Tract- and County-Level Income Inequality and Individual Risk of Obesity in the United States

PubMed Central

Fan, Jessie X.; Wen, Ming; Kowaleski-Jones, Lori

2015-01-01

Objectives We tested three alternative hypotheses regarding the relationship between income inequality and individual risk of obesity at two geographical scales: U.S. Census tract and county. Methods Income inequality was measured by Gini coefficients, created from the 2000 U.S. Census. Obesity was clinically measured in the 2003–2008 National Health and Nutrition Examination Survey (NHANES). The individual measures and area measures were geo-linked to estimate three sets of multi-level models: tract only, county only, and tract and county simultaneously. Gender was tested as a moderator. Results At both the tract and county levels, higher income inequality was associated with lower individual risk of obesity. The size of the coefficient was larger for county-level Gini than for tract-level Gini; and controlling income inequality at one level did not reduce the impact of income inequality at the other level. Gender was not a significant moderator for the obesity-income inequality association. Conclusions Higher tract and county income inequality was associated with lower individual risk of obesity, indicating that at least at the tract and county levels and in the context of cross-sectional data, the public health goal of reducing the rate of obesity is in line with anti-poverty policies of addressing poverty through mixed-income development where neighborhood income inequality is likely higher than homogeneous neighborhoods. PMID:26680289

Tract- and county-level income inequality and individual risk of obesity in the United States.

PubMed

Fan, Jessie X; Wen, Ming; Kowaleski-Jones, Lori

2016-01-01

We tested three alternative hypotheses regarding the relationship between income inequality and individual risk of obesity at two geographical scales: U.S. Census tract and county. Income inequality was measured by Gini coefficients, created from the 2000 U.S. Census. Obesity was clinically measured in the 2003-2008 National Health and Nutrition Examination Survey (NHANES). The individual measures and area measures were geo-linked to estimate three sets of multi-level models: tract only, county only, and tract and county simultaneously. Gender was tested as a moderator. At both the tract and county levels, higher income inequality was associated with lower individual risk of obesity. The size of the coefficient was larger for county-level Gini than for tract-level Gini; and controlling income inequality at one level did not reduce the impact of income inequality at the other level. Gender was not a significant moderator for the obesity-income inequality association. Higher tract and county income inequality was associated with lower individual risk of obesity, indicating that at least at the tract and county levels and in the context of cross-sectional data, the public health goal of reducing the rate of obesity is in line with anti-poverty policies of addressing poverty through mixed-income development where neighborhood income inequality is likely higher than homogeneous neighborhoods. Copyright © 2015 Elsevier Inc. All rights reserved.

Correlation between national income, HIV/AIDS and political status and mortalities in African countries.

PubMed

Andoh, S Y; Umezaki, M; Nakamura, K; Kizuki, M; Takano, T

2006-07-01

To investigate associations between mortalities in African countries and problems that emerged in Africa in the 1990s (reduction of national income, HIV/AIDS and political instability) by adjusting for the influences of development, sanitation and education. We compiled country-level indicators of mortalities, national net income (the reduction of national income by the debt), infection rate of HIV/AIDS, political instability, demography, education, sanitation and infrastructure, from 1990 to 2000 of all African countries (n=53). To extract major factors from indicators of the latter four categories, we carried out principal component analysis. We used multiple regression analysis to examine the associations between mortality indicators and national net income per capita, infection rate of HIV/AIDS, and political instability by adjusting the influence of other possible mortality determinants. Mean of infant mortality per 1000 live births (IMR); maternal mortality per 100,000 live birth (MMR); adult female mortality per 1000 population (AMRF); adult male mortality per 1000 population (AMRM); and life expectancy at birth (LE) in 2000 were 83, 733, 381, 435, and 51, respectively. Three factors were identified as major influences on development: education, sanitation and infrastructure. National net income per capita showed independent negative associations with MMR and AMRF, and a positive association with LE. Infection rate of HIV/AIDS was independently positively associated with AMRM and AMRF, and negatively associated with LE in 2000. Political instability score was independently positively associated with MMR. National net income per capita, HIV/AIDS and political status were predictors of mortality indicators in African countries. This study provided evidence for supporting health policies that take economic and political stability into account.

Is income inequality a determinant of population health? Part 2. U.S. National and regional trends in income inequality and age- and cause-specific mortality.

PubMed

Lynch, John; Smith, George Davey; Harper, Sam; Hillemeier, Marianne

2004-01-01

This article describes U.S. income inequality and 100-year national and 30-year regional trends in age- and cause-specific mortality. There is little congruence between national trends in income inequality and age- or cause-specific mortality except perhaps for suicide and homicide. The variable trends in some causes of mortality may be associated regionally with income inequality. However, between 1978 and 2000 those regions experiencing the largest increases in income inequality had the largest declines in mortality (r= 0.81, p < 0.001). Understanding the social determinants of population health requires appreciating how broad indicators of social and economic conditions are related, at different times and places, to the levels and social distribution of major risk factors for particular health outcomes.

National income and environmental concern: Observations from 35 countries.

PubMed

Lo, Alex Y

2016-10-01

National income produces mixed impacts on public environmental concern. In a cross-national survey, environmental concern was measured in terms of propensity to act and environmental risk perception. Results of a multilevel regression analysis show that these two measures respond to gross domestic product per capita in opposite ways. Citizens of advanced industrial countries are more likely than those of lower-income countries to contribute to environmental protection. However, they are less likely to see the harmful impacts on the environment as very dangerous. Using an indicator of national adaptive capacity, this article demonstrates that environmental risk perception is a function of a country's estimated capacity for coping with condition changes. The stronger sense of collective security among citizens of wealthier nations offers a possible explanation for the negative effects of national income. These results indicate the complex relationship between development and public environmental concern across countries. © The Author(s) 2015.

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.

Income Mobility Breeds Tolerance for Income Inequality: Cross-National and Experimental Evidence.

PubMed

Shariff, Azim F; Wiwad, Dylan; Aknin, Lara B

2016-05-01

American politicians often justify income inequality by referencing the opportunities people have to move between economic stations. Though past research has shown associations between income mobility and resistance to wealth redistribution policies, no experimental work has tested whether perceptions of mobility influence tolerance for inequality. In this article, we present a cross-national comparison showing that income mobility is associated with tolerance for inequality and experimental work demonstrating that perceptions of higher mobility directly affect attitudes toward inequality. We find support for both the prospect of upward mobility and the view that peoples' economic station is the product of their own efforts, as mediating mechanisms. © The Author(s) 2016.

The Kids are All Right? Income Inequality and Civic Engagement among Our Nation's Youth.

PubMed

Godfrey, Erin B; Cherng, Hua-Yu Sebastian

2016-11-01

Prior work suggests that income inequality depresses civic participation among adults. However, associations between income inequality and youth civic engagement have not been assessed. This is true despite evidence that other features of communities influence youth civic development. To fill the gap, we examine associations between county-level income inequality and civic engagement among a nationally representative sample of 12,240 15-year-olds (50 % female). We find opposite patterns than those suggested by the adult literature. Higher county-level income inequality is associated with slightly more civic engagement (greater importance of helping others, higher rates of volunteering often), and this is particularly true for low-socioeconomic status and racial/ethnic minority youth. Potential developmental and structural explanations for these differences are offered. In addition, practical implications of these findings are drawn, and future research directions for scholars studying youth are proposed.

The global impact of non-communicable diseases on healthcare spending and national income: a systematic review.

PubMed

Muka, Taulant; Imo, David; Jaspers, Loes; Colpani, Veronica; Chaker, Layal; van der Lee, Sven J; Mendis, Shanthi; Chowdhury, Rajiv; Bramer, Wichor M; Falla, Abby; Pazoki, Raha; Franco, Oscar H

2015-04-01

The impact of non-communicable diseases (NCDs) in populations extends beyond ill-health and mortality with large financial consequences. To systematically review and meta-analyze studies evaluating the impact of NCDs (including coronary heart disease, stroke, type 2 diabetes mellitus, cancer (lung, colon, cervical and breast), chronic obstructive pulmonary disease and chronic kidney disease) at the macro-economic level: healthcare spending and national income. Medical databases (Medline, Embase and Google Scholar) up to November 6th 2014. For further identification of suitable studies, we searched reference lists of included studies and contacted experts in the field. We included randomized controlled trials, systematic reviews, cohorts, case-control, cross-sectional, modeling and ecological studies carried out in adults assessing the economic consequences of NCDs on healthcare spending and national income without language restrictions. All abstracts and full text selection was done by two independent reviewers. Any disagreements were resolved through consensus or consultation of a third reviewer. Data were extracted by two independent reviewers using a pre-designed data collection form. Studies evaluating the impact of at least one of the selected NCDs on at least one of the following outcome measures: healthcare expenditure, national income, hospital spending, gross domestic product (GDP), gross national product, net national income, adjusted national income, total costs, direct costs, indirect costs, inpatient costs, outpatient costs, per capita healthcare spending, aggregate economic outcome, capital loss in production levels in a country, economic growth, GDP per capita (per capita income), percentage change in GDP, intensive growth, extensive growth, employment, direct governmental expenditure and non-governmental expenditure. From 4,364 references, 153 studies met our inclusion criteria. Most of the studies were focused on healthcare related costs of NCDs

State-level income inequality and family burden of U.S. families raising children with special health care needs.

PubMed

Parish, Susan L; Rose, Roderick A; Dababnah, Sarah; Yoo, Joan; Cassiman, Shawn A

2012-02-01

Growing evidence supports the hypothesis that income inequality within a nation influences health outcomes net of the effect of any given household's absolute income. We tested the hypothesis that state-level income inequality in the United States is associated with increased family burden for care and health-related expenditures for low-income families of children with special health care needs. We analyzed the 2005-06 wave of the National Survey of Children with Special Health Care Needs, a probability sample of approximately 750 children with special health care needs in each state and the District of Columbia in the US Our measure of state-level income inequality was the Gini coefficient. Dependent measures of family caregiving burden included whether the parent received help arranging or coordinating the child's care and whether the parent stopped working due to the child's health. Dependent measures of family financial burden included absolute burden (spending in past 12 months for child's health care needs) and relative burden (spending as a proportion of total family income). After controlling for a host of child, family, and state factors, including family income and measures of the severity of a child's impairments, state-level income inequality has a significant and independent association with family burden related to the health care of their children with special health care needs. Families of children with special health care needs living in states with greater levels of income inequality report higher rates of absolute and relative financial burden. Copyright © 2011 Elsevier Ltd. All rights reserved.

Income inequality widens the existing income-related disparity in depression risk in post-apartheid South Africa: evidence from a nationally representative panel study

PubMed Central

Burns, Jonathan K; Tomita, Andrew; Lund, Crick

2017-01-01

Aim Income inequality (II) and poverty are major challenges in South Africa (SA) yet little is known about their interaction on population mental health. We explored relationships between district II, household income (HHI) and depressive symptoms in national panel data. Method We used 3 waves (2008, 2010, 2012) of the SA National Income Dynamics Study (n=25936) in adjusted mixed effects logistic regression to assess if the relationship between HHI and depressive symptoms is dependent on level of II. Depressive symptoms were assessed with Centre for Epidemiologic Studies Depression scale, and District inequality ratios (P10P90) derived from HHI distributions in 53 districts. Results Lower HHI and increasing II were associated with depressive symptoms. The interaction term between HHI and II on depressive symptoms was significant (β=0.01, 95% CI:<0.01–0.01); with increasing II and decreasing HHI, depression risk increased. Conclusion II widens income-related disparities in depression risk in SA, with policy implications for understanding socioeconomic determinants of mental health and informing global efforts to reduce disparities in high poverty and inequality contexts. PMID:28237744

Measuring Socioeconomic Inequalities With Predicted Absolute Incomes Rather Than Wealth Quintiles: A Comparative Assessment Using Child Stunting Data From National Surveys.

PubMed

Fink, Günther; Victora, Cesar G; Harttgen, Kenneth; Vollmer, Sebastian; Vidaletti, Luís Paulo; Barros, Aluisio J D

2017-04-01

To compare the predictive power of synthetic absolute income measures with that of asset-based wealth quintiles in low- and middle-income countries (LMICs) using child stunting as an outcome. We pooled data from 239 nationally representative household surveys from LMICs and computed absolute incomes in US dollars based on households' asset rank as well as data on national consumption and inequality levels. We used multivariable regression models to compare the predictive power of the created income measure with the predictive power of existing asset indicator measures. In cross-country analysis, log absolute income predicted 54.5% of stunting variation observed, compared with 20% of variation explained by wealth quintiles. For within-survey analysis, we also found absolute income gaps to be predictive of the gaps between stunting in the wealthiest and poorest households (P < .001). Our results suggest that absolute income levels can greatly improve the prediction of stunting levels across and within countries over time, compared with models that rely solely on relative wealth quintiles.

Global Trends in Adolescent Fertility, 1990-2012, in Relation to National Wealth, Income Inequalities, and Educational Expenditures.

PubMed

Santelli, John S; Song, Xiaoyu; Garbers, Samantha; Sharma, Vinit; Viner, Russell M

2017-02-01

National wealth, income inequalities, and expenditures on education can profoundly influence the health of a nation's women, children, and adolescents. We explored the association of trends in national socioeconomic status (SES) indicators with trends in adolescent birth rates (ABRs), by nation and region. An ecologic research design was employed using national-level data from the World Bank on birth rates per 1,000 women aged 15-19 years, national wealth (per capita gross domestic product or GDP), income inequality (Gini index), and expenditures on education as a percentage of GDP (EduExp). Data were available for 142 countries and seven regions for 1990-2012. Multiple linear regression for repeated measures with generalized estimating equations was used to examine independent associations. ABRs in 2012 varied >200-fold-with the highest rates in Sub-Saharan Africa and lowest rates in the Western Europe/Central Asia region. The median national ABR fell 40% from 72.4/1,000 in 1990 to 43.6/1,000 in 2012. The largest regional declines in ABR occurred in South Asia (70%), Europe/Central Asia (63%), and the Middle East/North Africa (53%)-regions with lower income inequality. In multivariable analyses considering change over time, ABRs were negatively associated with GDP and EduExp and positively associated with greater income inequality. ABRs have declined globally since 1990. Declines closely followed rising socioeconomic status and were greater where income inequalities were lower in 1990. Reducing poverty and income inequalities and increasing investments in education should be essential components of national policies to prevent adolescent childbearing. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Life expectancy and national income in Europe, 1900-2008: an update of Preston's analysis.

PubMed

Mackenbach, Johan P; Looman, Caspar Wn

2013-08-01

In the past, upward shifts of the so-called Preston curve, which relates life expectancy to national income, have contributed importantly to worldwide increases in life expectancy. These shifts were due to rapid diffusion of knowledge and technology for infectious disease control from high-income to low-income countries. We assessed to what extent life expectancy growth in Europe has been accompanied by upward shifts in the relation between national income and life expectancy in later parts of the 20th century, when progress in cardiovascular disease control was the main driver of life expectancy growth. Data on national income (gross domestic product per capita, in 1990 international dollars), life expectancy and cause-specific mortality covering the period 1900-2008 were extracted from international data banks. (Change in) life expectancy and age-standardized mortality was regressed on (change in) national income, and the regression parameters were used to estimate the contribution to rising life expectancy and declining mortality in Europe as a whole of changes in national income vs shifts in the relation between national income and health outcomes. Large upward shifts in the relation between national income and life expectancy only occurred before 1960, and were due to rapid declines in mortality from infectious diseases which were independent of rises in national income. These shifts account for between two-thirds and four-fifths of the increase in life expectancy in Europe as a whole during this period. After 1960, upward shifts in the relation between national income and life expectancy were much smaller, and contributed only between one-quarter and one-half to the increase in life expectancy in Europe as a whole. During the latter period, declines in mortality from cardiovascular disease were mainly attributable to increases in national income. In contrast to earlier periods, recent life expectancy growth in European countries appears to have been dependent

Regional factors interact with educational and income tax levels to influence food intake in France.

PubMed

Wyndels, K; Dallongeville, J; Simon, C; Bongard, V; Wagner, A; Ruidavets, J-B; Arveiler, D; Ferrières, J; Amouyel, P; Dauchet, L

2011-09-01

The goal of the present study was to assess whether geographic factors affect the relationship between socioeconomic indicators and adherence to the French National Nutritional Health Programme (Programme National Nutrition Santé (PNNS)) guidelines. The MONA LISA-NUT study (2005-2007) is a cross-sectional survey of a representative sample from northern, northeastern and southwestern France. Educational level and household income tax were recorded by trained interviewers. Food intake was assessed with a 3-day food diary in 3188 subjects aged from 35-64 years. Adherence to the PNNS guidelines was assessed with a validated score (the French score of indicators of the PNNS objective (FSIPO)). Multivariate analyses were adjusted for gender, age, marital status, body mass index, energy intake and medically prescribed diets. The FSIPO score was higher in southwestern France than in the two other regions (P<0.0001). The FSIPO score was correlated with the educational level in northern and northeastern France (P<0.0001) but not in southwestern France (region-education interaction: P<0.001). This interaction was accounted for by fruit and vegetable (P<0.0001), calcium (P=0.03), saturated fatty acid (P<0.0001), and fibre (P=0.0001) components of the FSIPO score. In contrast, the income tax level and the FSIPO score were positively correlated (P<0.0001) to a similar extent in all three regions (region × income tax interaction: P=0.09). The relationship between educational level and adherence to the national nutritional health guidelines differs from one region of France to another, suggesting that nutrition education programmes should perhaps be adapted on a regional basis. In contrast, guideline adherence is correlated with income tax level independently of geographical factors, suggesting that financial constraints on food choices are uniform across France.

Does Income Inequality Harm Health? New Cross-National Evidence

ERIC Educational Resources Information Center

Beckfield, Jason

2004-01-01

The provocative hypothesis that income inequality harms population health has sparked a large body of research, some of which has reported strong associations between income inequality and population health. Cross-national evidence is frequently cited in support of this important hypothesis, but the hypothesis remains controversial, and the…

The impact of income inequality and national wealth on child and adolescent mortality in low and middle-income countries.

PubMed

Ward, Joseph L; Viner, Russell M

2017-05-11

Income inequality and national wealth are strong determinants for health, but few studies have systematically investigated their influence on mortality across the early life-course, particularly outside the high-income world. We performed cross-sectional regression analyses of the relationship between income inequality (national Gini coefficient) and national wealth (Gross Domestic Product (GDP) averaged over previous decade), and all-cause and grouped cause national mortality rate amongst infants, 1-4, 5-9, 10-14, 15-19 and 20-24 year olds in low and middle-income countries (LMIC) in 2012. Gini models were adjusted for GDP. Data were available for 103 (79%) countries. Gini was positively associated with increased all-cause and communicable disease mortality in both sexes across all age groups, after adjusting for national wealth. Gini was only positively associated with increased injury mortality amongst infants and 20-24 year olds, and increased non-communicable disease mortality amongst 20-24 year old females. The strength of these associations tended to increase during adolescence. Increasing GDP was negatively associated with all-cause, communicable and non-communicable disease mortality in males and females across all age groups. GDP was also associated with decreased injury mortality in all age groups except 15-19 year old females, and 15-24 year old males. GDP became a weaker predictor of mortality during adolescence. Policies to reduce income inequality, rather than prioritising economic growth at all costs, may be needed to improve adolescent mortality in low and middle-income countries, a key development priority.

Income inequality widens the existing income-related disparity in depression risk in post-apartheid South Africa: Evidence from a nationally representative panel study.

PubMed

Burns, Jonathan K; Tomita, Andrew; Lund, Crick

2017-05-01

Income inequality (II) and poverty are major challenges in South Africa (SA) yet little is known about their interaction on population mental health. We explored relationships between district II, household income (HHI) and depressive symptoms in national panel data. We used 3 waves (2008, 2010, 2012) of the SA National Income Dynamics Study (n=25936) in adjusted mixed effects logistic regression to assess if the relationship between HHI and depressive symptoms is dependent on level of II. Depressive symptoms were assessed with Centre for Epidemiologic Studies Depression scale, and District inequality ratios (P10P90) derived from HHI distributions in 53 districts. Lower HHI and increasing II were associated with depressive symptoms. The interaction term between HHI and II on depressive symptoms was significant (β=0.01, 95% CI: <0.01-0.01); with increasing II and decreasing HHI, depression risk increased. II widens income-related disparities in depression risk in SA, with policy implications for understanding socioeconomic determinants of mental health and informing global efforts to reduce disparities in high poverty and inequality contexts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Quantifying the individual-level association between income and mortality risk in the United States using the National Longitudinal Mortality Study.

PubMed

Brodish, Paul Henry; Hakes, Jahn K

2016-12-01

Policy makers would benefit from being able to estimate the likely impact of potential interventions to reverse the effects of rapidly rising income inequality on mortality rates. Using multiple cohorts of the National Longitudinal Mortality Study (NLMS), we estimate the absolute income effect on premature mortality in the United States. A multivariate Poisson regression using the natural logarithm of equivilized household income establishes the magnitude of the absolute income effect on mortality. We calculate mortality rates for each income decile of the study sample and mortality rate ratios relative to the decile containing mean income. We then apply the estimated income effect to two kinds of hypothetical interventions that would redistribute income. The first lifts everyone with an equivalized household income at or below the U.S. poverty line (in 2000$) out of poverty, to the income category just above the poverty line. The second shifts each family's equivalized income by, in turn, 10%, 20%, 30%, or 40% toward the mean household income, equivalent to reducing the Gini coefficient by the same percentage in each scenario. We also assess mortality disparities of the hypothetical interventions using ratios of mortality rates of the ninth and second income deciles, and test sensitivity to the assumption of causality of income on mortality by halving the mortality effect per unit of equivalized household income. The estimated absolute income effect would produce a three to four percent reduction in mortality for a 10% reduction in the Gini coefficient. Larger mortality reductions result from larger reductions in the Gini, but with diminishing returns. Inequalities in estimated mortality rates are reduced by a larger percentage than overall estimated mortality rates under the same hypothetical redistributions. Copyright © 2016 Elsevier Ltd. All rights reserved.

A higher level of education amplifies the inverse association between income and disability in the Spanish elderly.

PubMed

Abellán, Antonio; Rodríguez-Laso, Ángel; Pujol, Rogelio; Barrios, Laura

2015-12-01

This paper aims to estimate if the education level modifies the association of income with disability prevalence in the elderly. Education can have a confounding effect on income or interact with it as a health determinant. It is important to analyze the relationship between socio-economic status and disability in older people, because it helps to better understand health inequalities and organize appropriate social policies. The study is based on the Survey on Disability, Personal Autonomy and Dependency Situations (Spanish National Statistics Institute). Binary logistic regression models are adjusted (bivariate, adjusted for gender and age, with all variables and with the interaction between income and education levels). A bad adjustment of the model is detected and a scobit link is added, which helps to differentiate disabled and non-disabled individuals better. People with difficulty in carrying out activities of daily living are much older, frequently women and with low education and income levels. The significant interaction between education level and income means that the odds of being disabled is 43% less in people of high income compared with people of low income if they are well educated, while it is only 21%, among those with low education. A higher education level amplifies significantly the inverse association between income and disability in the Spanish elderly, what suggests that those with higher education will profit more than those with lower education from universal economic benefits policies aimed at the disabled, increasing health inequalities between groups.

For whom is income inequality most harmful? A multi-level analysis of income inequality and mortality in Norway.

PubMed

Dahl, Espen; Ivar Elstad, Jon; Hofoss, Dag; Martin-Mollard, Melissa

2006-11-01

This study investigates the degree to which contextual income inequality in economic regions in Norway affected mortality during the 1990s, above the effects of mean regional income and individual-level confounders. A further objective is to explore whether income inequality effects on mortality differed between socioeconomic groups. Data were constructed by linkages of administrative registers encompassing all Norwegian inhabitants. The outcome variable was all-cause mortality during 6 years (i.e., died 1994-1999 or alive end of 1999). Men and women aged 25-66 in 1993 were analysed. Regions' mean income and income inequality (in terms of gini coefficients) were calculated from consumption-units-adjusted family disposable income. Individual-level variables included sex, age, marital status, individual income, education, and being a recipient of health-related welfare benefits. Multilevel logistic regression models were fitted for 2,197,231 individuals nested within 88 regions. After adjusting for regional mean income and individual-level variables, the odds ratio (OR) for mortality 1994-1999 was 1.028 (95% CI 1.023-1.033) on the gini variable multiplied by 100. Analyses of cross-level interactions indicated some, albeit modest, income inequality effects on mortality in the upper income and educational categories. Among those with low individual income, low education, and among recipients of health-related welfare benefits, mortality effects of higher regional income inequality were significantly stronger than among those more advantageously placed in the social structure. The results of this study differ from previous studies which have suggested that contextual income inequality has a minor impact on population health in egalitarian countries. The results indicate that in Norway, neither a comparatively egalitarian income distribution nor generous and comprehensive welfare institutions hindered the emergence of regional-level income inequality effects on mortality

Impact of Income Inequality on the Nation's Health.

PubMed

López, Diego B; Loehrer, Andrew P; Chang, David C

2016-10-01

Income inequality in the United States has been increasing in recent decades. It is unclear whether income inequality has an independent effect on health outcomes, or whether it simply correlates with increasing levels of poverty. The goal of this study was to evaluate whether income inequality is significantly associated with US county health care expenditures and health care use. Cross-sectional analysis of county health expenditure data from the Health Resources and Services Administration's Area Resources File, county income inequality measures (Gini coefficient) from the Census' American Community Survey, and estimates of potentially preventable admissions and potentially discretionary procedures from the Nationwide Inpatient Sample (1998 to 2011). Datasets were linked via county Federal Information Processing Standard codes. Multivariable linear and Poisson regression analyses were performed at the county level adjusting for county characteristics. A total of 1,237 counties (of 3,144) were included. Income inequality was associated with higher health care expenditures, with each 1 percentage-point increase in county Gini coefficient associated with a US$40,008 increase in annual county Medicare cost (p = 0.003), and an increase of 174.7 total county Medicare inpatient days per year (p < 0.001). Even after accounting for poverty level and county characteristics, counties with higher inequality had higher potentially preventable admission (eg 4.86 rate ratio for low-birth-weight hospital admissions in the top income inequality quartile compared with bottom quartile; p < 0.001) and a higher incidence of potentially discretionary procedures (eg 1.79 rate ratio for prostatectomy for benign prostatic hyperplasia in the top income inequality quartile compared with bottom quartile; p < 0.001). Income inequality is independently associated with higher health care expenditures and more health care use, with increases in both potentially discretionary procedures and in

Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study.

PubMed

Kim, Daniel; Griffin, Beth Ann; Kabeto, Mohammed; Escarce, José; Langa, Kenneth M; Shih, Regina A

2016-01-01

Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function. In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8-20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors. Higher MSA-level income inequality predicted lower cognitive function 16-18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (β = -0.86; 95% CI = -1.41, -0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods. Among older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States.

Lagged Associations of Metropolitan Statistical Area- and State-Level Income Inequality with Cognitive Function: The Health and Retirement Study

PubMed Central

Kim, Daniel; Griffin, Beth Ann; Kabeto, Mohammed; Escarce, José; Langa, Kenneth M.; Shih, Regina A.

2016-01-01

Purpose Much variation in individual-level cognitive function in late life remains unexplained, with little exploration of area-level/contextual factors to date. Income inequality is a contextual factor that may plausibly influence cognitive function. Methods In a nationally-representative cohort of older Americans from the Health and Retirement Study, we examined state- and metropolitan statistical area (MSA)-level income inequality as predictors of individual-level cognitive function measured by the 27-point Telephone Interview for Cognitive Status (TICS-m) scale. We modeled latency periods of 8–20 years, and controlled for state-/metropolitan statistical area (MSA)-level and individual-level factors. Results Higher MSA-level income inequality predicted lower cognitive function 16–18 years later. Using a 16-year lag, living in a MSA in the highest income inequality quartile predicted a 0.9-point lower TICS-m score (β = -0.86; 95% CI = -1.41, -0.31), roughly equivalent to the magnitude associated with five years of aging. We observed no associations for state-level income inequality. The findings were robust to sensitivity analyses using propensity score methods. Conclusions Among older Americans, MSA-level income inequality appears to influence cognitive function nearly two decades later. Policies reducing income inequality levels within cities may help address the growing burden of declining cognitive function among older populations within the United States. PMID:27332986

24 CFR 81.17 - Affordability-Income level definitions-family size and income known (owner-occupied units, actual...

Code of Federal Regulations, 2010 CFR

2010-04-01

... definitions-family size and income known (owner-occupied units, actual tenants, and prospective tenants). 81...—Income level definitions—family size and income known (owner-occupied units, actual tenants, and...-income families, where the unit is owner-occupied or, for rental housing, family size and income...

Income inequality, poverty and crime across nations.

PubMed

Pare, Paul-Philippe; Felson, Richard

2014-09-01

We examine the relationship between income inequality, poverty, and different types of crime. Our results are consistent with recent research in showing that inequality is unrelated to homicide rates when poverty is controlled. In our multi-level analyses of the International Crime Victimization Survey we find that inequality is unrelated to assault, robbery, burglary, and theft when poverty is controlled. We argue that there are also theoretical reasons to doubt that the level of income inequality of a country affects the likelihood of criminal behaviour. © London School of Economics and Political Science 2014.

US State-level income inequality and risks of heart attack and coronary risk behaviors: longitudinal findings.

PubMed

Pabayo, Roman; Kawachi, Ichiro; Gilman, Stephen E

2015-07-01

To examine prospectively the association between US state income inequality and incidence of heart attack. We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,445). Respondents completed interviews at baseline (2001-2002) and follow-up (2004-2005). Weighted multilevel modeling was used to determine if US state-level income inequality (measured by the Gini coefficient) at baseline was a predictor of heart attack during follow-up, controlling for individual-level and state-level covariates. In comparison to residents of US states in the lowest quartile of income inequality, those living in the second [Adjusted Odds Ratio (AOR) = 1.71, 95 % CI 1.16-2.53)], third (AOR = 1.81, 95 % CI 1.28-2.57), and fourth (AOR = 2.04, 95 % CI 1.26-3.29) quartiles were more likely to have a heart attack. Similar findings were obtained when we excluded those who had a heart attack prior to baseline. This study is one of the first to empirically show the longitudinal relationship between income inequality and coronary heart disease. Living in a state with higher income inequality increases the risk for heart attack among US adults.

National Differences in Intelligence, Crime, Income, and Skin Color

ERIC Educational Resources Information Center

Rushton, J. Philippe; Templer, Donald I.

2009-01-01

National differences in murder, rape, and serious assault were examined in 113 countries in relation to national IQ, income, skin color, birth rate, life expectancy, infant mortality, and HIV/AIDS. Data were collated from the 1993-1996 International Crime Statistics published by INTERPOL. Violent crime was found to be lower in countries with…

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).

Nation's Capital to cover low-income women's abortions.

PubMed

1994-04-15

Sharon Pratt Kelly, the mayor of the District of Columbia, has announced that, effective May 1, 1994, the city will use its Medical Charities Fund to pay for "medically appropriate" abortions for women with annual incomes of US$13,200 who do not have health insurance that covers abortions. This income level represents 185% of the federal poverty level for single women. The determination as to whether an abortion is "appropriate" will be made by the woman's physician. From 1989-93, there was a ban on the use of District of Columbia tax monies to cover abortions for local women. In 1988, however, approximately 4000 District women received funding for their abortions. The US$1 million Medical Charities Fund was originally set up to cover emergency room bills for low-income District residents who did not qualify for Medicaid. $650,000 is expected to be added to the fund; in addition, the District's 1995 budget will allocate funding earmarked for abortion coverage for low-income women.

US State-level income inequality and risks of heart attack and coronary risk behaviors: longitudinal findings

PubMed Central

Kawachi, Ichiro; Gilman, Stephen E.

2015-01-01

Objective To examine prospectively the association between US state income inequality and incidence of heart attack. Methods We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,445). Respondents completed interviews at baseline (2001–2002) and follow-up (2004–2005). Weighted multilevel modeling was used to determine if US state-level income inequality (measured by the Gini coefficient) at baseline was a predictor of heart attack during follow-up, controlling for individual-level and state-level covariates. Results In comparison to residents of US states in the lowest quartile of income inequality, those living in the second [Adjusted Odds Ratio (AOR) =1.71, 95 % CI 1.16–2.53)], third (AOR = 1.81, 95 % CI 1.28–2.57), and fourth (AOR = 2.04, 95 % CI 1.26–3.29) quartiles were more likely to have a heart attack. Similar findings were obtained when we excluded those who had a heart attack prior to baseline. Conclusions This study is one of the first to empirically show the longitudinal relationship between income inequality and coronary heart disease. Living in a state with higher income inequality increases the risk for heart attack among US adults. PMID:25981210

12 CFR 1282.17 - Affordability-Income level definitions-family size and income known (owner-occupied units, actual...

Code of Federal Regulations, 2010 CFR

2010-01-01

... GOALS AND MISSION Housing Goals § 1282.17 Affordability—Income level definitions—family size and income..., for rental housing, family size and income information for the dwelling unit is known to the... sizes: Number of persons in family Percentageof area median income 1 70 2 80 3 90 4 100 5 or more...

Income inequality and periodontal diseases in rich countries: an ecological cross-sectional study.

PubMed

Sabbah, Wael; Sheiham, Aubrey; Bernabé, Eduardo

2010-10-01

There are adverse effects of income inequality on morbidity and mortality. This relationship has not been adequately examined in relation to oral health. To examine the relationship between income inequality and periodontal disease in rich countries. Adults aged 35-44 years in 17 rich countries with populations of more than 2 million. National level data on periodontal disease, income inequality and absolute national income were collected from 17 rich countries with populations of more than 2m. Pearson and partial correlations were used to examine the relationship between income inequality and percentage of 35-44-year-old adults with periodontal pockets > or = 4 mm and > or = 6 mm deep, adjusting for absolute national income. Higher levels of income inequality were significantly associated with higher levels of periodontal disease, independently of absolute national income. Absolute income was not associated with levels of periodontal disease in these 17 rich countries. Income inequality appears to be an important contextual determinant of periodontal disease. The results emphasise the importance of relative income rather than absoluteincome in relation to periodontal disease in rich countries.

The rich get richer and the poor get poorer: Country- and state-level income inequality moderates the job insecurity-burnout relationship.

PubMed

Jiang, Lixin; Probst, Tahira M

2017-04-01

Despite the prevalence of income inequality in today's society, research on the implications of income inequality for organizational research is scant. This study takes the first step to explore the contextual role of national- and state- level income inequality as a moderator in the relationship between individual-level job insecurity (JI) and burnout. Drawing from conservation of resource (COR) theory, we argue that income inequality at the country-level and state-level threatens one's obtainment of object (i.e., material coping) and condition (i.e., nonmaterial coping) resources, thus serving as an environmental stressor exacerbating one's burnout reactions to JI. The predicted cross-level interaction effect of income inequality was tested in 2 studies. Study 1 consisting of 23,778 individuals nested in 30 countries explored the moderating effect of country-level income inequality on the relationship between individual JI and exhaustion. Study 2 collected data from 402 employees residing in 48 states in the United States, and tested the moderating effect of state-level income inequality on the relationship between JI and burnout (i.e., emotional exhaustion and cynicism). Results of both studies converge to support the exacerbating role of higher-level income inequality on the JI -burnout relationship. Our findings contribute to the literature on psychological health disparities by exploring the contextual role of income inequality as a predictor of differential reactions to JI. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

National Income and Income Inequality, Family Affluence and Life Satisfaction among 13 Year Old Boys and Girls: A Multilevel Study in 35 Countries

ERIC Educational Resources Information Center

Levin, Kate Ann; Torsheim, Torbjorn; Vollebergh, Wilma; Richter, Matthias; Davies, Carolyn A.; Schnohr, Christina W.; Due, Pernille; Currie, Candace

2011-01-01

Adolescence is a critical period where many patterns of health and health behaviour are formed. The objective of this study was to investigate cross-national variation in the relationship between family affluence and adolescent life satisfaction, and the impact of national income and income inequality on this relationship. Data from the 2006…

Relationship between urbanization and CO2 emissions depends on income level and policy.

PubMed

Ponce de Leon Barido, Diego; Marshall, Julian D

2014-04-01

We investigate empirically how national-level CO2 emissions are affected by urbanization and environmental policy. We use statistical modeling to explore panel data on annual CO2 emissions from 80 countries for the period 1983-2005. Random- and fixed-effects models indicate that, on the global average, the urbanization-emission elasticity value is 0.95 (i.e., a 1% increase in urbanization correlates with a 0.95% increase in emissions). Several regions display a statistically significant, positive elasticity for fixed- and random-effects models: lower-income Europe, India and the Sub-Continent, Latin America, and Africa. Using two proxies for environmental policy/outcomes (ratification status for the Kyoto Protocol; the Yale Environmental Performance Index), we find that in countries with stronger environmental policy/outcomes, urbanization has a more beneficial (or, a less negative) impact on emissions. Specifically, elasticity values are -1.1 (0.21) for higher-income (lower-income) countries with strong environmental policy, versus 0.65 (1.3) for higher-income (lower-income) countries with weak environmental policies. Our finding that the urbanization-emissions elasticity may depend on the strength of a country's environmental policy, not just marginal increases in income, is in contrast to the idea of universal urban scaling laws that can ignore local context. Most global population growth in the coming decades is expected to occur in urban areas of lower-income countries, which underscores the importance of these findings.

Global income-related inequalities in HIV testing.

PubMed

Larose, Auburn; Moore, Spencer; Harper, Sam; Lynch, John

2011-09-01

Voluntary counseling and testing (VCT) is an important prevention initiative in reducing HIV/AIDS transmission. Despite current global prevention efforts, many low- and middle-income countries continue reporting low VCT levels. Little is known about the association of within- and between-country socioeconomic inequalities and VCT. Based on the 'inverse equity hypothesis,' this study examines the degree to which low socioeconomic groups in developing countries are disadvantaged in VCT. Using recently released data from the 2002 to 2003 World Health Survey (WHS) for 106 705 individuals in 49 countries, this study used multilevel logistic regression to examine the association of individual- and national-level factors with VCT, and whether national economic development moderated the association between individual income and VCT. Individual income was based on country-specific income quintiles. National economic development was based on national gross domestic product per capita (GDP/c). Effect modification was evaluated with the likelihood ratio test (G(2)). Individuals eligible for the VCT question of the WHS were adults between the ages of 18-49 years; women who had given birth in the last 2 years were excluded from this question. VCT was more likely among higher income quintiles and in countries with higher GDP/c. GDP/c moderated the association between individual income and VCT whereby relative income differences in VCT were greater in countries with lower GDP/c (G(2)= 9.21; P= 0.002). Individual socio-demographic characteristics were also associated with the likelihood of a person having VCT. Relative socioeconomic inequalities in VCT coverage appear to decline when higher SES groups reach a certain level of coverage. These findings suggest that changes to international VCT programs may be necessary to moderate the relative VCT differences between high- and low-income individuals in lower GDP/c nations.

Ecological analysis of teen birth rates: association with community income and income inequality.

PubMed

Gold, R; Kawachi, I; Kennedy, B P; Lynch, J W; Connell, F A

2001-09-01

To examine whether per capita income and income inequality are independently associated with teen birth rate in populous U.S. counties. This study used 1990 U.S. Census data and National Center for Health Statistics birth data. Income inequality was measured with the 90:10 ratio, a ratio of percent of cumulative income held by the richest and poorest population deciles. Linear regression and analysis of variance were used to assess associations between county-level average income, income inequality, and teen birth rates among counties with population greater than 100,000. Among teens aged 15-17, income inequality and per capita income were independently associated with birth rate; the mean birth rate was 54 per 1,000 in counties with low income and high income inequality, and 19 per 1,000 in counties with high income and low inequality. Among older teens (aged 18-19) only per capita income was significantly associated with birth rate. Although teen childbearing is the result of individual behaviors, these findings suggest that community-level factors such as income and income inequality may contribute significantly to differences in teen birth rates.

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

Alternatives to national average income data as eligibility criteria for international subsidies: a social justice perspective.

PubMed

Shebaya, Sirine; Sutherland, Andrea; Levine, Orin; Faden, Ruth

2010-12-01

Current strategies to address global inequities in access to life-saving vaccines use averaged national income data to determine eligibility. While largely successful in the lowest income countries, we argue that this approach could lead to significant inefficiencies from the standpoint of justice if applied to middle-income countries, where income inequalities are large and lead to national averages that obscure truly needy populations. Instead, we suggest alternative indicators more sensitive to social justice concerns that merit consideration by policy-makers developing new initiatives to redress health inequities in middle-income countries. © 2009 Blackwell Publishing Ltd.

Income, Education, and Inflammation: Differential Associations in a National Probability Sample (The MIDUS Study)

PubMed Central

Friedman, Elliot M.; Herd, Pamela

2010-01-01

Objective To examine the associations between income and education and three markers of inflammation: interleukin-6 (IL-6), C-reactive protein (CRP), and fibrinogen. Socioeconomic status is inversely linked with health outcomes, but the biological processes by which social position “gets under the skin” to affect health are poorly understood. Method Cross-sectional analyses involved participants (n = 704) from the second wave of the national population-based Survey of Midlife Development in the United States (MIDUS). Data on pretax household-adjusted income and educational attainment were collected by questionnaire and telephone interview, respectively. Detailed medical history interviews, inventories of medication, and fasting blood samples for assessment of inflammatory proteins were obtained during an overnight clinic stay. Results All three inflammatory proteins were inversely associated with both income and education in bivariate analyses. However, multivariate regression models, adjusting for potential confounds, showed that only low income predicted higher levels of inflammatory proteins. Moreover, inclusion of IL-6 in the regression models for CRP and fibrinogen eliminated the associations with income. Conclusion These results suggest that income explains the association between education and peripheral inflammation. In short, the reason that higher education is linked to reduced peripheral inflammation is because it reduces the risk for low income status, which is what is directly associated with reduced peripheral inflammation. The findings also suggest that the links between income and both CRP and fibrinogen are mediated by IL-6. These observations help to sharpen our understanding of the relationship between social position and biological markers of illness in the United States. PMID:20100883

Securing support for eye health policy in low- and middle-income countries: identifying stakeholders through a multi-level analysis.

