care centers, and randomly selected homes in the U.S. should accentuate the need for alternative pest management programs that incorporate safer and more sustainable protocols for pest controls.

HOUSEHOLD PESTICIDE CONTAMINATION FROM INDOOR PEST CONTROL APPLICATIONS IN URBAN LOW-INCOME PUBLIC HOUSING DWELLINGS: A COMMUNITY-BASED PARTICIPATORY RESEARCH

PubMed Central

Adamkiewicz, Gary; Attfield, Kathleen; Kapp, Michaela; Spengler, John D; Tao, Lin; Xie, Shao Hua

2013-01-01

We designed this community-based participatory research (CBPR) project aiming to generate evidence-based research results in order to encourage residents living in urban low-income public housing dwellings engaging in a community-wide integrated pest management (IPM) program with the intention to improve their health and quality of life, as well as household conditions. We enrolled 20 families and their children in this study in which we utilized environmental exposure assessment (surface wipe and indoor air) tools to quantitatively assessing residential pesticide exposure in young children before the implementation of an IPM program. We analyzed those samples for 19 organophosphate (OP) and pyrethroid pesticides. The most commonly detected pesticides were pyrethroids, particularly permethrin and cypermethrin with average concentrations of 2.47 and 3.87 µg/m2, respectively. In many dwellings, we detected OPs, which are no longer available on the market, however, their levels are significantly lower than those of pyrethroids. None of the 20 families was free from pesticide contamination in their households, and pesticides were commonly detected in living room and children’s bedroom. The correlation among household hygienic conditions, the sighting of live pests/pest debris, and the degree of indoor pesticide contamination highlights the failure of conventional chemical-based applications for pest controls. The results from the current study, as well as other recent studies, conducted in low-income public housing, child care centers, and randomly selected homes in the U.S. should accentuate the need for alternative pest management programs that incorporate safer and more sustainable protocols for pest controls. PMID:23363037

Household food insecurity, diet quality, and weight status among indigenous women (Mah Meri) in Peninsular Malaysia.

PubMed

Pei, Chong Su; Appannah, Geeta; Sulaiman, Norhasmah

2018-04-01

This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia. The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women. Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups ( P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened ( P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals ( P < 0.01), as well as for meat, poultry, and eggs ( P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat ( P < 0.05) and sodium ( P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age ( P < 0.025). The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household level was associated with higher body weight. Therefore

The Economic Organization of Extended Family Households by Race/Ethnicity and Socioeconomic Status.

PubMed

Reyes, Adriana M

2018-02-01

This study examines differences in the amount of economic support or mutual benefit derived from extended family living arrangements by studying differences in monetary contributions to essential household expenditures across family units in extended family households. Using the 2008 Survey of Income and Program Participation, multivariate regression and selection models are estimated to assess racial differences in family contributions toward household expenses in extended family households. Extended family households have very unequal monetary contributions towards household rent and utilities, although Hispanics have less unequal monetary contributions compared to other racial groups. Hispanic and Asians extended family households experience decreasing inequality in financial contributions as the income of each family increases whereas no relationship between financial contributions and income is found for whites or blacks. This suggests a different cultural orientation to extended family living arrangements for Asians and Hispanics compared to non-Hispanic whites.

45 CFR 1305.4 - Age of children and family income eligibility.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 4 2014-10-01 2014-10-01 false Age of children and family income eligibility. 1305.4 Section 1305.4 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... § 1305.4 Age of children and family income eligibility. (a) To be eligible for Head Start services, a...

45 CFR 1305.4 - Age of children and family income eligibility.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 4 2012-10-01 2012-10-01 false Age of children and family income eligibility. 1305.4 Section 1305.4 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... § 1305.4 Age of children and family income eligibility. (a) To be eligible for Head Start services, a...

School attributes, household characteristics, and demand for schooling: A case study of rural Peru

NASA Astrophysics Data System (ADS)

Ilon, Lynn; Moock, Peter

1991-12-01

Educational expansion, long a goal of many LDCs, has become a difficult policy to pursue. Growing populations, shrinking national incomes and higher marginal costs of schooling as schooling reaches more rural dwellers have caused policy makers to take a hard look at factors which influence educational demand and expansion. This paper examines the case of Peru where rural areas have yet to attain the nearly universal enrollment of urban areas. The study examines 2500 rural households to explore reasons why children do not attend school, drop out of school, and begin school at later ages. The study finds that the monetary costs of schools (fees and other costs) have a substantial influence on parental decisions regarding school attendance and continuation. Sensitivity analysis reveals that mother's education has a bearing on their children's educational participation, particularly in low-income households. Sensitivity analysis also reveals that school attendance of low income and female children are most strongly affected by simulated changes in school fees.

Household dynamics and socioeconomic conditions in the context of incident adolescent orphaning in KwaZulu-Natal, South Africa

PubMed Central

DeSilva, Mary Bachman; Skalicky, Anne; Beard, Jennifer; Cakwe, Mandisa; Zhuwau, Tom; Quinlan, Tim; Simon, Jonathon L.

2012-01-01

We compared demographics, socioeconomic status, and food insecurity between households with and without recent orphans in a region of high HIV/AIDS mortality in South Africa. We recruited a cohort of 197 recent orphans and 528 non-orphans ages 9–15 and their households using stratified cluster sampling. Households were classified into three groups: orphan-only (N=50); non-orphan-only (N=377); and mixed (N=210). Between September 2004 and May 2007, households were interviewed three times regarding demographics, income and assets, and food insecurity. Baseline bivariate associations were assessed using chi-square- and t-tests. Longitudinal bivariate associations and multivariate models were tested using generalized estimating equations. At baseline, mixed households generally exhibited greater characteristics of vulnerability than orphan and non-orphan households. They were larger, had older, less educated household heads, and reported a much smaller annual per capita income. Orphan households were more likely to report a death in the previous year, and less likely to have an adult employed. These differences persisted over the study. Even non-orphan households exhibited characteristics of vulnerability, with 14% reporting a death one year before baseline, 45% of whom were prime-age adults. At baseline, a much smaller proportion of orphan households reported receiving the child support grant than the other household types, but notably, there were no differences among households in receipt of the grant by Round 3. Household food insecurity was highly prevalent: more than one in five orphan-only and mixed households reported being food insecure in the previous month. These findings suggest that the effects of HIV/AIDS only exacerbate existing high levels of poverty in the district, as virtually all households are vulnerable regardless of orphan status. Community-level programs must help families address a spectrum of needs, including food security, caregiving, and

Income-related inequalities in preventive and curative dental care use among working-age Japanese adults in urban areas: a cross-sectional study.

PubMed

Murakami, Keiko; Aida, Jun; Ohkubo, Takayoshi; Hashimoto, Hideki

2014-09-19

Preventive dental care use remains relatively low in Japan, especially among working-age adults. Universal health insurance in Japan covers curative dental care with an out-of-pocket payment limit, though its coverage of preventive dental care is limited. The aim of this study was to test the hypothesis that income inequality in dental care use is found in preventive, but not curative dental care among working-age Japanese adults. A cross-sectional survey was conducted using a computer-assisted, self-administered format for community residents aged 25-50 years. In all, 4357 residents agreed to participate and complete the questionnaire (valid response rate: 31.3%). Preventive dental care use was measured according to whether the participant had visited a dentist or a dental hygienist during the past year for dental scaling or fluoride or orthodontic treatments. Curative dental care use was assessed by dental visits for other reasons. The main explanatory variable was equivalent household income. Logistic regression analyses with linear trend tests were conducted to determine whether there were significant income-related gradients with curative or preventive dental care use. Among the respondents, 40.0% of men and 41.5% of women had used curative dental care in the past year; 24.1% of men and 34.1% of women had used preventive care. We found no significant income-related gradients of curative dental care among either men or women (p = 0.234 and p = 0.270, respectively). Significant income-related gradients of preventive care were observed among both men and women (p < 0.001 and p = 0.003, respectively). Among women, however, income-related differences were no longer significant (p = 0.126) after adjusting for education and other covariates. Compared with men with the lowest income, the highest-income group had a 1.79-fold significantly higher probability for using preventive dental care. The prevalence of preventive dental care use was lower than that of curative

The effects of income on mental health: evidence from the social security notch.