PubMed

Morone, Piergiuseppe; Camacho Cuena, Eva; Kocur, Ivo; Banatvala, Nicholas

2014-05-01

This article empirically evaluates advocacy in low- and middle-income countries as a key tool for raising policy priority and securing high-level decision maker support in eye health. We used a unique data set based on a survey conducted by World Health Organization in 2011 on eye care and prevention of blindness in 82 low- and middle-income countries. The theoretical framework derives from the idea that a plethora of stakeholders at local and global level pressure national governments, acting in economic and the political spheres. Previously, eye care has not been investigated in such a framework. We found structural differences across countries with different income levels and proposed policy recommendations to secure high-level decision makers' support for promoting eye health. Three case studies suggest that, in order to secure more support and resources for eye health, domestic and international stakeholders must strengthen their engagement with ministries of health at political and above all economic levels.

A New Majority: Low Income Students Now a Majority in the Nation's Public Schools. Research Bulletin

ERIC Educational Resources Information Center

Southern Education Foundation, 2015

2015-01-01

For the first time in recent history, a majority of the schoolchildren attending the nation's public schools come from low income families. The latest data collected from the states by the National Center for Education Statistics (NCES), evidence that 51 percent of the students across the nation's public schools were low income in 2013. The…

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

School bullying, homicide and income inequality: a cross-national pooled time series analysis.

PubMed

Elgar, Frank J; Pickett, Kate E; Pickett, William; Craig, Wendy; Molcho, Michal; Hurrelmann, Klaus; Lenzi, Michela

2013-04-01

To examine the relation between income inequality and school bullying (perpetration, victimisation and bully/victims) and explore whether the relation is attributable to international differences in violent crime. Between 1994 and 2006, the Health Behaviour in School-aged Children study surveyed 117 nationally representative samples of adolescents about their involvement in school bullying over the previous 2 months. Country prevalence rates of bullying were matched to data on income inequality and homicides. With time and country differences held constant, income inequality positively related to the prevalence of bullying others at least twice (b = 0.25), victimisation by bullying at least twice (b = 0.29) and both bullied and victimisation at least twice (b = 0.40). The relation between income inequality and victimisation was partially mediated by country differences in homicides. Understanding the social determinants of school bullying facilitates anti-bullying policy by identifying groups at risk and exposing its cultural and economic influences. This study found that cross-national differences in income inequality related to the prevalence of school bullying in most age and gender groups due, in part, to a social milieu of interpersonal violence.

Global effects of income and income inequality on adult height and sexual dimorphism in height.

PubMed

Bogin, Barry; Scheffler, Christiane; Hermanussen, Michael

2017-03-01

Average adult height of a population is considered a biomarker of the quality of the health environment and economic conditions. The causal relationships between height and income inequality are not well understood. We analyze data from 169 countries for national average heights of men and women and national-level economic factors to test two hypotheses: (1) income inequality has a greater association with average adult height than does absolute income; and (2) neither income nor income inequality has an effect on sexual dimorphism in height. Average height data come from the NCD-RisC health risk factor collaboration. Economic indicators are derived from the World Bank data archive and include gross domestic product (GDP), Gross National Income per capita adjusted for personal purchasing power (GNI_PPP), and income equality assessed by the Gini coefficient calculated by the Wagstaff method. Hypothesis 1 is supported. Greater income equality is most predictive of average height for both sexes. GNI_PPP explains a significant, but smaller, amount of the variation. National GDP has no association with height. Hypothesis 2 is rejected. With greater average adult height there is greater sexual dimorphism. Findings support a growing literature on the pernicious effects of inequality on growth in height and, by extension, on health. Gradients in height reflect gradients in social disadvantage. Inequality should be considered a pollutant that disempowers people from the resources needed for their own healthy growth and development and for the health and good growth of their children. © 2017 Wiley Periodicals, Inc.

Income inequality and happiness.

PubMed

Oishi, Shigehiro; Kesebir, Selin; Diener, Ed

2011-09-01

Using General Social Survey data from 1972 to 2008, we found that Americans were on average happier in the years with less national income inequality than in the years with more national income inequality. We further demonstrated that this inverse relation between income inequality and happiness was explained by perceived fairness and general trust. That is, Americans trusted other people less and perceived other people to be less fair in the years with more national income inequality than in the years with less national income inequality. The negative association between income inequality and happiness held for lower-income respondents, but not for higher-income respondents. Most important, we found that the negative link between income inequality and the happiness of lower-income respondents was explained not by lower household income, but by perceived unfairness and lack of trust.

Food prices and consumer demand: differences across income levels and ethnic groups.

PubMed

Ni Mhurchu, Cliona; Eyles, Helen; Schilling, Chris; Yang, Qing; Kaye-Blake, William; Genç, Murat; Blakely, Tony

2013-01-01

Targeted food pricing policies may improve population diets. To assess their effects on inequalities, it is important to determine responsiveness to price changes across income levels and ethnic groups. Our goal was to estimate price elasticity (PE) values for major commonly consumed food groups in New Zealand, by income and ethnicity. PE values represent percentage change in demand associated with 1% change in price of that good (own-PE) or another good (cross-PE). We used food expenditure data from national household economic surveys in 2007/08 and 2009/10 and Food Price Index data from 2007 and 2010. Adopting an Almost Ideal Demand System approach, own-PE and cross-PE estimates were derived for 24 food categories, household income quintiles, and two ethnic groups (Māori and non-Māori). Own-PE estimates (with two exceptions) ranged from -0.44 to -1.78. Cross-PE estimates were generally small; only 31% of absolute values were greater than 0.10. Excluding the outlier 'energy drinks', nine of 23 food groups had significantly stronger own-PEs for the lowest versus highest income quintiles (average regression-based difference across food groups -0.30 (95% CI -0.62 to 0.02)). Six own-PEs were significantly stronger among Māori; the average difference for Māori: non-Māori across food groups was -0.26 (95% CI -0.52 to 0.00). Food pricing policies have potential to improve population diets. The greater sensitivity of low-income households and Māori to price changes suggests the beneficial effects of such policies on health would be greatest for these groups.

Breast Cancer Screening Programmes across the WHO European Region: Differences among Countries Based on National Income Level.

PubMed

Altobelli, Emma; Rapacchietta, Leonardo; Angeletti, Paolo Matteo; Barbante, Luca; Profeta, Filippo Valerio; Fagnano, Roberto

2017-04-23

Breast cancer (BC) is the most frequent tumour affecting women all over the world. In low- and middle-income countries, where its incidence is expected to rise further, BC seems set to become a public health emergency. The aim of the present study is to provide a systematic review of current BC screening programmes in WHO European Region to identify possible patterns. Multiple correspondence analysis was performed to evaluate the association among: measures of occurrence; GNI level; type of BC screening programme; organization of public information and awareness campaigns regarding primary prevention of modifiable risk factors; type of BC screening services; year of screening institution; screening coverage and data quality. A key difference between High Income (HI) and Low and Middle Income (LMI) States, emerging from the present data, is that in the former screening programmes are well organized, with approved screening centres, the presence of mobile units to increase coverage, the offer of screening tests free of charge; the fairly high quality of occurrence data based on high-quality sources, and the adoption of accurate methods to estimate incidence and mortality. In conclusion, the governments of LMI countries should allocate sufficient resources to increase screening participation and they should improve the accuracy of incidence and mortality rates.

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

Income Levels and Response to Contingency Management for Smoking Cessation.

PubMed

López-Núñez, Carla; Secades-Villa, Roberto; Peña-Suárez, Elsa; Fernández-Artamendi, Sergio; Weidberg, Sara

2017-06-07

Contingency management (CM) has demonstrated its efficacy in treating many drug addictions, including nicotine. However, one of the most commonly perceived limitations with regard to its dissemination into community settings is whether this protocol could be equally effective for treating patients across different income levels. This study aimed to examine whether individuals' income levels affect treatment success in a cognitive behavioral treatment (CBT) that included a voucher-based CM protocol for smoking cessation. A total of 92 treatment-seeking smokers in a community setting were randomly assigned to a CBT group (N = 49) or to a CBT plus CM group (N = 43). The CM procedure included a voucher program through which smoking abstinence was reinforced on a schedule of escalating magnitude of reinforcement with a reset contingency. We analyzed the impact of self-reported monthly income, alone and in combination with treatment condition, on short-term (treatment retention) and long-term (self-reported number of days of continuous smoking abstinence at 6-month follow-up) results. Income had no effect on treatment retention and continuous abstinence outcomes at 6-month follow-up in either treatment condition. Treatment modality emerged as the only significant predictor of treatment success. Our findings suggest that treatment-seeking smokers from the general population respond equally well to CM regardless of their income levels. The results of this randomized controlled trial support the generalizability of this evidenced-based program into community settings.

Are income-related differences in active travel associated with physical environmental characteristics? A multi-level ecological approach.

PubMed

Rind, Esther; Shortt, Niamh; Mitchell, Richard; Richardson, Elizabeth A; Pearce, Jamie

2015-06-05

Rates of active travel vary by socio-economic position, with higher rates generally observed among less affluent populations. Aspects of both social and built environments have been shown to affect active travel, but little research has explored the influence of physical environmental characteristics, and less has examined whether physical environment affects socio-economic inequality in active travel. This study explored income-related differences in active travel in relation to multiple physical environmental characteristics including air pollution, climate and levels of green space, in urban areas across England. We hypothesised that any gradient in the relationship between income and active travel would be least pronounced in the least physically environmentally-deprived areas where higher income populations may be more likely to choose active transport as a means of travel. Adults aged 16+ living in urban areas (n = 20,146) were selected from the 2002 and 2003 waves of the UK National Travel Survey. The mode of all short non-recreational trips undertaken by the sample was identified (n = 205,673). Three-level binary logistic regression models were used to explore how associations between the trip being active (by bike/walking) and three income groups, varied by level of multiple physical environmental deprivation. Likelihood of making an active trip among the lowest income group appeared unaffected by physical environmental deprivation; 15.4% of their non-recreational trips were active in both the least and most environmentally-deprived areas. The income-related gradient in making active trips remained steep in the least environmentally-deprived areas because those in the highest income groups were markedly less likely to choose active travel when physical environment was 'good', compared to those on the lowest incomes (OR = 0.44, 95% CI = 0.22 to 0.89). The socio-economic gradient in active travel seems independent of physical environmental

Food Prices and Consumer Demand: Differences across Income Levels and Ethnic Groups

PubMed Central

Ni Mhurchu, Cliona; Eyles, Helen; Schilling, Chris; Yang, Qing; Kaye-Blake, William; Genç, Murat; Blakely, Tony

2013-01-01

Background Targeted food pricing policies may improve population diets. To assess their effects on inequalities, it is important to determine responsiveness to price changes across income levels and ethnic groups. Objective Our goal was to estimate price elasticity (PE) values for major commonly consumed food groups in New Zealand, by income and ethnicity. PE values represent percentage change in demand associated with 1% change in price of that good (own-PE) or another good (cross-PE). Design We used food expenditure data from national household economic surveys in 2007/08 and 2009/10 and Food Price Index data from 2007 and 2010. Adopting an Almost Ideal Demand System approach, own-PE and cross-PE estimates were derived for 24 food categories, household income quintiles, and two ethnic groups (Māori and non-Māori). Results Own-PE estimates (with two exceptions) ranged from −0.44 to −1.78. Cross-PE estimates were generally small; only 31% of absolute values were greater than 0.10. Excluding the outlier ‘energy drinks’, nine of 23 food groups had significantly stronger own-PEs for the lowest versus highest income quintiles (average regression-based difference across food groups −0.30 (95% CI −0.62 to 0.02)). Six own-PEs were significantly stronger among Māori; the average difference for Māori: non-Māori across food groups was −0.26 (95% CI −0.52 to 0.00). Conclusions Food pricing policies have potential to improve population diets. The greater sensitivity of low-income households and Māori to price changes suggests the beneficial effects of such policies on health would be greatest for these groups. PMID:24098408

The Impact of Wind Development on County-Level Income and Employment: A Review of Methods and an Empirical Analysis

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

Eric Lantz

2012-09-21

To gain an understanding of the long-term county-level impacts from a large sample of wind power projects and to understand the potential significance of methodological criticisms, the U.S. Department of Agriculture, the Lawrence Berkeley National Laboratory, and the National Renewable Energy Laboratory recently joined efforts to complete a first-of-its-kind study that quantifies the annual impact on county-level personal income resulting from wind power installations in nearly 130 counties across 12 states. The results of this study as well as a comparison with the prior county-level estimates generated from input-output models, are summarized in the fact sheet.

Education, income and ethnic differences in cumulative biological risk profiles in a national sample of US adults: NHANES III (1988-1994).

PubMed

Seeman, Teresa; Merkin, Sharon S; Crimmins, Eileen; Koretz, Brandon; Charette, Susan; Karlamangla, Arun

2008-01-01

Data from the nationally representative US National Health and Nutrition Examination Survey (NHANES) III cohort were used to examine the hypothesis that socio-economic status is consistently and negatively associated with levels of biological risk, as measured by nine biological parameters known to predict health risks (diastolic and systolic blood pressure, pulse, HDL and total cholesterol, glycosylated hemoglobin, c-reactive protein, albumin and waist-hip ratio), resulting in greater cumulative burdens of biological risk among those of lower education and/or income. As hypothesized, consistent education and income gradients were seen for biological parameters reflecting cardiovascular, metabolic and inflammatory risk: those with lower education and income exhibiting greater prevalence of high-risk values for each of nine individual biological risk factors. Significant education and income gradients were also seen for summary indices reflecting cumulative burdens of cardiovascular, metabolic and inflammatory risks as well as overall total biological risks. Multivariable cumulative logistic regression models revealed that the education and income effects were each independently and negatively associated with cumulative biological risks, and that these effects remained significant independent of age, gender, ethnicity and lifestyle factors such as smoking and physical activity. There were no significant ethnic differences in the patterns of association between socio-economic status and biological risks, but older age was associated with significantly weaker education and income gradients.

Median dermatology base incomes in senior academia and practice are comparable, but a significant income gap exists at junior levels.

PubMed

Tierney, Emily; Kimball, Alexa Boer

2006-08-01

The perception that dermatologists in practice have substantially higher incomes than in academics is often cited as the primary reason people choose to practice outside academic institutions. We sought to compare the incomes of dermatologists in academics versus various practice settings. Data from various surveys of dermatologists from 2002 to 2004 were adjusted for annual inflation to the year 2004 and compared. Benefits and bonuses were not included. The income level of clinical instructors, who are 7.0% of all academic dermatology faculty, were not available for inclusion. Median dermatology faculty income (combined average of assistant, associate, and professor levels) was 192,267 dollars, 12.0% less than the median practice income of 215,303 dollars. There was substantial variation across regions, institutions, and types of nonacademic practice. Median starting incomes for dermatology residency graduates were comparable in practice across multiple data sources (182,116 dollars-200,000 dollars) and private universities (189,336 dollars); however, both were significantly higher than median starting incomes in public universities (83,349 dollars). This study relied on self-reported data. Although all attempts were made to use comparable information, variances in how data were collected and classified may exist. Initial income for those entering practice is equivalent to those entering academia in private universities; however, incomes for both of these groups are 2- to 3-fold higher than those entering academia in public universities. This discrepancy may discourage some recent trainees, some of whom have high debt and high expenses, from entering the field of academic dermatology. Because incomes in academia increase predictably with increasing rank, overall self-reported incomes for established dermatologists in practice and senior academia are comparable.

42 CFR 435.236 - Individuals in institutions who are eligible under a special income level.

Code of Federal Regulations, 2010 CFR

2010-10-01

... a special income level. 435.236 Section 435.236 Public Health CENTERS FOR MEDICARE & MEDICAID... in institutions who are eligible under a special income level. (a) If the agency provides Medicaid... not institutionalized; but (2) Have income below a level specified in the plan under § 435.722. (See...

Agreement between aggregate and individual-level measures of income and education: a comparison across three patient groups.

PubMed

Marra, Carlo A; Lynd, Larry D; Harvard, Stephanie S; Grubisic, Maja

2011-03-31

The association between lower socioeconomic status and poorer health outcomes has been observed using both individual-level and aggregate-level measures of income and education. While both are predictive of health outcomes, previous research indicates poor agreement between individual-level and aggregate-level measures. The purpose of this study was to determine the level of agreement between aggregate-level and individual-level measures of income and education among three distinct patient groups, specifically asthma, diabetes, and rheumatoid patients. Individual-level measures of annual household income and education were derived from three separate surveys conducted among patients with asthma (n = 359), diabetes (n = 281) and rheumatoid arthritis (n = 275). Aggregate-level measures of income and education were derived from the 2001 Canadian census, including both census tract-and dissemination area-level measures. Cross-tabulations of individual-level income by aggregate-level income were used to determine the percentage of income classifications in agreement. The kappa statistic (simple and weighted), Spearman's rank correlations, and intra-class correlation coefficient (ICC) were also calculated. Individual-level and aggregate-level education was compared using Chi-Square tests within patient groups. Point biserial correlation coefficients between individual-level and aggregate-level education were computed. Individual-level income was poorly correlated with aggregate-level measures, which provided the worst estimations of income among patients in the lowest income category at the individual-level. Both aggregate-level measures were best at approximating individual-level income in patients with diabetes, in whom aggregate-level estimates were only significantly different from individual-level measures for patients in the lowest income category. Among asthma patients, the proportion of patients classified by aggregate-level measures as having a university degree

Allocation of development assistance for health: is the predominance of national income justified?

PubMed Central

Sterck, Olivier; Roser, Max; Ncube, Mthuli; Thewissen, Stefan

2018-01-01

Abstract Gross national income (GNI) per capita is widely regarded as a key determinant of health outcomes. Major donors heavily rely on GNI per capita to allocate development assistance for health (DAH). This article questions this paradigm by analysing the determinants of health outcomes using cross-sectional data from 99 countries in 2012. We use disability-adjusted life years (Group I) per capita as our main indicator for health outcomes. We consider four primary variables: GNI per capita, institutional capacity, individual poverty and the epidemiological surroundings. Our empirical strategy has two innovations. First, we construct a health poverty line of 10.89 international-$ per day, which measures the minimum level of income an individual needs to have access to basic healthcare. Second, we take the contagious nature of communicable diseases into account, by estimating the extent to which the population health in neighbouring countries (the epidemiological surroundings) affects health outcomes. We apply a spatial two-stage least-squares model to mitigate the risks of reverse causality. Our model captures 92% of the variation in health outcomes. We emphasize four findings. First, GNI per capita is not a significant predictor of health outcomes once other factors are controlled for. Second, the poverty gap below the 10.89 health poverty line is a good measure of universal access to healthcare, as it explains 19% of deviation in health outcomes. Third, the epidemiological surroundings in which countries are embedded capture as much as 47% of deviation in health outcomes. Finally, institutional capacity explains 10% of deviation in health outcomes. Our empirical findings suggest that allocation frameworks for DAH should not only take into account national income, which remains an important indicator of countries’ financial capacity, but also individual poverty, governance and epidemiological surroundings to increase impact on health outcomes. PMID:29415236

Exploring the Effects of Financial Aid on the Gap in Student Dropout Risks by Income Level

ERIC Educational Resources Information Center

Chen, Rong; DesJardins, Stephen L.

2008-01-01

Using national survey data and discrete-time logit modeling, this research seeks to understand whether student aid mediates the relationship between parental income and student dropout behavior. Our analysis confirms that there is a gap in dropout rates for low-income students compared with their upper income peers, and suggests that some types of…

Income inequality, alcohol use, and alcohol-related problems.

PubMed

Karriker-Jaffe, Katherine J; Roberts, Sarah C M; Bond, Jason

2013-04-01

We examined the relationship between state-level income inequality and alcohol outcomes and sought to determine whether associations of inequality with alcohol consumption and problems would be more evident with between-race inequality measures than with the Gini coefficient. We also sought to determine whether inequality would be most detrimental for disadvantaged individuals. Data from 2 nationally representative samples of adults (n = 13,997) from the 2000 and 2005 National Alcohol Surveys were merged with state-level inequality and neighborhood disadvantage indicators from the 2000 US Census. We measured income inequality using the Gini coefficient and between-race poverty ratios (Black-White and Hispanic-White). Multilevel models accounted for clustering of respondents within states. Inequality measured by poverty ratios was positively associated with light and heavy drinking. Associations between poverty ratios and alcohol problems were strongest for Blacks and Hispanics compared with Whites. Household poverty did not moderate associations with income inequality. Poverty ratios were associated with alcohol use and problems, whereas overall income inequality was not. Higher levels of alcohol problems in high-inequality states may be partly due to social context.

Multiple imputation: an application to income nonresponse in the National Survey on Recreation and the Environment

Treesearch

Stanley J. Zarnoch; H. Ken Cordell; Carter J. Betz; John C. Bergstrom

2010-01-01

Multiple imputation is used to create values for missing family income data in the National Survey on Recreation and the Environment. We present an overview of the survey and a description of the missingness pattern for family income and other key variables. We create a logistic model for the multiple imputation process and to impute data sets for family income. We...

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 Child Mortality in Wealthy Nations.

PubMed

Collison, David

2016-01-01

This chapter presents evidence of a relationship between child mortality data and socio-economic factors in relatively wealthy nations. The original study on child mortality that is reported here, which first appeared in a UK medical journal, was undertaken in a school of business by academics with accounting and finance backgrounds. The rationale explaining why academics from such disciplines were drawn to investigate these issues is given in the first part of the chapter. The findings related to child mortality data were identified as a special case of a wide range of social and health indicators that are systematically related to the different organisational approaches of capitalist societies. In particular, the so-called Anglo-American countries show consistently poor outcomes over a number of indicators, including child mortality. Considerable evidence has been adduced in the literature to show the importance of income inequality as an explanation for such findings. An important part of the chapter is the overview of a relatively recent publication in the epidemiological literature entitled The Spirit Level: Why Equality Is Better for Everyone, which was written by Wilkinson and Pickett. © 2016 S. Karger AG, Basel.

[Mental income inequality: a "virus" which affects health and happiness].

PubMed

Bouffard, Léandre; Dubé, Micheline

2013-01-01

The purpose of this paper is to demonstrate the impact of income inequality on various indexes of mental health and on happiness in wealthy nations. Initially, the unequal distribution of income is documented in wealthy nations, especially in the United States of America. After the World War II, income equality was at a level never reached before, but since the eighties, income inequality has raised dramatically in many industrialized countries. The 2008 crisis has worsened the situation in many of them, particularly in the United States. Furthermore, prejudices have increased against women, Blacks, Spanish-speakers and those who receive social welfare. A selective review of the literature is made in order to document the impact of income inequality on a few indicators of mental health (from WHO, UN, UNICEF, OCDE and World Bank) and on happiness, defined here as life satisfaction. Income inequality is positively related to the following indexes: Index of Mental Illness from the WHO (0.73), Index of the United Nations' Office on Drug Consumption (0.63) and a composite Index of ten psychosocial problems, constituted by Wilkinson and Pickett, 2013 (0.87). On the other hand, income inequality is negatively associated to the UNICEF Index of Child Well-Being (-0.71). Furthermore, the level of anxiety and of depression is higher in countries where income inequality is greater. The correlation between happiness and income inequality in the 23 wealthy nations is -0.48; this correlation becomes -0.41 after control of the effect of the GNP (Gross National Product). These results support the idea that it is relative income - not absolute income - which matters in the evaluation of our life and of our happiness. In underdeveloped nations, any increase in GNP promotes the well-being of the citizens; whereas in wealthy nations, it is the equality of the distribution that is more important. Many arguments supporting the causal relation from income inequality to psychosocial

EITC Participation and Association with Financial Distress among Rural Low-Income Families

ERIC Educational Resources Information Center

Gudmunson, Clinton G.; Son, Seohee; Lee, Jaerim; Bauer, Jean W.

2010-01-01

This study examined Earned Income Tax Credit (EITC) participation among rural, low-income families, by income level, and investigated whether nonparticipation corresponds with increased financial distress. Rates of EITC participation among 314 rural low-income mothers were lower than national averages, especially among the lowest earners. There…

Personal Income Taxation. National Education Association Search.

ERIC Educational Resources Information Center

National Education Association, Washington, DC. Research Div.

The second in a series on school finance, this report describes the principles of fair and adequate state and local income taxation. The political setting is discussed, and the nature of indiviudal income taxes is explained by examining which states tax income and what income they tax. Tables 2, 3, and 4 demonstrate the expanding school financing…

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.

Examining the lag time between state-level income inequality and individual disabilities: a multilevel analysis.

PubMed

Gadalla, Tahany M; Fuller-Thomson, Esme

2008-12-01

State-level income inequality has been found to have an effect on individual health outcomes, even when controlled for important individual-level variables such as income, education, age, and gender. The effect of income inequality on health may not be immediate and may, in fact, have a substantial lag time between exposure to inequality and eventual health outcome. We used the 2006 American Community Survey to examine the association of state-level income inequality and 2 types of physical disabilities. We used 6 different lag times, ranging between 0 and 25 years, on the total sample and on those who resided in their state of birth. Income inequality in 1986 had the strongest correlation with 2006 disability levels. Odds ratios were consistently 10% higher for those born in the same state compared with the total population.

Has the National Cancer Screening Program reduced income inequalities in screening attendance in South Korea?

PubMed

Kim, Sujin; Kwon, Soonman; Subramanian, S V

2015-11-01

In 1999, the Korean government introduced the National Cancer Screening Program (NCSP) to increase the cancer-screening rate, particularly among the low-income population. This study investigates how the NCSP has decreased both relative and absolute income inequalities in the uptake of cancer screening in South Korea. A nationally representative cross-sectional repeated data from the Korea National Health and Nutrition Examination Survey 1998-2012, managed by the Ministry of Health and Welfare, was used to assess changes over time and the extent of discontinuity at the NCSP-recommended initiation age in the uptake of screening for breast, colorectal, and gastric cancers across income quartiles. Relative inequalities in the uptake of screening for all cancers decreased significantly over the policy period. Absolute inequalities did not change for most cancers, but marginally increased from 9 to 14% points in the uptake of screening for colorectal cancer among men. At the recommended initiation age, absolute inequalities did not change for breast and colorectal cancers but increased from 5 to 16% points for gastric cancer, for which relative inequality significantly decreased. The NCSP, which reduced out-of-pocket payment, may not decrease absolute gap although it leads to overall increases in the uptake of cancer screening and decreases in relative inequalities. Further investigations are needed to understand barriers that prevent the low-income population from attending cancer screening.

Nations' income inequality predicts ambivalence in stereotype content: how societies mind the gap.

PubMed

Durante, Federica; Fiske, Susan T; Kervyn, Nicolas; Cuddy, Amy J C; Akande, Adebowale Debo; Adetoun, Bolanle E; Adewuyi, Modupe F; Tserere, Magdeline M; Ramiah, Ananthi Al; Mastor, Khairul Anwar; Barlow, Fiona Kate; Bonn, Gregory; Tafarodi, Romin W; Bosak, Janine; Cairns, Ed; Doherty, Claire; Capozza, Dora; Chandran, Anjana; Chryssochoou, Xenia; Iatridis, Tilemachos; Contreras, Juan Manuel; Costa-Lopes, Rui; González, Roberto; Lewis, Janet I; Tushabe, Gerald; Leyens, Jacques-Philippe; Mayorga, Renée; Rouhana, Nadim N; Castro, Vanessa Smith; Perez, Rolando; Rodríguez-Bailón, Rosa; Moya, Miguel; Morales Marente, Elena; Palacios Gálvez, Marisol; Sibley, Chris G; Asbrock, Frank; Storari, Chiara C

2013-12-01

Income inequality undermines societies: The more inequality, the more health problems, social tensions, and the lower social mobility, trust, life expectancy. Given people's tendency to legitimate existing social arrangements, the stereotype content model (SCM) argues that ambivalence-perceiving many groups as either warm or competent, but not both-may help maintain socio-economic disparities. The association between stereotype ambivalence and income inequality in 37 cross-national samples from Europe, the Americas, Oceania, Asia, and Africa investigates how groups' overall warmth-competence, status-competence, and competition-warmth correlations vary across societies, and whether these variations associate with income inequality (Gini index). More unequal societies report more ambivalent stereotypes, whereas more equal ones dislike competitive groups and do not necessarily respect them as competent. Unequal societies may need ambivalence for system stability: Income inequality compensates groups with partially positive social images. © 2012 The British Psychological Society.

Community-level income inequality and HIV prevalence among persons who inject drugs in Thai Nguyen, Vietnam.

PubMed

Lim, Travis W; Frangakis, Constantine; Latkin, Carl; Ha, Tran Viet; Minh, Nguyen Le; Zelaya, Carla; Quan, Vu Minh; Go, Vivian F

2014-01-01

Socioeconomic status has a robust positive relationship with several health outcomes at the individual and population levels, but in the case of HIV prevalence, income inequality may be a better predictor than absolute level of income. Most studies showing a relationship between income inequality and HIV have used entire countries as the unit of analysis. In this study, we examine the association between income inequality at the community level and HIV prevalence in a sample of persons who inject drugs (PWID) in a concentrated epidemic setting. We recruited PWID and non-PWID community participants in Thai Nguyen, Vietnam, and administered a cross-sectional questionnaire; PWID were tested for HIV. We used ecologic regression to model HIV burden in our PWID study population on GINI indices of inequality calculated from total reported incomes of non-PWID community members in each commune. We also modeled HIV burden on interaction terms between GINI index and median commune income, and finally used a multi-level model to control for community level inequality and individual level income. HIV burden among PWID was significantly correlated with the commune GINI coefficient (r = 0.53, p = 0.002). HIV burden was also associated with GINI coefficient (β = 0.082, p = 0.008) and with median commune income (β = -0.018, p = 0.023) in ecological regression. In the multi-level model, higher GINI coefficient at the community level was associated with higher odds of individual HIV infection in PWID (OR = 1.46 per 0.01, p = 0.003) while higher personal income was associated with reduced odds of infection (OR = 0.98 per $10, p = 0.022). This study demonstrates a context where income inequality is associated with HIV prevalence at the community level in a concentrated epidemic. It further suggests that community level socioeconomic factors, both contextual and compositional, could be indirect determinants of HIV infection in PWID.

Community-Level Income Inequality and HIV Prevalence among Persons Who Inject Drugs in Thai Nguyen, Vietnam

PubMed Central

Lim, Travis W.; Frangakis, Constantine; Latkin, Carl; Ha, Tran Viet; Minh, Nguyen Le; Zelaya, Carla; Quan, Vu Minh; Go, Vivian F.

2014-01-01

Socioeconomic status has a robust positive relationship with several health outcomes at the individual and population levels, but in the case of HIV prevalence, income inequality may be a better predictor than absolute level of income. Most studies showing a relationship between income inequality and HIV have used entire countries as the unit of analysis. In this study, we examine the association between income inequality at the community level and HIV prevalence in a sample of persons who inject drugs (PWID) in a concentrated epidemic setting. We recruited PWID and non-PWID community participants in Thai Nguyen, Vietnam, and administered a cross-sectional questionnaire; PWID were tested for HIV. We used ecologic regression to model HIV burden in our PWID study population on GINI indices of inequality calculated from total reported incomes of non-PWID community members in each commune. We also modeled HIV burden on interaction terms between GINI index and median commune income, and finally used a multi-level model to control for community level inequality and individual level income. HIV burden among PWID was significantly correlated with the commune GINI coefficient (r = 0.53, p = 0.002). HIV burden was also associated with GINI coefficient (β = 0.082, p = 0.008) and with median commune income (β = −0.018, p = 0.023) in ecological regression. In the multi-level model, higher GINI coefficient at the community level was associated with higher odds of individual HIV infection in PWID (OR = 1.46 per 0.01, p = 0.003) while higher personal income was associated with reduced odds of infection (OR = 0.98 per $10, p = 0.022). This study demonstrates a context where income inequality is associated with HIV prevalence at the community level in a concentrated epidemic. It further suggests that community level socioeconomic factors, both contextual and compositional, could be indirect determinants of HIV infection in PWID. PMID

Income Inequality, Alcohol Use, and Alcohol-Related Problems

PubMed Central

C. M. Roberts, Sarah; Bond, Jason

2013-01-01

Objectives. We examined the relationship between state-level income inequality and alcohol outcomes and sought to determine whether associations of inequality with alcohol consumption and problems would be more evident with between-race inequality measures than with the Gini coefficient. We also sought to determine whether inequality would be most detrimental for disadvantaged individuals. Methods. Data from 2 nationally representative samples of adults (n = 13 997) from the 2000 and 2005 National Alcohol Surveys were merged with state-level inequality and neighborhood disadvantage indicators from the 2000 US Census. We measured income inequality using the Gini coefficient and between-race poverty ratios (Black–White and Hispanic–White). Multilevel models accounted for clustering of respondents within states. Results. Inequality measured by poverty ratios was positively associated with light and heavy drinking. Associations between poverty ratios and alcohol problems were strongest for Blacks and Hispanics compared with Whites. Household poverty did not moderate associations with income inequality. Conclusions. Poverty ratios were associated with alcohol use and problems, whereas overall income inequality was not. Higher levels of alcohol problems in high-inequality states may be partly due to social context. PMID:23237183

Allocation of development assistance for health: is the predominance of national income justified?

PubMed

Sterck, Olivier; Roser, Max; Ncube, Mthuli; Thewissen, Stefan

2018-02-01

Gross national income (GNI) per capita is widely regarded as a key determinant of health outcomes. Major donors heavily rely on GNI per capita to allocate development assistance for health (DAH). This article questions this paradigm by analysing the determinants of health outcomes using cross-sectional data from 99 countries in 2012. We use disability-adjusted life years (Group I) per capita as our main indicator for health outcomes. We consider four primary variables: GNI per capita, institutional capacity, individual poverty and the epidemiological surroundings. Our empirical strategy has two innovations. First, we construct a health poverty line of 10.89 international-$ per day, which measures the minimum level of income an individual needs to have access to basic healthcare. Second, we take the contagious nature of communicable diseases into account, by estimating the extent to which the population health in neighbouring countries (the epidemiological surroundings) affects health outcomes. We apply a spatial two-stage least-squares model to mitigate the risks of reverse causality. Our model captures 92% of the variation in health outcomes. We emphasize four findings. First, GNI per capita is not a significant predictor of health outcomes once other factors are controlled for. Second, the poverty gap below the 10.89 health poverty line is a good measure of universal access to healthcare, as it explains 19% of deviation in health outcomes. Third, the epidemiological surroundings in which countries are embedded capture as much as 47% of deviation in health outcomes. Finally, institutional capacity explains 10% of deviation in health outcomes. Our empirical findings suggest that allocation frameworks for DAH should not only take into account national income, which remains an important indicator of countries' financial capacity, but also individual poverty, governance and epidemiological surroundings to increase impact on health outcomes. The Author(s) 2017

32 CFR 33.25 - Program income.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Program income. 33.25 Section 33.25 National... Post-Award Requirements Financial Administration § 33.25 Program income. (a) General. Grantees are encouraged to earn income to defray program costs. Program income includes income from fees for services...

Income Distribution Over Educational Levels: A Simple Model.

ERIC Educational Resources Information Center

Tinbergen, Jan

An econometric model is formulated that explains income per person in various compartments of the labor market defined by three main levels of education and by education required. The model enables an estimation of the effect of increased access to education on that distribution. The model is based on a production for the economy as a whole; a…

Burden of disease associated with lower levels of income among US adults aged 65 and older.

PubMed

Lubetkin, Erica I; Jia, Haomiao

2017-01-16

Persons aged 65 years and older represent a heterogeneous group whose prevalence in the USA is expected to markedly increase. Few investigations have examined the total burden of disease attributable to lower levels of income in a single number that accounts for morbidity and mortality. We ascertained respondents' health-related quality of life (HRQOL) scores and mortality status from the 2003 to 2004, 2005 to 2006, 2007 to 2008 and 2009 to 2010 cohorts of the National Health and Nutrition Examination Survey (NHANES) with mortality follow-up through 31 December 2011. A mapping algorithm based on respondents' age and answers to the 4 core Healthy Days questions was used to obtain values of a preference-based measure of HRQOL, the EuroQol five dimensions questionnaire (EQ-5D) index, which enables quality-adjusted life years (QALYs) to be calculated. We included only respondents aged 65 years and older at the baseline, yielding a total sample size of 4952. We estimated mean QALYs according to different categories of income based on the percentage of Federal Poverty Level (FPL). After adjusting for age, gender and education, the remaining QALYs decreased with each successive decrement of category of income, ranging from 18.4 QALY (≥500% FPL) to 8.6 QALY (<100% FPL). Compared with participants with a mean income of ≥250% FPL, participants with an income <250% FPL had significant losses in QALY for most of the sociodemographic groups examined. In contrast, persons with a lower educational attainment did not show a corresponding loss in QALY according to income category. This study confirmed the association between lower income category and greater burden of disease, as measured by QALYs lost, among the US population aged 65 years and older. Our findings provide additional evidence of the role played by other key determinants of health and how factors not traditionally addressed by the healthcare system impact the life cycle of individuals and communities

Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003-2010.

PubMed

Tester, June M; Laraia, Barbara A; Leung, Cindy W; Mietus-Snyder, Michele L

2016-02-11

Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003-2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14-3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11-2.82), and Apo B (OR = 1.98; 95% CI, 1.17-3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14-6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity alone.

Absolute Income, Relative Income, and Happiness

ERIC Educational Resources Information Center

Ball, Richard; Chernova, Kateryna

2008-01-01

This paper uses data from the World Values Survey to investigate how an individual's self-reported happiness is related to (i) the level of her income in absolute terms, and (ii) the level of her income relative to other people in her country. The main findings are that (i) both absolute and relative income are positively and significantly…

Testing the status-legitimacy hypothesis: A multilevel modeling approach to the perception of legitimacy in income distribution in 36 nations.

PubMed

Caricati, Luca

2017-01-01

The status-legitimacy hypothesis was tested by analyzing cross-national data about social inequality. Several indicators were used as indexes of social advantage: social class, personal income, and self-position in the social hierarchy. Moreover, inequality and freedom in nations, as indexed by Gini and by the human freedom index, were considered. Results from 36 nations worldwide showed no support for the status-legitimacy hypothesis. The perception that income distribution was fair tended to increase as social advantage increased. Moreover, national context increased the difference between advantaged and disadvantaged people in the perception of social fairness: Contrary to the status-legitimacy hypothesis, disadvantaged people were more likely than advantaged people to perceive income distribution as too large, and this difference increased in nations with greater freedom and equality. The implications for the status-legitimacy hypothesis are discussed.

Income inequality and adolescent fertility in low-income countries.

PubMed

Castro, Ruben; Fajnzylber, Eduardo

2017-09-28

: The well-known socioeconomic gradient in health does not imply that income inequality by itself has any effect on well-being. However, there is evidence of a positive association between income inequality and adolescent fertility across countries. Nevertheless, this key finding is not focused on low-income countries. This study applies a multilevel logistic regression of country-level adolescent fertility on country-level income inequality plus individual-level income and controls to the Demographic and Health Surveys data. A negative association between income inequality and adolescent fertility was found among low-income countries, controlling for income (OR = 0.981; 95%CI: 0.963-0.999). Different measures and different subsamples of countries show the same results. Therefore, the international association between income inequality and adolescent fertility seems more complex than previously thought.

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

The Inequality Footprints of Nations: A Novel Approach to Quantitative Accounting of Income Inequality

PubMed Central

Alsamawi, Ali; Murray, Joy; Lenzen, Manfred; Moran, Daniel; Kanemoto, Keiichiro

2014-01-01

In this study we use economic input-output analysis to calculate the inequality footprint of nations. An inequality footprint shows the link that each country's domestic economic activity has to income distribution elsewhere in the world. To this end we use employment and household income accounts for 187 countries and an historical time series dating back to 1990. Our results show that in 2010, most developed countries had an inequality footprint that was higher than their within-country inequality, meaning that in order to support domestic lifestyles, these countries source imports from more unequal economies. Amongst exceptions are the United States and United Kingdom, which placed them on a par with many developing countries. Russia has a high within-country inequality nevertheless it has the lowest inequality footprint in the world, which is because of its trade connections with the Commonwealth of Independent States and Europe. Our findings show that the commodities that are inequality-intensive, such as electronic components, chemicals, fertilizers, minerals, and agricultural products often originate in developing countries characterized by high levels of inequality. Consumption of these commodities may implicate within-country inequality in both developing and developed countries. PMID:25353333

The inequality footprints of nations: a novel approach to quantitative accounting of income inequality.

PubMed

Alsamawi, Ali; Murray, Joy; Lenzen, Manfred; Moran, Daniel; Kanemoto, Keiichiro

2014-01-01

In this study we use economic input-output analysis to calculate the inequality footprint of nations. An inequality footprint shows the link that each country's domestic economic activity has to income distribution elsewhere in the world. To this end we use employment and household income accounts for 187 countries and an historical time series dating back to 1990. Our results show that in 2010, most developed countries had an inequality footprint that was higher than their within-country inequality, meaning that in order to support domestic lifestyles, these countries source imports from more unequal economies. Amongst exceptions are the United States and United Kingdom, which placed them on a par with many developing countries. Russia has a high within-country inequality nevertheless it has the lowest inequality footprint in the world, which is because of its trade connections with the Commonwealth of Independent States and Europe. Our findings show that the commodities that are inequality-intensive, such as electronic components, chemicals, fertilizers, minerals, and agricultural products often originate in developing countries characterized by high levels of inequality. Consumption of these commodities may implicate within-country inequality in both developing and developed countries.

Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level

PubMed Central

Lu, Chunling; Black, Maureen M; Richter, Linda M

2018-01-01

Summary Background A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. Methods We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. Findings The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million–307·4 million) in 2004 to 249·4 million (209·3 million–292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46–56) to 43% (36–51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Interpretation Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. Funding National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO. PMID:27717632

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.

Impact of Wind Development on County-Level Income and Employment: A Review of Methods and an Empirical Analysis (Fact Sheet)

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

Not Available

2012-09-01

To gain an understanding of the long-term county-level impacts from a large sample of wind power projects and to understand the potential significance of methodological criticisms, the U.S. Department of Agriculture, the Lawrence Berkeley National Laboratory, and NREL recently joined efforts to complete a first-of-its-kind study that quantifies the annual impact on county-level personal income resulting from wind power installations in nearly 130 counties across 12 states. The results of this study, as well as a comparison with the prior county-level estimates generated from input-output models, are summarized here.

Income inequality and child maltreatment in the United States.

PubMed

Eckenrode, John; Smith, Elliott G; McCarthy, Margaret E; Dineen, Michael

2014-03-01

To examine the relation between county-level income inequality and rates of child maltreatment. Data on substantiated reports of child abuse and neglect from 2005 to 2009 were obtained from the National Child Abuse and Neglect Data System. County-level data on income inequality and children in poverty were obtained from the American Community Survey. Data for additional control variables were obtained from the American Community Survey and the Health Resources and Services Administration Area Resource File. The Gini coefficient was used as the measure of income inequality. Generalized additive models were estimated to explore linear and nonlinear relations among income inequality, poverty, and child maltreatment. In all models, state was included as a fixed effect to control for state-level differences in victim rates. Considerable variation in income inequality and child maltreatment rates was found across the 3142 US counties. Income inequality, as well as child poverty rate, was positively and significantly correlated with child maltreatment rates at the county level. Controlling for child poverty, demographic and economic control variables, and state-level variation in maltreatment rates, there was a significant linear effect of inequality on child maltreatment rates (P < .0001). This effect was stronger for counties with moderate to high levels of child poverty. Higher income inequality across US counties was significantly associated with higher county-level rates of child maltreatment. The findings contribute to the growing literature linking greater income inequality to a range of poor health and well-being outcomes in infants and children.

Income and Well-Being across European Provinces

ERIC Educational Resources Information Center

Okulicz-Kozaryn, Adam

2012-01-01

The majority of studies investigate the effect of income on life satisfaction at either individual or country level. This study contributes with analysis at the (sub-national) province level across West European countries. I use a unique dataset Eurobarometer 44.2 Bis that is representative of province populations in a multilevel model. Provinces…

The national financial adjustment policy and the equalisation of health levels among prefectures.

PubMed

Takano, T; Nakamura, K

2001-10-01

The objectives of this study were to examine (1) trends concerning financial assistance from the national government to local governments, (2) trends regarding death rates and life expectancies among prefectures, and (3) the effect of the national financial adjustment policy in equalising both the revenues of local governments and variations in the health levels among prefectures in terms of death rates and life expectancies. The study analysed prefectural income, the amount of national taxes collected, financial assistance from the national government to local governments, and age adjusted death rates and life expectancies of all of the prefectures in Japan during the period from 1965 through 1995. (1) Under the financial adjustment policy, financial assistance from the national government to the local governments, which consists of the sum of the local allocation tax and treasury disbursements, increased from 1831 billion yen in 1965 to 31 116 billion yen in 1995. (2) During the same period, the age adjusted death rate per 100 000 people decreased from 1168.9 (1965) to 545.3 (1995). The range of variation in the age adjusted death rate among prefectures diminished as the coefficient of variation of the death rate declined from 0.060 in 1965 to 0.043 in 1995. (3) There was a significant statistical correlation between higher prefectural incomes and lower mortality rates during from 1965 until 1975 (p < 0.05), whereas this correlation was indistinct in the 1980s and has not been observed since 1990. (4) The relative health level of Tokyo has declined in terms of its ranking among all the prefectures with regard to life expectancy, from being the best in 1965 to below average in 1995. The national financial adjustment policy to balance the revenues of local governments has increased the health levels of rural prefectures. It is probable that the policy reduced the disparity in death rates and life expectancies among prefectures throughout the country. However, the

Widening Income Inequalities: Higher Education's Role in Serving Low Income Students

ERIC Educational Resources Information Center

Dalton, Jon C.; Crosby, Pamela C.

2015-01-01

Many scholars argue that America is becoming a dangerously divided nation because of increasing inequality, especially in income distribution. This article examines the problem of widening income inequality with particular focus on the role that colleges and universities and their student affairs organizations play in serving low income students…

Trends in the Level and Distribution of Income in Metropolitan Areas, 1959-1969. Discussion Paper 316-75.

ERIC Educational Resources Information Center

Danziger, Sheldon

An overview of the level and distribution of income for a sample of Standard Metropolitan Statistical Areas (SMSAs) during the period 1959-1969, using data on pretax pretransfer incomes published by the Internal Revenue Service, is presented in this paper. Several results are described. (1) The level and distribution of income vary widely among…

The need for sustainability and alignment of future support for National Immunization Technical Advisory Groups (NITAGs) in low and middle-income countries.

PubMed

Howard, Natasha; Bell, Sadie; Walls, Helen; Blanchard, Laurence; Brenzel, Logan; Jit, Mark; Mounier-Jack, Sandra

2018-02-22

National Immunisation Technical Advisory Groups (NITAGs) provide independent guidance to health ministries to support evidence-based and nationally relevant immunisation decisions. We examined NITAGs' value, sustainability, and need for support in low and middle-income countries, drawing from a mixed-methods study including 130 global and national-level key informant interviews. NITAGs were particularly valued for providing independent and nationally owned evidence-based decision-making (EBDM), but needed to be integrated within national processes to effectively balance independence and influence. Participants agreed that most NITAGs, being relatively new, would need developmental and strengthening support for at least a decade. While national governments could support NITAG functioning, external support is likely needed for requisite capacity building. This might come from Gavi mechanisms and WHO, but would require alignment among stakeholders to be effective.

Ethical and social issues facing obstetricians in low-income countries.

PubMed

Ogwuegbu, Chigbu Chibuike; Eze, Onah Hyacinth

2009-06-01

A review of publications on ethical and social issues from low-income countries was done with the aim of highlighting the major ethical and social issues facing obstetricians in these countries. Low-income countries were identified using the World Health Organization income group classification of member nations. Obstetricians in low-income countries face a wide range of special social and ethical issues that reflect the peculiarities of their practice environment characterized by poverty, low education, deep attachment to tradition and culture, low social status of women, and high levels of physician's paternalism.

Do people die from income inequality of a decade ago?

PubMed

Zheng, Hui

2012-07-01

The long-term impact of income inequality on health has not been fully explored in the current literature. Until now, 4 studies have examined the lagged effect on population/group mortality rate at the aggregate level, and 7 studies have investigated the effect of income inequality on subsequent individual mortality risk within a restricted time period. These 11 studies suffer from the same limitation: they do not simultaneously control for a series of preceding income inequalities. The results of these studies are also mixed. Using the U.S. National Health Interview Survey data 1986-2004 with mortality follow-up data 1986-2006 (n = 701,179), this study investigates the lagged effects of national-level income inequality on individual mortality risk. These effects are tested by using a discrete-time hazard model where contemporaneous and preceding income inequalities are treated as time-varying person-specific covariates, which then track a series of income inequalities that a respondent faces from the survey year until s/he dies or is censored. Findings suggest that income inequality did not have an instantaneous detrimental effect on individual mortality risk, but began exerting its influence 5 years later. This effect peaked at 7 years, and then diminished after 12 years. This pattern generally held for three measures of income inequality: the Gini coefficient, the Atkinson index, and the Theil entropy index. The findings suggest that income inequality has a long-term detrimental impact on individual mortality risk. This study also explains discrepancies in the existant literature. Copyright © 2012 Elsevier Ltd. All rights reserved.

The "new" military and income inequality: A cross national analysis.

PubMed

Kentor, Jeffrey; Jorgenson, Andrew K; Kick, Edward

2012-05-01

Military expenditures have escalated over the last three decades in both developed and less developed countries, without a corresponding expansion of military personnel. Spending has instead been directed towards hi-tech weaponry, what we refer to as the "new" military. We hypothesize that this new, increasingly capital-intensive military is no longer a pathway of upward mobility or employer of last resort for many uneducated, unskilled, or unemployed people, with significant consequences for those individuals and society as a whole. One such consequence, we argue, is an increase in income inequality. We test this hypothesis with cross-national panel models, estimated for 82 developed and less developed countries from 1970 to 2000. Findings indicate that military capital-intensiveness, as measured by military expenditures per soldier, exacerbates income inequality net of control variables. Neither total military expenditures/GDP nor military participation has a significant effect. It appears from these findings that today's "new" military establishment is abrogating its historical role as an equalizing force in society, with important policy implications. Copyright © 2011 Elsevier Inc. All rights reserved.

Effect of GNI on Infant Mortality Rate in Low Income, Lower Middle Income, Upper Middle Income and High Income Countries.

PubMed

Jalal, Sabeena; Khan, Najib Ullah; Younis, Mustafa Z

2016-01-01

Global disparities in health form a complex issue adversely affecting much of the world's population. What has been found is that national income and other general socio-economic factors are strong determinants of population health (Houweling, 2005 & Schell, 2007). In countries where resources are less, people are much less healthy than people living in rich countries. In wealthier countries that have made immense progress in health indicators, the resulting change in age structure and morbidity and mortality patterns portends even greater financial demands on the health sector. This study noted the trends in several health indicators versus economic indicators and related it to low income, lower middle income, upper middle income and high income countries. We noted that there is improvement in all health indicators along with an increasing GNI per Capita and GDP. In low income regions though, the rate of improvement is slower as opposed to high income countries. However, there is progress, which is leading to an increase in aging population.

Income Inequality and US Children's Secondhand Smoke Exposure: Distinct Associations by Race-Ethnicity.

PubMed

Shenassa, Edmond D; Rossen, Lauren M; Cohen, Jonathan; Morello-Frosch, Rachel; Payne-Sturges, Devon C

2017-11-01

Prior studies have found considerable racial and ethnic disparities in secondhand smoke (SHS) exposure. Although a number of individual-level determinants of this disparity have been identified, contextual determinants of racial and ethnic disparities in SHS exposure remain unexamined. The objective of this study was to examine disparities in serum cotinine in relation to area-level income inequality among 14 649 children from the National Health and Nutrition Examination Survey. We fit log-normal regression models to examine disparities in serum cotinine in relation to Metropolitan Statistical Areas level income inequality among 14 649 nonsmoking children aged 3-15 from the National Health and Nutrition Examination Survey (1999-2012). Non-Hispanic black children had significantly lower serum cotinine than non-Hispanic white children (-0.26; 95% CI: -0.38, -0.15) in low income inequality areas, but this difference was attenuated in areas with high income inequality (0.01; 95% CI: -0.16, 0.18). Serum cotinine declined for non-Hispanic white and Mexican American children with increasing income inequality. Serum cotinine did not change as a function of the level of income inequality among non-Hispanic black children. We have found evidence of differential associations between SHS exposure and income inequality by race and ethnicity. Further examination of environments which engender SHS exposure among children across various racial/ethnic subgroups can foster a better understanding of how area-level income inequality relates to health outcomes such as levels of SHS exposure and how those associations differ by race/ethnicity. In the United States, the association between children's risk of SHS exposure and income inequality is modified by race/ethnicity in a manner that is inconsistent with theories of income inequality. In overall analysis this association appears to be as predicted by theory. However, race-specific analyses reveal that higher levels of income

Income inequality, the psychosocial environment, and health: comparisons of wealthy nations.

PubMed

Lynch, J; Smith, G D; Hillemeier, M; Shaw, M; Raghunathan, T; Kaplan, G

2001-07-21

The theory that income inequality and characteristics of the psychosocial environment (indexed by such things as social capital and sense of control over life's circumstances) are key determinants of health and could account for health differences between countries has become influential in health inequalities research and for population health policy. We examined cross-sectional associations between income inequality and low birthweight, life expectancy, self-rated health, and age-specific and cause-specific mortality among countries providing data in wave III (around 1989-92) of the Luxembourg Income Study. We also used data from the 1990-91 wave of the World Values Survey (WVS). We obtained life expectancy, mortality, and low birthweight data from the WHO Statistical Information System. Among the countries studied, higher income inequality was strongly associated with greater infant mortality (r=0.69, p=0.004 for women; r=0.74, p=0.002 for men). Associations between income inequality and mortality declined with age at death, and then reversed among those aged 65 years and older. Income inequality was inconsistently associated with specific causes of death and was not associated with coronary heart disease (CHD), breast or prostate cancer, cirrhosis, or diabetes mortality. Countries that had greater trade union membership and political representation by women had better child mortality profiles. Differences between countries in levels of social capital showed generally weak and somewhat inconsistent associations with cause-specific and age-specific mortality. Income inequality and characteristics of the psychosocial environment like trust, control, and organisational membership do not seem to be key factors in understanding health differences between these wealthy countries. The associations that do exist are largely limited to child health outcomes and cirrhosis. Explanations for between-country differences in health will require an appreciation of the complex

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…

Individual education, area income, and mortality and recurrence of myocardial infarction in a Medicare cohort: the National Longitudinal Mortality Study.

PubMed

Coady, Sean A; Johnson, Norman J; Hakes, Jahn K; Sorlie, Paul D

2014-07-09

The Medicare program provides universal access to hospital care for the elderly; however, mortality disparities may still persist in this population. The association of individual education and area income with survival and recurrence post Myocardial Infarction (MI) was assessed in a national sample. Individual level education from the National Longitudinal Mortality Study was linked to Medicare and National Death Index records over the period of 1991-2001 to test the association of individual education and zip code tabulation area median income with survival and recurrence post-MI. Survival was partitioned into 3 periods: in-hospital, discharge to 1 year, and 1 year to 5 years and recurrence was partitioned into two periods: 28 day to 1 year, and 1 year to 5 years. First MIs were found in 8,043 women and 7,929 men. In women and men 66-79 years of age, less than a high school education compared with a college degree or more was associated with 1-5 year mortality in both women (HRR 1.61, 95% confidence interval 1.03-2.50) and men (HRR 1.37, 1.06-1.76). Education was also associated with 1-5 year recurrence in men (HRR 1.68, 1.18-2.41, < High School compared with college degree or more), but not women. Across the spectrum of survival and recurrence periods median zip code level income was inconsistently associated with outcomes. Associations were limited to discharge-1 year survival (RR lowest versus highest quintile 1.31, 95% confidence interval 1.03-1.67) and 28 day-1 year recurrence (RR lowest versus highest quintile 1.72, 95% confidence interval 1.14-2.57) in older men. Despite the Medicare entitlement program, disparities related to individual socioeconomic status remain. Additional research is needed to elucidate the barriers and mechanisms to eliminating health disparities among the elderly.

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."

Global estimates of human papillomavirus vaccination coverage by region and income level: a pooled analysis.

PubMed

Bruni, Laia; Diaz, Mireia; Barrionuevo-Rosas, Leslie; Herrero, Rolando; Bray, Freddie; Bosch, F Xavier; de Sanjosé, Silvia; Castellsagué, Xavier

2016-07-01

Since 2006, many countries have implemented publicly funded human papillomavirus (HPV) immunisation programmes. However, global estimates of the extent and impact of vaccine coverage are still unavailable. We aimed to quantify worldwide cumulative coverage of publicly funded HPV immunisation programmes up to 2014, and the potential impact on future cervical cancer cases and deaths. Between Nov 1 and Dec 22, 2014, we systematically reviewed PubMed, Scopus, and official websites to identify HPV immunisation programmes worldwide, and retrieved age-specific HPV vaccination coverage rates up to October, 2014. To estimate the coverage and number of vaccinated women, retrieved coverage rates were converted into birth-cohort-specific rates, with an imputation algorithm to impute missing data, and applied to global population estimates and cervical cancer projections by country and income level. From June, 2006, to October, 2014, 64 countries nationally, four countries subnationally, and 12 overseas territories had implemented HPV immunisation programmes. An estimated 118 million women had been targeted through these programmes, but only 1% were from low-income or lower-middle-income countries. 47 million women (95% CI 39-55 million) received the full course of vaccine, representing a total population coverage of 1·4% (95% CI 1·1-1·6), and 59 million women (48-71 million) had received at least one dose, representing a total population coverage of 1·7% (1·4-2·1). In more developed regions, 33·6% (95% CI 25·9-41·7) of females aged 10-20 years received the full course of vaccine, compared with only 2·7% (1·8-3·6) of females in less developed regions. The impact of the vaccine will be higher in upper-middle-income countries (178 192 averted cases by age 75 years) than in high-income countries (165 033 averted cases), despite the lower number of vaccinated women (13·3 million vs 32·2 million). Many women from high-income and upper-middle-income countries have

Changes in income inequality and the health of immigrants

PubMed Central

Hamilton, Tod G.; Kawachi, Ichiro

2016-01-01

Research suggests that income inequality is inversely associated with health. This association has been documented in studies that utilize variation in income inequality across countries or across time from a single country. The primary criticism of these approaches is their inability to account for potential confounders that are associated with income inequality. This paper uses variation in individual experiences of income inequality among immigrants within the United States (U.S.) to evaluate whether individuals who moved from countries with greater income inequality than the U.S. have better health than those who migrated from countries with less income in equality than the U.S. Utilizing individual-level (March Current Population Survey) and country-level data (the United Nations Human Development Reports), we show that among immigrants who have resided in the U.S. between 6 and 20 years, self-reported health is more favorable for the immigrants in the former category (i.e., greater income inequality) than those in the latter (i.e., lower income inequality). Results also show that self-reported health is better among immigrants from more developed countries and those who have more years of education, are male, and are married. PMID:23352417

What We Know about Community College Low-Income and Minority Student Outcomes: Descriptive Statistics from National Surveys

ERIC Educational Resources Information Center

Bailey, Thomas; Jenkins, Davis; Leinbach, Timothy

2005-01-01

This report summarizes the latest available national statistics on access and attainment by low income and minority community college students. The data come from the National Center for Education Statistics' (NCES) Integrated Postsecondary Education Data System (IPEDS) annual surveys of all postsecondary educational institutions and the NCES…

12 CFR 1282.18 - Affordability-Income level definitions-family size not known (actual or prospective tenants).

Code of Federal Regulations, 2010 CFR

2010-01-01

....18 Affordability—Income level definitions—family size not known (actual or prospective tenants). In... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Affordability-Income level definitions-family size not known (actual or prospective tenants). 1282.18 Section 1282.18 Banks and Banking FEDERAL...

Measuring Income and Projecting Energy Use

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

Pitcher, Hugh M.

2009-11-01

Abstract: Energy is a key requirement for a healthy, productive life and a major driver of the emissions leading to an increasingly warm planet. The implications of a doubling and redoubling of per capita incomes over the remainder of this century for energy use are a critical input into understanding the magnitude of the carbon management problem. A substantial controversy about how the Special Report on Emssions Scenarios (SRES) measured income and the potential implications of how income was measured for long term levels of energy use is revisited again in the McKibbin, Pearce and Stegman article appearing elsewhere inmore » this issue. The recent release of a new set of purchasing power estimates of national income, and the preparations for creating new scenarios to support the IPCC’s fifth assessment highlight the importance of the issues which have arisen surrounding income and energy use. Comparing the 1993 and 2005 ICP results on Purchasing Power Parity (PPP) based measures of income reveals that not only do the 2005 ICP estimates share the same issue of common growth rates for real income as measured by PPP and US $, but the lack of coherence in the estimates of PPP incomes, especially for developing countries raises yet another obstacle to resolving the best way to measure income. Further, the common use of an income term to mediate energy demand (as in the Kaya identity) obscures an underlying reality about per capita energy demands, leading to unreasonable estimates of the impact of changing income measures and of the recent high GDP growth rates in India and China. Significant new research is required to create both a reasonable set of GDP growth rates and long term levels of energy use.« less

Personal needs versus national needs: public attitudes regarding health care priorities at the personal and national levels.

PubMed

Kaplan, Giora; Baron-Epel, Orna

2015-01-01

Many stakeholders have little or no confidence in the ability of the public to express their opinions on health policy issues. The claim often arises that lay people prioritize according to their own personal experiences and may lack the broad perspective necessary to understand the needs of the population at large. In order to test this claim empirically, this study compares the public's priorities regarding personal insurance to their priorities regarding allocation of national health resources. Thus, the study should shed light on the extent to which the public's priorities at the national level are a reflection of their priorities at the personal level. A telephone survey was conducted with a representative sample of the Israeli adult population aged 18 and over (n = 1,225). The public's priorities were assessed by asking interviewees to assume that they were the Minister of Health and from this point of view allocate an additional budget among various health areas. Their priorities at the personal level were assessed by asking interviewees to choose preferred items for inclusion in their personal supplementary health insurance. Over half of the respondents (54%) expressed different personal and national priorities. In multivariable logistic analysis, "population group" was the only variable found to be statistically significant; Jews were 1.8 times more likely than Arabs to give a similar response to both questions. Income level was of borderline significance. At least half of the population was able to differentiate between their personal needs and national policy needs. We do not advocate a decision-making process based on polls or referendums. However, we believe that people should be allowed to express their priorities regarding national policy issues, and that decision-makers should consider these as one of the factors used to determine policy decisions.

32 CFR 32.24 - Program income.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Program income. 32.24 Section 32.24 National... income. (a) DoD Components shall apply the standards set forth in this section in requiring recipient organizations to account for program income related to projects financed in whole or in part with Federal funds...

32 CFR 37.1335 - Program income.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Program income. 37.1335 Section 37.1335 National... TECHNOLOGY INVESTMENT AGREEMENTS Definitions of Terms Used in This Part § 37.1335 Program income. Gross income earned by the recipient or a participant that is generated by a supported activity or earned as a...

32 CFR 34.14 - Program income.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Program income. 34.14 Section 34.14 National... Financial and Program Management § 34.14 Program income. (a) DoD Components shall apply the standards in this section to the disposition of program income from projects financed in whole or in part with...

Risk of poor development in young children in low-income and middle-income countries: an estimation and analysis at the global, regional, and country level.

PubMed

Lu, Chunling; Black, Maureen M; Richter, Linda M

2016-12-01

A 2007 study published in The Lancet estimated that approximately 219 million children aged younger than 5 years were exposed to stunting or extreme poverty in 2004. We updated the 2004 estimates with the use of improved data and methods and generated estimates for 2010. We used country-level prevalence of stunting in children younger than 5 years based on the 2006 Growth Standards proposed by WHO and poverty ratios from the World Bank to estimate children who were either stunted or lived in extreme poverty for 141 low-income and middle-income countries in 2004 and 2010. To avoid counting the same children twice, we excluded children jointly exposed to stunting and extreme poverty from children living in extreme poverty. To examine the robustness of estimates, we also used moderate poverty measures. The 2007 study underestimated children at risk of poor development. The estimated number of children exposed to the two risk factors in low-income and middle-income countries decreased from 279·1 million (95% CI 250·4 million-307·4 million) in 2004 to 249·4 million (209·3 million-292·6 million) in 2010; prevalence of children at risk fell from 51% (95% CI 46-56) to 43% (36-51). The decline occurred in all income groups and regions with south Asia experiencing the largest drop. Sub-Saharan Africa had the highest prevalence in both years. These findings were robust to variations in poverty measures. Progress has been made in reducing the number of children exposed to stunting or poverty between 2004 and 2010, but this is still not enough. Scaling up of effective interventions targeting the most vulnerable children is urgently needed. National Institutes of Health, Bill & Melinda Gates Foundation, Hilton Foundation, and WHO. Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND license. Published by Elsevier Ltd.. All rights reserved.

76 FR 4550 - Income Level for Individuals Eligible for Assistance

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-26

... Poverty Guidelines as issued by the Department of Health and Human Services. DATES: Effective Date: This... maximum income level equivalent to one hundred and twenty-five percent (125%) of the Federal Poverty... issuing the Federal Poverty Guidelines. The figures for 2010 set out below are equivalent to 125% of the...

Income, income inequality and youth smoking in low- and middle-income countries.

PubMed

Li, David X; Guindon, G Emmanuel

2013-04-01

To examine the relationships between income, income inequality and current smoking among youth in low- and middle-income countries. Pooled cross-sectional data from the Global Youth Tobacco Surveys, conducted in low- and middle-income countries, were used to conduct multi-level logistic analyses that accounted for the nesting of students in schools and of schools in countries. A total of 169 283 students aged 13-15 from 63 low- and middle-income countries. Current smoking was defined as having smoked at least one cigarette in the past 30 days. Gross domestic product (GDP) per capita was our measure of absolute income. Contemporaneous and lagged (10-year) Gini coefficients, as well as the income share ratio of the top decile of incomes to the bottom decile, were our measures of income inequality. Our analyses reveal a significant positive association between levels of income and youth smoking. We find that a 10% increase in GDP per capita increases the odds of being a current smoker by at least 2.5%, and potentially considerably more. Our analyses also suggest a relationship between the distribution of incomes and youth smoking: youth from countries with more unequal distributions of income tend to have higher odds of currently smoking. There is a positive association between gross domestic product and the odds of a young person in a low- and middle-income country being a current smoker. Given the causal links between smoking and a wide range of youth morbidities, the association between smoking and income inequality may underlie a substantial portion of the health disparities observed that are currently experiencing rapid economic growth. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

Dyslipidemia and Food Security in Low-Income US Adolescents: National Health and Nutrition Examination Survey, 2003–2010

PubMed Central

Laraia, Barbara A.; Leung, Cindy W.; Mietus-Snyder, Michele L.

2016-01-01

Introduction Low levels of food security are associated with dyslipidemia and chronic disease in adults, particularly in women. There is a gap in knowledge about the relationship between food security among youth and dyslipidemia and chronic disease. We investigated the relationship between food security status and dyslipidemia among low-income adolescents. Methods We analyzed data from adolescents aged 12 to 18 years (N = 1,072) from households with incomes at or below 200% of the federal poverty level from the National Health and Nutrition Examination Survey (NHANES) 2003–2010. We used logistic regression to examine the relationship between household food security status and the odds of having abnormalities with fasting total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), serum triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), TG/HDL-C ratio, and apolipoprotein B (Apo B). Models included age, sex, race/ethnicity, smoking status, partnered status in the household, and maternal education, with additional adjustment for adiposity. Results Household food security status was not associated with elevated TC or LDL-C. Adolescents with marginal food security were more likely than food-secure peers to have elevated TGs (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.14–3.05), TG/HDL-C ratio (OR = 1.74; 95% CI, 1.11–2.82), and Apo B (OR = 1.98; 95% CI, 1.17–3.36). Female adolescents with marginal food security had greater odds than male adolescents of having low HDL-C (OR = 2.69; 95% CI, 1.14–6.37). No elevated odds of dyslipidemia were found for adolescents with low or very low food security. Adjustment for adiposity did not attenuate estimates. Conclusion In this nationally representative sample, low-income adolescents living in households with marginal food security had increased odds of having a pattern consistent with atherogenic dyslipidemia, which represents a cardiometabolic burden above their risk from adiposity

A cross-national comparison of income gradients in oral health quality of life in four welfare states: application of the Korpi and Palme typology

PubMed Central

Sanders, A E; Slade, G D; John, M T; Steele, J G; Suominen-Taipale, A L; Lahti, S; Nuttall, N M; Allen, P Finbarr

2013-01-01

Background The extent to which welfare states may influence health outcomes has not been explored. It was hypothesised that policies which target the poor are associated with greater income inequality in oral health quality of life than those that provide earnings-related benefits to all citizens. Methods Data were from nationally representative surveys in the UK (n=4064), Finland (n=5078), Germany (n=1454) and Australia (n=2292) conducted from 1998 to 2002. The typology of Korpi and Palme classifies these countries into four different welfare states. In each survey, subjects completed the Oral Health Impact Profile (OHIP-14) questionnaire, which evaluates the adverse consequence of dental conditions on quality of life. For each country, survey estimation commands were used to create linear regression models that estimated the slope of the gradient between four quartiles of income and OHIP-14 severity scores. Parameter estimates for income gradients were contrasted across countries using Wald χ2 tests specifying a critical p value of 0.008, equivalent to a Bonferroni correction of p<0.05 for the six pairwise tests. Results Statistically significant income gradients in OHIP-14 severity scores were found in all countries except Germany. A global test confirmed significant cross-national differences in the magnitude of income gradients. In Australia, where a flat rate of benefits targeted the poor, the mean OHIP-14 severity score reduced by 1.7 units (95% CI −2.15 to −1.34) with each increasing quartile of household income, a significantly steeper gradient than in other countries. Conclusion The coverage and generosity of welfare state benefits appear to influence levels of inequality in population oral health quality of life. PMID:19351621

Age- and sex-specific relationships between household income, education, and diabetes mellitus in Korean adults: the Korea National Health and Nutrition Examination Survey, 2008-2010.

PubMed

Kim, So-Ra; Han, Kyungdo; Choi, Jin-Young; Ersek, Jennifer; Liu, Junxiu; Jo, Sun-Jin; Lee, Kang-Sook; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Lee, Seung-Hwan; Park, Yong-Moon

2015-01-01

To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults. Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels. The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected. We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.

Age- and Sex-Specific Relationships between Household Income, Education, and Diabetes Mellitus in Korean Adults: The Korea National Health and Nutrition Examination Survey, 2008-2010

PubMed Central

Kim, So-Ra; Han, Kyungdo; Choi, Jin-Young; Ersek, Jennifer; Liu, Junxiu; Jo, Sun-Jin; Lee, Kang-Sook; Yim, Hyeon Woo; Lee, Won-Chul; Park, Yong Gyu; Lee, Seung-Hwan; Park, Yong-Moon

2015-01-01

Background To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults. Methods Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels. Results The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected. Conclusions We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations. PMID:25622031

Aligning and Elevating University-Based Low-Income Nutrition Education through the Land-Grant University Cooperative Extension System. National Report

ERIC Educational Resources Information Center

Schneider, Connie

2014-01-01

The nation's Land-Grant University Cooperative Extension System (LGU-CES) is committed to ensuring that low-income populations have a safe, affordable, and healthy food supply. Two low-income nutrition education programs that are core to this commitment are the Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition…

24 CFR 81.18 - Affordability-Income level definitions-family size not known (actual or prospective tenants).

Code of Federal Regulations, 2010 CFR

2010-04-01

... definitions-family size not known (actual or prospective tenants). 81.18 Section 81.18 Housing and Urban... CORPORATION (FREDDIE MAC) Housing Goals § 81.18 Affordability—Income level definitions—family size not known... moderate-income families where family size is not known to the GSE, income will be adjusted using unit size...

Generation of national political priority for surgery: a qualitative case study of three low-income and middle-income countries.

PubMed

Dare, Anna J; Bleicher, Josh; Lee, Katherine C; Elobu, Alex E; Kamara, Thaim B; Liko, Osborne; Luboga, Samuel; Danlop, Akule; Kune, Gabriel; Hagander, Lars; Leather, Andrew J M; Yamey, Gavin

2015-04-27

Surgical conditions exert a major health burden in low-income and middle-income countries (LMICs), yet surgery remains a low priority on national health agendas. Little is known about the national factors that influence whether surgery is prioritised in LMICs. We investigated factors that could facilitate or prevent surgery from being a health priority in three LMICs. We undertook three country case studies in Papua New Guinea, Uganda, and Sierra Leone, using a qualitative process-tracing method. In total 72 semi-structured interviews were conducted between March and June, 2014, in the three countries. Interviews were designed to query informants' attitudes, values, and beliefs about how and why different health issues, including surgical care, were prioritised within their country. Informants were providers, policy makers, civil society, funders, and other stakeholders involved with health agenda setting and surgical care. Interviews were analysed with Dedoose, a qualitative data analysis tool. Themes were organised into a conceptual framework adapted from Shiffman and Smith to assess the factors that affected whether surgery was prioritised. In all three countries, effective political and surgical leadership, access to country-specific surgical disease indicators, and higher domestic health expenditures are facilitating factors that promote surgical care on national health agendas. Competing health and policy interests and poor framing of the need for surgery prevent the issue from receiving more attention. In Papua New Guinea, surgical care is a moderate-to-high health priority. Surgical care is embedded in the national health plan and there are influential leaders with surgical interests. Surgical care is a low-to-moderate health priority in Uganda. Ineffectively used policy windows and little national data on surgical disease have impeded efforts to increase priority for surgery. Surgical care remains a low health priority in Sierra Leone. Resource constraints

Substance abuse and dependence among low income African Americans: using data from the national survey on drug use & health to demystify assumptions.

PubMed

Windsor, Liliane Cambraia; Negi, Nalini

2009-07-01

The media has portrayed African Americans as drug users and criminals. The purpose of this study is to test the assumption that low-income African Americans use more alcohol, nicotine, marijuana, and illicit drugs than other racial groups using data from the 2005 National Survey on Drug Use and Health to compare drug abuse and dependence across low income racial groups (N = 20,172). Most respondents were white, female, and older than 26 years of age. The majority completed high school and reported annual family incomes between $10,000 and $19,000. Few participants reported receiving public assistance. Drug abuse and dependence rates varied across drug type and across race. Drug dependence and abuse were measured using the Nicotine Dependence Syndrome Scale and criteria from the Diagnostic and Statistical Manual of Mental Disorders. Hierarchical regression was conducted to examine the level of association between racial background and drug abuse and dependence after controlling for age and gender. Results reveal that the assumption of high drug and alcohol use and abuse rates among low-income African Americans should be, at best, reexamined. This study has significant implications for both policy and social work practice because it breaks down normalized and biased assumptions of low-income African American drug use.

Income levels of bad-debt and free-care patients in Massachusetts hospitals.

PubMed

Weissman, J S; Dryfoos, P; London, K

1999-01-01

This study disputes the common notion that many hospitalized patients whose expenses are written off to bad debt are able to pay their bills. By matching 1996 state tax returns to more than 350,000 bad-debt and free-care claims at seven Massachusetts hospitals, we found that most patients involved had incomes below the federal poverty level and thus were presumably eligible for either public programs or hospital-based free care. This suggests that hospitals and public officials need to investigate further why low-income, uninsured patients are not receiving benefits for which they are eligible. Our results also suggest that measurements of indigent care levels in hospitals for purposes of research or regulation should include some portion of bad debt.

Forecasting sex differences in mortality in high income nations: The contribution of smoking

PubMed Central

Pampel, Fred

2011-01-01

To address the question of whether sex differences in mortality will in the future rise, fall, or stay the same, this study uses relative smoking prevalence among males and females to forecast future changes in relative smoking-attributed mortality. Data on 21 high income nations from 1975 to 2000 and a lag between smoking prevalence and mortality allow forecasts up to 2020. Averaged across nations, the results for logged male/female ratios in smoking mortality reveal equalization of the sex differential. However, continued divergence in non-smoking mortality rates would counter convergence in smoking mortality rates and lead to future increases in the female advantage overall, particularly in nations at late stages of the cigarette epidemic (such as the United States and the United Kingdom). PMID:21874120

Off-premise alcohol purchasing in Australia: Variations by age group, income level and annual amount purchased.

PubMed

Jiang, Heng; Callinan, Sarah; Livingston, Michael; Room, Robin

2017-03-01

To delineate what type and how much alcohol is purchased from different types of off-licence premises and how this varies across demographic sub-groups, as a basis for public debate and decisions on pricing and planning policies to reduce alcohol-related harm in Australia. The data on alcohol purchasing from off-licence premises are taken from the Australian Alcohol Consumption and Purchasing survey-a nationally representative landline and mobile telephone survey in 2013 on the experiences with alcohol consumption and purchasing of 2020 Australians aged 16+. The present analysis uses data from 1730 respondents who purchased alcohol from off-licence premises in the previous 6 months. The majority (54%) of alcohol purchased from off-licence premises was sold from liquor barns (large warehouse-style alcohol stores), with bottle shops (31%) the second most common outlet. Cask wine was the cheapest alcohol available at off-licence premises in Australia. Respondents in higher alcohol purchasing quintiles and with those with lower income purchased a higher percentage of cheaper alcohol in their total volume of purchasing than lower purchasing quintiles and those with middle and higher income, and younger respondents purchased more expensive alcohol than older age groups. A minimum unit price or increasing alcohol taxes may effectively reduce alcohol purchasing for lower income heavy alcohol purchasers and older age groups from off-licence premise sources, and may be less effective on younger age groups. [Jiang H, Callinan S, Livingston M, Room R. Off-premise alcohol purchasing in Australia: Variations by age group, income level and annual amount purchased. Drug Alcohol Rev 2017;36:210-219]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Reading and Comprehension Levels in a Sample of Urban, Low-Income Persons

ERIC Educational Resources Information Center

Delgado, Cheryl; Weitzel, Marilyn

2013-01-01

Objective: Because health literacy is related to healthcare outcomes, this study looked at reading and comprehension levels in a sample of urban, low-income persons. Design: This was a descriptive exploration of reading comprehension levels, controlled for medical problems that could impact on vision and therefore ability to read. Setting: Ninety…

Changes in income inequality and the health of immigrants.

PubMed

Hamilton, Tod G; Kawachi, Ichiro

2013-03-01

Research suggests that income inequality is inversely associated with health. This association has been documented in studies that utilize variation in income inequality across countries or across time from a single country. The primary criticism of these approaches is their inability to account for potential confounders that are associated with income inequality. This paper uses variation in individual experiences of income inequality among immigrants within the United States (U.S.) to evaluate whether individuals who moved from countries with greater income inequality than the U.S. have better health than those who migrated from countries with less income in equality than the U.S. Utilizing individual-level (March Current Population Survey) and country-level data (the United Nations Human Development Reports), we show that among immigrants who have resided in the U.S. between 6 and 20 years, self-reported health is more favorable for the immigrants in the former category (i.e., greater income inequality) than those in the latter (i.e., lower income inequality). Results also show that self-reported health is better among immigrants from more developed countries and those who have more years of education, are male, and are married. Copyright © 2012. Published by Elsevier Ltd.

Socioeconomic determinants of infant mortality: a worldwide study of 152 low-, middle-, and high-income countries.

PubMed

Schell, Carl Otto; Reilly, Marie; Rosling, Hans; Peterson, Stefan; Ekström, Anna Mia

2007-01-01

To reach the Millennium Development Goals for health, influential international bodies advocate for more resources to be directed to the health sector, in particular medical treatment. Yet, health has many determinants beyond the health sector that are less evident than proximate predictors. To assess the relative importance of major socioeconomic determinants of population health, measured as infant mortality rate (IMR), at country level. National-level data from 152 countries based on World Development Indicators 2003 were used for multivariate linear regression analyses of five socioeconomic predictors of IMR: public spending on health, GNI/capita, poverty rate, income equality (Gini index), and young female illiteracy rate. Analyses were performed on a global level and stratified for low-, middle-, and high-income countries. In order of importance, GNI/capita, young female illiteracy, and income equality predicted 92% of the variation in national IMR whereas public spending on health and poverty rate were non-significant determinants when adjusted for confounding. In low-income countries, female illiteracy was more important than GNI/capita. Income equality (Gini index) was an independent predictor of IMR in middle-income countries only. In high-income countries none of these predictors was significant. The relative importance of major health determinants varies between income levels, thus extrapolating health policies from high- to low-income countries is problematic. Since the size, per se, of public health spending does not independently predict health outcomes, functioning health systems are necessary to make health investments efficient. Potential health gains from improved female education and economic growth should be considered in low- and middle-income countries.

Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study.

PubMed

2017-03-01

Evidence to guide policymakers in developing affordable and equitable cancer control plans are scarce in low- and middle-income countries (LMIC). The 2012-2014 ASEAN Costs in Oncology Study prospectively followed-up 9513 newly diagnosed cancer patients from eight LMIC in Southeast Asia for 12 months. Overall and country-specific incidence of financial catastrophe (out-of-pocket health costs ≥ 30% of annual household income), economic hardship (inability to make necessary household payments), poverty (living below national poverty line), and all-cause mortality were determined. Stepwise multinomial regression was used to estimate the extent to which health insurance, cancer stage and treatment explained these outcomes. The one-year incidence of mortality (12% in Malaysia to 45% in Myanmar) and financial catastrophe (24% in Thailand to 68% in Vietnam) were high. Economic hardship was reported by a third of families, including inability to pay for medicines (45%), mortgages (18%) and utilities (12%), with 28% taking personal loans, and 20% selling assets (not mutually exclusive). Out of households that initially reported incomes above the national poverty levels, 4·9% were pushed into poverty at one year. The adverse economic outcomes in this study were mainly attributed to medical costs for inpatient/outpatient care, and purchase of drugs and medical supplies. In all the countries, cancer stage largely explained the risk of adverse outcomes. Stage-stratified analysis however showed that low-income patients remained vulnerable to adverse outcomes even when diagnosed with earlier cancer stages. The LMIC need to realign their focus on early detection of cancer and provision of affordable cancer care, while ensuring adequate financial risk protection, particularly for the poor. Copyright © 2017 Elsevier Ltd. All rights reserved.

Lead levels in blood and saliva in a low-income population of Detroit, Michigan

PubMed Central

Nriagu, Jerome; Burt, Brian; Linder, Aaron; Ismail, Amid; Sohn, Woosung

2006-01-01

The relationships between blood lead (PbB) and saliva lead (PbSa) concentrations and the determinants of PbB and PbSa status in 970 low-income adults in the city of Detroit, Michigan were explored. Average PbB and PbSa values in the sample population were found to be 2.7 ± 0.1 μg/dl and 2.4 ± 0.13 μg/l (equivalent to 0.24 ± 0.13 μg/dl), respectively, and a weak but statistically significant association was found between the lead levels in the two types of body fluid samples. The average PbB level for men (4.0 ± 0.56 μg/dl) was higher than that for women (2.7 ± 0.11 μg/dl); other significant predictors of PbB included age, level of education, being employed, income level, the presence of peeling paint on the wall at home and smoking. There was no gender- or age-dependent difference in blood saliva values but statistically significant correlations were found between PbSa and level of education, employment, income level and smoking. Dental caries was severe in this population. Only 0.5% of the participants had no clinical signs of caries, over 80% had cavitated carious lesions (i.e., lesions that had progressed into dentin), and the number of lost teeth and carious lesions averaged 3.4 and 30, respectively. Weak but significant associations were found between PbB as well as PbSa and measures of dental caries in the study population. The positive associations are believed to be a reflection of the fact that the risk factors for dental caries, especially in low-income populations of the US, overlap extensively with those of lead poisoning and may not have a causal significance. PMID:16443391

Nonmarital First Births, Marriage, and Income Inequality.