PubMed

Golberstein, Ezra

2015-03-01

Mental health is a key component of overall wellbeing and mental disorders are relatively common, including among older adults. Yet the causal effect of income on mental health status among older adults is poorly understood. This paper considers the effects of a major source of transfer income, Social Security retirement benefits, on the mental health of older adults. The Social Security benefit "Notch" is as a large, permanent, and exogenous shock to Social Security income in retirement. The "Notch" is used to identify the causal effect of Social Security income on mental health among older ages using data from the AHEAD cohort of the Health and Retirement Study. We find that increases in Social Security income significantly improve mental health status and the likelihood of a psychiatric diagnosis for women, but not for men. The effects of income on mental health for older women are statistically significant and meaningful in magnitude. While this is one of the only studies to use plausibly exogenous variation in household income to identify the effect of income on mental health, a limitation of this work is that the results only directly pertain to lower-education households. Public policy proposals that alter retirement benefits for the elderly may have important effects on the mental health of older adults.

Household Food Insecurity Is Associated with Nutritional Status among Iranian Children.

PubMed

Shahraki, Soudabeh Hamedi; Amirkhizi, Farshad; Amirkhizi, Behzad; Hamedi, Sousan

2016-01-01

This cross-sectional study was conducted to determine household food security status and sociodemographic factors influencing it and to examine whether food insecurity of household is a risk factor for underweight, stunting, and thinness in primary school children of Sistan and Baluchestan Province in southeastern Iran. A sample of 610 students aged 7-11 years was selected by a multistage cluster random sampling method during December 2013-May 2014. Using U.S. Department of Agriculture Food Security questionnaire, 42.3% of households showed some degree of food insecurity. Food insecurity was positively associated with household size (p = .002) and number of children per household (p = .001) and negatively associated with mother's and father's education level (p = .005 and p = .042, respectively), father's occupation status, and household income (p < .0001). Children living in food insecure with severe hunger households were 10.13, 10.07, and 4.54 times as likely to be underweight, stunted, and thin, respectively, as counterparts from food secure households. The findings showed food insecurity was prevalent and associated with sociodemographic factors among households with schoolchildren in southeastern Iran. Nutritional status of children was also associated with food security status of their households.

Understanding Aging in a Middle Eastern Context: The SHARE-Israel Survey of Persons Aged 50 and Older

PubMed Central

Litwin, Howard

2013-01-01

This article describes the development of SHARE-Israel, the survey of persons aged 50 and older in Israel, and preliminary results from an early data release. The introduction of an HRS-inspired computer-based survey into a Middle East country required linguistic and cultural adaptations of the survey mechanisms that had not been previously experienced in other countries. Preliminary findings showed that the majority group of veteran Jewish-Israelis aged 50 and over is in a favorable position in terms of health, employment status and household income compared to Arab-Israelis and to new immigrants to Israel from the Former Soviet Union. Arab-Israelis aged 50 and over are at greater risk due to greater disability and lower incomes. Recent immigrants from the former Soviet Union are at greatest risk. They report having the highest degree of depression, long term problems and activity limitation, the fewest children, low rates of home ownership and low incomes. Comparing the older Israeli population with their European counterparts revealed that Israelis are more depressed; more Israeli women are employed, and fewer Israeli men are retired; and household income in Israel is lower, but rises relatively when correcting for purchasing power parity. These trends point to several areas that will require attention in the formulation of public policy on behalf of the aging population in Israel. PMID:18626759

Understanding aging in a Middle Eastern context: the SHARE-Israel survey of persons aged 50 and older.

PubMed

Litwin, Howard

2009-03-01

This article describes the development of SHARE-Israel, the survey of persons aged 50 and older in Israel, and preliminary results from an early data release. The introduction of an HRS-inspired computer-based survey into a Middle East country required linguistic and cultural adaptations of the survey mechanisms that had not been previously experienced in other countries. Preliminary findings showed that the majority group of veteran Jewish-Israelis aged 50 and over is in a favorable position in terms of health, employment status and household income compared to Arab-Israelis and to new immigrants to Israel from the Former Soviet Union. Arab-Israelis aged 50 and over are at greater risk due to greater disability and lower incomes. Recent immigrants from the former Soviet Union are at greatest risk. They report having the highest degree of depression, long term problems and activity limitation, the fewest children, low rates of home ownership and low incomes. Comparing the older Israeli population with their European counterparts revealed that Israelis are more depressed; more Israeli women are employed, and fewer Israeli men are retired; and household income in Israel is lower, but rises relatively when correcting for purchasing power parity. These trends point to several areas that will require attention in the formulation of public policy on behalf of the aging population in Israel.

Onchocerciasis control in Nigeria: will households be able to afford community-directed treatment with ivermectin?

PubMed

Onwujekwe, O; Shu, E; Onwuameze, O; Ndum, C; Okonkwo, P

2001-12-21

To determine the level of affordability of community-directed treatment with ivermectin (CDTI) to households living in two onchocerciasis endemic Nigerian communities namely Toro in the north and Nike in the south. The proportion of the cost of treating people with ivermectin will deplete in average monthly/projected annual household expenditure on food and health care, and on average monthly and projected annual household income were respectively calculated and used to determine the level of affordability of CDTI. Questionnaires administered to heads of households or their representatives were used to collect information on the household expenditures and income. The suggested unit CDTI cost of $0.20 was used. However, as a test of sensitivity, we also used the unit cost of $0.056 which some community based distributors are charging per treatment. Using $0.20 as the unit treatment cost, this will consume less than 0.05% of average annual household income in both communities. It will equally deplete 0.05% of combined annual household expenditures on food and health care in both communities. However, using $0.056 as the unit treatment cost, then 0.02% of average annual household expenditure on health care, 0.01% average annual expenditure on combined health care and food, and 0.01% of average annual household income will be depleted. The households living in both communities may be able to afford CDTI schemes. However, the final decision on levels of affordability lies with the households. They will decide whether they can afford to trade-off some household income for ivermectin distribution.

The role of household chaos in understanding relations between early poverty and children's academic achievement

PubMed Central

Mokrova, Irina; Vernon-Feagans, Lynne; Willoughby, Michael; Pan, Yi

2016-01-01

The following prospective longitudinal study used an epidemiological sample (N = 1,236) to consider the potential mediating role of early cumulative household chaos (6–58 months) on associations between early family income poverty (6 months) and children's academic achievement in kindergarten. Two dimensions of household chaos, disorganization and instability, were examined as mediators. Results revealed that, in the presence of household disorganization (but not instability) and relevant covariates, income poverty was no longer directly related to academic achievement. Income poverty was, however, positively related to household disorganization, which was, in turn, associated with lower academic achievement. Study results are consistent with previous research indicating that household chaos conveys some of the adverse longitudinal effects of income poverty on children's outcomes and extend previous findings specifically to academic achievement in early childhood. PMID:27330247

Income inequality and depressive symptoms in South Africa: A longitudinal analysis of the National Income Dynamics Study.

PubMed

Adjaye-Gbewonyo, Kafui; Avendano, Mauricio; Subramanian, S V; Kawachi, Ichiro

2016-11-01

Research suggests that income inequality may detrimentally affect mental health. We examined the relationship between district-level income inequality and depressive symptoms among individuals in South Africa-one of the most unequal countries in the world-using longitudinal data from Wave 1 (2008) and Wave 3 (2012) of the National Income Dynamics Study. Depressive symptoms were measured using the Center for Epidemiological Studies of Depression Short Form while district Gini coefficients were estimated from census and survey sources. Age, African population group, being single, being female, and having lower household income were independently associated with higher depressive symptoms. However, in longitudinal, fixed-effects regression models controlling for several factors, district-level Gini coefficients were not significantly associated with depressive symptoms scores. Our results do not support the hypothesis of a causal link between income inequality and depressive symptoms in the short-run. Possible explanations include the high underlying levels of inequality in all districts, or potential lags in the effect of inequality on depression. Copyright © 2016 Elsevier Ltd. All rights reserved.