PubMed

Cherlin, Andrew J; Ribar, David; Yasutake, Suzumi

2016-08-01

Many aggregate-level studies suggest a relationship between economic inequality and socio-demographic outcomes such as family formation, health, and mortality; but individual-level evidence is lacking. Nor is there satisfactory evidence on the mechanisms by which inequality may have an effect. We study the determinants of transitions to a nonmarital first birth as a single parent or as a cohabiting parent compared to transitions to marriage prior to a first birth among unmarried, childless young adults in the National Longitudinal Survey of Youth, 1997 cohort, from 1997 to 2011. We include measures of county-group-level household income inequality and of the availability of jobs typically held by high-school graduates and which pay above-poverty wages. We find that greater income inequality is associated with a reduced likelihood of transitioning to marriage prior to a first birth for both women and men. The association between levels of inequality and transitions to marriage can be partially accounted for by the availability of jobs of the type we measured. Some models also suggest that greater income inequality is associated with a reduced likelihood of transitioning to a first birth while cohabiting.

Nonmarital First Births, Marriage, and Income Inequality

PubMed Central

Cherlin, Andrew J.; Ribar, David; Yasutake, Suzumi

2017-01-01

Many aggregate-level studies suggest a relationship between economic inequality and socio-demographic outcomes such as family formation, health, and mortality; but individual-level evidence is lacking. Nor is there satisfactory evidence on the mechanisms by which inequality may have an effect. We study the determinants of transitions to a nonmarital first birth as a single parent or as a cohabiting parent compared to transitions to marriage prior to a first birth among unmarried, childless young adults in the National Longitudinal Survey of Youth, 1997 cohort, from 1997 to 2011. We include measures of county-group-level household income inequality and of the availability of jobs typically held by high-school graduates and which pay above-poverty wages. We find that greater income inequality is associated with a reduced likelihood of transitioning to marriage prior to a first birth for both women and men. The association between levels of inequality and transitions to marriage can be partially accounted for by the availability of jobs of the type we measured. Some models also suggest that greater income inequality is associated with a reduced likelihood of transitioning to a first birth while cohabiting. PMID:29176906

Income-related health inequalities across regions in Korea

PubMed Central

2011-01-01

Introduction In addition to economic inequalities, there has been growing concern over socioeconomic inequalities in health across income levels and/or regions. This study measures income-related health inequalities within and between regions and assesses the possibility of convergence of socioeconomic inequalities in health as regional incomes converge. Methods We considered a total of 45,233 subjects (≥ 19 years) drawn from the four waves of the Korean National Health and Nutrition Examination Survey (KNHANES). We considered true health as a latent variable following a lognormal distribution. We obtained ill-health scores by matching self-rated health (SRH) to its distribution and used the Gini Coefficient (GC) and an income-related ill-health Concentration Index (CI) to examine inequalities in income and health, respectively. Results The GC estimates were 0.3763 and 0.0657 for overall and spatial inequalities, respectively. The overall CI was -0.1309, and the spatial CI was -0.0473. The spatial GC and CI estimates were smaller than their counterparts, indicating substantial inequalities in income (from 0.3199 in Daejeon to 0.4233 Chungnam) and income-related health inequalities (from -0.1596 in Jeju and -0.0844 in Ulsan) within regions. The results indicate a positive relationship between the GC and the average ill-health and a negative relationship between the CI and the average ill-health. Those regions with a low level of health tended to show an unequal distribution of income and health. In addition, there was a negative relationship between the GC and the CI, that is, the larger the income inequalities, the larger the health inequalities were. The GC was negatively related to the average regional income, indicating that an increase in a region's average income reduced income inequalities in the region. On the other hand, the CI showed a positive relationship, indicating that an increase in a region's average income reduced health inequalities in the

Locals, incomers and intra-national migration: place-identities and a Scottish island.

PubMed

McKinlay, Andy; McVittie, Chris

2007-03-01

In a trans-national context, immigrants are often described as essentially different from existing residents. However these descriptions of group differences are occasioned constructions of immigrants, and talk about nations provides frameworks of history and space within which immigration is understood. Claimed group differences and the proposed commonality of nation together present a challenging context for immigrants to negotiate identities and to gain acceptance. Drawing on the concept of place-identity, we examined here whether similar issues arise in intra-national migration to a remote Scottish island. We conducted semi-structured interviews with individuals who had lived on the island for periods ranging from 14 months to 20 years. The interviewees described island residents as comprising different groups, in terms such as residence, motivation, place of birth, and connections to other locations. The interviewees negotiated place-identities that compared favourably with others with more transitory connections but unfavourably with residents of longer-standing. Findings show that spatial connections can be used to account for varying degrees of social status in such locations. But some issues relevant to trans-national immigration still arise in intra-national migration, even in the absence of racial, ethnic, religious, or language differences. In short, 'incomers' cannot readily do 'being local'.

Diet quality of Americans differs by age, sex, race/ethnicity, income, and education level.

PubMed

Hiza, Hazel A B; Casavale, Kellie O; Guenther, Patricia M; Davis, Carole A

2013-02-01

An index that assesses the multidimensional components of the diet across the lifecycle is useful in describing diet quality. The purpose of this study was to use the Healthy Eating Index-2005, a measure of diet quality in terms of conformance to the 2005 Dietary Guidelines for Americans, to describe the diet quality of Americans by varying sociodemographic characteristics in order to provide insight as to where diets need to improve. The Healthy Eating Index-2005 scores were estimated using 1 day of dietary intake data provided by participants in the 2003-2004 National Health and Nutrition Examination Survey. Mean daily intakes of foods and nutrients, expressed per 1,000 kilocalories, were estimated using the population ratio method and compared with standards that reflect the 2005 Dietary Guidelines for Americans. Participants included 3,286 children (2 to 17 years), 3,690 young and middle-aged adults (18 to 64 years), and 1,296 older adults (65+ years). Results are reported as percentages of maximum scores and tested for significant differences (P ≤ 0.05) by age, sex, race/ethnicity, income, and education levels. Children and older adults had better-quality diets than younger and middle-aged adults; women had better-quality diets than men; Hispanics had better-quality diets than blacks and whites; and diet quality of adults, but not children, generally improved with income level, except for sodium. The diets of Americans, regardless of socioeconomic status, are far from optimal. Problematic dietary patterns were found among all sociodemographic groups. Major improvements in the nutritional health of the American public can be made by improving eating patterns. Published by Elsevier Inc.

Wider income gaps, wider waistbands? An ecological study of obesity and income inequality.

PubMed

Pickett, Kate E; Kelly, Shona; Brunner, Eric; Lobstein, Tim; Wilkinson, Richard G

2005-08-01

To see if obesity, deaths from diabetes, and daily calorie intake are associated with income inequality among developed countries. Ecological study of 21 developed countries.Countries: Countries were eligible for inclusion if they were among the top 50 countries with the highest gross national income per capita by purchasing power parity in 2002, had a population over 3 million, and had available data on income inequality and outcome measures. Percentage of obese (body mass index >30) adult men and women, diabetes mortality rates, and calorie consumption per capita per day. Adjusting for gross national per capita income, income inequality was positively correlated with the percentage of obese men (r = 0.48, p = 0.03), the percentage of obese women (r = 0.62, p = 0.003), diabetes mortality rates per 1 million people (r = 0.46, p = 0.04), and average calories per capita per day (r = 0.50, p = 0.02). Correlations were stronger if analyses were weighted for population size. The effect of income inequality on female obesity was independent of average calorie intake. Obesity, diabetes mortality, and calorie consumption were associated with income inequality in developed countries. Increased nutritional problems may be a consequence of the psychosocial impact of living in a more hierarchical society.

Dental caries, parents educational level, family income and dental service attendance among children in Italy.

PubMed

Cianetti, S; Lombardo, G; Lupatelli, E; Rossi, G; Abraha, I; Pagano, S; Paglia, L

2017-03-01

The aim of this study was to verify whether socioeconomic determinants, such as parents' educational level, family income and dental service attendance by children, are associated with the presence of caries among an Italian population of children. An observational retrospective study was carried out in a population of children aged 4-14 years who visited the Paediatric Dentistry Department of the University of Perugia, Italy. Children were stratified according to familial socioeconomic level (father's and mother's educational level, family income) and dental service attendance of children. Age- and sex- adjusted odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated by means of multivariate logistic regression models. A sample of 231 children (mean age 8.1 yrs, SD 2.6; 127 males, 104 females) was recruited. One hundred and sixty three (70.46%) children in the study had caries. Caries presence in children was higher in children where the mothers' educational level was lower (OR =6.1; 95% CI = 3.1 to 12.7), in children where the fathers' educational level was lower (OR =2.9; 95% CI =1.6 to 5.5) and in children with lower family income (OR = 9.9; 95% 95% CI = 5.1 to 20.1). No statistically significant difference were observed in terms of caries presence between the children who were visited at least once by a dentist and children who were not previously seen by a dental practitioner (OR = 0.8; 95% CI = 0.4 to 1.6). Socioeconomic level was an important predictor of caries presence among children. Both low income and low parental educational level were related to an increased presence of caries, whereas previous dental visits experience did not affect caries presence in children.

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.

Impact of geographic accessibility on utilization of the annual health check-ups by income level in Japan: A multilevel analysis.

PubMed

Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

2017-01-01

Although both geographic accessibility and socioeconomic status have been indicated as being important factors for the utilization of health care services, their combined effect has not been evaluated. The aim of this study was to reveal whether an income-dependent difference in the impact of geographic accessibility on the utilization of government-led annual health check-ups exists. Existing data collected and provided by Chiba City Hall were employed and analyzed as a retrospective cohort study. The subjects were 166,966 beneficiaries of National Health Insurance in Chiba City, Japan, aged 40 to 74 years. Of all subjects, 54,748 (32.8%) had an annual health check-up in fiscal year 2012. As an optimal index of geographic accessibility has not been established, five measures were calculated: travel time to the nearest health care facility, density of health care facilities (number facilities within a 30-min walking distance from the district of residence), and three indices based on the two-step floating catchment area method. Three-level logistic regression modeling with random intercepts for household and district of residence was performed. Of the five measures, density of health care facilities was the most compatible according to Akaike's information criterion. Both low density and low income were associated with decreased utilization of the health check-ups. Furthermore, a linear relationship was observed between the density of facilities and utilization of the health check-ups in all income groups and its slope was significantly steeper among subjects with an equivalent income of 0.00 yen than among those with equivalent income of 1.01-2.00 million yen (p = 0.028) or 2.01 million yen or more (p = 0.040). This result indicated that subjects with lower incomes were more susceptible to the effects of geographic accessibility than were those with higher incomes. Thus, better geographic accessibility could increase the health check-up utilization and also

Impact of geographic accessibility on utilization of the annual health check-ups by income level in Japan: A multilevel analysis

PubMed Central

Fujita, Misuzu; Hata, Akira

2017-01-01

Although both geographic accessibility and socioeconomic status have been indicated as being important factors for the utilization of health care services, their combined effect has not been evaluated. The aim of this study was to reveal whether an income-dependent difference in the impact of geographic accessibility on the utilization of government-led annual health check-ups exists. Existing data collected and provided by Chiba City Hall were employed and analyzed as a retrospective cohort study. The subjects were 166,966 beneficiaries of National Health Insurance in Chiba City, Japan, aged 40 to 74 years. Of all subjects, 54,748 (32.8%) had an annual health check-up in fiscal year 2012. As an optimal index of geographic accessibility has not been established, five measures were calculated: travel time to the nearest health care facility, density of health care facilities (number facilities within a 30-min walking distance from the district of residence), and three indices based on the two-step floating catchment area method. Three-level logistic regression modeling with random intercepts for household and district of residence was performed. Of the five measures, density of health care facilities was the most compatible according to Akaike’s information criterion. Both low density and low income were associated with decreased utilization of the health check-ups. Furthermore, a linear relationship was observed between the density of facilities and utilization of the health check-ups in all income groups and its slope was significantly steeper among subjects with an equivalent income of 0.00 yen than among those with equivalent income of 1.01–2.00 million yen (p = 0.028) or 2.01 million yen or more (p = 0.040). This result indicated that subjects with lower incomes were more susceptible to the effects of geographic accessibility than were those with higher incomes. Thus, better geographic accessibility could increase the health check-up utilization and also

Effect of Childhood Victimization on Occupational Prestige and Income Trajectories

PubMed Central

Fernandez, Cristina A.; Christ, Sharon L.; LeBlanc, William G.; Arheart, Kristopher L.; Dietz, Noella A.; McCollister, Kathyrn E.; Fleming, Lora E.; Muntaner, Carles; Muennig, Peter; Lee, David J.

2015-01-01

Background Violence toward children (childhood victimization) is a major public health problem, with long-term consequences on economic well-being. The purpose of this study was to determine whether childhood victimization affects occupational prestige and income in young adulthood. We hypothesized that young adults who experienced more childhood victimizations would have less prestigious jobs and lower incomes relative to those with no victimization history. We also explored the pathways in which childhood victimization mediates the relationships between background variables, such as parent’s educational impact on the socioeconomic transition into adulthood. Methods A nationally representative sample of 8,901 young adults aged 18–28 surveyed between 1999–2009 from the National Longitudinal Survey of Youth 1997 (NLSY) were analyzed. Covariate-adjusted multivariate linear regression and path models were used to estimate the effects of victimization and covariates on income and prestige levels and on income and prestige trajectories. After each participant turned 18, their annual 2002 Census job code was assigned a yearly prestige score based on the 1989 General Social Survey, and their annual income was calculated via self-reports. Occupational prestige and annual income are time-varying variables measured from 1999–2009. Victimization effects were tested for moderation by sex, race, and ethnicity in the multivariate models. Results Approximately half of our sample reported at least one instance of childhood victimization before the age of 18. Major findings include 1) childhood victimization resulted in slower income and prestige growth over time, and 2) mediation analyses suggested that this slower prestige and earnings arose because victims did not get the same amount of education as non-victims. Conclusions Results indicated that the consequences of victimization negatively affected economic success throughout young adulthood, primarily by slowing the

Shoulder Activity Level is Associated With Type of Employment and Income in the Normative Population Without Shoulder Disorders.

PubMed

Brophy, Robert H; Lin, Kenneth M; Skillington, S Andrew; Hepper, C Tate; Smith, Matthew V

2016-10-01

Socioeconomic variables influence various healthcare issues in different ways. The effect of socioeconomic variables on the shoulder has not been well studied. Because activity level, defined by how much a patient actually does, is an important patient outcome measure and prognostic factor for the shoulder, studying its association with occupation and income will advance our understanding of how these variables relate to shoulder disorders, treatments, and outcomes. We asked: (1) Does shoulder activity score correlate with income level, stratified by gender? (2) Do different employment groups-heavy, moderate, light, student, retired-have different shoulder activity scores, as stratified by gender? (3) Is type of sports participation (contact or overhead) associated with income level, employment type, race, or household size? A survey collected the Brophy and Marx shoulder activity score and demographic information, such as age, gender, race, income, type of employment, and household size from 1625 individuals 18 years and older with no current or previous shoulder pain or injury who are members of a research panel matched to the United States population by age, gender, household income and size, race/ethnicity, and geography. Men and women were analyzed separately. Activity level was controlled for age. Shoulder activity correlated with income level among men (R = 0.03; p < 0.001) and women (R = 0.06; p = 0.0002). For men, heavy employment had the highest Shoulder Activity Scale (SAS) level (12.1 ± 4.9), which was more than SAS levels in sedentary (9.1 ± 4.5; mean difference, 3.0; 95% CI, 2.5-3.6; p = 0.001), student (8.8 ± 5.1; mean difference, 3.3; 95% CI, 3.0-3.7; p = 0.007), retired (8.0 ± 4.6; mean difference, 4.1; 95% CI, 3.6-4.7; p = 0.0001), and not working (7.5 ± 5.3; mean difference, 4.6; 95% CI, 4.6-4.6; p < 0.001) categories; similarly, for women, heavy employment had the highest SAS level (12.0 ± 5.8). However, as there were few women working in

Wider income gaps, wider waistbands? An ecological study of obesity and income inequality

PubMed Central

Pickett, K.; Kelly, S.; Brunner, E.; Lobstein, T.; Wilkinson, R.

2005-01-01

Objectives: To see if obesity, deaths from diabetes, and daily calorie intake are associated with income inequality among developed countries. Design: Ecological study of 21 developed countries. Countries: Countries were eligible for inclusion if they were among the top 50 countries with the highest gross national income per capita by purchasing power parity in 2002, had a population over 3 million, and had available data on income inequality and outcome measures. Main outcome measures: Percentage of obese (body mass index >30) adult men and women, diabetes mortality rates, and calorie consumption per capita per day. Results: Adjusting for gross national per capita income, income inequality was positively correlated with the percentage of obese men (r = 0.48, p = 0.03), the percentage of obese women (r = 0.62, p = 0.003), diabetes mortality rates per 1 million people (r = 0.46, p = 0.04), and average calories per capita per day (r = 0.50, p = 0.02). Correlations were stronger if analyses were weighted for population size. The effect of income inequality on female obesity was independent of average calorie intake. Conclusions: Obesity, diabetes mortality, and calorie consumption were associated with income inequality in developed countries. Increased nutritional problems may be a consequence of the psychosocial impact of living in a more hierarchical society. PMID:16020644

National and regional under-5 mortality rate by economic status for low-income and middle-income countries: a systematic assessment.

PubMed

Chao, Fengqing; You, Danzhen; Pedersen, Jon; Hug, Lucia; Alkema, Leontine

2018-05-01

The progress to achieve the fourth Millennium Development Goal in reducing mortality rate in children younger than 5 years since 1990 has been remarkable. However, work remains to be done in the Sustainable Development Goal era. Estimates of under-5 mortality rates at the national level can hide disparities within countries. We assessed disparities in under-5 mortality rates by household economic status in low-income and middle-income countries (LMICs). We estimated country-year-specific under-5 mortality rates by wealth quintile on the basis of household wealth indices for 137 LMICs from 1990 to 2016, using a Bayesian statistical model. We estimated the association between quintile-specific and national-level under-5 mortality rates. We assessed the levels and trends of absolute and relative disparity in under-5 mortality rate between the poorest and richest quintiles, and among all quintiles. In 2016, for all LMICs (excluding China), the aggregated under-5 mortality rate was 64·6 (90% uncertainty interval [UI] 61·1-70·1) deaths per 1000 livebirths in the poorest households (first quintile), 31·3 (29·5-34·2) deaths per 1000 livebirths in the richest households (fifth quintile), and in between those outcomes for the middle quintiles. Between 1990 and 2016, the largest absolute decline in under-5 mortality rate occurred in the two poorest quintiles: 77·6 (90% UI 71·2-82·6) deaths per 1000 livebirths in the poorest quintile and 77·9 (72·0-82·2) deaths per 1000 livebirths in the second poorest quintile. The difference in under-5 mortality rate between the poorest and richest quintiles decreased significantly by 38·8 (90% UI 32·9-43·8) deaths per 1000 livebirths between 1990 and 2016. The poorest to richest under-5 mortality rate ratio, however, remained similar (2·03 [90% UI 1·94-2·11] in 1990, 1·99 [1·91-2·08] in 2000, and 2·06 [1·92-2·20] in 2016). During 1990-2016, around half of the total under-5 deaths occurred in the poorest two quintiles

A snapshot of current gestational diabetes management practices from 26 low-income and lower-middle-income countries.

PubMed

Utz, Bettina; Kolsteren, Patrick; De Brouwere, Vincent

2016-08-01

To identify screening and management practices for gestational diabetes mellitus (GDM) in low-income and lower-middle-income countries. A cross-sectional survey was conducted between November 12, 2014 and May 11, 2015. Questionnaires were distributed to gynecologists, endocrinologists, and medical doctors who were representatives of national professional societies or were involved in providing care to patients with GDM in low-income or lower-middle-income countries in Africa, South Asia, and Latin America. The data were descriptively analyzed. Questionnaires were sent to 182 individuals and 77 healthcare providers from 26 countries completed the survey. The results demonstrated high diversity in screening and management practices. Only 52 (68%) participants reported that any guidelines were available in their setting. Management of GDM was found to take place mainly at the tertiary level and reported practices, including the frequency of post-diagnosis follow-up, modalities of glucose surveillance, and treatment and practices surrounding delivery, varied and did not always reflect the most recent evidence. Attempts to ensure greater adherence to latest consensus guidelines are required, and should be accompanied by systemic changes to improve the detection and management of GDM at primary- and secondary-level healthcare facilities to facilitate patient access to GDM screening and treatment. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Data on Income inequality in Germany, France, Italy, Spain, the UK, and other affluent nations, 2012.

PubMed

Dorling, Danny

2015-12-01

This data article contains information on the distribution of household incomes in the five most populous European countries as surveyed in 2012, with data released in 2014 and published here aggregated and so further anonymized in 2015. The underlying source data is the already anonymized EU Statistics on Income and Living Conditions (EUSILC) Microdata. The data include the annual household income required in each country to fall within the best-off 1% in that country, median and mean incomes, average (mean) incomes of the best off 1%, 0.1% and estimates for the 0.01%, 0.001% and so on for the UK, and of the 90% and worse-off 10%, the best-off 10% and best-off 1% of households for all countries. Average income from the state is also calculated by these income categories and the number of people working in finance and receiving over €1,000,000 a year in income is reported from other sources (the European Banking Authority). Finally income distribution data is provided from the USA and the rest of Europe in order to allow comparisons to be made. The data revealed the gross household (simple unweighted) median incomes in 2012 to have been (in order from best-off country by median to worse-off): France €39,000, Germany: €33,400, UK: €36,300, Italy €33,400 and Spain €27,000. However the medians, once households are weighted to reflect the nation populations do differ although they are in the same order: France €36,000, Germany: €33,400, UK: €31,300, Italy €31,000 and Spain €23,700. Thus weighting to increase representativeness of the medians reduces each by €3000, €0, €5000, €3300 and €3300 respectively. In short, the middle (weighted median) French household is €4700 a year better off than the middle UK family, and that is before housing costs are considered. This Data in Brief article accompanies Dorling, D. (2015) Income Inequality in the UK: Comparisons with five large Western European countries and the USA [1].

Diagnostic reference levels in low- and middle-income countries: early "ALARAm" bells?

PubMed

Meyer, Steven; Groenewald, Willem A; Pitcher, Richard D

2017-04-01

Background In 1996 the International Commission on Radiological Protection (ICRP) introduced diagnostic reference levels (DRLs) as a quality assurance tool for radiation dose optimization. While many countries have published DRLs, available data are largely from high-income countries. There is arguably a greater need for DRLs in low- and middle-income-countries (LMICs), where imaging equipment may be older and trained imaging technicians are scarce. To date, there has been no critical analysis of the published work on DRLs in LMICs. Such work is important to evaluate data deficiencies and stimulate future quality assurance initiatives. Purpose To review the published work on DRLs in LMICs and to critically analyze the comprehensiveness of available data. Material and Methods Medline, Scopus, and Web of Science database searches were conducted for English-language articles published between 1996 and 2015 documenting DRLs for diagnostic imaging in LMICs. Retrieved articles were analyzed and classified by geographical region, country of origin, contributing author, year of publication, imaging modality, body part, and patient age. Results Fifty-three articles reported DRLs for 28 of 135 LMICs (21%), reflecting data from 26/104 (25%) middle-income countries and 2/31 (6%) low-income countries. General radiography (n = 26, 49%) and computerized tomography (n = 17, 32%) data were most commonly reported. Pediatric DRLs (n = 14, 26%) constituted approximately one-quarter of published work. Conclusion Published DRL data are deficient in the majority of LMICs, with the paucity most striking in low-income countries. DRL initiatives are required in LMICs to enhance dose optimization.

The Consequences of High Cigarette Excise Taxes for Low-Income Smokers

PubMed Central

Farrelly, Matthew C.; Nonnemaker, James M.; Watson, Kimberly A.

2012-01-01

Background To illustrate the burden of high cigarette excise taxes on low-income smokers. Methodology/Principal Findings Using data from the New York and national Adult Tobacco Surveys from 2010–2011, we estimated how smoking prevalence, daily cigarette consumption, and share of annual income spent on cigarettes vary by annual income (less than $30,000; $30,000–$59,999; and more than $60,000). The 2010–2011 sample includes 7,536 adults and 1,294 smokers from New York and 3,777 adults and 748 smokers nationally. Overall, smoking prevalence is lower in New York (16.1%) than nationally (22.2%) and is strongly associated with income in New York and nationally (P<.001). Smoking prevalence ranges from 12.2% to 33.7% nationally and from 10.1% to 24.3% from the highest to lowest income group. In 2010–2011, the lowest income group spent 23.6% of annual household income on cigarettes in New York (up from 11.6% in 2003–2004) and 14.2% nationally. Daily cigarette consumption is not related to income. Conclusions/Significance Although high cigarette taxes are an effective method for reducing cigarette smoking, they can impose a significant financial burden on low-income smokers. PMID:22984447

Income inequality among American states and the incidence of major depression.

PubMed

Pabayo, Roman; Kawachi, Ichiro; Gilman, Stephen E

2014-02-01

Although cross-sectional and ecological studies have shown that higher area-level income inequality is related to increased risk for depression, few longitudinal studies have been conducted. This investigation examines the relationship between state-level income inequality and major depression among adults participating in a population-based, representative longitudinal study. We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=34 653). Respondents completed structured diagnostic interviews at baseline (2001-2002) and follow-up (2004-2005). Weighted multilevel modelling was used to determine if U.S. state-level income inequality (measured by the Gini coefficient) was a significant predictor of depression at baseline and at follow-up, while controlling for individual-level and state-level covariates. We also repeated the longitudinal analyses, excluding those who had a history of depression or at baseline, in order to test whether income inequality was related to incident depression. State-level inequality was associated with increased incidence of depression among women but not men. In comparison to women residing in states belonging to the lowest quintile of income inequality, women were at increased risk for depression in the second (OR=1.18, 95% CI 0.86 to 1.62), third (OR=1.22, 95% CI 0.91 to 1.62), fourth (OR=1.37, 95% CI 1.03 to 1.82) and fifth (OR=1.50, 95% CI 1.14 to 1.96) quintiles at follow-up (p<0.05 for the linear trend). Living in a state with higher income inequality increases the risk for the development of depression among women.

An environmental intervention aimed at increasing physical activity levels in low-income women.

PubMed

Speck, Barbara J; Hines-Martin, Vicki; Stetson, Barbara A; Looney, Stephen W

2007-01-01

Regular physical activity is a health promotion and disease prevention behavior. Of all demographic groups, low-income women report the lowest levels of physical activity. The purpose of this study was to test an intervention aimed at reducing community environmental barriers to physical activity in low-income women. The research design was mixed methodology: (1) quantitative (quasi-experimental, pretest-posttest, cohort design in which no treatment partitioning was possible) and (2) qualitative (focus groups). The setting was a church-sponsored community center centrally located in a low-income urban neighborhood. The comparison group was recruited first followed by the intervention group to control for setting. The sample consisted of 104 women (comparison group, n = 53; intervention group, n = 51) between the ages of 18 and 63 years who were residents of neighborhoods served by the community center. No between-group differences were found for physical activity behavior. Significant between-group differences in cholesterol (P = .007) and perception of physical activity (P = .033) were observed. Significant intervention group increases from pretest to posttest were found related to advanced registered nurse practitioner support, friend support, and more positive physical activity environment at the community center. Qualitative data supported and enriched the quantitative data. Physical activity levels were not significantly different between the groups. In a sample of low-income women who have multiple barriers, improving attitudes, expanding their knowledge of community resources, and providing physical activity opportunities in their neighborhoods are important intermediate steps toward initiation and maintenance of regular physical activity.

Gender-specific interactions between education and income in relation to obesity: a cross-sectional analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V)

PubMed Central

Chung, Woojin; Lim, Seung-ji; Lee, Sunmi; Kim, Roeul; Kim, Jaeyeun

2017-01-01

Objectives To identify gender-specific associations between education and income in relation to obesity in developed countries by considering both the interaction-effect terms of the independent variables and their main-effect terms. Design A cross-sectional study. Education and income levels were chosen as socioeconomic status indicators. Sociodemographics, lifestyles and medical conditions were used as covariates in multivariable logistic regression models. Adjusted ORs and predicted probabilities of being obese were computed and adjusted for a complex survey design. Setting Data were obtained from the Fifth Korea National Health and Nutrition Examination Survey (2010–2012). Participants The sample included 7337 male and 9908 female participants aged ≥19 years. Outcome measure Obesity was defined as body mass index of ≥25, according to a guideline for Asians. Results In models with no interaction-effect terms of independent variables, education was significantly associated with obesity in both men and women, but income was significant only in women. However, in models with the interaction-effect terms, education was significant only in women, but income was significant only in men. The interaction effect between income and education was significant in men but not in women. Participants having the highest predicted probability of being obese over educational and income levels differed between the two types of models, and between men and women. A prediction using the models with the interaction-effect terms demonstrated that for all men, the highest level of formal education was associated with an increase in their probability of being obese by as much as 26%. Conclusions The well-known, negative association between socioeconomic status and obesity in developed countries may not be valid when interaction effects are included. Ignoring these effects and their gender differences may result in the targeting of wrong populations for reducing obesity prevalence

Income inequality, socioeconomic deprivation and depressive symptoms among older adults in Mexico.

PubMed

Fernández-Niño, Julián Alfredo; Manrique-Espinoza, Betty Soledad; Bojorquez-Chapela, Ietza; Salinas-Rodríguez, Aarón

2014-01-01

Depression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health - specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico. Cross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model. Socioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not. The results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group.

Income is a stronger predictor of mortality than education in a national sample of US adults.

PubMed

Sabanayagam, Charumathi; Shankar, Anoop

2012-03-01

Low socioeconomic status (SES) is associated with mortality in several populations. SES measures, such as education and income, may operate through different pathways. However, the independent effect of each measure mutually adjusting for the effect of other SES measures is not clear. The association between poverty-income ratio (PIR) and education and all-cause mortality among 15,646 adults, aged >20 years, who participated in the Third National Health and Nutrition Examination Survey in the USA, was examined. The lower PIR quartiles and less than high school education were positively associated with all-cause mortality in initial models adjusting for the demographic, lifestyle and clinical risk factors. After additional adjustment for education, the lower PIR quartiles were still significantly associated with all-cause mortality. The multivariable odds ratio (OR) [95% confidence interval (CI)] of all-cause mortality comparing the lowest to the highest quartile of PIR was 2.11 (1.52-2.95, p trend < or = 0.0001). In contrast, after additional adjustment for income, education was no longer associated with all-cause mortality [multivariable OR (95% CI) of all-cause mortality comparing less than high school to more than high school education was 1.05 (0.85-1.31, p trend=0.57)]. The results suggest that income may be a stronger predictor of mortality than education, and narrowing the income differentials may reduce the health disparities.

Who Moves to Mixed-Income Neighborhoods?*

PubMed Central

McKinnish, Terra; White, T. Kirk

2011-01-01

This paper uses confidential Census data, specifically the 1990 and 2000 Census Long Form data, to study the income dispersion of recent cohorts of migrants to mixed-income neighborhoods. We investigate whether neighborhoods with high levels of income dispersion attract economically diverse in-migrants. If recent in-migrants to mixed-income neighborhoods exhibit high levels of income dispersion, this is consistent with stable mixed-income neighborhoods. If, however, mixed-income neighborhoods are comprised of homogenous low-income (high-income) cohorts of long-term residents combined with homogenous high-income (low-income) cohorts of recent arrivals, this is consistent with neighborhood transition. Our results indicate that neighborhoods with high levels of income dispersion do in fact attract a much more heterogeneous set of in-migrants, particularly from the tails of the income distribution. Our results also suggest that the residents of mixed-income neighborhoods may be less heterogeneous with respect to lifetime income. PMID:21479114

Expanding federal funding to community health centers slows decline in access for low-income adults.

PubMed

McMorrow, Stacey; Zuckerman, Stephen

2014-06-01

To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000-2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001-2008). We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. © Health Research and Educational Trust.

Improving pathology and laboratory medicine in low-income and middle-income countries: roadmap to solutions.

PubMed

Sayed, Shahin; Cherniak, William; Lawler, Mark; Tan, Soo Yong; El Sadr, Wafaa; Wolf, Nicholas; Silkensen, Shannon; Brand, Nathan; Looi, Lai Meng; Pai, Sanjay A; Wilson, Michael L; Milner, Danny; Flanigan, John; Fleming, Kenneth A

2018-05-12

Insufficient awareness of the centrality of pathology and laboratory medicine (PALM) to a functioning health-care system at policy and governmental level, with the resultant inadequate investment, has meant that efforts to enhance PALM in low-income and middle-income countries have been local, fragmented, and mostly unsustainable. Responding to the four major barriers in PALM service delivery that were identified in the first paper of this Series (workforce, infrastructure, education and training, and quality assurance), this second paper identifies potential solutions that can be applied in low-income and middle-income countries (LMICs). Increasing and retaining a quality PALM workforce requires access to mentorship and continuing professional development, task sharing, and the development of short-term visitor programmes. Opportunities to enhance the training of pathologists and allied PALM personnel by increasing and improving education provision must be explored and implemented. PALM infrastructure must be strengthened by addressing supply chain barriers, and ensuring laboratory information systems are in place. New technologies, including telepathology and point-of-care testing, can have a substantial role in PALM service delivery, if used appropriately. We emphasise the crucial importance of maintaining PALM quality and posit that all laboratories in LMICs should participate in quality assurance and accreditation programmes. A potential role for public-private partnerships in filling PALM services gaps should also be investigated. Finally, to deliver these solutions and ensure equitable access to essential services in LMICs, we propose a PALM package focused on these countries, integrated within a nationally tiered laboratory system, as part of an overarching national laboratory strategic plan. Copyright © 2018 Elsevier Ltd. All rights reserved.

[The right to share in the nation's wealth: from the Family Allowance Program to Basic Citizenship Income].

PubMed

Suplicy, Eduardo Matarazzo

2007-01-01

This paper presents the positive outcomes of Brazil's Family Allowance Program, in terms of combating hunger and eradicating poverty, stressing that this is the first step towards introducing a Basic Income for Citizenship (RBC - Renda Básica de Cidadania) in Brazil, as established in 2004 through Law N degrees 10,835. This Basic Income for Citizenship will be phased in by stages at the discretion of the Executive Branch, starting with the neediest segments of the population. Everyone will be endowed with the unconditional right to receive an income that will be sufficient - as far as possible - to cover vital requirements. This is not a matter of charity or welfare, but rather an across-the-board right to share in the wealth of the nation. The rationality of this tool for ensuring real freedom and dignity for all is also examined here.

Income inequality and cause-specific mortality during economic development.

PubMed

Lau, Elaine W; Schooling, C Mary; Tin, Keith Y; Leung, Gabriel M

2012-04-01

Life expectancy is strongly related to national income, whether there is an additional contribution of income inequality is unclear. We used negative binomial regression to examine the association of neighborhood-level Gini, adjusted for age, sex, and income, with mortality rates in Hong Kong from 1976 to 2006. The association of neighborhood Gini with all-cause mortality varied over time (p-value for interaction < .01). Neighborhood Gini was positively associated with nonmedical mortality in 1976 to 1986; incident rate ratio (IRR) 1.09, 95% confidence interval (95% CI) 1.02-1.16 per 0.1 change and in 1991 to 2006, IRR 1.24, 95% CI 1.13-1.36, adjusted for age, sex and absolute income. Similarly adjusted, Gini was not associated with all-cause mortality in 1976 to 1986 (IRR 0.96, 95% CI 0.93-1.00) but was in 1991 to 2006 (IRR 1.25, 95% CI 1.20-1.29), when Gini was also positively associated with death from cardiovascular diseases, respiratory diseases and some cancers. Independent of income, income inequality was positively associated with nonmedical mortality rates at a low level of spatial aggregation, indicating the consistent harms of social disharmony. However, the impact on medical mortality was less consistent, suggesting the relevance of contextual factors. Copyright © 2012 Elsevier Inc. All rights reserved.

Education determines a nation's health, but what determines educational outcomes? A cross-national comparative analysis.

PubMed

Siddiqi, Arjumand; Kawachi, Ichiro; Berkman, Lisa; Hertzman, Clyde; Subramanian, S V

2012-02-01

This study is premised on the notion that public health policy should address not only health itself, but also primary determinants of health. We examined the effect of national policies on educational outcomes, in particular, on adolescent reading literacy (ARL). We compared the effect of traditional policy indicators--national income and educational spending--with income inequality, a measure of redistributive policies. We used Organization for Economic Cooperation and Development (OECD) data that provide a rare opportunity to test policy effects after accounting for competing individual-, school-, and country-level explanations. Our sample consisted of 119,814 students, 5126 schools, and 24 countries. Multilevel/Hierarchical regression findings were striking: GDP had a significant, but negligible effect on ARL scores (β=0.002, SE=0.0008), while educational spending had no significant effect. By contrast, income inequality exhibited a larger inverse association (β=-1.15, SE=0.57). Among the wealthy nations in OECD, additional economic prosperity and educational spending is trumped by distribution of income for its effect on ARL. Our study yielded a striking result about education, a major determinant of health. Not only is income inequality a significant determinant of ARL scores, but direct spending on education and overall national economic prosperity are not.

Multiple Sclerosis impact on employment and income in New Zealand.

PubMed

Pearson, J F; Alla, S; Clarke, G; Mason, D F; Anderson, T; Richardson, A; Miller, D H; Sabel, C E; Abernethy, D A; Willoughby, E W; Taylor, B V

2017-09-01

We investigated the demographic, social and clinical characteristics associated with employment status and income for people with multiple sclerosis (MS) in New Zealand (NZ). The NZ National MS Prevalence study included all persons resident in NZ on census day 2006 diagnosed with MS (96.7% coverage). Factors associated with employment and income status among the working age population (25-64 years) were identified by linear regression. Over 90% of working age people with MS (n=1727) had a work history, but 54% were not working. Work loss occurred early in the disease course, and at low disability (P<.001). Advancing age, progressive disease, longer disease duration, higher disability levels, partner loss and lower education were associated with work loss (P<.001). Working age people with MS had lower income than the NZ population (P<.0001). Higher qualifications yielded no additional income for MS females and about half the additional income for MS males (P<.0001). MS profoundly reduces employment and income early in the disease course, and at low levels of disability, however, unemployment is not entirely accounted for by clinical, social and demographic factors. These findings suggest social supports should be explored early in the disease course to reduce loss of income and unemployment for people with MS. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Income Inequality and the Differential Effect of Adverse Childhood Experiences in US Children.

PubMed

Halfon, Neal; Larson, Kandyce; Son, John; Lu, Michael; Bethell, Christina

Adverse childhood experiences (ACEs) can affect health and development across the life course. Despite a general understanding that adversity is associated with lower income, we know less about how ACEs manifest at different income levels and how these income-related patterns affect children's health and development. Data from the 2011 to 2012 National Survey of Children's Health were used to examine the prevalence of 9 ACEs in US children, across 4 levels of household income, and in relationship to 5 parent-reported measures of child health. Bivariate analyses and multivariable logistic regression models were used to examine the associations between number of ACEs and children's health outcomes on the basis of the 4 income groups. When partitioned according to income strata, the proportion of children who experienced ACEs showed a steep income gradient, particularly for children who experienced ≥4 ACEs. The linear gradient across income groups was less pronounced for each specific ACE, with several ACEs (experience of divorce, drug and alcohol exposure, parental mental illness) showing high reported prevalence in all but the highest income group. Multivariate analysis showed a consistent income-related gradient for each of the health outcomes. However, higher income was not necessarily found to be a protective factor against ACEs. ACEs are distributed across the income ladder and not just concentrated below the poverty level. This suggests that a more comprehensive policy strategy that includes targeted as well as universal interventions is warranted. Copyright © 2016 Academic Pediatric Association. All rights reserved.

National use of asbestos in relation to economic development.

PubMed

Le, Giang Vinh; Takahashi, Ken; Karjalainen, Antti; Delgermaa, Vanya; Hoshuyama, Tsutomu; Miyamura, Yoshitaka; Furuya, Sugio; Higashi, Toshiaki; Pan, Guowei; Wagner, Gregory

2010-01-01

National disparities in asbestos use will likely lead to an unequal burden of asbestos diseases. As economic status may be linked to asbestos use, we assessed, globally, the relationship between indicators of national economic development and asbestos use. For the 135 countries that have ever used asbestos, per capita asbestos use (kilograms per capita per year) was compared with per capita gross domestic product (GDP) in 1990 Geary-Khamis dollars (GKD) for the period 1920-2003. Countries were grouped into three income levels (high, middle, and low) that were adapted from the 2003 World Bank categories. The historical pattern of asbestos use followed the environmental Kuznets curve in which use by high-income countries peaked when incomes attained 10,000-15,000 GKD and essentially ceased at income levels over 20,000 GKD. Currently, middle- and low-income countries are increasing their use of asbestos, closely following the paths once traced by higher income countries. Developing countries have the opportunity to eliminate asbestos use sooner than high-income countries and thus reduce the future burden of asbestos diseases.

Trends in the Family Income Distribution by Race/Ethnicity and Income Source, 1988–2009

PubMed Central

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

2015-01-01

The recent dramatic rise in U.S. income inequality has prompted a great deal of research on trends in overall family income and changes in sources of family income, especially among the highest income earners. However, less is known about changes in sources of income among the bottom 99% or about racial/ethnic differences in those trends. The present research contributes to the literatures on income trends and racial economic inequality by using family-level data from the 1988–2009 Current Population Survey to examine changes in overall family income and the proportion of income coming from employment, property/assets, and transfers across five different levels of family income for white-, black, and Hispanic-headed families. We find that at all income levels above the 25th percentile, employment income is by far the largest contributor to family income for all racial/ethnic groups. Employment income trended upward over the period in both real dollars and as a percentage of total family income. In this respect, white, black and Hispanic families are remarkably similar. The racial gap in total family income has remained fairly stable over the period, but this trend conceals a narrowing of racial differences in property income, mostly as a function of the decline in property income among whites, a widening of racial differences in transfer income among the bottom 25%, and a widening of racial differences in employment income, particularly at the top of the family income distribution. Income accrued from wealth is a very small component of overall family income for all three racial groups, even for the highest-income families (top 1%). PMID:26180265

Global Dental Research Productivity and Its Association With Human Development, Gross National Income, and Political Stability.

PubMed

Allareddy, Veerasathpurush; Allareddy, Veeratrishul; Rampa, Sankeerth; Nalliah, Romesh P; Elangovan, Satheesh

2015-09-01

The objective of this study is to examine the associations between country level factors (such as human development, economic productivity, and political stability) and their dental research productivity. This study is a cross-sectional analysis of bibliometric data from Scopus search engine. Human Development Index (HDI), Gross National Income per capita (GNI), and Failed State Index measures were the independent variables. Outcomes were "Total number of publications (articles or articles in press) in the field of dentistry" and "Total number of publications in the field of dentistry per million population." Non-parametric tests were used to examine the association between the independent and outcome variables. During the year 2013, a total of 11,952 dental research articles were published across the world. The top 5 publishing countries were United States, Brazil, India, Japan, and United Kingdom. "Very High" HDI countries had significantly higher number of total dental research articles and dental research articles per million population when compared to the "High HDI," "Medium HDI," and "Low HDI" countries (p < 0.0001). There was a significant linear relationship between the GNI quartile income levels and outcome metrics (p ≤ 0.007). Countries which were highly politically stable were associated with significantly higher dental research productivity (p < 0.0001). There appears to be a regional concentration of articles with just five countries contributing to over 50% of all articles. The human development and economic development of a country are linearly correlated with dental research productivity. Dental research productivity also increases with increasing political stability of a country. Copyright © 2015 Elsevier Inc. All rights reserved.

What explains the association between neighborhood-level income inequality and the risk of fatal overdose in New York City?

PubMed

Nandi, Arijit; Galea, Sandro; Ahern, Jennifer; Bucciarelli, Angela; Vlahov, David; Tardiff, Kenneth

2006-08-01

Accidental drug overdose is a substantial cause of mortality for drug users. Using a multilevel case-control study we previously have shown that neighborhood-level income inequality may be an important determinant of overdose death independent of individual-level factors. Here we hypothesized that the level of environmental disorder, the level of police activity, and the quality of the built environment in a neighborhood mediate this association. Data from the New York City (NYC) Mayor's Management Report, the NYC Police Department, and the NYC Housing and Vacancy Survey were used to define constructs for the level of environmental disorder, the level of police activity and the quality of the built environment, respectively. In multivariable models the odds of death due to drug overdose in neighborhoods in the top decile of income inequality compared to the most equitable neighborhoods decreased from 1.63 to 1.12 when adjusting for the three potential mediators. Path analyses show that the association between income inequality and the rate of drug overdose mortality was primarily explained by an indirect effect through the level of environmental disorder and the quality of the built environment in a neighborhood. Implications of these findings for the reduction of drug overdose mortality associated with the distribution of income are discussed.

A Review of National-Level Adaptation Planning with Regards to the Risks Posed by Climate Change on Infectious Diseases in 14 OECD Nations

PubMed Central

Panic, Mirna; Ford, James D.

2013-01-01

Climate change is likely to have significant implications for human health, particularly through alterations of the incidence, prevalence, and distribution of infectious diseases. In the context of these risks, governments in high income nations have begun developing strategies to reduce potential climate change impacts and increase health system resilience (i.e., adaptation). In this paper, we review and evaluate national-level adaptation planning in relation to infectious disease risks in 14 OECD countries with respect to “best practices” for adaptation identified in peer-reviewed literature. We find a number of limitations to current planning, including negligible consideration of the needs of vulnerable population groups, limited emphasis on local risks, and inadequate attention to implementation logistics, such as available funding and timelines for evaluation. The nature of planning documents varies widely between nations, four of which currently lack adaptation plans. In those countries where planning documents were available, adaptations were mainstreamed into existing public health programs, and prioritized a sectoral, rather than multidisciplinary, approach. The findings are consistent with other scholarship examining adaptation planning indicating an ad hoc and fragmented process, and support the need for enhanced attention to adaptation to infectious disease risks in public health policy at a national level. PMID:24351735

Macro-level determinants of young people's subjective health and health inequalities: a multilevel analysis in 27 welfare states.

PubMed

Rathmann, Katharina; Ottova, Veronika; Hurrelmann, Klaus; de Looze, Margarethe; Levin, Kate; Molcho, Michal; Elgar, Frank; Gabhainn, Saoirse Nic; van Dijk, Jitse P; Richter, Matthias

2015-04-01

Cross-national studies have rarely focused on young people. The aim of this study is to investigate whether macro-level determinants are associated with health and socioeconomic inequalities in young people's health. Data were collected from the Health Behaviour in School-aged Children (HBSC) study in 2006, which included 11- to 15-year old adolescents from 27 European and North American countries (n=134,632). This study includes national income, health expenditure, income inequality, and welfare regime dummy-variables as macro-level determinants, using hierarchical regression modelling. Psychosomatic health complaints and socioeconomic inequalities in psychosomatic health complaints. Adolescents in countries with higher income inequality and with liberal welfare tradition were associated with more health complaints and a stronger relationship between socioeconomic status and macro-level determinants compared to adolescents from countries with lower income inequality or the Social Democratic regime. National income and health expenditure were not related to health complaints. Countries with higher national income, public health expenditure and income inequality showed stronger associations between socioeconomic status and psychosomatic health complaints. Results showed that macro-level characteristics are relevant determinants of health and health inequalities in adolescence. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Income Inequality and Happiness: An Inverted U-Shaped Curve.

PubMed

Yu, Zonghuo; Wang, Fei

2017-01-01

Numerous studies agree that income inequality, rather than absolute income, is an important predictor of happiness. However, its specific role has been controversial. We argue that income inequality and happiness should exhibit an inverted U-shaped relationship due to the dynamic competing process between two effects: when income inequality is relatively low, the signal effect will be the dominating factor, in which individuals feel happy because they consider income inequality as a signal of social mobility and expect upward mobility; however, if income inequality level increases beyond a critical point, the jealousy effect will become the dominating factor, in which individuals tend to be unhappy because they are disillusioned about the prospect of upward mobility and jealous of their wealthier peers. This hypothesis is tested in a longitudinal dataset on the United States and a cross-national dataset on several European countries. In both datasets, the Gini coefficient (a common index of a society's income inequality) and its quadratic term were significant predictors of personal happiness. Further examinations of the quadratic relationships showed that the signal effect was only presented in the European data, while the jealousy effect was presented in both datasets. These findings shed new light on our understanding of the relationship between income inequality and personal happiness.

Income Inequality and Happiness: An Inverted U-Shaped Curve

PubMed Central

Yu, Zonghuo; Wang, Fei

2017-01-01

Numerous studies agree that income inequality, rather than absolute income, is an important predictor of happiness. However, its specific role has been controversial. We argue that income inequality and happiness should exhibit an inverted U-shaped relationship due to the dynamic competing process between two effects: when income inequality is relatively low, the signal effect will be the dominating factor, in which individuals feel happy because they consider income inequality as a signal of social mobility and expect upward mobility; however, if income inequality level increases beyond a critical point, the jealousy effect will become the dominating factor, in which individuals tend to be unhappy because they are disillusioned about the prospect of upward mobility and jealous of their wealthier peers. This hypothesis is tested in a longitudinal dataset on the United States and a cross-national dataset on several European countries. In both datasets, the Gini coefficient (a common index of a society’s income inequality) and its quadratic term were significant predictors of personal happiness. Further examinations of the quadratic relationships showed that the signal effect was only presented in the European data, while the jealousy effect was presented in both datasets. These findings shed new light on our understanding of the relationship between income inequality and personal happiness. PMID:29225588

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.

Association Between Cigarette Smoking Prevalence and Income Level: A Systematic Review and Meta-Analysis.

PubMed

Casetta, Brunilda; Videla, Alejandro J; Bardach, Ariel; Morello, Paola; Soto, Natalie; Lee, Kelly; Camacho, Paul Anthony; Hermoza Moquillaza, Rocío Victoria; Ciapponi, Agustín

2017-11-07

Previous evidence linked low socioeconomic status with higher smoking prevalence. Our objective was to assess the strength of this association in the world population, updating a previous work. Systematic review and meta-analysis of observational studies. Subgroup analyses included continents, WHO regions, country mortality levels, gender, age, risk of bias, and study publication date. Independent reviewers selected studies, assessed potential bias and extracted data. We searched MEDLINE, EMBASE, CENTRAL, SOCINDEX, AFRICAN INDEX MEDICUS, and LILACS, and other sources from 1989 to 2013 reporting direct measurements of income and current cigarette smoking. We retrieved 13,583 articles and included 93 for meta-analysis. Median smoking prevalence was 17.8% (range 3-70%). Lower income was consistently associated with higher smoking prevalence (odds ratio [OR]: 1.45; 95% confidence interval [CI]: 1.35-1.56). This association was statistically significant in the subgroup analysis by WHO regions for the Americas (OR: 1.54; 95% CI: 1.42-1.68), South East Asia (OR: 1.53; 95% CI: 1.10-2.00), Europe (OR: 1.45; 95% CI: 1.29-1.63), and Western Pacific (OR: 1.32; 95% CI: 1.02-1.72), and in studies conducted during 1990s (OR: 1.42; 95% CI: 1.24-1.62) and 2000s (OR: 1.48; 95%CI: 1.30-1.64). Likewise, it was noted in low-mortality countries (OR: 1.48; 95% CI: 1.37-1.60) and for both genders. Prevalence was highest in the lowest income levels compared to the middle (OR: 1.69; 95% CI: 1.49-1.92), followed by the middle level compared to the highest (OR: 1.31; 95% CI: 1.20-1.43). Our results show that current cigarette smoking was significantly associated with lower income worldwide and across subgroups, suggesting a dose-response relationship. This unique updated systematic review shows a consistent inverse dose-response relationship between cigarette smoking and income level, present among most geographical areas and country characteristics. Public health measures should take into

State-level income inequality and meeting physical activity guidelines; differential associations among US men and women.

PubMed

Pabayo, Roman; Fuller, Daniel; Lee, Eun Young; Horino, Masako; Kawachi, Ichiro

2017-07-23

Previous work has identified a relationship between income inequality and risk for obesity and heart attack. We investigated the relationship between state-level income inequality and physical activity among US adults. We used Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional data from a population based and representative sample of n = 428 828 US adults. Multilevel models were used to determine the association between state-level income inequality and participation in physical activity and strengthening exercises in the previous month. In comparison to males, females were significantly more likely to report being physically inactive (OR = 1.07, 95% CI = 1.04, 1.11), and less likely to meet aerobic activity requirements (OR = 0.90, 95% CI = 0.88, 0.93), meet strengthening activities (OR = 0.71, 95% CI = 0.69, 0.74), and meet overall physical activity recommendations (OR = 0.91, 95% CI = 0.88, 0.94). Cross-level Gini × sex interactions indicated that income inequality was associated with increased odds for participating in no physical activity (OR = 1.08, 95% CI = 1.05, 1.12), decreased odds in participating in strengthening physical activity (OR = 0.92, 95% CI = 0.89, 0.96), aerobic activity (OR = 0.96, 95% CI = 0.93, 0.99), and in meeting overall physical activity recommendations (OR = 0.93, 95% CI = 0.91, 0.95) among women only. Future studies are needed to identify mechanisms in which income inequality leads to physical activity behavior among US women. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Income Inequality, Socioeconomic Deprivation and Depressive Symptoms among Older Adults in Mexico

PubMed Central

Fernández-Niño, Julián Alfredo; Manrique-Espinoza, Betty Soledad; Bojorquez-Chapela, Ietza; Salinas-Rodríguez, Aarón

2014-01-01

Objective Depression is the second most common mental disorder in older adults (OA) worldwide. The ways in which depression is influenced by the social determinants of health – specifically, by socioeconomic deprivation, income inequality and social capital - have been analyzed with only partially conclusive results thus far. The objective of our study was to estimate the association of income inequality and socioeconomic deprivation at the locality, municipal and state levels with the prevalence of depressive symptoms among OA in Mexico. Methods Cross-sectional study based on a nationally representative sample of 8,874 OA aged 60 and over. We applied the brief seven-item version of the Center for Epidemiologic Studies Depression Scale (CES-D) to determine the presence of depressive symptoms. Additionally, to select the principal context variables, we used the Deprivation Index of the National Population Council of Mexico at the locality, municipal and state levels, and the Gini Index at the municipal and state levels. Finally, we estimated the association of income inequality and socioeconomic deprivation with the presence of depressive symptoms using a multilevel logistic regression model. Results Socioeconomic deprivation at the locality (OR = 1.28; p<0.10) and municipal levels (OR = 1.16; p<0.01) correlated significantly with the presence of depressive symptoms, while income inequality did not. Conclusions The results of our study confirm that the social determinants of health are relevant to the mental health of OA. Further research is required, however, to identify which are the specific socioeconomic deprivation components at the locality and municipal levels that correlate with depression in this population group. PMID:25250620

Improving life expectancy: how many years behind has the USA fallen? A cross-national comparison among high-income countries from 1958 to 2007.

PubMed

Verguet, Stéphane; Jamison, Dean T

2013-01-01

Many studies have documented higher mortality levels in the USA compared to other high-income nations. We add to this discussion by quantifying how many years behind comparison countries the USA has fallen and by identifying when US mortality rates began to diverge. We use full life tables, for men and women, for 17 high-income countries including the USA. We extract the life expectancy at birth and compute the mortality rates for each 5-year age group from birth up to age 80. Using the metric of how many 'years behind' a country has fallen, we compare US mortality levels with those in other high-income countries ('comparators'). We report life expectancy for 17 high-income countries, for the period 1958-2007. Up to the late 1970s, US men and especially women closely tracked comparators in life expectancy. In the late 1970s in the USA, most strikingly women began to diverge from comparators so that the US female life expectancy in 2007 corresponded to that of the comparators' average 10 years earlier. Mortality rates also began to diverge from the late 1970s, and the largest mortality gap was in the 15-49 age group, for both men and women, where the USA had fallen about 40 years behind the comparators by 2007. Some causes proposed for the relatively high US mortality today-racial differences, lack of universal health insurance, US exceptionalism-changed little while the mortality gap emerged and grew. This suggests that explanations for the growing gap lie elsewhere. Quantification of how many years behind the USA has fallen can help provide clues about where to look for potential causes and remedies.

Income Inequality and Intergenerational Income Mobility in the United States

PubMed Central

Bloome, Deirdre

2015-01-01

Is there a relationship between family income inequality and income mobility across generations in the United States? As family income inequality rose in the United States, parental resources available for improving children’s health, education, and care diverged. The amount and rate of divergence also varied across US states. Researchers and policy analysts have expressed concern that relatively high inequality might be accompanied by relatively low mobility, tightening the connection between individuals’ incomes during childhood and adulthood. Using data from the Panel Study of Income Dynamics, the National Longitudinal Survey of Youth, and various government sources, this paper exploits state and cohort variation to estimate the relationship between inequality and mobility. Results provide very little support for the hypothesis that inequality shapes mobility in the United States. The inequality children experienced during youth had no robust association with their economic mobility as adults. Formal analysis reveals that offsetting effects could underlie this result. In theory, mobility-enhancing forces may counterbalance mobility-reducing effects. In practice, the results suggest that in the US context, the intergenerational transmission of income may not be very responsive to changes in inequality. PMID:26388653

Equal Talents, Unequal Opportunities: A Report Card on State Support for Academically Talented Low-Income Students

ERIC Educational Resources Information Center

Plucker, Jonathan; Giancola, Jennifer; Healey, Grace; Arndt, Daniel; Wang, Chen

2015-01-01

Year after year, in every state and community in our nation, students from low-income families are less likely than other students to reach advanced levels of academic performance, even when demonstrating the potential to do so. These income-based "excellence gaps" appear in elementary school and continue through high school. It is a…

Income Inequality and IQ.

ERIC Educational Resources Information Center

Murray, Charles

The importance of intelligence quotient (IQ) to income is analyzed using data from the National Longitudinal Survey of Youth, a study that began in 1979 with 12,686 subjects. Data for this study go through the 1994 interview wave, so that the most recent income data is for 1993. Statistical techniques are used to separate the influence of IQ from…

47 CFR 11.43 - National level participation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false National level participation. 11.43 Section 11...) Organization § 11.43 National level participation. Entities that wish to voluntarily participate in the national level EAS may submit a written request to the Chief, Public Safety and Homeland Security Bureau...

Expanding Federal Funding to Community Health Centers Slows Decline in Access for Low-Income Adults

PubMed Central

McMorrow, Stacey; Zuckerman, Stephen

2014-01-01

Objective To identify the impact of the Health Center Growth Initiative on access to care for low-income adults. Data Sources Data on federal funding for health centers are from the Bureau of Primary Health Care's Uniform Data System (2000–2007), and individual-level measures of access and use are derived from the National Health Interview Survey (2001–2008). Study Design We estimate person-level models of access and use as a function of individual- and market-level characteristics. By using market-level fixed effects, we identify the effects of health center funding on access using changes within markets over time. We explore effects on low-income adults and further examine how those effects vary by insurance coverage. Data Collection We calculate health center funding per poor person in a health care market and attach this information to individual observations on the National Health Interview Survey. Health care markets are defined as hospital referral regions. Principal Findings Low-income adults in markets with larger funding increases were more likely to have an office visit and to have a general doctor visit. These results were stronger for uninsured and publicly insured adults. Conclusions Expansions in federal health center funding had some mitigating effects on the access declines that were generally experienced by low-income adults over this time period. PMID:24344818

Radiologist income, receipts, and academic performance: an analysis of many nations.

PubMed

Semelka, Richard C; Busireddy, K K; Burke, Lauren Mb; Ramalho, Miguel; Martí-Bonmatí, Luis; Morana, Giovanni; AlObaidy, Mamdoh; Elias, Jorge

2016-12-01

Background Considerable interest exists in comparison between healthcare systems across multiple countries, especially where cost enters the discussion. Purpose To evaluate the relationship between radiologists' income, receipts for studies, and academic performance across multiple countries. Material and Methods The annual income of radiologists and receipts for computed tomography (CT) and magnetic resonance imaging (MRI) were obtained based on a survey sent to expert radiologists practicing in 23 countries of varying developmental status. Articles published in generalist radiology journals determined the academic performance of each country. Results Among the developed countries, Canada has the highest estimated annual income for both private ($700,000/year) and university radiologists ($600,000/year) while Spain has the lowest income for private practice ($68,000/year) and Portugal has the lowest income for university practice ($57,300/year). Among the developing countries, Saudi Arabia has the highest incomes for both private ($210,000/year) and university ($140,000/year) radiologists and Vietnam has the lowest incomes for both private ($30,000/year) and university ($6,000/year) radiologists. Total receipts for CT and MRI studies ranged from $80/study (Portugal) to $1000/study (USA) in developed countries, and ranged from $30/study (Egypt) to $700/study (Saudi Arabia) in developing countries. A moderate correlation ( r = 0.482) was seen between radiologist's income and the receipts for combined practice in all countries. The radiology journal academic quotient was highest in The Netherlands among developed countries, and Turkey among developing countries. Conclusion A relatively broad range of radiologists' income is observed among developed and developing countries, which shows correlation with the receipts for advanced imaging studies. Countries with an acceptable compromise between income, receipts, and academic performance, may be the best models for

National Income Inequality and Declining GDP Growth Rates Are Associated with Increases in HIV Diagnoses among People Who Inject Drugs in Europe: A Panel Data Analysis

PubMed Central

Nikolopoulos, Georgios K.; Fotiou, Anastasios; Kanavou, Eleftheria; Richardson, Clive; Detsis, Marios; Pharris, Anastasia; Suk, Jonathan E.; Semenza, Jan C.; Costa-Storti, Claudia; Paraskevis, Dimitrios; Sypsa, Vana; Malliori, Melpomeni-Minerva; Friedman, Samuel R.; Hatzakis, Angelos

2015-01-01

Background There is sparse evidence that demonstrates the association between macro-environmental processes and drug-related HIV epidemics. The present study explores the relationship between economic, socio-economic, policy and structural indicators, and increases in reported HIV infections among people who inject drugs (PWID) in the European Economic Area (EEA). Methods We used panel data (2003–2012) for 30 EEA countries. Statistical analyses included logistic regression models. The dependent variable was taking value 1 if there was an outbreak (significant increase in the national rate of HIV diagnoses in PWID) and 0 otherwise. Explanatory variables included the growth rate of Gross Domestic Product (GDP), the share of the population that is at risk for poverty, the unemployment rate, the Eurostat S80/S20 ratio, the Gini coefficient, the per capita government expenditure on health and social protection, and variables on drug control policy and drug-using population sizes. Lags of one to three years were investigated. Findings In multivariable analyses, using two-year lagged values, we found that a 1% increase of GDP was associated with approximately 30% reduction in the odds of an HIV outbreak. In GDP-adjusted analyses with three-year lagged values, the effect of the national income inequality on the likelihood of an HIV outbreak was significant [S80/S20 Odds Ratio (OR) = 3.89; 95% Confidence Interval (CI): 1.15 to 13.13]. Generally, the multivariable analyses produced similar results across three time lags tested. Interpretation Given the limitations of ecological research, we found that declining economic growth and increasing national income inequality were associated with an elevated probability of a large increase in the number of HIV diagnoses among PWID in EEA countries during the last decade. HIV prevention may be more effective if developed within national and European-level policy contexts that promote income equality, especially among vulnerable

National income inequality and declining GDP growth rates are associated with increases in HIV diagnoses among people who inject drugs in Europe: a panel data analysis.

PubMed

Nikolopoulos, Georgios K; Fotiou, Anastasios; Kanavou, Eleftheria; Richardson, Clive; Detsis, Marios; Pharris, Anastasia; Suk, Jonathan E; Semenza, Jan C; Costa-Storti, Claudia; Paraskevis, Dimitrios; Sypsa, Vana; Malliori, Melpomeni-Minerva; Friedman, Samuel R; Hatzakis, Angelos

2015-01-01

There is sparse evidence that demonstrates the association between macro-environmental processes and drug-related HIV epidemics. The present study explores the relationship between economic, socio-economic, policy and structural indicators, and increases in reported HIV infections among people who inject drugs (PWID) in the European Economic Area (EEA). We used panel data (2003-2012) for 30 EEA countries. Statistical analyses included logistic regression models. The dependent variable was taking value 1 if there was an outbreak (significant increase in the national rate of HIV diagnoses in PWID) and 0 otherwise. Explanatory variables included the growth rate of Gross Domestic Product (GDP), the share of the population that is at risk for poverty, the unemployment rate, the Eurostat S80/S20 ratio, the Gini coefficient, the per capita government expenditure on health and social protection, and variables on drug control policy and drug-using population sizes. Lags of one to three years were investigated. In multivariable analyses, using two-year lagged values, we found that a 1% increase of GDP was associated with approximately 30% reduction in the odds of an HIV outbreak. In GDP-adjusted analyses with three-year lagged values, the effect of the national income inequality on the likelihood of an HIV outbreak was significant [S80/S20 Odds Ratio (OR) = 3.89; 95% Confidence Interval (CI): 1.15 to 13.13]. Generally, the multivariable analyses produced similar results across three time lags tested. Given the limitations of ecological research, we found that declining economic growth and increasing national income inequality were associated with an elevated probability of a large increase in the number of HIV diagnoses among PWID in EEA countries during the last decade. HIV prevention may be more effective if developed within national and European-level policy contexts that promote income equality, especially among vulnerable groups.

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

Diffusion of new medication across different income groups under a universal health insurance program: an example involving newly enlisted nonsteroidal anti-inflammatory drugs for elderly osteoarthritis patients.

PubMed

Wang, Pen-Jen; Chou, Yiing-Jenq; Lee, Cheng-Hua; Pu, Christy

2010-10-01

The aim of this research was to determine whether socioeconomic status, as measured by income level, impacts on the diffusion to patients of newly reimbursed nonsteroidal anti-inflammatory drugs (NSAIDs) under the National Health Insurance program in Taiwan. We used income tax records to identify the income levels of 324 male and 551 female randomly sampled osteoarthritis patients aged over 60 years in 2000. The study period was 2 years (t (1) = April 2001-March 2002 and t (2) = April 2002-March 2003). Generalized estimating equation models were used to analyze the impact of income level on being prescribed one of the newly reimbursed NSAIDs. The impact of income level on being treated with the new drug was positive and significant for females (OR = 2.11, p < 0.01) but not for males. The interaction term between income groups and the time trend was insignificant. Other factors associated with being treated with the new drug include age, habit of health-care utilization, and residential characteristics. Diffusion of new drugs still depends on income level despite the presence of a universal national health insurance system in Taiwan.

Delivering modern, high-quality, affordable pathology and laboratory medicine to low-income and middle-income countries: a call to action.

PubMed

Horton, Susan; Sullivan, Richard; Flanigan, John; Fleming, Kenneth A; Kuti, Modupe A; Looi, Lai Meng; Pai, Sanjay A; Lawler, Mark

2018-05-12

Modern, affordable pathology and laboratory medicine (PALM) systems are essential to achieve the 2030 Sustainable Development Goals for health in low-income and middle-income countries (LMICs). In this last in a Series of three papers about PALM in LMICs, we discuss the policy environment and emphasise three crucial high-level actions that are needed to deliver universal health coverage. First, nations need national strategic laboratory plans; second, these plans require adequate financing for implementation; and last, pathologists themselves need to take on leadership roles to advocate for the centrality of PALM to achieve the Sustainable Development Goals for health. The national strategic laboratory plan should deliver a tiered, networked laboratory system as a central element. Appropriate financing should be provided, at a level of at least 4% of health expenditure. Financing of new technologies such as molecular diagnostics is challenging for LMICs, even though many of these tests are cost-effective. Point-of-care testing can substantially reduce test-reporting time, but this benefit must be balanced with higher costs. Our research analysis highlights a considerable deficiency in advocacy for PALM; pathologists have been invisible in national and international health discourse and leadership. Embedding PALM in LMICs can only be achieved if pathologists advocate for these services, and undertake leadership roles, both nationally and internationally. We articulate eight key recommendations to address the current barriers identified in this Series and issue a call to action for all stakeholders to come together in a global alliance to ensure the effective provision of PALM services in resource-limited settings. Copyright © 2018 Elsevier Ltd. All rights reserved.

National Use of Asbestos in Relation to Economic Development

PubMed Central

Le, Giang Vinh; Takahashi, Ken; Karjalainen, Antti; Delgermaa, Vanya; Hoshuyama, Tsutomu; Miyamura, Yoshitaka; Furuya, Sugio; Higashi, Toshiaki; Pan, Guowei; Wagner, Gregory

2010-01-01

Background National disparities in asbestos use will likely lead to an unequal burden of asbestos diseases. Objectives As economic status may be linked to asbestos use, we assessed, globally, the relationship between indicators of national economic development and asbestos use. Methods For the 135 countries that have ever used asbestos, per capita asbestos use (kilograms per capita per year) was compared with per capita gross domestic product (GDP) in 1990 Geary–Khamis dollars (GKD) for the period 1920–2003. Countries were grouped into three income levels (high, middle, and low) that were adapted from the 2003 World Bank categories. Results The historical pattern of asbestos use followed the environmental Kuznets curve in which use by high-income countries peaked when incomes attained 10,000–15,000 GKD and essentially ceased at income levels over 20,000 GKD. Currently, middle- and low-income countries are increasing their use of asbestos, closely following the paths once traced by higher income countries. Conclusions Developing countries have the opportunity to eliminate asbestos use sooner than high-income countries and thus reduce the future burden of asbestos diseases. PMID:20056590

Associations between national viral hepatitis policies/programmes and country-level socioeconomic factors: a sub-analysis of data from the 2013 WHO viral hepatitis policy report.

PubMed

Lazarus, Jeffrey V; Sperle, Ida; Safreed-Harmon, Kelly; Gore, Charles; Cebolla, Beatriz; Spina, Alexander

2017-07-26

As more countries worldwide develop national viral hepatitis strategies, it is important to ask whether context-specific factors affect their decision-making. This study aimed to determine whether country-level socioeconomic factors are associated with viral hepatitis programmes and policy responses across WHO Member States (MS). WHO MS focal points completed a questionnaire on national viral hepatitis policies. This secondary analysis of data reported in the 2013 Global Policy Report on the Prevention and Control of Viral Hepatitis in WHO Member States used logistic regression to examine associations between four survey questions and four socioeconomic factors: country income level, Human Development Index (HDI), health expenditure and physician density. This analysis included 119 MS. MS were more likely to have routine viral hepatitis surveillance and to have a national strategy and/or policy/guidelines for preventing infection in healthcare settings if they were in the higher binary categories for income level, HDI, health expenditure and physician density. In multivariable analyses, the only significant finding was a positive association between having routine surveillance and being in the higher binary HDI category (adjusted odds ratio 26; 95% confidence interval 2.0-340). Countries with differing socioeconomic status indicators did not appear to differ greatly regarding the existence of key national policies and programmes. A more nuanced understanding of the multifaceted interactions of socioeconomic factors, health policy, service delivery and health outcomes is needed to support country-level efforts to eliminate viral hepatitis.

Income Inequality and Adolescent Gambling Severity: Findings from a Large-Scale Italian Representative Survey

PubMed Central

Canale, Natale; Vieno, Alessio; Lenzi, Michela; Griffiths, Mark D.; Borraccino, Alberto; Lazzeri, Giacomo; Lemma, Patrizia; Scacchi, Luca; Santinello, Massimo

2017-01-01

Background: Studies have shown that problems related to adult gambling have a geographical and social gradient. For instance, adults experiencing gambling-related harms live in areas of greater deprivation; are unemployed, and have lower income. However, little is known about the impact of socioeconomic inequalities on adolescent problem gambling. The main purpose of the present study was to investigate the contextual influences of income inequality on at-risk or problem gambling (ARPG) in a large-scale nationally representative sample of Italian adolescents. A secondary aim was to analyze the association between perceived social support (from family, peers, teachers, and classmates) and ARPG. Methods: Data from the 2013–2014 Health Behavior in School-aged Children Survey (HBSC) Study was used for cross-sectional analyses of ARPG. A total of 20,791 15-year-old students completed self-administered questionnaires. Region-level data on income inequality (GINI index) and overall wealth (GDP per capita) were retrieved from the National Institute of Statistics (Istat). The data were analyzed using the multi-level logistic regression analysis, with students at the first level and regions at the second level. Results: The study demonstrated a North–South gradient for the prevalence of ARPG, with higher prevalence of ARPG in the Southern/Islands/Central Regions (e.g., 11% in Sicily) than in Northern Italy (e.g., 2% in Aosta Valley). Students in regions of high-income inequality were significantly more likely than those in regions of low-income inequality to be at-risk or problem gamblers (following adjustment for sex, family structure, family affluence, perceived social support, and regionale wealth). Additionally, perceived social support from parents and teachers were negatively related to ARPG. Conclusions: Income inequality may have a contextual influence on ARPG. More specifically, living in regions of highest income inequality appeared to be a potential factor

State-level variations in income-related inequality in health and health achievement in the US.

PubMed

Xu, Ke Tom

2006-07-01

The objective of this study was to examine state-level variations in income-related inequality in health and overall health achievement in the US. Data that were representative of the US and each state in 2001 were extracted from the Current Population Survey 2001. Income-related inequality in health and health achievement were measured by Health Concentration and Health Achievement Indices, respectively. Significant variations were found across states in income-related inequality in health and health achievement. In particular, states in the south and east regions, on average, experienced a higher degree of health inequality and lower health achievement. About 80% of the state-level variation in health achievement could be explained by demographics, economic structure and performance, and state and local government spending and burden. In contrast, medical care resource indicators were not found to contribute to health achievement in states. States with better health achievement were more urbanized, had lower proportions of minority groups, females and the elderly, fewer individuals below the poverty line, larger primary industry, and lower unemployment rates. Also, per capita state and local government spending, particularly the proportion spent on public health, was positively associated with better health achievement. Because of the direct implications of health level and distribution in resource allocation and social norms, states with a lower level of health achievement need to prioritize efforts in increasing and reallocating resources to diminish health inequality and to improve population health.

Excess mortality in women of reproductive age from low-income countries: a Swedish national register study.

PubMed

Esscher, Annika; Haglund, Bengt; Högberg, Ulf; Essén, Birgitta

2013-04-01

Cause-of-death statistics is widely used to monitor the health of a population. African immigrants have, in several European studies, shown to be at an increased risk of maternal death, but few studies have investigated cause-specific mortality rates in female immigrants. In this national study, based on the Swedish Cause of Death Register, we studied 27,957 women of reproductive age (aged 15-49 years) who died between 1988 and 2007. Age-standardized mortality rates per 100,000 person years and relative risks for death and underlying causes of death, grouped according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, were calculated and compared between women born in Sweden and in low-, middle- and high-income countries. The total age-standardized mortality rate per 100,000 person years was significantly higher for women born in low-income (84.4) and high-income countries (83.7), but lower for women born in middle-income countries (57.5), as compared with Swedish-born women (68.1). The relative risk of dying from infectious disease was 15.0 (95% confidence interval 10.8-20.7) and diseases related to pregnancy was 6.6 (95% confidence interval 2.6-16.5) for women born in low-income countries, as compared to Swedish-born women. Women born in low-income countries are at the highest risk of dying during reproductive age in Sweden, with the largest discrepancy in mortality rates seen for infectious diseases and diseases related to pregnancy, a cause of death pattern similar to the one in their countries of birth. The World Bank classification of economies may be a useful tool in migration research.

Excess mortality in women of reproductive age from low-income countries: a Swedish national register study

PubMed Central

Haglund, Bengt; Högberg, Ulf; Essén, Birgitta

2013-01-01

Background: Cause-of-death statistics is widely used to monitor the health of a population. African immigrants have, in several European studies, shown to be at an increased risk of maternal death, but few studies have investigated cause-specific mortality rates in female immigrants. Methods: In this national study, based on the Swedish Cause of Death Register, we studied 27 957 women of reproductive age (aged 15–49 years) who died between 1988 and 2007. Age-standardized mortality rates per 100 000 person years and relative risks for death and underlying causes of death, grouped according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, were calculated and compared between women born in Sweden and in low-, middle- and high-income countries. Results: The total age-standardized mortality rate per 100 000 person years was significantly higher for women born in low-income (84.4) and high-income countries (83.7), but lower for women born in middle-income countries (57.5), as compared with Swedish-born women (68.1). The relative risk of dying from infectious disease was 15.0 (95% confidence interval 10.8–20.7) and diseases related to pregnancy was 6.6 (95% confidence interval 2.6–16.5) for women born in low-income countries, as compared to Swedish-born women. Conclusions: Women born in low-income countries are at the highest risk of dying during reproductive age in Sweden, with the largest discrepancy in mortality rates seen for infectious diseases and diseases related to pregnancy, a cause of death pattern similar to the one in their countries of birth. The World Bank classification of economies may be a useful tool in migration research. PMID:22850186

Developing national obesity policy in middle-income countries: a case study from North Africa

PubMed Central

Holdsworth, Michelle; El Ati, Jalila; Bour, Abdellatif; Kameli, Yves; Derouiche, Abdelfettah; Millstone, Erik; Delpeuch, Francis

2013-01-01

Background The prevalence of overweight and obesity is a rapidly growing threat to public health in both Morocco and Tunisia, where it is reaching similar proportions to high-income countries. Despite this, a national strategy for obesity does not exist in either country. The aim of this study was to explore the views of key stakeholders towards a range of policies to prevent obesity, and thus guide policy makers in their decision making on a national level. Methods Using Multicriteria Mapping, data were gathered from 82 stakeholders (from 33 categories in Morocco and 36 in Tunisia) who appraised 12 obesity policy options by reference to criteria of their own choosing. Results The feasibility of policies in practical or political terms and their cost were perceived as more important than how effective they would be in reducing obesity. There was most consensus and preference for options targeting individuals through health education, compared with options that aimed at changing the environment, i.e. modifying food supply and demand (providing healthier menus/changing food composition/food sold in schools); controlling information (advertising controls/mandatory labelling) or improving access to physical activity. In Tunisia, there was almost universal consensus that at least some environmental-level options are required, but in Morocco, participants highlighted the need to raise awareness within the population and policy makers that obesity is a public health problem, accompanied by improving literacy before such measures would be accepted. Conclusion Whilst there is broad interest in a range of policy options, those measures targeting behaviour change through education were most valued. The different socioeconomic, political and cultural contexts of countries need to be accounted for when prioritizing obesity policy. Obesity was not recognized as a major public health priority; therefore, convincing policy makers about the need to prioritize action to prevent

Income inequality in today's China.

PubMed

Xie, Yu; Zhou, Xiang

2014-05-13

Using multiple data sources, we establish that China's income inequality since 2005 has reached very high levels, with the Gini coefficient in the range of 0.53-0.55. Analyzing comparable survey data collected in 2010 in China and the United States, we examine social determinants that help explain China's high income inequality. Our results indicate that a substantial part of China's high income inequality is due to regional disparities and the rural-urban gap. The contributions of these two structural forces are particularly strong in China, but they play a negligible role in generating the overall income inequality in the United States, where individual-level and family-level income determinants, such as family structure and race/ethnicity, play a much larger role.

Personality and happiness: a national-level analysis.

PubMed

Steel, Piers; Ones, Deniz S

2002-09-01

The possibility that national personality traits could explain national subjective well-being (SWB) is controversial, with many researchers arguing that traits are irrelevant to any national-level analysis. The weaknesses of this standpoint are reviewed, followed by a series of empirical investigations. Using Eysenck's 3-factor model (H. J. Eysenck & S. B. G. Eysenck, 1975) and P. T. Costa and R. M. McCrae's (1992b) 5-factor model, the authors found that Neuroticism and Extraversion correlated significantly with national SWB. Lie scale scores were also related strongly to national SWB. Neuroticism and Extraversion incrementally predicted SWB above gross national product per capita. The strength of these results indicates that personality can have stronger relationships at national levels of analysis than at the individual level. National personality traits appear to be unwisely neglected, having considerable but largely unconsidered explanatory power.

Predictors of Incomes. AIR Forum 1981 Paper.

ERIC Educational Resources Information Center

Witmer, David R.

Income predictions that provide some indication of the potential value of attending college are considered. Standard multiple regression analysis of data describing the income experiences of men 25 years old and older were used to determine differences in incomes of high school and college graduates. Information on the gross national product was…

The My Child Matters programme: effect of public-private partnerships on paediatric cancer care in low-income and middle-income countries.

PubMed

Howard, Scott C; Zaidi, Alia; Cao, Xueyuan; Weil, Olivier; Bey, Pierre; Patte, Catherine; Samudio, Angelica; Haddad, Laurie; Lam, Catherine G; Moreira, Claude; Pereira, Augusto; Harif, Mhamed; Hessissen, Laila; Choudhury, Salma; Fu, Ligia; Caniza, Miguela A; Lecciones, Julius; Traore, Fousseyni; Ribeiro, Raul C; Gagnepain-Lacheteau, Anne

2018-05-01

In low-income and middle-income countries, an excess in treatment failure for children with cancer usually results from misdiagnosis, inadequate access to treatment, death from toxicity, treatment abandonment, and relapse. The My Child Matters programme of the Sanofi Espoir Foundation has funded 55 paediatric cancer projects in low-income and middle-income countries over 10 years. We assessed the impact of the projects in these regions by using baseline assessments that were done in 2006. Based on these data, estimated 5-year survival in 2016 increased by a median of 5·1%, ranging from -1·5% in Venezuela to 17·5% in Ukraine. Of the 26 861 children per year who develop cancer in the ten index countries with My Child Matters projects that were evaluated in 2006, an estimated additional 1343 children can now expect an increase in survival outcome. For example, in Paraguay, a network of paediatric oncology satellite clinics was established and scaled up to a national level and has managed 884 patients since initiation in 2006. Additionally, the African Retinoblastoma Network was scaled up from a demonstration project in Mali to a network of retinoblastoma referral centres in five sub-Saharan African countries, and the African School of Paediatric Oncology has trained 42 physicians and 100 nurses from 16 countries. The My Child Matters programme has catalysed improvements in cancer care and has complemented the efforts of government, civil society, and the private sector to sustain and scale improvements in health care to a national level. Key elements of successful interventions include strong and sustained local leadership, community engagement, international engagement, and capacity building and support from government. Copyright © 2018 Elsevier Ltd. All rights reserved.

High economic inequality leads higher-income individuals to be less generous

PubMed Central

Côté, Stéphane; House, Julian; Willer, Robb

2015-01-01

Research on social class and generosity suggests that higher-income individuals are less generous than poorer individuals. We propose that this pattern emerges only under conditions of high economic inequality, contexts that can foster a sense of entitlement among higher-income individuals that, in turn, reduces their generosity. Analyzing results of a unique nationally representative survey that included a real-stakes giving opportunity (n = 1,498), we found that in the most unequal US states, higher-income respondents were less generous than lower-income respondents. In the least unequal states, however, higher-income individuals were more generous. To better establish causality, we next conducted an experiment (n = 704) in which apparent levels of economic inequality in participants’ home states were portrayed as either relatively high or low. Participants were then presented with a giving opportunity. Higher-income participants were less generous than lower-income participants when inequality was portrayed as relatively high, but there was no association between income and generosity when inequality was portrayed as relatively low. This research finds that the tendency for higher-income individuals to be less generous pertains only when inequality is high, challenging the view that higher-income individuals are necessarily more selfish, and suggesting a previously undocumented way in which inequitable resource distributions undermine collective welfare. PMID:26598668

High economic inequality leads higher-income individuals to be less generous.