Age at Immigration and the Incomes of Older Immigrants, 1994–2010

PubMed Central

Tienda, Marta

2015-01-01

Objectives. Seniors comprise a growing proportion of new U.S. immigrants. We investigate whether late-age immigrants are disadvantaged in older age relative to those arriving earlier in life, based on income, reliance on public benefits, and access to public medical insurance. We test whether the 1996 welfare reform law altered the relationships between age at immigration and these outcomes. Method. Immigrants aged 65 and older in the 1994–2010 Current Population Surveys were classified by age at immigration. Median and logistic regressions are used to estimate the association between age at immigration and several outcomes and to test whether these associations differ for arrivals before and after welfare reform. Results. Late-age immigration is strongly associated with lower personal income, lower rates of Medicare and Social Security receipt, and higher participation in Supplemental Security Income (SSI) and Medicaid. Arrival after 1996 is associated with lower rates of SSI, Medicaid, and Medicare receipt. The association between late-age immigration and income is stronger for post-1996 arrivals relative to earlier arrivals, whereas that between late-age immigration and Medicaid is weaker, suggesting that the penalty conferred by late-age immigration grew after reform. Discussion. Late-age immigrants face formidable economic disadvantages exacerbated by exclusion from public benefits, with implications for immigration, health care, and welfare policy. PMID:24942972

Multigenerational: Households and the School Readiness of Children Born to Unmarried Mothers

PubMed Central

Augustine, Jennifer March; Raley, R. Kelly

2013-01-01

Following the ongoing increase in nonmarital fertility, policy makers have looked for ways to limit the disadvantages faced by children of unmarried mothers. Recent initiatives included marriage promotion and welfare-to-work programs. Yet policy might also consider the promotion of three generational households. We know little about whether multigenerational households benefit children of unwed mothers, although they are mandated for unmarried teen mothers applying for welfare benefits. Multigenerational households are also becoming increasingly common. Thus, using data from the Panel Study of Income Dynamics (N = 217), this study examines whether grandparent-headed coresidential households benefit preschool-aged children’s school readiness, employing propensity score techniques to account for selection into these households. Findings reveal living with a grandparent is not associated with child outcomes for families that select into such arrangements but is positively associated with reading scores and behavior problems for families with a low propensity to coreside. The implications of these findings for policy are discussed. PMID:23847390

Food prices, household income, and resource allocation: socioeconomic perspectives on their effects on dietary quality and nutritional status.

PubMed

Bouis, Howarth E; Eozenou, Patrick; Rahman, Aminur

2011-03-01

The recent rise in agricultural commodity prices has been dramatic, and food prices are likely to follow an upward trend, at least in the medium-term. Moreover, the recent financial crisis has also lowered incomes and increased food prices. Not only does this reduce dietary quality, but expenditures for health, sanitation, and education will decline, all of which will have a detrimental effect on health and nutrition outcomes. To provide some perspectives on the role of major socioeconomic factors in driving health and nutrition outcomes. We use demand elasticity parameters estimated from household-level survey data to simulate an increase in food prices, which is then mapped into energy and nutrient intakes. Furthermore, we also use household-level data to analyze the implications of unequal intrahousehold distribution of food for the nutritional status of adult women and female children. A 50% increase in food prices results in a decrease in energy intake of 5% to 15% and in a decrease in iron intake of 10% to 30%, depending on the strength of the induced income effect. In a country like the Philippines, this would be equivalent to an increase of 25 percentage points in the proportion of women not meeting their requirements for iron intake. Increasing food prices will make fighting micronutrient malnutrition in developing countries more difficult. In societies where preference is given to males in the intrahousehold distribution of nonstaple foods, this objective will be even more challenging.

Satisfaction with Job and Income among Older Individuals across European Countries

ERIC Educational Resources Information Center

Bonsang, Eric; van Soest, Arthur

2012-01-01

Using data on individuals of age 50 and older from 11 European countries, we analyze two economic aspects of subjective well-being of older Europeans: satisfaction with household income, and job satisfaction. Both have been shown to contribute substantially to overall well-being (satisfaction with life or happiness). We use anchoring vignettes to…

Validation of the Malaysian Coping Strategy Instrument to measure household food insecurity in Kelantan, Malaysia.

PubMed

Sulaiman, Norhasmah; Shariff, Zalilah Mohd; Jalil, Rohana Abdul; Taib, Mohd Nasir Mohd; Kandiah, Mirnalini; Samah, Asnarulkhadi Abu

2011-12-01

Food insecurity occurs whenever people are not able to access enough food at all times for an active and healthy life or when adequate and safe food acquired by socially acceptable ways is not available. To validate the Malaysian Coping Strategy Instrument (MCSI) to measure household food insecurity in Kelantan, Malaysia. A cross-sectional study was conducted on 301 nonpregnant, nonlactating Malay women, aged between 19 and 49 years, living in rural and urban areas. The respondents were interviewed with the use of a structured questionnaire to obtain information on their demographic and socioeconomic characteristics, household food security, and dietary intake. Demographic and socioeconomic characteristics (household size, number of children, number of children attending school, household income, and per capita income) were significantly associated with household food-security status in rural and urban areas. Energy intake, fat intake, percentage of energy from fat, and number of servings of meat,fish, or poultry and legumes were significantly associated with household food-security status in rural areas. The dietary diversity score was significantly associated with household food-security status in rural and urban areas. Validating the MCSI in other areas of Malaysia as well as in similar settings elsewhere in the world before it is used to measure household food insecurity in the population is strongly recommended. In this study, the MCSI was found to be a reliable and valid measure of household food insecurity based on criterion-related validity, particularly in terms of demographic and socioeconomic characteristics and dietary diversity.

Maternal employment and Mexican school-age children overweight in 2012: the importance of households features.

PubMed

Espinosa, Alejandro Martínez

2018-01-01

International evidence regarding the relationship between maternal employment and school-age children overweight and obesity shows divergent results. In Mexico, this relationship has not been confirmed by national data sets analysis. Consequently, the objective of this article was to evaluate the role of the mothers' participation in labor force related to excess body weight in Mexican school-age children (aged 5-11 years). A cross-sectional study was conducted on a sample of 17,418 individuals from the National Health and Nutrition Survey 2012, applying binomial logistic regression models. After controlling for individual, maternal and contextual features, the mothers' participation in labor force was associated with children body composition. However, when the household features (living arrangements, household ethnicity, size, food security and socioeconomic status) were incorporated, maternal employment was no longer statically significant. Household features are crucial factors for understanding the overweight and obesity prevalence levels in Mexican school-age children, despite the mother having a paid job. Copyright: © 2018 Permanyer.

The association between personal income and aging: A population-based 13-year longitudinal study.

PubMed

Lin, Tzu-Yu; Chen, Chia-Yu; Tsao, Chueh-Yung; Hsu, Kuang-Hung

Population aging is set to increase the elder dependency ratio, causing a rapid increase in healthcare expenditures and financial burden on the government. This study aims to construct an aging score from age-related diseases and to perform longitudinal analyses to examine the association between personal income and aging. A total of 86,838 subjects drawn from a community with 384,617 residents in northern Taiwan were examined. Personal income and aging-related diseases were measured from the National Health Insurance database during 1997-2010. Multiple linear regression and stratified analyses were used. Our results indicate that subjects with low personal income (defined as monthly income ≤610 USD) can have high aging scores as calculated by selected aging-related diseases. In stratified analyses, moreover, subjects with low personal income tended to have higher aging scores across different anthropometric groups. The association was particularly evident in subjects >60years old, and they were noted across multiple strata, including those of catastrophic illness as well as type of primary care setting. This study found evidence for association between low income and aging in a population with compulsory health insurance program, where accessibility barriers were low in terms of health care resources and personal socioeconomic status. The economic inequity causes difference in aging process, which deserves for future interventions. Copyright © 2017 Elsevier B.V. All rights reserved.

"Healthy Aging at Older Ages: Are Income and Education Important?"

ERIC Educational Resources Information Center

Buckley, Neil J.; Denton, Frank T.; Robb, A. Leslie; Spencer, Byron G.

2004-01-01

Being higher on the socio-economic scale is correlated with being in better health, but is there is a causal relationship? Using 3 years of longitudinal data for individuals aged 50 and older from the Canadian Survey of Labour and Income Dynamics, we study the health transitions for those who were in good health in the first year, focusing…

The economic status of older people's households in urban and rural settings in Peru, Mexico and China: a 10/66 INDEP study cross-sectional survey.

PubMed

Prince, Martin J; Lloyd-Sherlock, Peter; Guerra, Mariella; Huang, Yueqin; Sosa, Ana Luisa; Uwakwe, Richard; Acosta, Isaac; Liu, Zhaorui; Gallardo, Sara; Guerchet, Maelenn; Mayston, Rosie; de Oca, Veronica Montes; Wang, Hong; Ezeah, Peter

2016-01-01

Few data are available from middle income countries regarding economic circumstances of households in which older people live. Many such settings have experienced rapid demographic, social and economic change, alongside increasing pension coverage. Population-based household surveys in rural and urban catchment areas in Peru, Mexico and China. Participating households were selected from all households with older residents. Descriptive analyses were weighted back for sampling fractions and non-response. Household income and consumption were estimated from a household key informant interview. 877 Household interviews (3177 residents). Response rate 68 %. Household income and consumption correlated plausibly with other economic wellbeing indicators. Household Incomes varied considerably within and between sites. While multigenerational households were the norm, older resident's incomes accounted for a high proportion of household income, and older people were particularly likely to pool income. Differences in the coverage and value of pensions were a major source of variation in household income among sites. There was a small, consistent inverse association between household pension income and labour force participation of younger adult co-residents. The effect of pension income on older adults' labour force participation was less clear-cut. Historical linkage of social protection to formal employment may have contributed to profound late-life socioeconomic inequalities. Strategies to formalise the informal economy, alongside increases in the coverage and value of non-contributory pensions and transfers would help to address this problem.

Contribution and efficiency of labor allocation analysis of income in household industry using raw material of agricultural commodity in South Sulawesi.

NASA Astrophysics Data System (ADS)

Tenriawaru, A. N.; Mahyuddin; Jamil, M. H.; Fudjaja, L.; Nurbaya, S.

2018-05-01

In South Sulawesi, various home industry businesses have grown. This industry is actually the basis of community livelihoods that need to be developed and nurtured by the government so family income get increased and the absorption of workers will improve the regional economy in general. The purpose of this study is to analyse the contribution of income, and efficiency of labour allocation in household industries made from raw agricultural commodities. The method of determining the respondents is done by direct appointment (purposive) on the industry players made from raw agricultural commodities. The type of research is quantitative descriptive and data are analysed using income analysis, cost analysis, income contribution analysis, Working Day (HOK) analysis and efficiency analysis of labour allocation. The results showed that the average income earned per year ranged from IDR. 16,866,867.- up to IDR. 125,271,500.-. There are 2 industries that have high contribution to family income such as banana chips industry and rice milling industry with value of 96.3% and 68.7% respectively. In the meantime, there are 5 industries with high average labour allocation efficiency of IDR. 218,135.- / HOK per day and above the efficiency standard of labour allocation based on UMR in South Sulawesi Province.

Distributions of households by size: differences and trends.

PubMed

Kuznets, S

1982-01-01

"This article deals with the distributions of households by size, that is, by number of persons, as they are observed in international comparisons, and for fewer countries, over time." The contribution of differentials in household size to inequality in income distribution among persons and households is discussed. Data are for both developed and developing countries. excerpt

Factors Influencing Household Uptake of Improved Solid Fuel Stoves in Low- and Middle-Income Countries: A Qualitative Systematic Review

PubMed Central

Debbi, Stanistreet; Elisa, Puzzolo; Nigel, Bruce; Dan, Pope; Eva, Rehfuess

2014-01-01

Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS) are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains. Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus. PMID:25123070

Factors influencing household uptake of improved solid fuel stoves in low- and middle-income countries: a qualitative systematic review.

PubMed

Debbi, Stanistreet; Elisa, Puzzolo; Nigel, Bruce; Dan, Pope; Eva, Rehfuess

2014-08-13

Household burning of solid fuels in traditional stoves is detrimental to health, the environment and development. A range of improved solid fuel stoves (IS) are available but little is known about successful approaches to dissemination. This qualitative systematic review aimed to identify factors that influence household uptake of IS in low- and middle-income countries. Extensive searches were carried out and studies were screened and extracted using established systematic review methods. Fourteen qualitative studies from Asia, Africa and Latin-America met the inclusion criteria. Thematic synthesis was used to synthesise data and findings are presented under seven framework domains. Findings relate to user and stakeholder perceptions and highlight the importance of cost, good stove design, fuel and time savings, health benefits, being able to cook traditional dishes and cleanliness in relation to uptake. Creating demand, appropriate approaches to business, and community involvement, are also discussed. Achieving and sustaining uptake is complex and requires consideration of a broad range of factors, which operate at household, community, regional and national levels. Initiatives aimed at IS scale up should include quantitative evaluations of effectiveness, supplemented with qualitative studies to assess factors affecting uptake, with an equity focus.

Expectation Returns and Households' Decision in the Schooling of Their Children in Khyber Pakhtunkhwa Pakistan

ERIC Educational Resources Information Center

Khan, Shahzad; Lurhathaiopath, Puangkaew; Matsushita, Shusuke

2017-01-01

This study aims to study households' expectations for their children's academic performance in Khyber Pakhtunkhwa, Pakistan. Education has a significant role in increasing the productivity and income level of an individual in a society. Household education, income, distance from school, gender discrimination within household and cost of education…

Effects of residential relocation on household and commuting expenditures in Shanghai, China.

PubMed

Day, Jennifer; Cervero, Robert

2010-01-01

Over the past three decades, China's cities have undergone massive spatial restructuring in the wake of market reforms and economic growth. One consequence has been a rapid migration of urban residents to the periphery. Some movers have been forced out either by rising urban rents or government reclamation of their residences. Others have relocated willingly to modernized housing or for other lifestyle reasons. This article examines the effects of relocation to the urban edge on household well-being. It explores the factors underlying changes in housing and transportation costs as households move to the periphery. The research also examines whether those who moved involuntarily are affected differently from those who moved by choice. Results show that, relative to those who moved by choice, involuntary movers are disproportionately and adversely affected in terms of job accessibility, commute time, housing consumption and disposable income. The findings also show that, compared with higher-income households, lower-income groups are disproportionately affected in relation to housing costs, accessibility losses, disposable income and household worker composition. These results indicate that relocation compensation for involuntarily relocated households should be expanded to include more than just housing value: it should encompass urban location changes, household needs and relocation costs.

Married Women's Resource Position and Household Food Expenditures in Cebu, Philippines

ERIC Educational Resources Information Center

Schmeer, Kammi K

2005-01-01

This study analyzes how married women use their access to and control over economic resources to increase household spending on food. Using data from Cebu, Philippines, where child malnutrition is high, this study finds that the more income women earn and control, the more households spend on food. Women's control over their income is particularly…

Racial differences in the household composition of elders by age, gender, and area of residence.

PubMed

Coward, R T; Lee, G R; Netzer, J K; Cutler, S J; Danigelis, N L

1996-01-01

Using census data and an innovative technique for describing the composition of households from the perspective of elders, this research provides a more detailed description of race differences in living arrangements of older persons than has previously existed. In addition, cross tabulations of race with other factors known to influence household composition (gender, age, and area of residence) are examined. While white women are more likely than black women to live alone, the reverse is true among men. Whites are more likely than blacks to live in married-couple-only households, and blacks are more likely than whites to live in multigenerational households, although these differences decrease with advancing age. Blacks are also more likely than whites to live with collateral kin or non-kin only, although these categories comprise small proportions of the population. Implications of these differences for caregiving and quality of life among older persons are discussed.

Effects of education and income on cognitive functioning among Indians aged 50 years and older: evidence from the Study on Global Ageing and Adult Health (SAGE) Wave 1 (2007-2010).

PubMed

Basu, Rashmita

2013-01-01

Relatively little is known about socioeconomic predictors of cognitive health among middle-aged and elderly Indians. The primary objective of this study was to examine the extent to which education and income influence cognitive functioning after adjusting for demographic characteristics, health risk factors and transgenerational factors such as parental education. The study also examined gender disparities in cognitive functioning across geographic regions in India. Using cross-sectional data from the World Health Organization Study on Global Ageing and Adult Health (SAGE) Wave 1 (2007-2010) in a national sample of adults aged 50 years or older, a generalized linear model was used to examine the impacts of education and per-capita income on overall cognitive functioning. The generalized estimating equation approach was utilized to quantify these impacts on respondents' overall cognitive performance score. This technique accounted for any correlation of responses of individuals within the same household. Respondents with primary or secondary education and those with education above secondary level scored 3.8 and 6 points (P < 0.001) respectively more than respondents who had no formal education. In a similar vein, individuals in higher per-capita income quartiles scored 0.4,1.0 and 1.8 (P < 0.001) more than respondents in the lowest income quartile. Although respondents in northern states scored 1.8 points higher than those from other geographic locations (P < 0.001), females in northern states had the worst cognitive performance (1.9 points lower) compared with females in other Indian states. In addition, early and adult life characteristics such as parental education, physical activity and a history of depression were found to be significant predictors of overall cognitive functioning. Education and income play important roles in influencing overall cognitive performance among middle-aged and elderly Indians. In addition, cognitive performance scores varied

Education Modifies the Association of Wealth with Obesity in Women in Middle-Income but Not Low-Income Countries: An Interaction Study Using Seven National Datasets, 2005-2010

PubMed Central

Aitsi-Selmi, Amina; Bell, Ruth; Shipley, Martin J.; Marmot, Michael G.