PubMed

Côté, Stéphane; House, Julian; Willer, Robb

2015-12-29

Research on social class and generosity suggests that higher-income individuals are less generous than poorer individuals. We propose that this pattern emerges only under conditions of high economic inequality, contexts that can foster a sense of entitlement among higher-income individuals that, in turn, reduces their generosity. Analyzing results of a unique nationally representative survey that included a real-stakes giving opportunity (n = 1,498), we found that in the most unequal US states, higher-income respondents were less generous than lower-income respondents. In the least unequal states, however, higher-income individuals were more generous. To better establish causality, we next conducted an experiment (n = 704) in which apparent levels of economic inequality in participants' home states were portrayed as either relatively high or low. Participants were then presented with a giving opportunity. Higher-income participants were less generous than lower-income participants when inequality was portrayed as relatively high, but there was no association between income and generosity when inequality was portrayed as relatively low. This research finds that the tendency for higher-income individuals to be less generous pertains only when inequality is high, challenging the view that higher-income individuals are necessarily more selfish, and suggesting a previously undocumented way in which inequitable resource distributions undermine collective welfare.

The United States Leads Other Nations In Differences By Income In Perceptions Of Health And Health Care.

PubMed

Hero, Joachim O; Zaslavsky, Alan M; Blendon, Robert J

2017-06-01

We examined income gaps in the period 2011-13 in self-assessments of personal health and health care across thirty-two middle- and high-income countries. While high-income respondents were generally more positive about their health and health care in most countries, the gap between them and low-income respondents was much bigger in some than in others. The United States has among the largest income-related differences in each of the measures we studied, which assessed both respondents' past experiences and their confidence about accessing needed health care in the future. Relatively low levels of moral discomfort over income-based health care disparities despite broad awareness of unmet need indicate more public tolerance for health care inequalities in the United States than elsewhere. Nonetheless, over half of Americans felt that income-based health care inequalities are unfair, and these respondents were significantly more likely than their compatriots to support major health system reform-differences that reflect the country's political divisions. Given the many provisions in the Affordable Care Act that seek to reduce disparities, any replacement would also require attention to disparities or risk taking a step backward in an area where the United States is in sore need of improvement. Project HOPE—The People-to-People Health Foundation, Inc.

Financing universal health coverage--effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries.

PubMed

Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

2015-07-18

How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995-2011. Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9.86 (95% CI 3.92-15.8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16.7, 9.16 to 24.3), but not for consumption taxes on goods and services (-$4.37, -12.9 to 4.11). In countries with low tax revenues (<$1000 per capita per year), an additional $100 tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6.74 percentage points (95% CI 0.87-12.6) and the extent of financial coverage by 11.4 percentage points (5.51-17.2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for higher consumption taxes. Progressive tax policies within a pro-poor framework

Cynical beliefs about human nature and income: Longitudinal and cross-cultural analyses.

PubMed

Stavrova, Olga; Ehlebracht, Daniel

2016-01-01

Based on the existing literature on worldview beliefs, cynical hostility, and Machiavellian cynicism, we suggest that holding cynical beliefs about human nature can be detrimental for individuals' income. Cynical individuals are more likely to avoid cooperation and trust or to overinvest in monitoring, control, and other means of protection from potential exploitation. As a result, they are more likely to forgo valuable opportunities for cooperation and consequently less likely to reap the benefits of joint efforts and mutual help compared with their less cynical counterparts. Studies 1 and 2, using nationally representative longitudinal surveys of the American population, show that individuals who endorsed cynical beliefs about human nature at baseline earned comparatively lower incomes 9 (Study 1) and 2 (Study 2) years later. In Study 3, applying a multilevel model of change to a nationally representative panel study of the German population, we show that cynical beliefs at baseline undermined an income increase in the course of the following 9 years. In Study 4, the negative effect of cynical beliefs on income proved to be independent of individual differences in the Big Five personality dimensions. Study 5 provided the first tentative evidence of the hypothesized mechanism underlying this effect. Using survey data from 41 countries, it revealed that the negative effect of cynical beliefs on income is alleviated in sociocultural contexts with low levels of prosocial behavior, high homicide rates and high overall societal cynicism levels. Holding cynical beliefs about others has negative economic outcomes unless such beliefs hold true. (c) 2016 APA, all rights reserved).

Changes in Income at Macro Level Predict Sex Ratio at Birth in OECD Countries.

PubMed

Kanninen, Ohto; Karhula, Aleksi

2016-01-01

The human sex ratio at birth (SRB) is approximately 107 boys for every 100 girls. SRB was rising until the World War II and has been declining slightly after the 1950s in several industrial countries. Recent studies have shown that SRB varies according to exposure to disasters and socioeconomic conditions. However, it remains unknown whether changes in SRB can be explained by observable macro-level socioeconomic variables across multiple years and countries. Here we show that changes in disposable income at the macro level positively predict SRB in OECD countries. A one standard deviation increase in the change of disposable income is associated with an increase of 1.03 male births per 1000 female births. The relationship is possibly nonlinear and driven by extreme changes. The association varies from country to country being particular strong in Estonia. This is the first evidence to show that economic and social conditions are connected to SRB across countries at the macro level. This calls for further research on the effects of societal conditions on general characteristics at birth.

Improving life expectancy: how many years behind has the USA fallen? A cross-national comparison among high-income countries from 1958 to 2007

PubMed Central

Verguet, Stéphane; Jamison, Dean T

2013-01-01

Objective Many studies have documented higher mortality levels in the USA compared to other high-income nations. We add to this discussion by quantifying how many years behind comparison countries the USA has fallen and by identifying when US mortality rates began to diverge. Design We use full life tables, for men and women, for 17 high-income countries including the USA. We extract the life expectancy at birth and compute the mortality rates for each 5-year age group from birth up to age 80. Using the metric of how many ‘years behind’ a country has fallen, we compare US mortality levels with those in other high-income countries (‘comparators’). Results We report life expectancy for 17 high-income countries, for the period 1958–2007. Up to the late 1970s, US men and especially women closely tracked comparators in life expectancy. In the late 1970s in the USA, most strikingly women began to diverge from comparators so that the US female life expectancy in 2007 corresponded to that of the comparators’ average 10 years earlier. Mortality rates also began to diverge from the late 1970s, and the largest mortality gap was in the 15–49 age group, for both men and women, where the USA had fallen about 40 years behind the comparators by 2007. Conclusions Some causes proposed for the relatively high US mortality today—racial differences, lack of universal health insurance, US exceptionalism—changed little while the mortality gap emerged and grew. This suggests that explanations for the growing gap lie elsewhere. Quantification of how many years behind the USA has fallen can help provide clues about where to look for potential causes and remedies. PMID:23833143

Cigarette characteristic and emission variations across high-, middle- and low-income countries.

PubMed

O'Connor, R J; Wilkins, K J; Caruso, R V; Cummings, K M; Kozlowski, L T

2010-12-01

The public health burden of tobacco use is shifting to the developing world, and the tobacco industry may apply some of its successful marketing tactics, such as allaying health concerns with product modifications. This study used standard smoking machine tests to examine the extent to which the industry is introducing engineering features that reduce tar and nicotine to cigarettes sold in middle- and low-income countries. Multicountry observational study. Cigarettes from 10 different countries were purchased in 2005 and 2007 with low-, middle- and high-income countries identified using the World Bank's per capita gross national income metric. Physical measurements of each brand were tested, and tobacco moisture and weight, paper porosity, filter ventilation and pressure drop were analysed. Tar, nicotine and carbon monoxide emission levels were determined for each brand using International Organization for Standardization and Canadian Intensive methods. Statistical analyses were performed using Statistical Package for the Social Sciences. Among cigarette brands with filters, more brands were ventilated in high-income countries compared with middle- and low-income countries [χ(2)(4)=25.92, P<0.001]. Low-income brands differed from high- and middle-income brands in engineering features such as filter density, ventilation and paper porosity, while tobacco weight and density measures separated the middle- and high-income groups. Smoke emissions differed across income groups, but these differences were largely negated when one accounted for design features. This study showed that as a country's income level increases, cigarettes become more highly engineered and the emissions levels decrease. In order to reduce the burden of tobacco-related disease and further effective product regulation, health officials must understand cigarette design and function within and between countries. Copyright © 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All

Cigarette characteristic and emission variations across high-, middle- and low-income countries

PubMed Central

O’Connor, R.J.; Wilkins, K.J.; Caruso, R.V.; Cummings, K.M.; Kozlowski, L.T.

2010-01-01

SUMMARY Objectives The public health burden of tobacco use is shifting to the developing world, and the tobacco industry may apply some of its successful marketing tactics, such as allaying health concerns with product modifications. This study used standard smoking machine tests to examine the extent to which the industry is introducing engineering features that reduce tar and nicotine to cigarettes sold in middle- and low-income countries. Study design Multicountry observational study. Methods Cigarettes from 10 different countries were purchased in 2005 and 2007 with low-, middle- and high-income countries identified using the World Bank’s per-capita gross national income metric. Physical measurements of each brand were tested, and tobacco moisture and weight, paper porosity, filter ventilation and pressure drop were analysed. Tar, nicotine and carbon monoxide emission levels were determined for each brand using International Organization for Standardization and Canadian Intensive methods. Statistical analyses were performed using Statistical Package for the Social Sciences. Results Among cigarette brands with filters, more brands were ventilated in high-income countries compared with middle- and low-income countries [χ2(4)=25.92, P<0.001]. Low-income brands differed from high- and middle-income brands in engineering features such as filter density, ventilation and paper porosity, while tobacco weight and density measures separated the middle- and high-income groups. Smoke emissions differed across income groups, but these differences were largely negated when one accounted for design features. Conclusions This study showed that as a country’s income level increases, cigarettes become more highly engineered and the emissions levels decrease. In order to reduce the burden of tobacco-related disease and further effective product regulation, health officials must understand cigarette design and function within and between countries. PMID:21030055

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).

A Swiss paradox? Higher income inequality of municipalities is associated with lower mortality in Switzerland.

PubMed

Clough-Gorr, Kerri M; Egger, Matthias; Spoerri, Adrian

2015-08-01

It has long been surmised that income inequality within a society negatively affects public health. However, more recent studies suggest there is no association, especially when analyzing small areas. This study aimed to evaluate the effect of income inequality on mortality in Switzerland using the Gini index on municipality level. The study population included all individuals >30 years at the 2000 Swiss census (N = 4,689,545) living in 2,740 municipalities with 35.5 million person-years of follow-up and 456,211 deaths over follow-up. Cox proportional hazard regression models were adjusted for age, gender, marital status, nationality, urbanization, and language region. Results were reported as hazard ratios (HR) with 95% confidence intervals. The mean Gini index across all municipalities was 0.377 (standard deviation 0.062, range 0.202-0.785). Larger cities, high-income municipalities and tourist areas had higher Gini indices. Higher income inequality was consistently associated with lower mortality risk, except for death from external causes. Adjusting for sex, marital status, nationality, urbanization and language region only slightly attenuated effects. In fully adjusted models, hazards of all-cause mortality by increasing Gini index quintile were HR = 0.99 (0.98-1.00), HR = 0.98 (0.97-0.99), HR = 0.95 (0.94-0.96), HR = 0.91 (0.90-0.92) compared to the lowest quintile. The relationship of income inequality with mortality in Switzerland is contradictory to what has been found in other developed high-income countries. Our results challenge current beliefs about the effect of income inequality on mortality on small area level. Further investigation is required to expose the underlying relationship between income inequality and population health.

Income inequality and the developing child: Is it all relative?

PubMed

Odgers, Candice L

2015-11-01

Children from low-income families are at heightened risk for a number of poor outcomes, including depression, antisocial behavior, poor physical health, and educational failure. Growing up in poverty is generally seen as toxic for children. However, less is known about how the "economic distance" between children and their peers influences behavior and health. This article examines how both poverty and the growing divide between low-income children and their peers may be influencing low-income children's life chances. Among wealthy nations, children in countries with higher levels of income inequality consistently fare worse on multiple indices of health, educational attainment, and well-being. New research also suggests that low-income children may be experiencing worse outcomes, and a form of "double disadvantage," when they live and attend school alongside more affluent versus similarly positioned peers. The role of subjective social status in explaining why some low-income children appear to suffer when growing up alongside more affluent peers is explored, alongside a call for additional research focused on how children come to understand, and respond to, their perceived social status. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

Sex differences in genetic and environmental influences on educational attainment and income.

PubMed

Orstavik, Ragnhild E; Czajkowski, Nikolai; Røysamb, Espen; Knudsen, Gun Peggy; Tambs, Kristian; Reichborn-Kjennerud, Ted

2014-12-01

In many Western countries, women now reach educational levels comparable to men, although their income remains considerably lower. For the past decades, it has become increasingly clear that these measures of socio-economic status are influenced by genetic as well as environmental factors. Less is known about the relationship between education and income, and sex differences. The aim of this study was to explore genetic and environmental factors influencing education and income in a large cohort of young Norwegian twins, with special emphasis on gender differences. National register data on educational level and income were obtained for 7,710 twins (aged 29-41 years). Bivariate Cholesky models were applied to estimate qualitative and quantitative gender differences in genetic and environmental influences, the relative contribution of genetic and environmental factors to the correlation between education and income, and genetic correlations within and between sexes and phenotypes. The phenotypic correlation between educational level and income was 0.34 (0.32-0.39) for men and 0.45 (0.43-0.48) for women. An ACE model with both qualitative and quantitative sex differences fitted the data best. The genetic correlation between men and women (rg) was 0.66 (0.22-1.00) for educational attainment and 0.38 (0.01-0.75) for income, and between the two phenotypes 0.31 (0.08-0.52) for men and 0.72 (0.64-0.85) for women. Our results imply that, in relatively egalitarian societies with state-supported access to higher education and political awareness of gender equality, genetic factors may play an important role in explaining sex differences in the relationship between education and income.

Food insecurity and low income in an English inner city.

PubMed

Tingay, Richard S; Tan, Chuan Jin; Tan, Neil C W; Tang, Stephen; Teoh, Pei Fen; Wong, Rebecca; Gulliford, Martin C

2003-06-01

Low incomes may not provide the minimum requirements for healthy living. We evaluated experiences of food insecurity in relation to income in inner London. Subjects attending 10 general medical practices completed a short self-administered questionnaire, including the short form Household Food Security Scale and a short food frequency questionnaire. Responses were obtained from 431/495 (87 per cent) subjects. Overall 87 (20 per cent) of subjects were classified as food insecure. Food insecurity was negatively associated with household income (p = 0.004). University-educated subjects (8 per cent) were less often food insecure than all others (26 per cent). Subjects who were food insecure were less likely to report eating fruit daily (food secure 48 per cent, food insecure 33 per cent, p = 0.017) or vegetables or salads daily (food secure 56 per cent, food insecure 34 per cent, p = 0.002). Experiences of food insecurity may be common in households with incomes at the level of the UK national minimum wage or lower.

The Effects of Education Quality on Income Growth and Mortality Decline

ERIC Educational Resources Information Center

Jamison, Eliot A.; Jamison, Dean T.; Hanushek, Eric A.

2007-01-01

Previous work shows that higher levels of education quality (as measured by international student achievement tests) increase growth rates of national income. This paper begins by confirming those findings in an analysis involving more countries over more time with additional controls. We then use the panel structure of our data to assess whether…

Correlates of healthy life expectancy in low- and lower-middle-income countries.

PubMed

Islam, Md Shariful; Mondal, Md Nazrul Islam; Tareque, Md Ismail; Rahman, Md Aminur; Hoque, Md Nazrul; Ahmed, Md Munsur; Khan, Hafiz T A

2018-04-11

Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries. In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives. The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors. To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.

Explaining the Growth in US Health Care Spending Using State-Level Variation in Income, Insurance, and Provider Market Dynamics

PubMed Central

Herring, Bradley; Trish, Erin

2015-01-01

The slowed growth in national health care spending over the past decade has led analysts to question the extent to which this recent slowdown can be explained by predictable factors such as the Great Recession or must be driven by some unpredictable structural change in the health care sector. To help address this question, we first estimate a regression model for state personal health care spending for 1991-2009, with an emphasis on the explanatory power of income, insurance, and provider market characteristics. We then use the results from this simple predictive model to produce state-level projections of health care spending for 2010-2013 to subsequently compare those average projected state values with actual national spending for 2010-2013, finding that at least 70% of the recent slowdown in health care spending can likely be explained by long-standing patterns. We also use the results from this predictive model to both examine the Great Recession’s likely reduction in health care spending and project the Affordable Care Act’s insurance expansion’s likely increase in health care spending. PMID:26655685

Income and Independence Effects on Marital Dissolution: Results from the Seattle and Denver Income-Maintenance Experiments.

ERIC Educational Resources Information Center

Hannan, Michael T.; And Others

1978-01-01

Discusses effects of income and income fluctuation on marital dissolution. Data are based on a model of nonlinear income and independence effects. Findings indicated that effects of an income maintenance program on marital dissolution depend upon the payment a couple receives, income before the program, level of the wife's independence, and…

Bhutan's National ECCD Impact Evaluation: Local, National, and Global Perspectives

ERIC Educational Resources Information Center

Pisani, Lauren; Dyenka, Karma; Sharma, Parvati; Chhetri, Nar; Dang, Sara; Gayleg, Karma; Wangdi, Chencho

2017-01-01

Early childhood care and development (ECCD) services have been steadily expanding with structures on the community, national, and international levels. However, many low- and middle-income countries still have very limited ECCD coverage, and there is a lack of global guidance on best practices for effectively expanding pre-primary education. In…

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.

Comparing the Income Elasticity of Health Spending in Middle-Income and High-Income Countries: The Role of Financial Protection

PubMed Central

Vargas Bustamante, Arturo; Shimoga, Sandhya V.

2018-01-01

Background: As middle-income countries become more affluent, economically sophisticated and productive, health expenditure patterns are likely to change. Other socio-demographic and political changes that accompany rapid economic growth are also likely to influence health spending and financial protection. Methods: This study investigates the relationship between growth on per-capita healthcare expenditure and gross domestic product (GDP) in a group of 27 large middle-income economies and compares findings with those of 24 high-income economies from the Organization for Economic Cooperation and Development (OECD) group. This comparison uses national accounts data from 1995-2014. We hypothesize that the aggregated income elasticity of health expenditure in middle-income countries would be less than one (meaning healthcare is a normal good). An initial exploratory analysis tests between fixed-effects and random-effects model specifications. A fixed-effects model with time-fixed effects is implemented to assess the relationship between the two measures. Unit root, Hausman and serial correlation tests are conducted to determine model fit. Additional explanatory variables are introduced in different model specifications to test the robustness of our regression results. We include the out-of-pocket (OOP) share of health spending in each model to study the potential role of financial protection in our sample of high- and middle-income countries. The first-difference of study variables is implemented to address non-stationarity and cointegration properties. Results: The elasticity of per-capita health expenditure and GDP growth is positive and statistically significant among sampled middle-income countries (51 per unit-growth in GDP) and high-income countries (50 per unit-growth in GDP). In contrast with previous research that has found that income elasticity of health spending in middle-income countries is larger than in high-income countries, our findings show that

The associations between US state and local social spending, income inequality, and individual all-cause and cause-specific mortality: The National Longitudinal Mortality Study.

PubMed

Kim, Daniel

2016-03-01

To investigate government state and local spending on public goods and income inequality as predictors of the risks of dying. Data on 431,637 adults aged 30-74 and 375,354 adults aged 20-44 in the 48 contiguous US states were used from the National Longitudinal Mortality Study to estimate the impacts of state and local spending and income inequality on individual risks of all-cause and cause-specific mortality for leading causes of death in younger and middle-aged adults and older adults. To reduce bias, models incorporated state fixed effects and instrumental variables. Each additional $250 per capita per year spent on welfare predicted a 3-percentage point (-0.031, 95% CI: -0.059, -0.0027) lower probability of dying from any cause. Each additional $250 per capita spent on welfare and education predicted 1.6-percentage point (-0.016, 95% CI: -0.031, -0.0011) and 0.8-percentage point (-0.008, 95% CI: -0.0156, -0.00024) lower probabilities of dying from coronary heart disease (CHD), respectively. No associations were found for colon cancer or chronic obstructive pulmonary disease; for diabetes, external injury, and suicide, estimates were inverse but modest in magnitude. A 0.1 higher Gini coefficient (higher income inequality) predicted 1-percentage point (0.010, 95% CI: 0.0026, 0.0180) and 0.2-percentage point (0.002, 95% CI: 0.001, 0.002) higher probabilities of dying from CHD and suicide, respectively. Empirical linkages were identified between state-level spending on welfare and education and lower individual risks of dying, particularly from CHD and all causes combined. State-level income inequality predicted higher risks of dying from CHD and suicide. Copyright © 2015 The Author. Published by Elsevier Inc. All rights reserved.

An Overview of Food Patterns and Diet Quality in Qatar: Findings from the National Household Income Expenditure Survey.

PubMed

Al-Thani, Mohammed; Al-Thani, Al-Anoud; Al-Mahdi, Nasser; Al-Kareem, Hefzi; Barakat, Darine; Al-Chetachi, Walaa; Tawfik, Afaf; Akram, Hammad

2017-05-15

Availability of accurate data pertaining to a population's dietary patterns and associated health outcomes is critical for proper development and implementation of related policies. This article is a first attempt to share the food patterns, amounts and diet quality among households (HH) in Qatar. Data from the 2012-2013 Qatar National Household Income and Expenditure Survey (HIES) was used. This cross-sectional survey included 3723 HH (1826 Qatari HH and 1897 non-Qatari HH). Dietary data on monthly amounts food items available at HH according to the nationality was used. The food items were expressed in terms of grams per capita per day and aggregated into groups to examine the food patterns, energy, and adequacy. The overall average amount of purchased food at HH in Qatar was 1885 g/capita/day. Qatari HH purchased more food (2118 g/capita/day) versus non-Qataris (1373 g/capita/day); however, the percentages of the amounts purchased by food types were similar among both nationalities. Average daily energy (kcal) per capita was almost double among Qatari HH (4275 kcal) vs. non-Qatari HH (2424 kcal). The food items under subsidy program for Qatari citizens provided 1753 kcal/capita/day and accounted for 41% of total daily energy. Proteins (29.2), fats (39.2), sodium (3.3), and vitamin C (32.5) had higher than recommended levels of nutrient density (grams per 1000 kcal). Calcium (227), vitamin A (302.3), fiber (2.0), and carbohydrates (132.6) had lower than recommended levels of nutrient energy density (g/1000 kcal). The study predicts unhealthy dietary habits among HH in Qatar and provides useful information for policy makers and healthcare community.

Challenges in managing infections among pediatric cancer patients: Suboptimal national essential medicines lists for low and middle income countries.

PubMed

Kirby, Jeannette; Ojha, Rohit P; Johnson, Kyle M; Bittner, Elizabeth C; Caniza, Miguela A

2015-02-01

Infection management for pediatric cancer patients may be compromised in low and middle income countries (LMICs) if key antimicrobials are not included in national essential medicines lists. We screened national essential medicines lists for 81 LMICs, and assessed the frequency and corresponding 95% confidence limits (CL) of countries that included the 15 International Society of Paediatric Oncology-recommended antimicrobial agents. Only 19% (95% CL: 11%, 28%) of countries included all recommended antimicrobials in their national essential medicines lists. The selection of antimicrobial agents for national essential medicines lists in LMICs warrants attention from a pediatric cancer perspective. Pediatr Blood Cancer 2015;62:204-207. © 2014 Wiley Periodicals, Inc. © 2014 Wiley Periodicals, Inc.

Financing universal health coverage—effects of alternative tax structures on public health systems: cross-national modelling in 89 low-income and middle-income countries

PubMed Central

Reeves, Aaron; Gourtsoyannis, Yannis; Basu, Sanjay; McCoy, David; McKee, Martin; Stuckler, David

2015-01-01

Summary Background How to finance progress towards universal health coverage in low-income and middle-income countries is a subject of intense debate. We investigated how alternative tax systems affect the breadth, depth, and height of health system coverage. Methods We used cross-national longitudinal fixed effects models to assess the relationships between total and different types of tax revenue, health system coverage, and associated child and maternal health outcomes in 89 low-income and middle-income countries from 1995–2011. Findings Tax revenue was a major statistical determinant of progress towards universal health coverage. Each US$100 per capita per year of additional tax revenues corresponded to a yearly increase in government health spending of $9·86 (95% CI 3·92–15·8), adjusted for GDP per capita. This association was strong for taxes on capital gains, profits, and income ($16·7, 9·16 to 24·3), but not for consumption taxes on goods and services (−$4·37, −12·9 to 4·11). In countries with low tax revenues (<$1000 per capita per year), an additional $100 tax revenue per year substantially increased the proportion of births with a skilled attendant present by 6·74 percentage points (95% CI 0·87–12·6) and the extent of financial coverage by 11·4 percentage points (5·51–17·2). Consumption taxes, a more regressive form of taxation that might reduce the ability of the poor to afford essential goods, were associated with increased rates of post-neonatal mortality, infant mortality, and under-5 mortality rates. We did not detect these adverse associations with taxes on capital gains, profits, and income, which tend to be more progressive. Interpretation Increasing domestic tax revenues is integral to achieving universal health coverage, particularly in countries with low tax bases. Pro-poor taxes on profits and capital gains seem to support expanding health coverage without the adverse associations with health outcomes observed for

The Incidence of the Property Tax on Homeowners: Evidence from the Panel Study of Income Dynamics.

ERIC Educational Resources Information Center

Ihlanfeldt, Keith Ray

1979-01-01

The direct estimates of the relationship between permanent income and property tax payments presented here suggest that the property tax on homeowners is progressive at the national level and generally proportional at the local level. Available from NTA-TIA, 21 East State Street, Columbus, OH 43215. (Author)

Heterogeneous impact of Taiwan's national health insurance on labor force participation of married women by income and family structures.

PubMed

Liao, Pei-An

2011-02-01

In this study, I investigate how the impact of the National Health Insurance (NHI) introduction in Taiwan in 1995 on the labor force participation (LFP) decisions of married women varies with income and family structures. Employing the difference-in-differences (DID) approach, I find that the NHI introduction reduced LFP of married women in the twenty-fifth to fiftieth percentiles of the income distribution between 17.8 and 21.7 percentage points (33%-40%). The difference-in-differences-in-differences (DIDID) results suggest that married women in different family structures (the presence of children under 3 or less healthy elderly household members) did not respond differently to the NHI introduction.

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.

Intimate partner violence among women in Spain: the impact of regional-level male unemployment and income inequality.

PubMed

Sanz-Barbero, Belén; Vives-Cases, Carmen; Otero-García, Laura; Muntaner, Carles; Torrubiano-Domínguez, Jordi; O'Campo, Patricia

2015-12-01

Intimate partner violence (IPV) against women is a complex worldwide public health problem. There is scarce research on the independent effect on IPV exerted by structural factors such as labour and economic policies, economic inequalities and gender inequality. To analyse the association, in Spain, between contextual variables of regional unemployment and income inequality and individual women's likelihood of IPV, independently of the women's characteristics. We conducted multilevel logistic regression to analyse cross-sectional data from the 2011 Spanish Macrosurvey of Gender-based Violence which included 7898 adult women. The first level of analyses was the individual women' characteristics and the second level was the region of residence. Of the survey participants, 12.2% reported lifetime IPV. The region of residence accounted for 3.5% of the total variability in IPV prevalence. We determined a direct association between regional male long-term unemployment and IPV likelihood (P = 0.007) and between the Gini Index for the regional income inequality and IPV likelihood (P < 0.001). Women residing in a region with higher gender-based income discrimination are at a lower likelihood of IPV than those residing in a region with low gender-based income discrimination (odds ratio = 0.64, 95% confidence intervals: 0.55-0.75). Growing regional unemployment rates and income inequalities increase women's likelihood of IPV. In times of economic downturn, like the current one in Spain, this association may translate into an increase in women's vulnerability to IPV. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The role of income inequality and social policies on income-related health inequalities in Europe.

PubMed

Jutz, Regina

2015-10-31

The aim of the paper is to examine the role of income inequality and redistribution for income-related health inequalities in Europe. This paper contributes in two ways to the literature on macro determinants of socio-economic inequalities in health. First, it widens the distinctive focus of the research field on welfare state regimes to quantifiable measures such as social policy indicators. Second, looking at income differences completes studies on socio-economic health inequalities, which often analyse health inequalities based on educational differences. Using data from the European Values Study (2008/2009), 42 European countries are available for analysis. Country characteristics are derived from SWIID, Eurostat, and ILO and include indicators for income inequality, social policies, and economic performance. The data is analysed by using a two-step hierarchical estimation approach: At the first step-the individual level-the effect of household income on self-assessed health is extracted and introduced as an indicator measuring income-related health inequalities at the second step, the country-level. Individual-level analyses reveal that income-related health inequalities exist all across Europe. Results from country-level analyses show that higher income inequality is significantly positively related to higher health inequalities while social policies do not show significant relations. Nevertheless, the results show the expected negative association between social policies and health inequalities. Economic performance also has a reducing influence on health inequalities. In all models, income inequality was the dominating explanatory effect for health inequalities. The analyses indicate that income inequality has more impact on health inequalities than social policies. On the contrary, social policies seemed to matter to all individuals regardless of socio-economic position since it is significantly positively linked to overall population health. Even though

Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005-2012.

PubMed

Tester, June M; Leung, Cindy W; Leak, Tashara M; Laraia, Barbara A

2017-07-06

Whole-grain consumption reduces risk of chronic disease, yet adolescents consume suboptimal amounts. It is unclear whether trends in consumption of whole grains have been positive among adolescents, and research assessing disparities by socioeconomic status is limited. The objective of our study was to evaluate recent trends in whole-grain consumption by US adolescents. We examined data on 3,265 adolescents aged 13 to18 years from the National Health and Nutrition Examination Survey (NHANES) 2005-2012. Intake of whole and refined grains was analyzed by using generalized linear models, and odds of no whole-grain intake were examined with logistic regression, adjusting for socioeconomic and demographic factors. We evaluated trends and examined heterogeneity of trends with respect to annual household income. Daily whole-grain consumption among adolescents increased overall by about a quarter-ounce-equivalent per day (oz-eq/d) (P trend <.001). We found a significant relationship between whole-grain intake and income. Daily whole grains (recommended as ≥3 oz-eq/d), increased (0.6 to 1.0 oz-eq/d) among high-income adolescents (P trend < .001) but remained at 0.5 oz-eq/d for low-income adolescents. The ratio of whole grains to total grains (recommended to be at least 50%) rose from 7.6% to 14.2% for high-income adolescents (P trend < .001), with no significant trend for the low-income group. Consumption of refined grains did not change. Odds of having no whole grains trended downward, but only for the high-income adolescents (P trend = .01). These data show significant (albeit modest) trends toward increased intake of whole grains among high-income adolescents nationwide that are absent among low-income peers. Future interventions and policies should address barriers to whole-grain consumption among this vulnerable group.

Income Related Inequality of Health Care Access in Japan: A Retrospective Cohort Study

PubMed Central

Fujita, Misuzu; Hata, Akira

2016-01-01

The purpose of this retrospective cohort study was to analyze the association between income level and health care access in Japan. Data from a total of 222,259 subjects (age range, 0–74 years) who submitted National Health Insurance claims in Chiba City from April 2012 to March 2014 and who declared income for the tax period from January 1 to December 31, 2012 were integrated and analyzed. The generalized estimating equation, in which household was defined as a cluster, was used to evaluate the association between equivalent income and utilization and duration of hospitalization and outpatient care services. A significant positive linear association was observed between income level and outpatient visit rates among all age groups of both sexes; however, a significantly higher rate and longer period of hospitalization, and longer outpatient care, were observed among certain lower income subgroups. To control for decreased income due to hospitalization, subjects hospitalized during the previous year were excluded, and the data was then reanalyzed. Significant inverse associations remained in the hospitalization rate among 40–59-year-old men and 60–69-year-old women, and in duration of hospitalization among 40–59 and 60–69-year-olds of both sexes and 70–74-year-old women. These results suggest that low-income individuals in Japan have poorer access to outpatient care and more serious health conditions than their higher income counterparts. PMID:26978270

Income-Related Inequalities in Access to Dental Care Services in Japan.

PubMed

Nishide, Akemi; Fujita, Misuzu; Sato, Yasunori; Nagashima, Kengo; Takahashi, Sho; Hata, Akira

2017-05-12

Background : This study aimed to evaluate whether income-related inequalities in access to dental care services exist in Japan. Methods : The subjects included beneficiaries of the National Health Insurance (NHI) in Chiba City, Japan, who had been enrolled from 1 April 2014 to 31 March 2015. The presence or absence of dental visits and number of days spent on dental care services during the year were calculated using insurance claims submitted. Equivalent household income was calculated using individual income data from 1 January to 31 December 2013, declared for taxation. Results : Of the 216,211 enrolled subjects, 50.3% had dental care during the year. Among those with dental visits, the average number of days (standard deviation) spent on dental care services per year was 7.7 (7.1). Low income was associated with a decreased rate of dental care utilization regardless of age and sex. However, there was a significant inverse linear association between the number of days spent on dental care services and income levels for both sexes. Conclusions : There were income-related inequalities in access to dental care services, regardless of the age group or sex, within the Japanese universal health insurance system.

Minimum income protection and European integration: trends and levels of minimum benefits in comparative perspective, 1990-2005.

PubMed

Nelson, Kenneth

2008-01-01

This article draws attention to the Europeanization of social policy and the development of minimum income protection in a large number of welfare democracies. The empirical analyses are based on unique institutional and comparative data on benefit levels from the Social Assistance and Minimum Income Protection Interim Dataset. There is some evidence of convergence in benefit levels among the European countries in the new millennium, but there is no clear proof of universal ambitions to fight poverty or of the existence of a single European social model. There are still welfare front-runners and those who lag behind in this regard, not only among industrial welfare democracies in general but also in Europe.

Income inequality in today’s China

PubMed Central

Xie, Yu; Zhou, Xiang

2014-01-01

Using multiple data sources, we establish that China's income inequality since 2005 has reached very high levels, with the Gini coefficient in the range of 0.53–0.55. Analyzing comparable survey data collected in 2010 in China and the United States, we examine social determinants that help explain China’s high income inequality. Our results indicate that a substantial part of China’s high income inequality is due to regional disparities and the rural-urban gap. The contributions of these two structural forces are particularly strong in China, but they play a negligible role in generating the overall income inequality in the United States, where individual-level and family-level income determinants, such as family structure and race/ethnicity, play a much larger role. PMID:24778237

Political economy of tobacco control in low-income and middle-income countries: lessons from Thailand and Zimbabwe. Global Analysis Project Team.

PubMed Central

Chantornvong, S.; Collin, J.; Dodgson, R.; Lee, K.; McCargo, D.; Seddon, D.; Vaughan, P.; Woelk, G.

2000-01-01

Crucial to the success of the proposed Framework Convention on Tobacco Control will be an understanding of the political and economic context for tobacco control policies, particularly in low-income and middle-income countries. Policy studies in Thailand and Zimbabwe employed the analytical perspective of political economy and a research strategy that used political mapping, a technique for characterizing and evaluating the political environment surrounding a policy issue, and stakeholder analysis, which seeks to identify key actors and to determine their capacity to shape policy outcomes. These policy studies clearly revealed how tobacco control in low-income and middle-income countries is also being shaped by developments in the global and regional political economy. Hence efforts to strengthen national control policies need to be set within the context of globalization and the international context. Besides the transnational tobacco companies, international tobacco groups and foreign governments, international agencies and nongovernmental organizations are also playing influential roles. It cannot be assumed, therefore, that the tobacco control strategies being implemented in industrialized countries will be just as effective and appropriate when implemented in developing countries. There is an urgent need to expand the number of such tobacco policy studies, particularly in low-income and middle-income countries. Comprehensive guidelines for tobacco policy analysis and research are required to support this process, as is a broader international strategy to coordinate further tobacco policy research studies at country, regional and global levels. PMID:10994265

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.

47 CFR 11.43 - National level participation.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false National level participation. 11.43 Section 11.43 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL EMERGENCY ALERT SYSTEM (EAS... national level EAS may submit a written request to the Chief, Public Safety and Homeland Security Bureau...

Translating national level forest service goals to local level land management: carbon sequestration

Treesearch

Steven McNulty; Emrys Treasure; Lisa Jennings; David Meriwether; David Harris; Paul Arndt

2017-01-01

The USDA Forest Service has many national level policies related to multiple use management. However, translating national policy to stand level forest management can be difficult. As an example of how a national policy can be put into action, we examined three case studies in which a desired future condition is evaluated at the national, region, and local scale. We...

Do racial inequities in infant mortality correspond to variations in societal conditions? A study of state-level income inequality in the U.S., 1992-2007.

PubMed

Siddiqi, Arjumand; Jones, Marcella K; Bruce, Donald J; Erwin, Paul C

2016-09-01

Prior studies have examined the association between income inequality and overall infant mortality rates (IMR). We examine effects of income inequality on racial inequities in IMR over the period 1992-2007 in the U.S. Race-specific state IMR data were obtained from 1992 to 2007, from which absolute and relative IMR inequities were calculated. Fixed and random effects models, adjusted for state-level median income, percent poverty, percent high school graduates, and unemployment rate, were used to determine contemporaneous and lagged state-level associations between income inequality and racial IMR inequities. Racial IMR inequities varied significantly across the U.S. Contemporaneous income inequality was negatively associated with white IMR only. Two-year lagged income inequality was negatively associated with black IMR and had the most pronounced effect on racial inequities in IMR. Future studies should consider lagged effects of income inequality on IMR and other health outcomes, and should examine other potential societal conditions that may account for state-level variations in racial IMR inequities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Educational inequalities in mortality are larger at low levels of income: A register-based study on premature mortality among 2.3 million Swedes, 2006-2009.

PubMed

Östergren, Olof

2018-08-01

Education develops skills that help individuals use available material resources more efficiently. When material resources are scarce, each decision becomes comparatively more important. Education may also protect from health-related income decline, since the highly educated tend to work in occupations with lower physical demands. Educational inequalities in health may, therefore, be more pronounced at lower levels of income. The aim of this study is to assess whether the shape of the income gradient in premature mortality depends on the level of education. Total population data on education, income and mortality was obtained by linking several Swedish registers. Income was defined as five-year average disposable household income for ages 35-64 and mortality follow-up covered the period 2006-2009. The final population comprised 2.3 million individuals, 6.2 million person-years and 14,362 deaths. Income was modeled using splines in order to allow variation in the functional form of the association across educational categories. Poisson regression with robust standard errors was used. The curvilinear shape of the association between income and mortality was more pronounced among those with a low education. Both absolute and relative educational inequalities in premature mortality tended to be larger at low levels of income. The greatest income differences in mortality were observed for those with a low education and the smallest for the highly educated. Education and income interact as predictors of mortality. Education is a more important factor for health when access to material resources is limited.

77 FR 61789 - Workforce Investment Act of 1998 (WIA); Lower Living Standard Income Level (LLSIL); Correction

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-11

... DEPARTMENT OF LABOR Employment and Training Administration Workforce Investment Act of 1998 (WIA); Lower Living Standard Income Level (LLSIL); Correction AGENCY: Employment and Training Administration, Labor. ACTION: Notice; correction. SUMMARY: The Employment and Training Administration (ETA) published...

An Overview of Food Patterns and Diet Quality in Qatar: Findings from the National Household Income Expenditure Survey

PubMed Central

Al-Thani, Mohammed; Al-Thani, Al-Anoud; Al-Mahdi, Nasser; Al-Kareem, Hefzi; Barakat, Darine; Al-Chetachi, Walaa; Tawfik, Afaf

2017-01-01

Introduction Availability of accurate data pertaining to a population’s dietary patterns and associated health outcomes is critical for proper development and implementation of related policies. This article is a first attempt to share the food patterns, amounts and diet quality among households (HH) in Qatar. Methods Data from the 2012-2013 Qatar National Household Income and Expenditure Survey (HIES) was used. This cross-sectional survey included 3723 HH (1826 Qatari HH and 1897 non-Qatari HH). Dietary data on monthly amounts food items available at HH according to the nationality was used. The food items were expressed in terms of grams per capita per day and aggregated into groups to examine the food patterns, energy, and adequacy. Results The overall average amount of purchased food at HH in Qatar was 1885 g/capita/day. Qatari HH purchased more food (2118 g/capita/day) versus non-Qataris (1373 g/capita/day); however, the percentages of the amounts purchased by food types were similar among both nationalities. Average daily energy (kcal) per capita was almost double among Qatari HH (4275 kcal) vs. non-Qatari HH (2424 kcal). The food items under subsidy program for Qatari citizens provided 1753 kcal/capita/day and accounted for 41% of total daily energy. Proteins (29.2), fats (39.2), sodium (3.3), and vitamin C (32.5) had higher than recommended levels of nutrient density (grams per 1000 kcal). Calcium (227), vitamin A (302.3), fiber (2.0), and carbohydrates (132.6) had lower than recommended levels of nutrient energy density (g/1000 kcal). Conclusions The study predicts unhealthy dietary habits among HH in Qatar and provides useful information for policy makers and healthcare community. PMID:28630807

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China.

PubMed

Liao, Chunxiao; Tan, Yayun; Wu, Chaoqun; Wang, Shengfeng; Yu, Canqing; Cao, Weihua; Gao, Wenjing; Lv, Jun; Li, Liming

2016-01-01

The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. The findings suggested food environment disparities did exist in different cities of China.

City Level of Income and Urbanization and Availability of Food Stores and Food Service Places in China

PubMed Central

Liao, Chunxiao; Tan, Yayun; Wu, Chaoqun; Wang, Shengfeng; Yu, Canqing; Cao, Weihua; Gao, Wenjing; Lv, Jun; Li, Liming

2016-01-01

Objective The contribution of unhealthy dietary patterns to the epidemic of obesity has been well recognized. Differences in availability of foods may have an important influence on individual eating behaviors and health disparities. This study examined the availability of food stores and food service places by city characteristics on city level of income and urbanization. Methods The cross-sectional survey was comprised of two parts: (1) an on-site observation to measure availability of food stores and food service places in 12 cities of China; (2) an in-store survey to determine the presence of fresh/frozen vegetables or fruits in all food stores. Trained investigators walked all the streets/roads within study tracts to identify all the food outlets. An observational survey questionnaire was used in all food stores to determine the presence of fresh/frozen vegetables or fruits. Urbanization index was determined for each city using a principal components factor analysis. City level of income and urbanization and numbers of each type of food stores and food service places were examined using negative binomial regression models. Results Large-sized supermarkets and specialty retailers had higher number of fresh/frozen vegetables or fruits sold compared to small/medium-sized markets. High-income versus low-income, high urbanized versus low urbanized areas had significantly more large-sized supermarkets and fewer small/medium-sized markets. In terms of restaurants, high urbanized cities had more western fast food restaurants and no statistically significant difference in the relative availability of any type of restaurants was found between high- and low-income areas. Conclusions The findings suggested food environment disparities did exist in different cities of China. PMID:26938866

12 CFR 1282.19 - Affordability-Rent level definitions-tenant income is not known.

Code of Federal Regulations, 2010 CFR

2010-01-01

... very low-, low-, or moderate-income families where the income of the family in the dwelling unit is not known to the Enterprise, the affordability of the unit is determined based on unit size as follows: (a) For moderate-income, maximum affordable rents to count as housing for moderate-income families shall...