2014-01-01

Background Education and wealth may have different associations with female obesity but this has not been investigated in detail outside high-income countries. This study examines the separate and inter-related associations of education and household wealth in relation to obesity in women in a representative sample of low- and middle-income countries (LMICs). Methods The seven largest national surveys were selected from a list of Demographic and Health Surveys (DHS) ordered by decreasing sample size and resulted in a range of country income levels. These were nationally representative data of women aged 15–49 years collected in the period 2005–2010. The separate and joint effects, unadjusted and adjusted for age group, parity, and urban/rural residence using a multivariate logistic regression model are presented Results In the four middle-income countries (Colombia, Peru, Jordan, and Egypt), an interaction was found between education and wealth on obesity (P-value for interaction <0.001). Among women with no/primary education the wealth effect was positive whereas in the group with higher education it was either absent or inverted (negative). In the poorer countries (India, Nigeria, Benin), there was no evidence of an interaction. Instead, the associations between each of education and wealth with obesity were independent and positive. There was a statistically significant difference between the average interaction estimates for the low-income and middle-income countries (P<0.001). Conclusions The findings suggest that education may protect against the obesogenic effects of increased household wealth as countries develop. Further research could examine the factors explaining the country differences in education effects. PMID:24608086

Differential Aging in Place and Depressive Symptoms: Interplay Among Time, Income, and Senior Housing.

PubMed

Park, Sojung; Kim, BoRin; Han, Yoonsun

2018-03-01

We examined cumulative and differential experiences of aging in place. Data came from the 2002 and 2010 wave of the Health Retirement Study. We modeled the trajectory of later-life depressive symptoms, and how senior-housing environments moderate the negative association between economic disadvantages and depressive symptoms. At baseline, economically disadvantaged older adults were more likely to exhibit depressive symptoms. However, detrimental effects of income group (non-low income vs. moderate income; non-low income vs. low income) on depressive symptoms did not significantly change over time. The age-leveler hypothesis may account for nonsignificant effects of disadvantaged income groups over time. Findings suggest that moderate-income seniors may experience positive differentials if they age in place in a supportive senior-housing environment. Moderate-income seniors may have broader opportunities in senior housing compared to private-home peers. Senior housing might partially counter risks such as low mental health, emerging from life-course disadvantage.

Income elasticity of health expenditures in Iran.

PubMed

Zare, Hossein; Trujillo, Antonio J; Leidman, Eva; Buttorff, Christine

2013-09-01

Because of its policy implications, the income elasticity of health care expenditures is a subject of much debate. Governments may have an interest in subsidizing the care of those with low income. Using more than two decades of data from the Iran Household Expenditure and Income Survey, this article investigates the relationship between income and health care expenditure in urban and rural areas in Iran, a resource rich, upper-middle-income country. We implemented spline and quantile regression techniques to obtain a more robust description of the relationship of interest. This study finds non-uniform effects of income on health expenditures. Although the results show that health care is a necessity for all income brackets, spline regression estimates indicate that the income elasticity is lowest for the poorest Iranians in urban and rural areas. This suggests that they will show low flexibility in medical expenses as income fluctuates. Further, a quantile regression model assessing the effect of income at different level of medical expenditure suggests that households with lower medical expenses are less elastic.

Comparison of the characteristics of fire and non-fire households in the 2004-2005 survey of fire department-attended and unattended fires.

PubMed

Greene, Michael A

2012-06-01

Comparison of characteristics of fire with non-fire households to determine factors differentially associated with fire households (fire risk factors). National household telephone survey in 2004-2005 by the US Consumer Product Safety Commission with 916 fire households and a comparison sample of 2161 non-fire households. There were an estimated 7.4 million fires (96.6% not reported to fire departments) with 130,000 injuries. Bivariate analysis and multivariate logistic regression analyses to assess differences in household characteristics. Significant factors associated with fire households were renting vs. owning (OR 1.988 p<0.0001); household members under 18 year of age (OR 1.277 p<0.0001); lack of residents over 64 years old (OR 0.552 p=0.0007); and college or higher education (some college OR 1.444 p=0.0360, college graduate OR 1.873, p<0.0001, postgraduate OR 2.156 p<0.0001). Not significant were age of house; race; ethnicity; and income. Number of smokers was borderline significant (OR 1.132 p=0.1019) but was significant in the subset of fire households with non-cooking fires (OR 1.383 p=0.0011). Single family houses were associated with non-fire households in the bivariate analysis but not in the multivariate analyses. Renting, household members under 18 years old and smokers are risk factors for unattended fires, similar to the literature for fatal and injury fires. Differences included household members over 65 years old (associated with non-fire households), college/postgraduate education (associated with fire households) and lack of significance of income. Preventing cooking fires (64% of survey incidents), smoking prevention efforts and fire prevention education for families with young children have the potential for reducing unattended fires and injuries.

Association between untreated dental caries and household food insecurity in schoolchildren.

PubMed

Santin, Gabriela Cristina; Pintarelli, Tatiana Pegoretti; Fraiz, Fabian Calixto; de Oliveira, Ana Cristina Borges; Paiva, Saul Martins; Ferreira, Fernanda Morais

2016-02-01

The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US$ 70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families.

Household preferences for reducing greenhouse gas emissions in four European high-income countries: Does health information matter? A mixed-methods study protocol.

PubMed

Herrmann, Alina; Fischer, Helen; Amelung, Dorothee; Litvine, Dorian; Aall, Carlo; Andersson, Camilla; Baltruszewicz, Marta; Barbier, Carine; Bruyère, Sébastien; Bénévise, Françoise; Dubois, Ghislain; Louis, Valérie R; Nilsson, Maria; Richardsen Moberg, Karen; Sköld, Bore; Sauerborn, Rainer

2017-08-01

It is now universally acknowledged that climate change constitutes a major threat to human health. At the same time, some of the measures to reduce greenhouse gas emissions, so-called climate change mitigation measures, have significant health co-benefits (e.g., walking or cycling more; eating less meat). The goal of limiting global warming to 1,5° Celsius set by the Conference of the Parties to the United Nations Framework Convention on Climate Change in Paris in 2015 can only be reached if all stakeholders, including households, take actions to mitigate climate change. Results on whether framing mitigation measures in terms of their health co-benefits increases the likelihood of their implementation are inconsistent. The present study protocol describes the transdisciplinary project HOPE (HOuseholds' Preferences for reducing greenhouse gas emissions in four European high-income countries) that investigates the role of health co-benefits in households' decision making on climate change mitigation measures in urban households in France, Germany, Norway and Sweden. HOPE employs a mixed-methods approach combining status-quo carbon footprint assessments, simulations of the reduction of households' carbon footprints, and qualitative in-depth interviews with a subgroup of households. Furthermore, a policy analysis of current household oriented climate policies is conducted. In the simulation of the reduction of households' carbon footprints, half of the households are provided with information on health co-benefits of climate change mitigation measures, the other half is not. Households' willingness to implement the measures is assessed and compared in between-group analyses of variance. This is one of the first comprehensive mixed-methods approaches to investigate which mitigation measures households are most willing to implement in order to reach the 1,5° target set by the Paris Agreement, and whether health co-benefits can serve as a motivator for households to

Racial and demographic differences in household travel and fuel purchase behavior

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gur, Y.; Millar, M.

1987-01-01

Monthly fuel purchase logs from the Residential Energy Consumption Survey's Household Transportation Panel (TP) were analyzed to determine the relationship between various household characteristics and purchase frequency, tank inventories, vehicle-miles traveled, and fuel expenditures. Multiple classification analysis (MCA) was used to relate observed differences in dependent variables to such index-type household characteristics as income and residence location, and sex, race and age of household head. Because it isolates the net effect of each parameter, after accounting for the effects of all other parameters, MCA is particularly appropriate for this type of analysis. Results reveal clear differences in travel and fuelmore » purchase behavior for four distinct groups of vehicle-owning households. Black households tend to own far fewer vehicles with lower fuel economy, to use them more intensively, to purchase fuel more frequently, and to maintain lower fuel inventories than white households. Similarly, poor households own fewer vehicles with lower fuel economy, but they drive them less intensively, purchase fuel more frequently, and maintain lower fuel inventories than nonpoor households. Elderly households also own fewer vehicles with lower fuel economy. But since they drive them much less intensively, their fuel purchases are much less frequent and their fuel inventories are higher than nonelderly households. Female-headed households also own fewer vehicles but with somewhat higher fuel economy. They drive them less intensively, maintain higher fuel inventories, and purchase fuel less frequently than male-headed households. 13 refs., 8 tabs.« less

The Effects of Income on Mental Health: Evidence from the Social Security Notch

PubMed Central

Golberstein, Ezra

2015-01-01

Background Mental health is a key component of overall wellbeing and mental disorders are relatively common, including among older adults. Yet the causal effect of income on mental health status among older adults is poorly understood. Aims This paper considers the effects of a major source of transfer income, Social Security retirement benefits, on the mental health of older adults. Methods The Social Security benefit “Notch” is as a large, permanent, and exogenous shock to Social Security income in retirement. The “Notch” is used to identify the causal effect of Social Security income on mental health among older ages using data from the AHEAD cohort of the Health and Retirement Study. Results We find that increases in Social Security income significantly improve mental health status and the likelihood of a psychiatric diagnosis for women, but not for men. Discussion The effects of income on mental health for older women are statistically significant and meaningful in magnitude. While this is one of the only studies to use plausibly exogenous variation in household income to identify the effect of income on mental health, a limitation of this work is that the results only directly pertain to lower-education households. Implications Public policy proposals that alter retirement benefits for the elderly may have important effects on the mental health of older adults. PMID:25862202

Volunteering, income and health.

PubMed

Detollenaere, Jens; Willems, Sara; Baert, Stijn

2017-01-01

Separate literatures have related volunteering to health gains and income gains. We study the association between volunteering, income and health within one statistical framework. A state-of-the-art mediation analysis is conducted on data concerning the health, volunteering and sociodemographic characteristics of 42926 individuals within 29 European countries. We find that volunteering is positively associated to self-rated health. This association is partially mediated by household income.

Volunteering, income and health

PubMed Central

Detollenaere, Jens; Willems, Sara

2017-01-01

Separate literatures have related volunteering to health gains and income gains. We study the association between volunteering, income and health within one statistical framework. A state-of-the-art mediation analysis is conducted on data concerning the health, volunteering and sociodemographic characteristics of 42926 individuals within 29 European countries. We find that volunteering is positively associated to self-rated health. This association is partially mediated by household income. PMID:28273163

Parental occupations, educational levels, and income and prevalence of dental caries in 3-year-old Japanese children.

PubMed

Kato, Hiromasa; Tanaka, Keiko; Shimizu, Ken; Nagata, Chisato; Furukawa, Shinya; Arakawa, Masashi; Miyake, Yoshihiro

2017-12-13

Most studies have investigated the association between parental socioeconomic factors and dental caries in children based on educational and income levels; studies focusing on parental occupation, however, have been relatively limited. This cross-sectional study examined the associations between parental occupations and levels of education and household income and the prevalence of dental caries in Japanese children aged 3 years. Study subjects were 6315 children. Oral examination results were obtained from the parents or guardians, who transcribed the information recorded by medical staff at a public health center from their maternal and child health handbooks to our self-administered questionnaire. Children were classified as having dental caries if one or more primary teeth had decayed or had been filled. Adjustment was made for sex, age, region of residence, breastfeeding duration, between-meal snack frequency, toothbrushing frequency, use of fluoride, regular dental check-ups, maternal smoking during pregnancy, and living with at least one household smoker. The prevalence of dental caries was 14.7%. Compared with having an unemployed father, having a father employed in professional and engineering, clerical, sales, security, or manufacturing process was significantly associated with a lower prevalence of dental caries. Compared with having an unemployed mother, having a mother employed in professional and engineering or service was significantly inversely associated with the prevalence of dental caries. Significant inverse associations were observed between parental levels of education and household income and the prevalence of dental caries. The findings of our study suggest that parental occupation affects the prevalence of dental caries in children. We confirm that higher levels of parental education and household income decreased the prevalence of dental caries.

Higher Educational Attainment but not Higher Income is Protective for Cardiovascular Risk in Deaf American Sign Language (ASL) Users

PubMed Central

McKee, Michael M.; McKee, Kimberly; Winters, Paul; Sutter, Erika; Pearson, Thomas

2013-01-01

Background Higher educational attainment and income provide cardiovascular protection in the general population. It is unknown if the same effect is seen among Deaf American Sign Language (ASL) users who face communication barriers in healthcare settings. Objective We sought to examine whether educational attainment and/or annual household income were inversely associated with cardiovascular risk in a sample of Deaf ASL users. Methods This cross-sectional study included 302 Deaf respondents aged 18-88 years from the Deaf Health Survey (2008), an adapted and translated Behavioral Risk Factor Surveillance System (BRFSS) administered in sign language. Associations between the self-reported cardiovascular disease equivalents (CVDE; any of the following: diabetes, myocardial infarction (MI), cerebral vascular attack (CVA), and angina) with educational attainment (≤high school [low education], some college, and ≥4 year college degree [referent]), and annual household income (<$25,000, $25,000-<$50,000, or ≥$50,000 [referent]) were assessed using a multivariate logistic regression adjusting for age, sex, race/ethnicity, and smoking history. Results Deaf respondents who reported ≤high school education were more likely to report the presence of a CVDE (OR 5.92; 95% CI 2.12-16.57) compared to Deaf respondents who reported having ≥4 year college degree after adjustment. However, low-income Deaf individuals (i.e. household incomes <$25,000) were not more likely to report the presence of a CVDE (OR=2.24; 95% CI 0.76-6.68) compared to high-income Deaf respondents after adjustment. Conclusion Low educational attainment was associated with higher likelihood of reported cardiovascular equivalents among Deaf individuals. Higher income did not appear to provide a cardiovascular protective effect for Deaf respondents. PMID:24411507

Associations between hair cortisol concentration, income, income dynamics and status incongruity in healthy middle-aged women

PubMed Central

Serwinski, Bianca; Salavecz, Gyöngyvér; Kirschbaum, Clemens; Steptoe, Andrew

2016-01-01

A body of research demonstrates that financial disadvantage is associated with general health inequalities and higher mortality rates. Most studies make use of cross-sectional analyses, although income can also be viewed as a dynamic concept. The use of endocrine-markers as proxies for health can provide information about the pathways involved in these associations. Hair cortisol analysis has been developed as a method for assessing sustained cortisol output as it provides an estimate of cumulative cortisol secretion over a prolonged time. The present study assessed income and income trajectory over a 4-year period in 164 working women (aged 26–65) in relation to hair cortisol in a longitudinal design. A negative association between hair cortisol and concurrent income was found (p = 0.025) and hair cortisol and changes in income over 4 years (p < 0.001), after adjustment for age, BMI, smoking status, hair treatment and country. Status incongruity, a mismatch between educational status and income group, was related to higher cortisol levels compared with status congruity (p = 0.009). These findings suggest that psychoneuroendocrinological pathways might partially explain the relationship between lower socio-economic status and adverse health outcomes. Future longitudinal research using hair cortisol analysis is warranted to clarify the time course of social mobility in relation to long-term cortisol, to investigate other underlying psychosocial factors implicated in these associations, and to determine the exact health implications of the neuroendocrine perturbations in individuals with limited economic resources. PMID:26923848

Associations between hair cortisol concentration, income, income dynamics and status incongruity in healthy middle-aged women.