Generating political priority for newborn survival in three low-income countries.

PubMed

Smith, Stephanie L; Shiffman, Jeremy; Kazembe, Abigail

2014-01-01

Deaths to babies in their first 28 days of life now account for more than 40% of global under-5 child mortality. High neonatal mortality poses a significant barrier to achieving the child survival Millennium Development Goal. Surmounting the problem requires national-level political commitment, yet only a few nation-states have prioritised this issue. We compare Bolivia, Malawi and Nepal, three low-income countries with high neonatal mortality, with a view to understanding why countries prioritise or neglect the issue. The three have had markedly different trajectories since 2000: attention grew steadily in Nepal, stagnated then grew in Malawi and grew then stagnated in Bolivia. The comparison suggests three implications for proponents seeking to advance attention to neglected health issues in low-income countries: the value of (1) advancing solutions with demonstrated efficacy in low-resource settings, (2) building on existing and emerging national priorities and (3) developing a strong network of domestic and international allies. Such actions help policy communities to weather political storms and take advantage of policy windows.

Individual Income, Area Deprivation, and Health: Do Income-Related Health Inequalities Vary by Small Area Deprivation?

PubMed

Siegel, Martin; Mielck, Andreas; Maier, Werner

2015-11-01

This paper aims to explore potential associations between health inequalities related to socioeconomic deprivation at the individual and the small area level. We use German cross-sectional survey data for the years 2002 and 2006, and measure small area deprivation via the German Index of Multiple Deprivation. We test the differences between concentration indices of income-related and small area deprivation related inequalities in obesity, hypertension, and diabetes. Our results suggest that small area deprivation and individual income both yield inequalities in health favoring the better-off, where individual income-related inequalities are significantly more pronounced than those related to small area deprivation. We then apply a semiparametric extension of Wagstaff's corrected concentration index to explore how individual-level health inequalities vary with the degree of regional deprivation. We find that the concentration of obesity, hypertension, and diabetes among lower income groups also exists at the small area level. The degree of deprivation-specific income-related inequalities in the three health outcomes exhibits only little variations across different levels of multiple deprivation for both sexes. Copyright © 2014 John Wiley & Sons, Ltd.

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.

Translating National Level Forest Service Goals to Local Level Land Management: Carbon Sequestration

NASA Astrophysics Data System (ADS)

McNulty, S.; Treasure, E.

2017-12-01

The USDA Forest Service has many national level policies related to multiple use management. However, translating national policy to stand level forest management can be difficult. As an example of how a national policy can be put into action, we examined three case studies in which a desired future condition is evaluated at the national, region and local scale. We chose to use carbon sequestration as the desired future condition because climate change has become a major area of concern during the last decade. Several studies have determined that the 193 million acres of US national forest land currently sequester 11% to 15% of the total carbon emitted as a nation. This paper provides a framework by which national scale strategies for maintaining or enhancing forest carbon sequestration is translated through regional considerations and local constraints in adaptive management practices. Although this framework used the carbon sequestration as a case study, this framework could be used with other national level priorities such as the National Environmental Protection Act (NEPA) or the Endangered Species Act (ESA).

The effect of private tubewells on income and income inequality in rural Pakistan

NASA Astrophysics Data System (ADS)

Wang, Zhiyu; Huang, Qiuqiong; Giordano, Mark

2015-08-01

Since the introduction of private tubewells in rural Pakistan, farmers have increasingly used groundwater to supplement canal water for irrigation and improve the reliability of the water supply. Farmers obtain groundwater either from their own tubewells or from other well owners. This paper examines the effect of private tubewells on rural income, both in terms of income level and income distribution since it may differ across farmers with different irrigation status (only canal water, canal water and groundwater from own tubewell, and canal water and purchased groundwater). The results show that private tubewells work to enhance rural income and reduce income inequality in rural Pakistan.

Suicide and poverty in low-income and middle-income countries: a systematic review.

PubMed

Iemmi, Valentina; Bantjes, Jason; Coast, Ernestina; Channer, Kerrie; Leone, Tiziana; McDaid, David; Palfreyman, Alexis; Stephens, Bevan; Lund, Crick

2016-08-01

Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low-income and middle-income countries. Nonetheless, evidence on the association between suicide and poverty in low-income and middle-income countries is scarce. We did a systematic review to understand the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries. We included studies testing the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries using bivariate or multivariate analysis and published in English between January, 2004, and April, 2014. We identified 37 studies meeting these inclusion criteria. In 18 studies reporting the association between completed suicide and poverty, 31 associations were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal suicidal ideations and behaviours and poverty, 36 associations were explored. Again, almost all studies reported a positive association. However, when considering each poverty dimension separately, we found substantial variations. These findings show a consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth, and unemployment is associated with suicidal ideations and behaviours. At the country level, there are insufficient data to draw clear conclusions. Available data show a potential benefit in addressing economic poverty within suicide prevention strategies, with particular attention to both chronic poverty and acute economic events. Copyright © 2016 Elsevier Ltd. All rights reserved.

Does the earned income tax credit increase children's weight? The impact of policy-driven income on childhood obesity.

PubMed

Jo, Young

2018-07-01

I exploit substantial increases in the earned income tax credit to study how a policy-driven change in family income affects childhood obesity. Using the National Longitudinal Survey of Youth 1979, my difference-in-differences estimates indicate that the probability of being obese increased by 3 percentage points among children whose families experienced a greater income shock. A further investigation suggests that a reduction in maternal time with children played a greater role in children's weight gain than income. The paper's finding shows that a program that is not designed for health purposes, such as earned income tax credit, can have unintended effects on health outcomes. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.

Comparing the Income Elasticity of Health Spending in Middle-Income and High-Income Countries: The Role of Financial Protection.

PubMed

Vargas Bustamante, Arturo; V Shimoga, Sandhya

2017-07-19

As middle-income countries become more affluent, economically sophisticated and productive, health expenditure patterns are likely to change. Other socio-demographic and political changes that accompany rapid economic growth are also likely to influence health spending and financial protection. This study investigates the relationship between growth on per-capita healthcare expenditure and gross domestic product (GDP) in a group of 27 large middle-income economies and compares findings with those of 24 high-income economies from the Organization for Economic Cooperation and Development (OECD) group. This comparison uses national accounts data from 1995-2014. We hypothesize that the aggregated income elasticity of health expenditure in middle-income countries would be less than one (meaning healthcare is a normal good). An initial exploratory analysis tests between fixed-effects and random-effects model specifications. A fixed-effects model with time-fixed effects is implemented to assess the relationship between the two measures. Unit root, Hausman and serial correlation tests are conducted to determine model fit. Additional explanatory variables are introduced in different model specifications to test the robustness of our regression results. We include the out-of-pocket (OOP) share of health spending in each model to study the potential role of financial protection in our sample of high- and middle-income countries. The first-difference of study variables is implemented to address non-stationarity and cointegration properties. The elasticity of per-capita health expenditure and GDP growth is positive and statistically significant among sampled middle-income countries (51 per unit-growth in GDP) and high-income countries (50 per unit-growth in GDP). In contrast with previous research that has found that income elasticity of health spending in middle-income countries is larger than in high-income countries, our findings show that elasticity estimates can change if

The Impact of Medicaid on Physician Use by Low-Income Children.

ERIC Educational Resources Information Center

Rosenbach, Margo L.

1989-01-01

Studies determinants of physician use by low-income children identified through the National Household Survey component of the National Medical Care Utilization and Expenditure Survey. Finds that Medicaid coverage increases access to office-based physicians within the low-income population. Presents health cost and policy implications. (MW)

Recent Uptrend in Whole-Grain Intake Is Absent for Low-Income Adolescents, National Health and Nutrition Examination Survey, 2005–2012

PubMed Central

Leung, Cindy W.; Leak, Tashara M.; Laraia, Barbara A.

2017-01-01

Introduction Whole-grain consumption reduces risk of chronic disease, yet adolescents consume suboptimal amounts. It is unclear whether trends in consumption of whole grains have been positive among adolescents, and research assessing disparities by socioeconomic status is limited. The objective of our study was to evaluate recent trends in whole-grain consumption by US adolescents. Methods We examined data on 3,265 adolescents aged 13 to18 years from the National Health and Nutrition Examination Survey (NHANES) 2005–2012. Intake of whole and refined grains was analyzed by using generalized linear models, and odds of no whole-grain intake were examined with logistic regression, adjusting for socioeconomic and demographic factors. We evaluated trends and examined heterogeneity of trends with respect to annual household income. Results Daily whole-grain consumption among adolescents increased overall by about a quarter-ounce–equivalent per day (oz-eq/d) (P trend <.001). We found a significant relationship between whole-grain intake and income. Daily whole grains (recommended as ≥3 oz-eq/d), increased (0.6 to 1.0 oz-eq/d) among high-income adolescents (P trend < .001) but remained at 0.5 oz-eq/d for low-income adolescents. The ratio of whole grains to total grains (recommended to be at least 50%) rose from 7.6% to 14.2% for high-income adolescents (P trend < .001), with no significant trend for the low-income group. Consumption of refined grains did not change. Odds of having no whole grains trended downward, but only for the high-income adolescents (P trend = .01). Conclusion These data show significant (albeit modest) trends toward increased intake of whole grains among high-income adolescents nationwide that are absent among low-income peers. Future interventions and policies should address barriers to whole-grain consumption among this vulnerable group. PMID:28682743

Cumulative family risks across income levels predict deterioration of children’s general health during childhood and adolescence

PubMed Central

Seo, Dong-Chul

2017-01-01

Family is considered an important agent in the health development of children. This process is significant but quite complex because the prevalence of potential risk factors in the family can hinder children’s health. This study examined if multiple family risks might have cumulative effect on children and youth’s health across various levels of household income. The data in this study were drawn from the 2011–2012 U.S. National Survey of Children’s Health (N = 79,601). A cumulative family risk (CFR) index was developed, which included such constructs as single-parenthood, unstable employment, large family, parenting stress, poor maternal education, poor maternal general health and poor maternal mental health. Multiple logistic regression analyses showed that CFR level was significantly related to children and youth’s poor health outcome (p < .001). When poverty levels were considered, however, the impact of CFRs on children and youth’s health was attenuated. The impact of CFRs was higher on children and youth from affluent families than on those from poor families. Overall there was a consistent pattern of trend in the point estimate as well as confidence limits as levels of affluence and numbers of family risk increased although some of the confidence intervals overlapped. Living in disadvantaged families might serve as a protective factor against CFRs possibly through repeated exposure to hardships and subsequent formation of resilience among some of the disadvantaged children. PMID:28520758

Has the role of personal income in alcohol drinking among teenagers changed between 1983 and 2013: a series of nationally representative surveys in Finland

PubMed Central

Lintonen, Tomi; Nevalainen, Jaakko

2017-01-01

Objective Affordability is known to be a key determinant of alcohol consumption, possibly even more important in adolescence. Relating adolescent drinking pattern developments over a period of time to trends in adolescent income can yield information on the significance of parental control of adolescent income. Design Biannual repeated cross-sectional surveys. Setting Nationally representative samples. Participants 14-year-old adolescents in the period 1983–2013 in Finland (N=33 771). Results Adolescents' alcohol drinking pattern was significantly associated with their disposable income. The OR for monthly drunkenness versus abstinence was 6.6 (95% CI 5.0 to 8.8) among girls and 9.0 (6.3 to 13.0) among boys in the highest income group compared with the lowest. However, the association between income and drinking pattern weakened considerably during the 30-year period. Conclusions Disposable income has been a significant predictor of adolescent alcohol drinking in the past 30 years. However, in the recent years, the amount of disposable money has decreased in importance. PMID:28416499

Education, Income Distribution and Intergenerational Mobility: Findings from Field Data

ERIC Educational Resources Information Center

Mohanty, Alekha Chandra

2016-01-01

The prevalence of widespread poverty and the increasing inequality in income distribution across nations point to the failure of the trickle-down theory. The long-held faith in the growth of income as the sole policy instrument to achieve the national objective of growth with equity has been put to the test. The increasing numbers of the poor,…

Income inequality and income segregation.

PubMed

Reardon, Sean F; Bischoff, Kendra

2011-01-01

This article investigates how the growth in income inequality from 1970 to 2000 affected patterns of income segregation along three dimensions: the spatial segregation of poverty and affluence, race-specific patterns of income segregation, and the geographic scale of income segregation. The evidence reveals a robust relationship between income inequality and income segregation, an effect that is larger for black families than for white families. In addition, income inequality affects income segregation primarily through its effect on the large-scale spatial segregation of affluence rather than by affecting the spatial segregation of poverty or by altering small-scale patterns of income segregation.

The effects of Earned Income Tax Credit payment expansion on maternal smoking.

PubMed

Averett, Susan; Wang, Yang

2013-11-01

The Earned Income Tax Credit is the largest antipoverty program in the USA. In 1993, the Earned Income Tax Credit benefit levels were changed significantly based on the number of children in the family such that families with two or more children experienced an exogenous expansion in their incomes. Using data from the National Longitudinal Survey of Youth 1979 cohort, we use a triple-difference plus fixed effects framework to examine the effect of this change on the probability of smoking among low-educated mothers. We find that the probability of smoking for White low-educated mothers of two or more children significantly decreased relative to those with only one child, and this result is robust to various specification tests. This result provides new evidence on the protective effect of income on health through changes in a health-related behavior and therefore has important policy implications. Copyright © 2012 John Wiley & Sons, Ltd.

Surgical follow-up costs disproportionately impact low-income patients.

PubMed

Scott, Aaron R; Rush, Augustus J; Naik, Aanand D; Berger, David H; Suliburk, James W

2015-11-01

Surgical procedures have significant costs at the national level, but the financial burden on patients is equally important. Patients' out-of-pocket costs for surgery and surgical care include not only direct medical costs but also the indirect cost of lost wages and direct nonmedical costs including transportation and childcare. We hypothesized that the nonmedical costs of routine postoperative clinic visits disproportionately impact low-income patients. This was a cross-sectional study performed in the postoperative acute care surgery clinic at a large, urban county hospital. A survey containing items about social, demographic, and financial data was collected from ambulatory patients. Nonmedical costs were calculated as the sum of transportation, childcare, and lost wages. Costs and cost to income ratios were compared between income strata. Ninety-seven patients responded to the survey of which 59 reported all items needed for cost calculations. The median calculated cost of a clinic visit was $27 (interquartile range $18-59). Components of this cost were $16 ($14-$20) for travel, $22 ($17-$50) for childcare among patients requiring childcare, and $0 ($0-$30) in lost wages. Low-income patients had significantly higher (P = 0.0001) calculated cost to income ratios, spending nearly 10% of their monthly income on these costs. The financial burden of routine postoperative clinic visits is significant. Consistent with our hypothesis, the lowest income patients are disproportionately impacted, spending nearly 10% of their monthly income on costs associated with the clinic visit. Future cost-containment efforts should examine alternative, lower cost methods of follow-up, which reduce financial burden. Copyright © 2015 Elsevier Inc. All rights reserved.

'The one with the purse makes policy': Power, problem definition, framing and maternal health policies and programmes evolution in national level institutionalised policy making processes in Ghana.

PubMed

Koduah, Augustina; Agyepong, Irene Akua; van Dijk, Han

2016-10-01

This paper seeks to advance our understanding of health policy agenda setting and formulation processes in a lower middle income country, Ghana, by exploring how and why maternal health policies and programmes appeared and evolved on the health sector programme of work agenda between 2002 and 2012. We theorized that the appearance of a policy or programme on the agenda and its fate within the programme of work is predominately influenced by how national level decision makers use their sources of power to define maternal health problems and frame their policy narratives. National level decision makers used their power sources as negotiation tools to frame maternal health issues and design maternal health policies and programmes within the framework of the national health sector programme of work. The power sources identified included legal and structural authority; access to authority by way of political influence; control over and access to resources (mainly financial); access to evidence in the form of health sector performance reviews and demographic health surveys; and knowledge of national plans such as Ghana Poverty Reduction Strategy. Understanding of power sources and their use as negotiation tools in policy development should not be ignored in the pursuit of transformative change and sustained improvement in health systems in low- and middle income countries (LMIC). Copyright © 2016 Elsevier Ltd. All rights reserved.

Income-based projections of water footprint of food consumption in Uzbekistan

NASA Astrophysics Data System (ADS)

Djanibekov, Nodir; Frohberg, Klaus; Djanibekov, Utkur

2013-11-01

Assessing future water requirements for feeding the growing population of Central Asia can improve understanding of the projected water supply scenarios in the region. Future water requirements will be partially determined by the dietary habits of the populations, and are thus responsive to significant variation of income levels. Using Uzbekistan as an example, this study projects the water footprints of income driven changes on the population's diet in Central Asia. To reveal the influence of large income changes on dietary habits a Normalized Quadratic-Quadratic Expenditure System was calibrated and applied to data from 2009. The national water footprints of food consumption in Uzbekistan were projected until 2034 by applying the parameterized demand system to estimate the respective water footprint values. The results showed that for Uzbekistan the projected increase in the food consumption water footprint would be primarily linked to income growth rather than population growth. Due to the high water footprint of common food products, the composition of the population's diet, and responsiveness to income, economic growth is expected to put greater pressure on water resources in Uzbekistan unless proper measures are undertaken.

Attained educational level and incident atherothrombotic events in low- and middle-income compared with high-income countries.

PubMed

Goyal, Abhinav; Bhatt, Deepak L; Steg, P Gabriel; Gersh, Bernard J; Alberts, Mark J; Ohman, E Magnus; Corbalán, Ramón; Eagle, Kim A; Gaxiola, Efrain; Gao, Runlin; Goto, Shinya; D'Agostino, Ralph B; Califf, Robert M; Smith, Sidney C; Wilson, Peter W F

2010-09-21

Studies report a protective effect of higher attained educational level (AEL) on cardiovascular outcomes. However, most of these studies have been conducted in high-income countries (HICs) and lack representation from low- and middle-income countries (LMICs), which bear >80% of the global burden of cardiovascular disease. The Reduction of Atherothrombosis for Continued Health (REACH) Registry is a prospective study of 67 888 subjects with either established atherothrombotic (coronary, cerebrovascular, and/or peripheral arterial) disease or multiple atherothrombotic risk factors enrolled from 5587 physician practices in 44 countries. At baseline, AEL (0 to 8 years, 9 to 12 years, trade or technical school, and university) was self-reported for 61 332 subjects. Outcomes included the baseline prevalence of atherothrombotic risk factors and the rate of incident cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) through 23 months across AEL groups, stratified by sex and world region (LMICs or HICs). Educational attainment was inversely associated with age and diabetes mellitus and directly associated with hypercholesterolemia in all subjects. However, for other risk factors such as obesity, smoking, hypertension, and baseline burden of vascular disease, AEL was protective (inversely associated) in HICs but not protective in LMICs. The protective effect of greater AEL on incident cardiovascular events was strongest in men from HICs (P<0.0001), more modest in women from HICs (P=0.0026) and in men from LMICs (P=0.082), and essentially absent in women from LMICs (P=0.32). In contrast to HICs, higher AEL may not be protective against cardiovascular events in LMICs, particularly in women.

National Education Trust Fund

ERIC Educational Resources Information Center

Shapp, Milton J.

1975-01-01

A proposal from the governor of Pennsylvania for financing all levels of education through a National Education Trust Fund (NETF) that would operate as the present Federal Highway Trust Fund does on a revolving, self-liquidating basis with the cost of an individual's education repaid through a progressive education tax on income. (JT)

Mortality, migration, income, and air pollution: a comparative study

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

Bozzo, S.R.; Novak, K.M.; Galdos, F.

1978-06-02

The interrelationships among different demographic factors, specific causes of death, median family income, and estimated air pollution emissions were examined. Using the Medical Data Base (MEDABA) developed at Brookhaven National Laboratory, the entire population of the United States was cross-tabulated by income and emission levels of air pollutants. Path analysis was used to examine a number of patterns and relationships for each age, race, and sex group containing a minimum of 10,000 persons. Competitive and complementary effects were observed. These effects were frequently age dependent and occasionaly sex related. This specialized data base, the application of path analysis, and themore » development of a dynamic population and mortality model, in combination, proved to be a useful tool for investigating the effects of energy related pollutants on the exposed population.« less

Social Change and Anomie: A Cross-National Study

ERIC Educational Resources Information Center

Zhao, Ruohui; Cao, Liqun

2010-01-01

We apply Durkheim's social transitional theory to explain the variation of anomie in 30 nations in the world. Combining data from two sources--the 1995 "World Values Survey and the United Nations University's World Income Inequality Database" or WIID--we test the hypothesis that rapid sociopolitical change at the structural level disrupts social…

Is Exposure to Income Inequality a Public Health Concern? Lagged Effects of Income Inequality on Individual and Population Health

PubMed Central

Mellor, Jennifer M; Milyo, Jeffrey

2003-01-01

Objective To examine the health consequences of exposure to income inequality. Data Sources Secondary analysis employing data from several publicly available sources. Measures of individual health status and other individual characteristics are obtained from the March Current Population Survey (CPS). State-level income inequality is measured by the Gini coefficient based on family income, as reported by the U.S. Census Bureau and Al-Samarrie and Miller (1967). State-level mortality rates are from the Vital Statistics of the United States; other state-level characteristics are from U.S. census data as reported in the Statistical Abstract of the United States. Study Design We examine the effects of state-level income inequality lagged from 5 to 29 years on individual health by estimating probit models of poor/fair health status for samples of adults aged 25–74 in the 1995 through 1999 March CPS. We control for several individual characteristics, including educational attainment and household income, as well as regional fixed effects. We use multivariate regression to estimate the effects of income inequality lagged 10 and 20 years on state-level mortality rates for 1990, 1980, 1970, and 1960. Principal Findings Lagged income inequality is not significantly associated with individual health status after controlling for regional fixed effects. Lagged income inequality is not associated with all cause mortality, but associated with reduced mortality from cardiovascular disease and malignant neoplasms, after controlling for state fixed-effects. Conclusions In contrast to previous studies that fail to control for regional variations in health outcomes, we find little support for the contention that exposure to income inequality is detrimental to either individual or population health. PMID:12650385

Mixed-Income Schools and Housing: Advancing the Neoliberal Urban Agenda

ERIC Educational Resources Information Center

Lipman, Pauline

2008-01-01

This article uses a social justice framework to problematize national and local policies in housing and education which propose to reduce poverty and improve educational performance of low-income students through mixed-income strategies. Drawing on research on Chicago, the article argues mixed-income strategies are part of the neoliberal…

The dynamics of the relationship between diabetes incidence and low income: longitudinal results from Canada's National Population Health Survey.

PubMed

Dinca-Panaitescu, Mihaela; Dinca-Panaitescu, Serban; Raphael, Dennis; Bryant, Toba; Pilkington, Beryl; Daiski, Isolde

2012-07-01

This paper sheds light on the dynamic relationship between people's experiences of low income and the development of type 2 diabetes (T2DM) by moving beyond the static perspective provided by cross-sectional studies to a long-term approach informed by longitudinal analyses. We analyzed data from the Canadian National Population Health Survey (NPHS) conducted by Statistics Canada from 1994 to 2007. The longitudinal sample is composed of 17,276 respondents (8046 males, 9230 females) 12 years of age or older. We further developed an algorithm to distinguish T2DM from other types of diabetes. Proportional hazard models with time-varying predictors were used to explore the dynamics of the relationship between low income and T2DM. The results suggest that living in low income and experiencing persistent low income are significant precursors of developing T2DM. Being in low income in the previous cycle of T2DM onset was associated with 77% higher risk of T2DM (hazard ratio 1.77; 95% CI: 1.48-2.12). The association between low income and diabetes incidence remains significant after adjusting for age, sex, health behaviors, and psychological distress (hazard ratio 1.24; 95% CI: 1.02-1.52). This study contributes to the under-developed research examining longitudinally the relationship between socioeconomic status and diabetes incidence. Employing this long-term approach, this study calls attention to the primary effect of socioeconomic position on diabetes incidence that cannot be explained entirely by behavioral factors. Findings draw attention to the need to address the role played in T2DM by the inequitable distribution of the social determinants of health. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Outcomes of patients in clinical trials with ST-segment elevation myocardial infarction among countries with different gross national incomes.

PubMed

Orlandini, Andrés; Díaz, Rafael; Wojdyla, Daniel; Pieper, Karen; Van de Werf, Frans; Granger, Christopher B; Harrington, Robert A; Boersma, Eric; Califf, Robert M; Armstrong, Paul; White, Harvey; Simes, John; Paolasso, Ernesto

2006-03-01

To evaluate whether there is an association between 30-day mortality in patients with ST-segment elevation myocardial infarction (STEMI) included in clinical trials and country gross national income (GNI). A retrospective analysis of the databases of five randomized trials including 50 310 patients with STEMI (COBALT 7169, GIK-2 2931, HERO-2 17,089, ASSENT-2 17,005, and ASSENT-3 6116 patients) from 53 countries was performed. Countries were divided into three groups according to their GNI based on the World Bank data: low (less than 2900 US dollars), medium (between 2900 US dollars and 9000 US dollars), and high GNI (more than 9000 US dollars per capita). Baseline characteristics, in-hospital management variables, and 30-day outcomes were evaluated. A previously defined logistic regression model was used to adjust for differences in baseline characteristics and to predict mortality. The observed mortality was higher than the predicted mortality in the low (12.1 vs. 11.8%) and in the medium income groups (9.4 vs. 7.9%), whereas it was lower in the high income group (4.9 vs. 5.6%). An inverse relationship between mortality and GNI was observed in STEMI clinical trials. Most of the variability in mortality can be explained by differences in baseline characteristics; however, after adjustment, lower income countries have higher mortality than the expected.

Associations between school meals offered through the National School Lunch Program and the School Breakfast Program and fruit and vegetable intake among ethnically diverse, low-income children.

PubMed

Robinson-O'Brien, Ramona; Burgess-Champoux, Teri; Haines, Jess; Hannan, Peter J; Neumark-Sztainer, Dianne

2010-10-01

Despite evidence in support of the health benefits associated with fruit and vegetable (FV) intake, national data indicate that FV consumption among school-aged children is below recommended levels, particularly among low-income children. School meals offered through the School Breakfast Program and National School Lunch Program can provide an important contribution to child FV intake. This study examines the proportion of fruits and vegetables consumed from school meals programs among ethnically diverse, low socioeconomic status children. Participants (n = 103) included fourth to sixth grade boys and girls from 4 urban elementary schools in St. Paul, Minnesota serving primarily low-income populations. Research staff interviewed children during school hours and recorded dietary intake via 24-hour recall. Analysis included descriptive statistics using cross tabulations and means. Average reported mean (SD) daily FV intake was 3.6 (2.5) servings, with 80% of children consuming fewer than 5 daily servings of FV. On average, children consumed over half of their daily FV intake within school. Children with low FV intake (<5 FV servings daily) consumed a higher proportion of their daily intake at school than children with higher FV intake (≥5 FV servings daily) (39% vs 59%; p = .002). Child FV intake is below recommended levels. School meals provide an important contribution to the daily FV intake among ethnically diverse, low socioeconomic status children, particularly among those with the lowest FV intake. School meals programs promoting FV intake within the school environment may provide an opportunity to encourage increased FV consumption. © 2010, American School Health Association.

Income inequality, disinvestment in health care and use of dental services.

PubMed

Bhandari, Bishal; Newton, Jonathan T; Bernabé, Eduardo

2015-01-01

To explore the interrelationships between income inequality, disinvestment in health care, and use of dental services at country level. This study pooled national estimates for use of dental services among adults aged 18 years or older from the 70 countries that participated in the World Health Survey from 2002 to 2004, together with aggregate data on national income (GDP per capita), income inequality (Gini coefficient), and disinvestment in health care (total health expenditure and dentist-to-population ratio) from various international sources. Use of dental services was defined as having had dental problems in the last 12 months and having received any treatment to address those needs. Associations between variables were explored using Pearson correlation coefficients and linear regression. Data from 63 countries representing the six WHO regions were analyzed. Use of dental services was negatively correlated with Gini coefficient (Pearson correlation coefficient -0.48, P < 0.001) and positively correlated with GDP per capita (0.40, P < 0.05), total health expenditure (0.45, P < 0.001), and dentist-to-population ratio (0.67, P < 0.001). The association between Gini coefficient and use of dental services was attenuated but remained significant after adjustments for GDP per capita, total health expenditure, and dentist-to-population ratio (regression coefficient -0.36; 95% CI -0.57, -0.15). This study shows an inverse relationship between income inequality and use of dental services. Of the two indicators of disinvestment in health care assessed, only dentist-to-population ratio was associated with income inequality and use of dental services. © 2014 American Association of Public Health Dentistry.

Has the role of personal income in alcohol drinking among teenagers changed between 1983 and 2013: a series of nationally representative surveys in Finland.

PubMed

Lintonen, Tomi; Nevalainen, Jaakko

2017-04-17

Affordability is known to be a key determinant of alcohol consumption, possibly even more important in adolescence. Relating adolescent drinking pattern developments over a period of time to trends in adolescent income can yield information on the significance of parental control of adolescent income. Biannual repeated cross-sectional surveys. Nationally representative samples. 14-year-old adolescents in the period 1983-2013 in Finland (N=33 771). Adolescents' alcohol drinking pattern was significantly associated with their disposable income. The OR for monthly drunkenness versus abstinence was 6.6 (95% CI 5.0 to 8.8) among girls and 9.0 (6.3 to 13.0) among boys in the highest income group compared with the lowest. However, the association between income and drinking pattern weakened considerably during the 30-year period. Disposable income has been a significant predictor of adolescent alcohol drinking in the past 30 years. However, in the recent years, the amount of disposable money has decreased in importance. 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/.

The personal and national costs of mental health conditions: impacts on income, taxes, government support payments due to lost labour force participation

PubMed Central

2011-01-01

Background Mental health conditions have the ability to interrupt an individual's ability to participate in the labour force, and this can have considerable follow on impacts to both the individual and the state. Method Cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers and STINMOD, an income and savings microsimulation model was used to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefits payments and lost GDP as a result of early retirement due to mental health conditions in Australians aged 45-64 in 2009. Results Individuals aged 45 to 64 years who have retired early due to depression personally have 73% lower income then their full time employed counterparts and those retired early due to other mental health conditions have 78% lower incomes. The national aggregate cost to government due to early retirement from these conditions equated to $278 million (£152.9 million) in lost income taxation revenue, $407 million (£223.9 million) in additional transfer payments and around $1.7 billion in GDP in 2009 alone. Conclusions The costs of mental health conditions to the individuals and the state are considerable. While individuals has to bear the economic costs of lost income in addition to the burden of the conditions itself, the impact on the state is loss of productivity from reduced workforce participation, lost income taxation revenue, and increased government support payments - in addition to direct health care costs. PMID:21526993

National mortality rates: the impact of inequality?

PubMed

Wilkinson, R G

1992-08-01

Although health is closely associated with income differences within each country there is, at best, only a weak link between national mortality rates and average income among the developed countries. On the other hand, there is evidence of a strong relationship between national mortality rates and the scale of income differences within each society. These three elements are coherent if health is affected less by changes in absolute material standards across affluent populations than it is by relative income or the scale of income differences and the resulting sense of disadvantage within each society. Rather than socioeconomic mortality differentials representing a distribution around given national average mortality rates, it is likely that the degree of income inequality indicates the burden of relative deprivation on national mortality rates.

Global variance in female population height: the influence of education, income, human development, life expectancy, mortality and gender inequality in 96 nations.

PubMed

Mark, Quentin J

2014-01-01

Human height is a heritable trait that is known to be influenced by environmental factors and general standard of living. Individual and population stature is correlated with health, education and economic achievement. Strong sexual selection pressures for stature have been observed in multiple diverse populations, however; there is significant global variance in gender equality and prohibitions on female mate selection. This paper explores the contribution of general standard of living and gender inequality to the variance in global female population heights. Female population heights of 96 nations were culled from previously published sources and public access databases. Factor analysis with United Nations international data on education rates, life expectancy, incomes, maternal and childhood mortality rates, ratios of gender participation in education and politics, the Human Development Index (HDI) and the Gender Inequality Index (GII) was run. Results indicate that population heights vary more closely with gender inequality than with population health, income or education.

Deepening Disparity: Income Equality in New York City.

ERIC Educational Resources Information Center

Elliott, Mark; Grote, Mae Watson; Levin-Waldman, Oren M.

Analysis of the Current Population Survey data for New York City reveals that the economic growth of the 1990s increased the income of families across the earnings spectrum nationally; however, earnings among families in the top quintile outpaced other quintiles, leading to an increase in income inequality. This inequality was substantially…

An exploratory multilevel analysis of income, income inequality and self-rated health of the elderly in China.

PubMed

Feng, Zhixin; Wang, Wenfei Winnie; Jones, Kelvyn; Li, Yaqing

2012-12-01

In the last three decades, China has experienced rapid economic development and growing economic inequality, such that economic disparities between rural and urban areas, as well as coastal and interior areas have deepened. Since the late 1990s China has also experienced an ageing population which has attracted attention to the wellbeing of the rapidly growing number of elderly. This research aims to characterise province differences in health and to explore the effects of individual income and economic disparity in the form of income inequality on health outcomes of the elderly. The study is based on the Chinese Longitudinal Healthy Longevity Survey data collected in 2008 for 23 provinces. Multilevel logistic models are employed to investigate the relationship between income, income inequality and self-rated health for the elderly using both individual and province-level variables. Results are presented as relative odds ratios, and for province differentials as Median Odds Ratios. The analysis is deliberately exploratory so as to find evidence of income effects if they exist and particular attention is placed on how province-level inequality (contemporaneous and lagged) may moderate individual relationships. The results show that the health of the elderly is not only affected by individual income (the odds of poor health are 3 times greater for the elderly with the lowest income compared to those at the upper quartile) but also by a small main effect for province-level income inequality (odds ratio of 1.019). There are significant cross-level interactions such that where inequality is high there are greater differences between those with and without formal education, and between men and women with the latter experiencing poorer health. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

Income inequality among American states and the conditional risk of post-traumatic stress disorder.

PubMed

Pabayo, Roman; Fuller, Daniel; Goldstein, Risë B; Kawachi, Ichiro; Gilman, Stephen E

2017-09-01

Vulnerability to post-traumatic disorder (PTSD) following a traumatic event can be influenced by individual-level as well as contextual factors. Characteristics of the social and economic environment might increase the odds for PTSD after traumatic events occur. One example that has been identified as a potential environmental determinant is income inequality. The purpose of this study is to investigate the association between State-level income inequality and PTSD among adults who have been exposed to trauma. We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n = 34,653). Structured diagnostic interviews were administered at baseline (2001-2002) and follow-up (2004-2005). Weighted multi-level logistic regression was used to determine if US State-level income inequality, as measured by the Gini coefficient, was associated with incident episodes of PTSD during the study's 3-year follow-up period adjusting for individual and state-level covariates. The mean Gini coefficient across states in the NESARC was 0.44 (SD = 0.02) and ranged from 0.39 to 0.53. Of the respondents, 27,638 reported exposure to a traumatic event. Of this sample, 6.9 and 2.3% experienced persistent or recurrent and incident PTSD, respectively. State-level inequality was not associated with increased odds for persistent or recurrent PTSD (OR = 1.02; 95% CI 0.85, 1.22), but was associated with incident PTSD (OR = 1.30, 95% CI 1.04, 1.63). The degree of income inequality in one's state of residence is associated with vulnerability to PTSD among individuals exposed to traumatic events. Additional work is needed to determine if this association is causal (or alternatively, is explained by other socio-contextual factors associated with income inequality), and if so, what anxiogenic mechanisms explain it.

Early childhood linear growth faltering in low-income and middle-income countries as a whole-population condition: analysis of 179 Demographic and Health Surveys from 64 countries (1993-2015).

PubMed

Roth, Daniel E; Krishna, Aditi; Leung, Michael; Shi, Joy; Bassani, Diego G; Barros, Aluisio J D

2017-12-01

The causes of early childhood linear growth faltering (known as stunting) in low-income and middle-income countries remain inadequately understood. We aimed to determine if the progressive postnatal decline in mean height-for-age Z score (HAZ) in low-income and middle-income countries is driven by relatively slow growth of certain high-risk children versus faltering of the entire population. Distributions of HAZ (based on WHO growth standards) were analysed in 3-month age intervals from 0 to 36 months of age in 179 Demographic and Health Surveys from 64 low-income and middle-income countries (1993-2015). Mean, standard deviation (SD), fifth percentiles, and 95th percentiles of the HAZ distribution were estimated for each age interval in each survey. Associations between mean HAZ and SD, fifth percentile, and 95th percentile were estimated using multilevel linear models. Stratified analyses were performed in consideration of potential modifiers (world region, national income, sample size, year, or mean HAZ in the 0-3 month age band). We also used Monte Carlo simulations to model the effects of subgroup versus whole-population faltering on the HAZ distribution. Declines in mean HAZ from birth to 3 years of age were accompanied by declines in both the fifth and 95th percentiles, leading to nearly symmetrical narrowing of the HAZ distributions. Thus, children with relatively low HAZ were not more likely to have faltered than taller same-age peers. Inferences were unchanged in surveys regardless of world region, national income, sample size, year, or mean HAZ in the 0-3 month age band. Simulations showed that the narrowing of the HAZ distribution as mean HAZ declined could not be explained by faltering limited to a growth-restricted subgroup of children. In low-income and middle-income countries, declines in mean HAZ with age are due to a downward shift in the entire HAZ distribution, revealing that children across the HAZ spectrum experience slower growth compared to

Income inequality is associated with stronger social comparison effects: The effect of relative income on life satisfaction.

PubMed

Cheung, Felix; Lucas, Richard E

2016-02-01

Previous research has shown that having rich neighbors is associated with reduced levels of subjective well-being, an effect that is likely due to social comparison. The current study examined the role of income inequality as a moderator of this relative income effect. Multilevel analyses were conducted on a sample of more than 1.7 million people from 2,425 counties in the United States. Results showed that higher income inequality was associated with stronger relative income effects. In other words, people were more strongly influenced by the income of their neighbors when income inequality was high. (c) 2016 APA, all rights reserved).

Income Inequality Is Associated with Stronger Social Comparison Effects: The Effect of Relative Income on Life Satisfaction

PubMed Central

Cheung, Felix; Lucas, Richard E.

2015-01-01

Previous research has shown that having rich neighbors is associated with reduced levels of subjective well-being, an effect that is likely due to social comparison. The current study examined the role of income inequality as a moderator of this relative income effect. Multilevel analyses were conducted on a sample of over 1.7 million people from 2,425 counties in the United States. Results showed that higher income inequality was associated with stronger relative income effects. In other words, people were more strongly influenced by the income of their neighbors when income inequality was high. PMID:26191957

The Use of Refundable Tax Credits to Increase Low-Income Children's After-School Physical Activity Level.

PubMed

Dunton, Genevieve; Ebin, Vicki J; Efrat, Merav W; Efrat, Rafael; Lane, Christianne J; Plunkett, Scott

2015-06-01

The current study investigates the extent to which a refundable tax credit could be used to increase low-income children's after-school physical activity levels. An experimental study was conducted evaluating the effectiveness of an intervention offering a simulated refundable tax credit to parents of elementary-school-age children (n = 130) for enrollment in after-school physical activity programs. A randomized controlled design was used, with data collected at baseline, immediately following the 4-month intervention (postintervention), and 6 weeks after the end of the intervention (follow-up). Evaluation measures included (1) enrollment rate, time spent, weekly participation frequency, duration of enrollment, and long-term enrollment patterns in after-school physical activity programs and (2) moderate to vigorous physical activity. The simulated tax credits did not significantly influence low-income children's rates of enrollment in after-school physical activity programs, frequency of participation, time spent in after-school physical activity programs, and overall moderate-to-vigorous intensity physical activity at postintervention or follow-up. The use of refundable tax credits as incentives to increase participation in after-school physical activity programs in low-income families may have limited effectiveness. Lawmakers might consider other methods of fiscal policy to promote physical activity such as direct payment to after-school physical activity program providers for enrolling and serving a low-income child in a qualified program, or improvements to programming and infrastructure.

The Effects of State Medicaid Expansion on Low-Income Individuals' Access to Health Care: Multilevel Modeling.

PubMed

Choi, Sunha; Lee, Sungkyu; Matejkowski, Jason

2018-06-01

This study aimed to examine how states' Medicaid expansion affected insurance status and access to health care among low-income expansion state residents in 2015, the second year of the expansion. Data from the 2012 and 2015 Behavioral Risk Factor Surveillance System were linked to state-level data. A nationally representative sample of 544,307 adults (ages 26-64 years) from 50 states and Washington, DC were analyzed using multilevel modeling. The results indicate substantial increases in health care access between 2012 and 2015 among low-income adults in Medicaid expansion states. The final conditional multilevel models with low-income adults who had income at or below 138% of the poverty line indicate that, after controlling for individual- and state-level covariates, those who resided in the Medicaid expansion states were more likely to have health insurance (OR = 1.97, P < .001), have a usual source of care (OR = 1.37, P < .01), and receive a routine checkup (OR = 1.24, P < .01), and were less likely to not see a doctor because of cost (OR = 0.66, P < .001) compared with low-income residents in non-expansion states in 2015. Moreover, the significant interaction terms indicate that adults living in non-expansion states with income below 100% of the poverty line are the most vulnerable compared with their counterparts in expansion states and with those with income between 100%-138% of the poverty line. This study demonstrates that state-level Medicaid expansion improved health care access among low-income US residents. However, residents with income below 100% of the poverty line in non-expansion states were disproportionately negatively affected by states' decision to not expand Medicaid coverage.