PubMed

Serwinski, Bianca; Salavecz, Gyöngyvér; Kirschbaum, Clemens; Steptoe, Andrew

2016-05-01

A body of research demonstrates that financial disadvantage is associated with general health inequalities and higher mortality rates. Most studies make use of cross-sectional analyses, although income can also be viewed as a dynamic concept. The use of endocrine-markers as proxies for health can provide information about the pathways involved in these associations. Hair cortisol analysis has been developed as a method for assessing sustained cortisol output as it provides an estimate of cumulative cortisol secretion over a prolonged time. The present study assessed income and income trajectory over a 4-year period in 164 working women (aged 26-65) in relation to hair cortisol in a longitudinal design. A negative association between hair cortisol and concurrent income was found (p=0.025) and hair cortisol and changes in income over 4 years (p<0.001), after adjustment for age, BMI, smoking status, hair treatment and country. Status incongruity, a mismatch between educational status and income group, was related to higher cortisol levels compared with status congruity (p=0.009). These findings suggest that psychoneuroendocrinological pathways might partially explain the relationship between lower socio-economic status and adverse health outcomes. Future longitudinal research using hair cortisol analysis is warranted to clarify the time course of social mobility in relation to long-term cortisol, to investigate other underlying psychosocial factors implicated in these associations, and to determine the exact health implications of the neuroendocrine perturbations in individuals with limited economic resources. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Food stress in Adelaide: the relationship between low income and the affordability of healthy food.

PubMed

Ward, Paul R; Verity, Fiona; Carter, Patricia; Tsourtos, George; Coveney, John; Wong, Kwan Chui

2013-01-01

Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a "Healthy Food Basket" methodology, this study costed a week's supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability). It is argued that families that spend more than 30% of household income on food could be experiencing "food stress." Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt.

Food Stress in Adelaide: The Relationship between Low Income and the Affordability of Healthy Food

PubMed Central

Ward, Paul R.; Verity, Fiona; Carter, Patricia; Tsourtos, George; Coveney, John; Wong, Kwan Chui

2013-01-01

Healthy food is becoming increasingly expensive, and families on low incomes face a difficult financial struggle to afford healthy food. When food costs are considered, families on low incomes often face circumstances of poverty. Housing, utilities, health care, and transport are somewhat fixed in cost; however food is more flexible in cost and therefore is often compromised with less healthy, cheaper food, presenting an opportunity for families on low incomes to cut costs. Using a “Healthy Food Basket” methodology, this study costed a week's supply of healthy food for a range of family types. It found that low-income families would have to spend approximately 30% of household income on eating healthily, whereas high-income households needed to spend about 10%. The differential is explained by the cost of the food basket relative to household income (i.e., affordability). It is argued that families that spend more than 30% of household income on food could be experiencing “food stress.” Moreover the high cost of healthy foods leaves low-income households vulnerable to diet-related health problems because they often have to rely on cheaper foods which are high in fat, sugar, and salt. PMID:23431321

Household food insecurity, diet quality, and weight status among indigenous women (Mah Meri) in Peninsular Malaysia

PubMed Central

2018-01-01

BACKGROUND/OBJECTIVES This cross-sectional study assessed household food security status and determined its association with diet quality and weight status among indigenous women from the Mah Meri tribe in Peninsular Malaysia. SUBJECTS/METHODS The Radimer/Cornell Hunger and Food Insecurity Instrument and the Malaysian Healthy Eating Index (HEI) were used to assess household food security status and diet quality, respectively. Information on socio-demographic characteristics and 24-hour dietary recall data were collected through face-to-face interview, and anthropometric measurements including weight, height, and body mass index (BMI) were obtained from 222 women. RESULTS Majority of households (82.9%) experienced different levels of food insecurity: 29.3% household food insecurity, 23.4% individual food insecurity, and 30.2% fell into the child hunger group. The food-secure group had significantly fewer children and smaller household sizes than the food-insecure groups (P < 0.05). The mean household income, income per capita, and food expenditure significantly decreased as food insecurity worsened (P < 0.001). The food-secure group had significantly higher Malaysian HEI scores for grains and cereals (P < 0.01), as well as for meat, poultry, and eggs (P < 0.001), than the food-insecure groups. The child-hunger group had significantly higher fat (P < 0.05) and sodium (P < 0.001) scores than the food-secure and household food-insecure groups. Compared to the individual food-insecure and child-hunger groups, multivariate analysis of covariance showed that the food-secure group was significantly associated with a higher Malaysian HEI score while the household food-insecure group was significantly associated with a higher BMI after controlling for age (P < 0.025). CONCLUSIONS The majority of indigenous households faced food insecurity. Food insecurity at the individual and child levels was associated with lower quality of diet, while food insecurity at the household

Income and assets of Social Security beneficiaries by type of benefit.

PubMed

Grad, S

1989-01-01

The SIPP data have provided a first look at the relative economic status of various types of Social Security beneficiaries. They have shown that the different types of Social Security beneficiaries face very different economic circumstances. Retired workers and wife beneficiaries have the highest family incomes adjusted for family size. Aged widows and minor children have the lowest family incomes, with high proportions of poor or near poor. And disabled workers are in between, but also have high proportions of poor or near poor. Retired-worker and wife beneficiary households also have considerably more asset holdings than disabled-worker or widow beneficiary households. Beneficiaries with high family incomes are very likely to live with relatives and to rely heavily on the relatives' income. The high-income families tend to have non-means-tested sources of family income other than Social Security amounting to substantial proportions of their total income and to have high asset holdings. Conversely, beneficiaries with low family incomes are very likely to live alone or with nonrelatives, to rely heavily on Social Security and means-tested benefits, and to have low asset holdings. A majority of ever-poor beneficiaries (with the exception of widow beneficiaries) are poor in only some months of a year. This situation is not consistent with the stereotype of beneficiaries living on fixed incomes. But the change in poverty status is often due to a change in the income of other family members rather than of the beneficiary. And in some cases, a change in poverty status occurs with little or no change in income as the cost of living rises.

Maternal resources and household food security: evidence from Nicaragua.

PubMed

Schmeer, Kammi K; Piperata, Barbara A; Herrera Rodríguez, Andrés; Salazar Torres, Virgilio Mariano; Centeno Cárdenas, Francisco José

2015-11-01

Women (especially mothers) are theorized as critical to reducing household food insecurity through their work and caregiver roles. The present study tests these assumptions, assessing how maternal economic and social resources are associated with food insecurity in households with young children. Data from a population-based sample of households was collected in León, Nicaragua (n 443). Data include a newly validated measure of household food insecurity (ELCSA), maternal resource measures, and household economic status and demographics. Regression analysis tests the statistical associations (P<0·05) of maternal resources with household, adult-specific and child-specific food insecurity. Municipality of León, Nicaragua. Households with children aged 3-11 years in rural and urban León. Only 25% of households with young children were food secure, with 50% mildly food insecure and 25% moderately/severely food insecure. When mothers contributed substantially to household income, the odds of moderate/severe household food insecurity were 34% lower than when their spouse/partner was the main provider. The odds of food insecurity were 60% lower when mothers managed household money, 48% lower when mothers had a secondary (v. primary) education, 65% higher among single mothers and 16% lower with each indicator of social support. Results were similar for adult- and child-specific food insecurity. This research provides new evidence that maternal economic and social resources are important for reducing household food insecurity and adult- and child-specific food insecurity. Women's social status, social support and access to economic resources need to be enhanced as a part of policies aimed to reduce food insecurity in high-poverty settings.

Community and household socioeconomic factors associated with pesticide-using, small farm household members' health: a multi-level, longitudinal analysis

PubMed Central

2011-01-01

Background Longitudinal studies using multi-level models to examine health inequalities in lower and middle income countries (LMICs) are rare. We explored socio-economic gradients in health among small farm members participating in a pesticide-related health and agriculture program in highland Ecuador. Methods We profiled 24 communities through key informant interviews, secondary data (percent of population with unsatisfied basic needs), and intervention implementation indicators. Pre (2005) and post (2007) surveys of the primary household and crop managers included common questions (education, age, and the health outcome - digit span scaled 0-10)) and pesticide-related practice questions specific to each. Household assets and pesticide use variables were shared across managers. We constructed multi-level models predicting 2007 digit span for each manager type, with staged introduction of predictor variables. Results 376 household managers (79% of 2005 participants) and 380 crop managers (76% of 2005 participants) had complete data for analysis. The most important predictor of 2007 digit span was 2005 digit span: β (Standard Error) of 0.31(0.05) per unit for household and 0.17(0.04) for crop managers. Household asset score was next most important: 0.14(0.06) per unit for household and 0.14(0.05) for crop managers. Community percent with unsatisfied basic needs was associated with reductions in 2007 digit span: -0.04(0.01) per percent for household and -0.03(0.01) for crop managers. Conclusions The important roles of life endowments and/or persistent neurotoxicity were exemplified by limited change in the health outcome. Gradients by household assets and community deprivation were indicative of ongoing, structural inequities within this LMIC. PMID:22094171

Absolute and Relative Socioeconomic Health Inequalities across Age Groups

PubMed Central

van Zon, Sander K. R.; Bültmann, Ute; Mendes de Leon, Carlos F.; Reijneveld, Sijmen A.

2015-01-01

Background The magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender. Methods The study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender. Results Absolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups. Conclusions Absolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of

Out-of-pocket expenditures for pharmaceuticals: lessons from the Austrian household budget survey.

PubMed

Sanwald, Alice; Theurl, Engelbert

2017-05-01

Paying pharmaceuticals out of pocket is an important source of financing pharmaceutical consumption. Only limited empirical knowledge is available on the determinants of these expenditures. In this article we analyze which characteristics of private households influence out-of-pocket pharmaceutical expenditure (OOPPE) in Austria. We use cross-sectional information on OOPPE and household characteristics provided by the Austrian household budget survey 2009/10. We split pharmaceutical expenditures into the two components prescription fees and over-the-counter (OTC) expenditures. To adjust for the specific characteristics of the data, we compare different econometric approaches: a two-part model, hurdle model, generalized linear model and zero-inflated negative binomial regression model. The finally selected econometric approaches give a quite consistent picture. The probability of expenditures of both types is strongly influenced by the household structure. It increases with age, doctoral visits and the presence of a female householder. The education level and income only increase the probability of OTC pharmaceuticals. The level of OTC expenditures remains widely unexplained while the household structure and age influence the expenditures for prescription fees. Insurance characteristics of private households, either private or public, play a minor role in explaining the expenditure levels in all specifications. This refers to a homogeneous and comprehensive provision of pharmaceuticals in the public part of the Austrian health care system. The article gives useful insights into the determinants of pharmaceutical expenditures of private households and supplements the previous research that focuses on the individual level.

Health-income inequality: the effects of the Icelandic economic collapse.

PubMed

Asgeirsdóttir, Tinna Laufey; Ragnarsdóttir, Dagný Osk

2014-07-25

Health-income inequality has been the focus of many studies. The relationship between economic conditions and health has also been widely studied. However, not much is known about how changes in aggregate economic conditions relate to health-income inequality. Nevertheless, such knowledge would have both scientific and practical value as substantial public expenditures are used to decrease such inequalities and opportunities to do so may differ over the business cycle. For this reason we examine the effect of the Icelandic economic collapse in 2008 on health-income inequality. The data used come from a health and lifestyle survey carried out by the Public Health Institute of Iceland in 2007 and 2009. A stratified random sample of 9,807 individuals 18-79 years old received questionnaires and a total of 42.1% answered in both years. As measures of health-income inequality, health-income concentration indices are calculated and decomposed into individual-level determinants. Self-assessed health is used as the health measure in the analyses, but three different measures of income are used: individual income, household income, and equivalized household income. In both years there is evidence of health-income inequality favoring the better off. However, changes are apparent between years. For males health-income inequality increases after the crisis while it remains fairly stable for females or slightly decreases. The decomposition analyses show that income itself and disability constitute the most substantial determinants of inequality. The largest increases in contributions between years for males come from being a student, having low education and being obese, as well as age and income but those changes are sensitive to the income measure used. Changes in health and income over the business cycle can differ across socioeconomic strata, resulting in cyclicality of income-related health distributions. As substantial fiscal expenditures go to limiting the relationship

Health-income inequality: the effects of the Icelandic economic collapse

PubMed Central

2014-01-01

Introduction Health-income inequality has been the focus of many studies. The relationship between economic conditions and health has also been widely studied. However, not much is known about how changes in aggregate economic conditions relate to health-income inequality. Nevertheless, such knowledge would have both scientific and practical value as substantial public expenditures are used to decrease such inequalities and opportunities to do so may differ over the business cycle. For this reason we examine the effect of the Icelandic economic collapse in 2008 on health-income inequality. Methods The data used come from a health and lifestyle survey carried out by the Public Health Institute of Iceland in 2007 and 2009. A stratified random sample of 9,807 individuals 18–79 years old received questionnaires and a total of 42.1% answered in both years. As measures of health-income inequality, health-income concentration indices are calculated and decomposed into individual-level determinants. Self-assessed health is used as the health measure in the analyses, but three different measures of income are used: individual income, household income, and equivalized household income. Results In both years there is evidence of health-income inequality favoring the better off. However, changes are apparent between years. For males health-income inequality increases after the crisis while it remains fairly stable for females or slightly decreases. The decomposition analyses show that income itself and disability constitute the most substantial determinants of inequality. The largest increases in contributions between years for males come from being a student, having low education and being obese, as well as age and income but those changes are sensitive to the income measure used. Conclusions Changes in health and income over the business cycle can differ across socioeconomic strata, resulting in cyclicality of income-related health distributions. As substantial fiscal

Predictors and prevalence of successful aging among older Malaysians.

PubMed

Hamid, Tengku Aizan; Momtaz, Yadollah Abolfathi; Ibrahim, Rahimah

2012-01-01

Successful aging is an important and worldwide concept in gerontology. However, until recently, there has been very little known about successful aging in Malaysia. This study was designed to describe the prevalence and correlates of successful aging among older Malaysians. Data for this study were obtained from the national survey 'The Mental Health and Quality of Life of Older Malaysians'. For this study, successful aging was defined based on a multidimensional model, encompassing the avoidance of chronic disease and physical functioning difficulty, and maintenance of good psychocognitive functioning. The prevalence of successful aging among older Malaysians was calculated at 13.8% (CI: 12.6-15.1). Results of multiple logistic regression analysis showed that age, educational attainment, household income, and ethnicity were significantly associated with successful aging. Results of this study show that successful agers were more likely to be among the younger age, ethnic Chinese, and those with a higher education level and household income, after adjusting for all other variables in the model. Copyright © 2011 S. Karger AG, Basel.

The Influence of Household- and Community-Level Sanitation and Fecal Sludge Management on Urban Fecal Contamination in Households and Drains and Enteric Infection in Children

PubMed Central

Berendes, David; Kirby, Amy; Clennon, Julie A.; Raj, Suraja; Yakubu, Habib; Leon, Juan; Robb, Katharine; Kartikeyan, Arun; Hemavathy, Priya; Gunasekaran, Annai; Ghale, Ben; Kumar, J. Senthil; Mohan, Venkata Raghava; Kang, Gagandeep; Moe, Christine

2017-01-01

Urban sanitation necessitates management of fecal sludge inside and outside the household. This study examined associations between household sanitation, fecal contamination, and enteric infection in two low-income neighborhoods in Vellore, India. Surveys and spatial analysis assessed the presence and clustering of toilets and fecal sludge management (FSM) practices in 200 households. Fecal contamination was measured in environmental samples from 50 households and household drains. Enteric infection was assessed from stool specimens from children under 5 years of age in these households. The two neighborhoods differed significantly in toilet coverage (78% versus 33%) and spatial clustering. Overall, 49% of toilets discharged directly into open drains (“poor FSM”). Children in households with poor FSM had 3.78 times higher prevalence of enteric infection when compared with children in other households, even those without toilets. In the neighborhood with high coverage of household toilets, children in households with poor FSM had 10 times higher prevalence of enteric infection than other children in the neighborhood and drains in poor FSM clusters who had significantly higher concentrations of genogroup II norovirus. Conversely, children in households with a toilet that contained excreta in a tank onsite had 55% lower prevalence of enteric infection compared with the rest of the study area. Notably, households with a toilet in the neighborhood with low toilet coverage had more fecal contamination on floors where children played compared with those without a toilet. Overall, both toilet coverage levels and FSM were associated with environmental fecal contamination and, subsequently, enteric infection prevalence in this urban setting. PMID:28719269