National mortality rates: the impact of inequality?

PubMed Central

Wilkinson, R G

1992-01-01

Although health is closely associated with income differences within each country there is, at best, only a weak link between national mortality rates and average income among the developed countries. On the other hand, there is evidence of a strong relationship between national mortality rates and the scale of income differences within each society. These three elements are coherent if health is affected less by changes in absolute material standards across affluent populations than it is by relative income or the scale of income differences and the resulting sense of disadvantage within each society. Rather than socioeconomic mortality differentials representing a distribution around given national average mortality rates, it is likely that the degree of income inequality indicates the burden of relative deprivation on national mortality rates. PMID:1636827

International validation of quality indicators for evaluating priority setting in low income countries: process and key lessons.

PubMed

Kapiriri, Lydia

2017-06-19

While there have been efforts to develop frameworks to guide healthcare priority setting; there has been limited focus on evaluation frameworks. Moreover, while the few frameworks identify quality indicators for successful priority setting, they do not provide the users with strategies to verify these indicators. Kapiriri and Martin (Health Care Anal 18:129-147, 2010) developed a framework for evaluating priority setting in low and middle income countries. This framework provides BOTH parameters for successful priority setting and proposes means of their verification. Before its use in real life contexts, this paper presents results from a validation process of the framework. The framework validation involved 53 policy makers and priority setting researchers at the global, national and sub-national levels (in Uganda). They were requested to indicate the relative importance of the proposed parameters as well as the feasibility of obtaining the related information. We also pilot tested the proposed means of verification. Almost all the respondents evaluated all the parameters, including the contextual factors, as 'very important'. However, some respondents at the global level thought 'presence of incentives to comply', 'reduced disagreements', 'increased public understanding,' 'improved institutional accountability' and 'meeting the ministry of health objectives', which could be a reflection of their levels of decision making. All the proposed means of verification were assessed as feasible with the exception of meeting observations which would require an insider. These findings results were consistent with those obtained from the pilot testing. These findings are relevant to policy makers and researchers involved in priority setting in low and middle income countries. To the best of our knowledge, this is one of the few initiatives that has involved potential users of a framework (at the global and in a Low Income Country) in its validation. The favorable validation

The Effect of Patient Neighborhood Income Level on the Purchase of Continuous Positive Airway Pressure Treatment among Patients with Sleep Apnea.

PubMed

Kendzerska, Tetyana; Gershon, Andrea S; Tomlinson, George; Leung, Richard S

2016-01-01

The cost of continuous positive airway pressure (CPAP) treatment for patients with low socioeconomic status may be an important barrier to successful treatment of obstructive sleep apnea under a copayment health care system. We evaluated an association between patient neighborhood income level and the purchase of a CPAP device under a cost-sharing health care insurance system. All adults who underwent a first diagnostic sleep study at St. Michael's Hospital (Toronto, ON, Canada) between 2004 and 2010 were included. Severity of obstructive sleep apnea was determined by the apnea-hypopnea index (AHI) and level of daytime sleepiness (by the Epworth Sleepiness Scale). Patient data were linked to provincial health administrative data from 1991 to 2013 to determine the purchase of CPAP equipment, comorbidities, neighborhood income, and rural status at baseline. Neighborhood income was categorized into quintiles, ranked from poorest (Q1) to wealthiest (Q5). Assuming that the majority of participants with severe obstructive sleep apnea (AHI > 30 events/h) and excessive daytime sleepiness (Epworth Sleepiness Scale ≥ 10) would have been strongly recommended CPAP, we evaluated the association between patient neighborhood income and purchase of a CPAP device in this group via multivariable Cox regressions. Of the 695 participants with severe obstructive sleep apnea and excessive daytime sleepiness, 400 (58%) purchased a CPAP device. Patients who accepted CPAP were more likely to live in a higher-income neighborhood. Cumulative incidence of CPAP acceptance at 6 months was 43% for individuals in a low-income neighborhood (Q1) and 52% in combined higher-income neighborhoods (Q2-5) (P = 0.05). Controlling for sex and age, living in higher-income neighborhoods was associated with a 27% increased chance of accepting CPAP compared with the lowest-income neighborhood (hazard ratio Q2-5 vs. Q1, 1.27; 95% confidence interval, 0.98-1.64; P = 0.07). Living in an

Availability and affordability of blood pressure-lowering medicines and the effect on blood pressure control in high-income, middle-income, and low-income countries: an analysis of the PURE study data.

PubMed

Attaei, Marjan W; Khatib, Rasha; McKee, Martin; Lear, Scott; Dagenais, Gilles; Igumbor, Ehimario U; AlHabib, Khalid F; Kaur, Manmeet; Kruger, Lanthe; Teo, Koon; Lanas, Fernando; Yusoff, Khalid; Oguz, Aytekin; Gupta, Rajeev; Yusufali, Afzalhussein M; Bahonar, Ahmad; Kutty, Raman; Rosengren, Annika; Mohan, Viswanathan; Avezum, Alvaro; Yusuf, Rita; Szuba, Andrzej; Rangarajan, Sumathy; Chow, Clara; Yusuf, Salim

2017-09-01

Hypertension is considered the most important risk factor for cardiovascular diseases, but its control is poor worldwide. We aimed to assess the availability and affordability of blood pressure-lowering medicines, and the association with use of these medicines and blood pressure control in countries at varying levels of economic development. We analysed the availability, costs, and affordability of blood pressure-lowering medicines with data recorded from 626 communities in 20 countries participating in the Prospective Urban Rural Epidemiological (PURE) study. Medicines were considered available if they were present in the local pharmacy when surveyed, and affordable if their combined cost was less than 20% of the households' capacity to pay. We related information about availability and affordability to use of these medicines and blood pressure control with multilevel mixed-effects logistic regression models, and compared results for high-income, upper-middle-income, lower-middle-income, and low-income countries. Data for India are presented separately because it has a large generic pharmaceutical industry and a higher availability of medicines than other countries at the same economic level. The availability of two or more classes of blood pressure-lowering drugs was lower in low-income and middle-income countries (except for India) than in high-income countries. The proportion of communities with four drug classes available was 94% in high-income countries (108 of 115 communities), 76% in India (68 of 90), 71% in upper-middle-income countries (90 of 126), 47% in lower-middle-income countries (107 of 227), and 13% in low-income countries (nine of 68). The proportion of households unable to afford two blood pressure-lowering medicines was 31% in low-income countries (1069 of 3479 households), 9% in middle-income countries (5602 of 65 471), and less than 1% in high-income countries (44 of 10 880). Participants with known hypertension in communities that had

Income Inequality or Performance Gap? A Multilevel Study of School Violence in 52 Countries.

PubMed

Contreras, Dante; Elacqua, Gregory; Martinez, Matias; Miranda, Álvaro

2015-11-01

The purpose of the study was to examine the association between income inequality and school violence and between the performance inequality and school violence in two international samples. The study used data from Trends in International Mathematics and Science Study 2011 and from the Central Intelligence Agency of United States which combined information about academic performance and students' victimization (physical and social) for 269,456 fourth-grade students and 261,747 eighth-grade students, with gross domestic product and income inequality data in 52 countries. Ecological correlations tested associations between income inequality and victimization and between school performance inequality and victimization among countries. Multilevel ordinal regression and multilevel regression analyses tested the strength of these associations when controlling for socioeconomic and academic performance inequality at school level and family socioeconomic status and academic achievement at student level. Income inequality was associated with victimization rates in both fourth and eighth grade (r ≈ .60). Performance inequality shows stronger association with victimization among eighth graders (r ≈ .46) compared with fourth graders (r ≈ .30). Multilevel analyses indicate that both an increase in the income inequality in the country and school corresponds with more frequent physical and social victimization. On the other hand, an increase in the performance inequality at the system level shows no consistent association to victimization. However, school performance inequality seems related to an increase in both types of victimizations. Our results contribute to the finding that income inequality is a determinant of school violence. This result holds regardless of the national performance inequality between students. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Characteristics of the Low-Income Population, 1971. Current Population Reports: Consumer Income, Series P-60, Number 86.

ERIC Educational Resources Information Center

Shelburne, Elizabeth C.

This report presents social and economic statistics for the population of the United States below the low-income level in 1971, based on the March 1972 Current Population Survey. Included are data on selected characteristics of the population below the low-income level in 1971, such as geographic distribution, race and ethnic origin, family…

Physical capital and the embodied nature of income inequality: gender differences in the effect of body size on workers' incomes in Canada.

PubMed

Perks, Thomas

2012-02-01

This study assesses the effects of body size--measured using the body mass index--on the income attainment of female and male workers in Canada. Using data from a national representative sample of Canadians, multivariate analyses show that, for female workers, the body size-income relationship is negative. However, for male workers, the body size-income relationship is positive and nonlinear. Using Bourdieu's conceptualization of physical capital, and Shilling's extension of it, it is argued that these results are suggestive of the relative importance of body size to the production and continuation of gender income inequality in Canada.

Promoting health equity: WHO health inequality monitoring at global and national levels.

PubMed

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

2015-01-01

Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

Promoting health equity: WHO health inequality monitoring at global and national levels

PubMed Central

Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne

2015-01-01

Background Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level. PMID:26387506

Trends and Divergences in Childhood Income Dynamics, 1970-2010.

PubMed

Hill, Heather D

2018-01-01

Earnings and income variability have increased since the 1970s, particularly at the bottom of the income distribution. Considerable evidence suggests that childhood income levels-captured as average or point-in-time yearly income-are associated with numerous child and adult outcomes. The importance to child development of stable proximal processes during childhood suggests that income variability may also be important, particularly if it is unpredictable, unintentional, or does not reflect an upward trend in family income. Using the Panel Study of Income Dynamics, this study documents trends since the 1970s in three dimensions of childhood income dynamics: level, variability, and growth (n=7991). The analysis reveals that income variability during childhood has grown over time, while income growth rates have not. In addition, the economic context of childhood has diverged substantially by socioeconomic status, race, and family structure, with the most disadvantaged children facing a double-whammy of low income and high variability. © 2018 Elsevier Inc. All rights reserved.

The personal and national costs of early retirement because of spinal disorders: impacts on income, taxes, and government support payments.

PubMed

Schofield, Deborah J; Shrestha, Rupendra N; Percival, Richard; Passey, Megan E; Callander, Emily J; Kelly, Simon J

2012-12-01

Spinal disorders can reduce an individual's ability to participate in the labor force, and this can lead to considerable impacts on both the individual and the state. This study was aimed to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefits payments, and lost gross domestic product (GDP) as a result of early retirement because of spinal disorders in Australians aged 45 to 64 years in 2009. This was done using cross-sectional analysis of the base population of Health&WealthMOD, a microsimulation model built on data from the Australian Bureau of Statistics' Survey of Disability, Ageing and Carers, and STINMOD, an income and savings microsimulation model. Linear regression models were used to examine the relationship between spinal disorders, labor force participation, income, taxation, and government support payments. It was found that individuals aged 45 to 64 years who have retired early because of spinal disorders have significantly lower income (79% less; 95% confidence interval [CI], -84.7, -71.1; p<.0001), pay significantly less taxation (100% less; 95% CI, -100.0, 99.9; p<.0001), and receive significantly more in government support payments (21,000% more; 95% CI, 12,767.0, 35,336.4; p<.0001) than those employed full time with no health condition. Individuals who have retired early because of spinal disorders have a median value of total weekly income of only AU$310, whereas those who are employed full time are likely to receive four times this. This has a large national aggregate impact, with AU$4.8 billion lost in annual individual earnings, AU$622 million in additional welfare payments, AU$497 million lost in taxation revenue for governments, and AU$2.9 billion in lost GDP: all attributable to spinal disorders through their impact on labor force participation. Although the individual has to bear the economic costs of lost income in addition to the burden of the condition itself, the state

Impact of income and income inequality on infant health outcomes in the United States.

PubMed

Olson, Maren E; Diekema, Douglas; Elliott, Barbara A; Renier, Colleen M

2010-12-01

The goal was to investigate the relationships of income and income inequality with neonatal and infant health outcomes in the United States. The 2000-2004 state data were extracted from the Kids Count Data Center. Health indicators included proportion of preterm births (PTBs), proportion of infants with low birth weight (LBW), proportion of infants with very low birth weight (VLBW), and infant mortality rate (IMR). Income was evaluated on the basis of median family income and proportion of federal poverty levels; income inequality was measured by using the Gini coefficient. Pearson correlations evaluated associations between the proportion of children living in poverty and the health indicators. Linear regression evaluated predictive relationships between median household income, proportion of children living in poverty, and income inequality for the 4 health indicators. Median family income was negatively correlated with all birth outcomes (PTB, r = -0.481; LBW, r = -0.295; VLBW, r = -0.133; IMR, r = -0.432), and the Gini coefficient was positively correlated (PTB, r = 0.339; LBW, r = 0.398; VLBW, r = 0.460; IMR, r = 0.114). The Gini coefficient explained a significant proportion of the variance in rate for each outcome in linear regression models with median family income. Among children living in poverty, the role of income decreased as the degree of poverty decreased, whereas the role of income inequality increased. Both income and income inequality affect infant health outcomes in the United States. The health of the poorest infants was affected more by absolute wealth than relative wealth.

Income inequality and depression: a systematic review and meta-analysis of the association and a scoping review of mechanisms.

PubMed

Patel, Vikram; Burns, Jonathan K; Dhingra, Monisha; Tarver, Leslie; Kohrt, Brandon A; Lund, Crick

2018-02-01

Most countries have witnessed a dramatic increase of income inequality in the past three decades. This paper addresses the question of whether income inequality is associated with the population prevalence of depression and, if so, the potential mechanisms and pathways which may explain this association. Our systematic review included 26 studies, mostly from high-income countries. Nearly two-thirds of all studies and five out of six longitudinal studies reported a statistically significant positive relationship between income inequality and risk of depression; only one study reported a statistically significant negative relationship. Twelve studies were included in a meta-analysis with dichotomized inequality groupings. The pooled risk ratio was 1.19 (95% CI: 1.07-1.31), demonstrating greater risk of depression in populations with higher income inequality relative to populations with lower inequality. Multiple studies reported subgroup effects, including greater impacts of income inequality among women and low-income populations. We propose an ecological framework, with mechanisms operating at the national level (the neo-material hypothesis), neighbourhood level (the social capital and the social comparison hypotheses) and individual level (psychological stress and social defeat hypotheses) to explain this association. We conclude that policy makers should actively promote actions to reduce income inequality, such as progressive taxation policies and a basic universal income. Mental health professionals should champion such policies, as well as promote the delivery of interventions which target the pathways and proximal determinants, such as building life skills in adolescents and provision of psychological therapies and packages of care with demonstrated effectiveness for settings of poverty and high income inequality. © 2018 World Psychiatric Association.

Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms

PubMed Central

Patel, Vikram; Burns, Jonathan K.; Dhingra, Monisha; Tarver, Leslie; Kohrt, Brandon A.; Lund, Crick

2018-01-01

Most countries have witnessed a dramatic increase of income inequality in the past three decades. This paper addresses the question of whether income inequality is associated with the population prevalence of depression and, if so, the potential mechanisms and pathways which may explain this association. Our systematic review included 26 studies, mostly from high‐income countries. Nearly two‐thirds of all studies and five out of six longitudinal studies reported a statistically significant positive relationship between income inequality and risk of depression; only one study reported a statistically significant negative relationship. Twelve studies were included in a meta‐analysis with dichotomized inequality groupings. The pooled risk ratio was 1.19 (95% CI: 1.07‐1.31), demonstrating greater risk of depression in populations with higher income inequality relative to populations with lower inequality. Multiple studies reported subgroup effects, including greater impacts of income inequality among women and low‐income populations. We propose an ecological framework, with mechanisms operating at the national level (the neo‐material hypothesis), neighbourhood level (the social capital and the social comparison hypotheses) and individual level (psychological stress and social defeat hypotheses) to explain this association. We conclude that policy makers should actively promote actions to reduce income inequality, such as progressive taxation policies and a basic universal income. Mental health professionals should champion such policies, as well as promote the delivery of interventions which target the pathways and proximal determinants, such as building life skills in adolescents and provision of psychological therapies and packages of care with demonstrated effectiveness for settings of poverty and high income inequality. PMID:29352539

Medicines coverage and community-based health insurance in low-income countries

PubMed Central

Vialle-Valentin, Catherine E; Ross-Degnan, Dennis; Ntaganira, Joseph; Wagner, Anita K

2008-01-01

Objectives The 2004 International Conference on Improving Use of Medicines recommended that emerging and expanding health insurances in low-income countries focus on improving access to and use of medicines. In recent years, Community-based Health Insurance (CHI) schemes have multiplied, with mounting evidence of their positive effects on financial protection and resource mobilization for healthcare in poor settings. Using literature review and qualitative interviews, this paper investigates whether and how CHI expands access to medicines in low-income countries. Methods We used three complementary data collection approaches: (1) analysis of WHO National Health Accounts (NHA) and available results from the World Health Survey (WHS); (2) review of peer-reviewed articles published since 2002 and documents posted online by national insurance programs and international organizations; (3) structured interviews of CHI managers about key issues related to medicines benefit packages in Lao PDR and Rwanda. Results In low-income countries, only two percent of WHS respondents with voluntary insurance belong to the lowest income quintile, suggesting very low CHI penetration among the poor. Yet according to the WHS, medicines are the largest reported component of out-of-pocket payments for healthcare in these countries (median 41.7%) and this proportion is inversely associated with income quintile. Publications have mentioned over a thousand CHI schemes in 19 low-income countries, usually without in-depth description of the type, extent, or adequacy of medicines coverage. Evidence from the literature is scarce about how coverage affects medicines utilization or how schemes use cost-containment tools like co-payments and formularies. On the other hand, interviews found that medicines may represent up to 80% of CHI expenditures. Conclusion This paper highlights the paucity of evidence about medicines coverage in CHI. Given the policy commitment to expand CHI in several countries

Climatic Warmth and National Wealth: Some Culture-Level Determinants of National Character Stereotypes.

PubMed

McCrae, Robert R; Terracciano, Antonio; Realo, Anu; Allik, Jüri

2007-12-01

National character stereotypes are widely shared, but do not reflect assessed levels of personality traits. In this article we present data illustrating the divergence of stereotypes and assessed personality traits in north and south Italy, test hypotheses about the associations of temperature and national wealth with national character stereotypes in 49 cultures, and explore possible links to national values and beliefs. Results suggest that warmth and wealth are common determinants of national stereotypes, but that there are also idiosyncratic influences on the perceptions of individual nations.

The Use of Refundable Tax Credits to Increase Low-Income Children's After-School Physical Activity Level

PubMed Central

Dunton, Genevieve; Ebin, Vicki J.; Efrat, Merav W.; Efrat, Rafael; Lane, Christianne J.; Plunkett, Scott

2014-01-01

Objective The present study investigates the extent to which a refundable tax credit could be used to increase low income children's after-school physical activity levels. Methods An experimental study was conducted evaluating the effectiveness of an intervention offering a simulated refundable tax credit to parents of elementary school-age children (n=130) for enrollment in after-school physical activity programs. A randomized-controlled design was used, with data collected at baseline, immediately following the four month intervention (post-intervention), and six-weeks after the end of the intervention (follow-up). Evaluation measures included: (a) enrollment rate, time spent, weekly participation frequency, duration of enrollment and long term enrollment patterns in after-school physical activity programs; and (b) moderate-to-vigorous physical activity (MVPA). Results The simulated tax credits did not significantly influence low- income children's rates of enrollment in after-school physical activity programs, frequency of participation, time spent in after-school physical activity programs, and overall moderate-to-vigorous intensity physical activity at post-intervention or follow-up. Conclusion The use of refundable tax credits as incentives to increase participation in after-school physical activity programs in low-income families may have limited effectiveness. Lawmakers might consider other methods of fiscal policy to promote physical activity such as direct payment to after-school physical activity program providers for enrolling and serving a low- income child in a qualified program, or improvements to programming and infrastructure. PMID:25184738

The Changing Nonlinear Relationship between Income and Terrorism

PubMed Central

Enders, Walter; Hoover, Gary A.

2014-01-01

This article reinvestigates the relationship between real per capita gross domestic product (GDP) and terrorism. We devise a terrorism Lorenz curve to show that domestic and transnational terrorist attacks are each more concentrated in middle-income countries, thereby suggesting a nonlinear income–terrorism relationship. Moreover, this point of concentration shifted to lower income countries after the rising influence of the religious fundamentalist and nationalist/separatist terrorists in the early 1990s. For transnational terrorist attacks, this shift characterized not only the attack venue but also the perpetrators’ nationality. The article then uses nonlinear smooth transition regressions to establish the relationship between real per capita GDP and terrorism for eight alternative terrorism samples, accounting for venue, perpetrators’ nationality, terrorism type, and the period. Our nonlinear estimates are shown to be favored over estimates using linear or quadratic income determinants of terrorism. These nonlinear estimates are robust to additional controls. PMID:28579636

Early adolescent childbearing in low- and middle-income countries: associations with income inequity, human development and gender equality.

PubMed

Decker, Michele R; Kalamar, Amanda; Tunçalp, Özge; Hindin, Michelle J

2017-03-01

Reducing unwanted adolescent childbearing is a global priority. Little is known about how national-level economic and human development indicators relate to early adolescent childbearing. This ecological study evaluates associations of Gross Domestic Product (GDP), GINI index, Human Development Index (HDI) and Gender-related Development Index (GDI; i.e. the HDI adjusted for gender disparities) with early adolescent childbearing in 27 low- and middle-income countries (LMICs) across three time periods. Among women ages 18–24, prevalence estimates for early birth (<16 years) were calculated by nation, and weighted linear regressions evaluated associations between national indicators and early childbearing. To examine temporal trends, analyses were stratified by year groupings. Early adolescent childbearing declined over time, with the greatest change observed in Bangladesh (31.49% in 1996/7 to 19.69% in 2011). In adjusted models, GDI was negatively associated with early childbearing, i.e. early childbearing prevalence decreased as GDI increased. In the most recent time period, relative to the lowest GDI group, the average prevalence of early childbearing was significantly lower in the middle (-12.40, P < 0.00) and upper (-10.96, P = 0.03) tertiles after adjustment for the other indicators. These other indicators showed no consistent association with early childbearing. As national-level GDI increased, early adolescent childbearing declined. The GDI, which reflects human development adjusted for gender disparities in educational and economic prospects, was more consistently related to early adolescent childbearing than the absolute development prospects as given by the HDI. While creating gender equality is an important goal in and of itself, the findings emphasize the potential for improved national-level gender equitable development as a means to improve adolescents’ sexual and reproductive health.

Climatic Warmth and National Wealth: Some Culture-Level Determinants of National Character Stereotypes

PubMed Central

McCrae, Robert R.; Terracciano, Antonio; Realo, Anu; Allik, Jüri

2009-01-01

National character stereotypes are widely shared, but do not reflect assessed levels of personality traits. In this article we present data illustrating the divergence of stereotypes and assessed personality traits in north and south Italy, test hypotheses about the associations of temperature and national wealth with national character stereotypes in 49 cultures, and explore possible links to national values and beliefs. Results suggest that warmth and wealth are common determinants of national stereotypes, but that there are also idiosyncratic influences on the perceptions of individual nations. PMID:20046546

Low Serum Testosterone Levels Are Associated with Elevated Urinary Mandelic Acid, and Strontium Levels in Adult Men According to the US 2011–2012 National Health and Nutrition Examination Survey

PubMed Central

Liu, Hui; Héroux, Paul; Zhang, Qunwei; Jiang, Zhao-Yan; Gu, Aihua

2015-01-01

Background Little is known regarding the effects of environmental exposure of chemicals on androgenic system in the general population. We studied 5,107 subjects included in the National Health and Nutrition Examination Survey (2011–2012). Methods Urinary, serum, and blood levels of 15 subclasses comprising 110 individual chemicals were analyzed for their association with serum testosterone levels. The subjects were divided into high and low testosterone groups according to the median testosterone concentration (374.51 ng/dL). Odds ratios (ORs) of individual chemicals in association with testosterone were estimated using logistic regression after adjusting for age, ethnicity, cotinine, body mass index, creatinine, alcohol, and the poverty income ratio. Results Adjusted ORs for the highest versus lowest quartiles of exposure were 2.12 (95% CI: 1.07, 4.21; Ptrend = 0.044), 1.84 (95% CI: 1.02, 3.34; Ptrend = 0.018) for the association between urinary mandelic acid, and strontium quartiles with low testosterone concentrations in adult men, respectively. However, no association was observed for the remaining chemicals with testosterone. Conclusions The National Health and Nutrition Examination Survey data suggest that elevations in urinary mandelic acid, and strontium levels are negatively related to low serum testosterone levels in adult men. PMID:25996772

A longitudinal study on the impact of income change and poverty on smoking cessation.

PubMed

Young-Hoon, Kit-Ngan

2012-01-01

Research on the association between income and smoking cessation has examined income as a static phenomenon, either cross-sectionally or as a predictor variable in longitudinal studies. This study recognizes income as a dynamic entity and examines the relationship between a change in income and subsequent smoking behaviour. Longitudinal data from the National Population Health Survey (1994/5 to 2008/9) were used to examine the impact of (1) change in income and (2) change in poverty status, on the probability of being a former or current smoker among a sample of Canadians identified as having ever smoked. Covariates include socio-demographic characteristics, number of cigarettes smoked per day, and smoking in the home. Smoking behaviour was not associated with a change in household income but was associated with a change in household income that moved an individual across the poverty threshold. Canadians whose income increased to above the poverty threshold were less likely to continue smoking than someone who remained in poverty (OR = 0.72, 95% CI: 0.62-0.84). Those who remained out of poverty were also less likely to continue smoking than someone who remained in poverty (OR = 0.66, 95% CI: 0.57-0.75). There was no significant difference between those who remained in poverty and those whose income decreased to below the poverty level. This study strengthens the link between smoking and poverty and supports strategies that address income as a socio-economic determinant of health. Policies that increase household incomes above the poverty line may lead to improvements in smoking cessation rates.

Impact of Socio-Health Factors on Life Expectancy in the Low and Lower Middle Income Countries

PubMed Central

MONDAL, Md. Nazrul Islam; SHITAN, Mahendran

2013-01-01

Abstract Background This study is concerned with understanding the impact of demographic changes, socioeconomic inequalities, and the availability of health factors on life expectancy (LE) in the low and lower middle income countries. Methods The cross-country data were collected from 91 countries from the United Nations agencies in 2012. LE is the response variable with demographics (total fertility rate, and adolescent fertility rate), socioeconomic status (mean year of schooling, and gross national income per capita), and health factors (physician density, and HIV prevalence rate) are as the three main predictors. Stepwise multiple regression analysis is used to extract the main factors. Results The necessity of more healthcare resources and higher levels of socioeconomic advantages are more likely to increase LE. On the other hand, demographic changes and health factors are more likely to increase LE by way of de-cease fertility rates and disease prevalence. Conclusion These findings suggest that international efforts should aim at increasing LE, especially in the low income countries through the elimination of HIV prevalence, adolescent fertility, and illiteracy. PMID:26060637

Recalibrating the spirit level: An analysis of the interaction of income inequality and poverty and its effect on health.

PubMed

Rambotti, Simone

2015-08-01

The publication of The Spirit Level (Wilkinson and Pickett, 2009) marked a paramount moment in the analysis of health and inequality, quickly attracting a remarkable degree of attention, both positive and negative, both in academic and in public discourse. Following at least 20 years of research, the book proposes a simple and powerful argument: inequality per se, more specifically income inequality, is harmful to every aspect of social life. In order to confirm this idea, the authors present a series of bivariate, cross-sectional associations showing comparisons across countries and within the United States. Despite the methodological limitations of this approach, the authors advance causal claims concerning the detrimental effects of income inequality. They also rule out poverty as a plausible alternative explanation, without directly measuring it. Meanwhile, over the last decade stratification scholars have demonstrated the nonlinear effect of economic factors, especially income, on health. The results suggest that a relative approach is best for analyzing dynamics at the top of the income distribution, whereas an absolute approach seems most appropriate for studying the bottom of the distribution. Consistent with this perspective, here I reanalyze data from The Spirit Level, adding a measure of poverty, in order to control the effect of inequality and explore its interaction with poverty. The findings show that inequality and poverty-which I contend are two interdependent but nonetheless distinct phenomena-interact across countries, such that the detrimental effects of inequality are present or stronger in countries with high poverty, and absent or weaker in countries with low poverty; poverty replaces inequality as the favored explanation of health and social ills across states. The new evidence suggests that income distributions are characterized by a complex interplay between inequality and poverty, whose interaction deserves further analysis. Copyright �

Low-Income Students and Highly Selective Private Colleges: Geography, Searching, and Recruiting

ERIC Educational Resources Information Center

Hill, Catharine B.; Winston, Gordon C.

2010-01-01

In earlier work, the authors found that only 10% of the students at 28 of the nation's most selective private colleges and universities came from families in the bottom 40% of the US family income distribution and that there is a larger share of low-income high-ability students in the national population than in the student bodies of these…

Economic Disparities in Middle Childhood Development: Does Income Matter?

ERIC Educational Resources Information Center

Votruba-Drzal, Elizabeth

2006-01-01

A large literature has documented the influence of family economic resources on child development, yet income's effects in middle childhood have been understudied. Using data from the National Longitudinal Survey of Youth (N = 3,551), the author examined the influence of family income in early and middle childhood on academic skills and…

Income inequality and mortality: a multilevel prospective study of 521 248 individuals in 50 US states.

PubMed

Backlund, Eric; Rowe, Geoff; Lynch, John; Wolfson, Michael C; Kaplan, George A; Sorlie, Paul D

2007-06-01

Some of the most consistent evidence in favour of an association between income inequality and health has been among US states. However, in multilevel studies of mortality, only two out of five studies have reported a positive relationship with income inequality after adjustment for the compositional characteristics of the state's inhabitants. In this study, we attempt to clarify these mixed results by analysing the relationship within age-sex groups and by applying a previously unused analytical method to a database that contains more deaths than any multilevel study to date. The US National Longitudinal Mortality Study (NLMS) was used to model the relationship between income inequality in US states and mortality using both a novel and previously used methodologies that fall into the general framework of multilevel regression. We adjust age-sex specific models for nine socioeconomic and demographic variables at the individual level and percentage black and region at the state level. The preponderance of evidence from this study suggests that 1990 state-level income inequality is associated with a 40% differential in state level mortality rates (95% CI = 26-56%) for men 25-64 years and a 14% (95% CI = 3-27%) differential for women 25-64 years after adjustment for compositional factors. No such relationship was found for men or women over 65. The relationship between income inequality and mortality is only robust to adjustment for compositional factors in men and women under 65. This explains why income inequality is not a major driver of mortality trends in the United States because most deaths occur at ages 65 and over. This analysis does suggest, however, the certain causes of death that occur primarily in the population under 65 may be associated with income inequality. Comparison of analytical techniques also suggests coefficients for income inequality in previous multilevel mortality studies may be biased, but further research is needed to provide a definitive

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.

Higher levels of state depression in masculine than in feminine nations.

PubMed

Arrindell, W A; Steptoe, A; Wardle, J

2003-07-01

Studies using identical measures have identified different levels of depression in different countries or cultures. Until now, however, explanations for such differences, other than methodological ones, have not been empirically addressed. It was hypothesized and found that soft or feminine nations in which both women and men are offered equal opportunities for the fulfillment of multiple social roles that are associated with good self-rated health would score significantly lower on national depression levels than tough or masculine societies in which such opportunities exist to a clearly lesser extent. Analyses of data collected in 14 nations in Europe (total N>5000) demonstrated that higher scores on Hofstede's national masculinity index and lower ones on national wealth were independent predictors of higher national depression levels. National trait neuroticism did not mediate the relationship between national masculinity and national depression levels.

Income diversification and risk for fishermen.

PubMed

Kasperski, Stephen; Holland, Daniel S

2013-02-05

Catches and prices from many fisheries exhibit high interannual variability, leading to variability in the income derived by fishery participants. The economic risk posed by this may be mitigated in some cases if individuals participate in several different fisheries, particularly if revenues from those fisheries are uncorrelated or vary asynchronously. We construct indices of gross income diversification from fisheries at the level of individual vessels and find that the income of the current fleet of vessels on the US West Coast and in Alaska is less diverse than at any point in the past 30 y. We also find a dome-shaped relationship between the variability of individuals' income and income diversification, which implies that a small amount of diversification does not reduce income risk but that higher levels of diversification can substantially reduce the variability of income from fishing. Moving from a single fishery strategy to a 50-25-25 split in revenues reduces the expected coefficient of variation of gross revenues between 24% and 65% for the vessels included in this study. The increasing access restrictions in many marine fisheries through license reductions and moratoriums have the potential to limit fishermen's ability to diversify their income risk across multiple fisheries. Catch share programs often result in consolidation initially and may reduce diversification. However, catch share programs also make it feasible for fishermen to build a portfolio of harvest privileges and potentially reduce their income risk. Therefore, catch share programs create both threats and opportunities for fishermen wishing to maintain diversified fishing strategies.

Income diversification and risk for fishermen

PubMed Central

Kasperski, Stephen; Holland, Daniel S.

2013-01-01

Catches and prices from many fisheries exhibit high interannual variability, leading to variability in the income derived by fishery participants. The economic risk posed by this may be mitigated in some cases if individuals participate in several different fisheries, particularly if revenues from those fisheries are uncorrelated or vary asynchronously. We construct indices of gross income diversification from fisheries at the level of individual vessels and find that the income of the current fleet of vessels on the US West Coast and in Alaska is less diverse than at any point in the past 30 y. We also find a dome-shaped relationship between the variability of individuals' income and income diversification, which implies that a small amount of diversification does not reduce income risk but that higher levels of diversification can substantially reduce the variability of income from fishing. Moving from a single fishery strategy to a 50-25-25 split in revenues reduces the expected coefficient of variation of gross revenues between 24% and 65% for the vessels included in this study. The increasing access restrictions in many marine fisheries through license reductions and moratoriums have the potential to limit fishermen's ability to diversify their income risk across multiple fisheries. Catch share programs often result in consolidation initially and may reduce diversification. However, catch share programs also make it feasible for fishermen to build a portfolio of harvest privileges and potentially reduce their income risk. Therefore, catch share programs create both threats and opportunities for fishermen wishing to maintain diversified fishing strategies. PMID:23341621

Poverty, Pregnancy, and Birth Outcomes: A Study of the Earned Income Tax Credit.

PubMed

Hamad, Rita; Rehkopf, David H

2015-09-01

Economic interventions are increasingly recognised as a mechanism to address perinatal health outcomes among disadvantaged groups. In the US, the earned income tax credit (EITC) is the largest poverty alleviation programme. Little is known about its effects on perinatal health among recipients and their children. We exploit quasi-random variation in the size of EITC payments to examine the effects of income on perinatal health. The study sample includes women surveyed in the 1979 National Longitudinal Survey of Youth (n = 2985) and their children born during 1986-2000 (n = 4683). Outcome variables include utilisation of prenatal and postnatal care, use of alcohol and tobacco during pregnancy, term birth, birthweight, and breast-feeding status. We first examine the health effects of both household income and EITC payment size using multivariable linear regressions. We then employ instrumental variables analysis to estimate the causal effect of income on perinatal health, using EITC payment size as an instrument for household income. We find that EITC payment size is associated with better levels of several indicators of perinatal health. Instrumental variables analysis, however, does not reveal a causal association between household income and these health measures. Our findings suggest that associations between income and perinatal health may be confounded by unobserved characteristics, but that EITC income improves perinatal health. Future studies should continue to explore the impacts of economic interventions on perinatal health outcomes, and investigate how different forms of income transfers may have different impacts. © 2015 John Wiley & Sons Ltd.

Lifetime income patterns and alcohol consumption: Investigating the association between long- and short-term income trajectories and drinking

PubMed Central

Cerdá, Magdalena; Johnson-Lawrence, Vicki; Galea, Sandro

2011-01-01

Lifetime patterns of income may be an important driver of alcohol use. In this study, we evaluated the relationship between long-term and short-term measures of income and the relative odds of abstaining, drinking lightly-moderately and drinking heavily. We used data from the US Panel Study on Income Dynamics (PSID), a national population-based cohort that has been followed annually or biannually since 1968. We examined 3111 adult respondents aged 30-44 in 1997. Latent class growth mixture models with a censored normal distribution were used to estimate income trajectories followed by the respondent families from 1968-1997, while repeated measures multinomial generalized logit models estimated the odds of abstinence (no drinks per day) or heavy drinking (at least 3 drinks a day), relative to light/moderate drinking (<1-2 drinks a day), in 1999-2003. Lower income was associated with higher odds of abstinence and of heavy drinking, relative to light/moderate drinking. For example, belonging to a household with stable low income ($11-20,000) over 30 years was associated with 1.57 odds of abstinence, and 2.14 odds of heavy drinking in adulthood. The association between lifetime income patterns and alcohol use decreased in magnitude and became non-significant once we controlled for past-year income, education and occupation. Lifetime income patterns may have an indirect association with alcohol use, mediated through current socioeconomic conditions. PMID:21890256

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.

Educational assortative mating and income inequality in Denmark.

PubMed

Breen, Richard; Andersen, Signe Hald

2012-08-01

Many writers have expressed a concern that growing educational assortative mating will lead to greater inequality between households in their earnings or income. In this article, we examine the relationship between educational assortative mating and income inequality in Denmark between 1987 and 2006. Denmark is widely known for its low level of income inequality, but the Danish case provides a good test of the relationship between educational assortative mating and inequality because although income inequality increased over the period we consider, educational homogamy declined. Using register data on the exact incomes of the whole population, we find that change in assortative mating increased income inequality but that these changes were driven by changes in the educational distributions of men and women rather than in the propensity for people to choose a partner with a given level of education.

Income dynamics and the Affordable Care Act.

PubMed

Shore-Sheppard, Lara D

2014-12-01

To examine the sources of family income dynamics leading to movement into and out of Medicaid expansion and subsidy eligibility under the Affordable Care Act. Survey of Income and Program Participation (SIPP): 1996, 2001, 2004, 2008 panels. Considering four broad subsidy eligibility categories for monthly Modified Adjusted Gross Income (MAGI) (<138 percent of the Federal Poverty Level [FPL], 138-250 percent FPL, 250-400 percent FPL, and >400 percent FPL), I use duration analysis to examine determinants of movements between categories over the course of a year. Using detailed monthly data, I determine the members of tax-filing units and calculate an approximation of MAGI at the monthly level. The analysis sample is adults ages 22-64 years. Incomes are highly variable within a year, particularly at the lower end of the income distribution. Employment transitions, including transitions not involving a period of nonemployment, and family structure changes strongly predict sufficient income volatility to trigger a change in subsidy category. Income volatility arising from employment and family structure changes is likely to trigger changes in subsidy eligibility within the year, but the sources and effects of the volatility differ substantially depending on the individual's position in the income distribution. © Health Research and Educational Trust.

Income Dynamics and the Affordable Care Act

PubMed Central

Shore-Sheppard, Lara D

2014-01-01

Objective To examine the sources of family income dynamics leading to movement into and out of Medicaid expansion and subsidy eligibility under the Affordable Care Act. Data Source Survey of Income and Program Participation (SIPP): 1996, 2001, 2004, 2008 panels. Study Design Considering four broad subsidy eligibility categories for monthly Modified Adjusted Gross Income (MAGI) (<138 percent of the Federal Poverty Level [FPL], 138–250 percent FPL, 250–400 percent FPL, and >400 percent FPL), I use duration analysis to examine determinants of movements between categories over the course of a year. Data Collection/Extraction Using detailed monthly data, I determine the members of tax-filing units and calculate an approximation of MAGI at the monthly level. The analysis sample is adults ages 22–64 years. Principal Findings Incomes are highly variable within a year, particularly at the lower end of the income distribution. Employment transitions, including transitions not involving a period of nonemployment, and family structure changes strongly predict sufficient income volatility to trigger a change in subsidy category. Conclusions Income volatility arising from employment and family structure changes is likely to trigger changes in subsidy eligibility within the year, but the sources and effects of the volatility differ substantially depending on the individual's position in the income distribution. PMID:25327987

Subjective wellbeing and income: Empirical patterns in the rural developing world

PubMed Central

Reyes-García, Victoria; Babigumira, Ronnie; Pyhälä, Aili; Wunder, Sven; Zorondo-Rodríguez, Francisco; Angelsen, Arild

2016-01-01

A commonality in the economics of happiness literature is that absolute income matters more for the subjective wellbeing of people at low income levels. In this article, we use a large sample of people in rural areas of developing countries with relatively low income levels to test whether subjective wellbeing an increasing function of absolute income in our sample, and to analyze the existence of adaptation and social comparison effects on subjective wellbeing. Our sample includes 6973 rural households in 23 countries throughout Asia, Africa, and Latin America. The average total income per adult equivalent in our sample was US$1555, whereas levels of subjective wellbeing resembled levels found in previous research using cross-country data. We find that, despite low levels of absolute income, levels of subjective wellbeing of our respondents resemble levels found in previous research using cross-country data. We also find remarkable similarities in many of the determinants of subjective wellbeing previously tested. Our data show that absolute income covariates with subjective wellbeing, but -as for richer samples- the magnitude of the association is lower once we control for adaptation and social comparison. Finally, our results suggest that social comparison has a stronger effect than adaptation in explaining the subjective wellbeing of our sample. Our findings highlight the importance of adaptation and social comparison even at low levels of absolute income. PMID:27642259

Subjective wellbeing and income: Empirical patterns in the rural developing world.

PubMed

Reyes-García, Victoria; Babigumira, Ronnie; Pyhälä, Aili; Wunder, Sven; Zorondo-Rodríguez, Francisco; Angelsen, Arild

2016-04-01

A commonality in the economics of happiness literature is that absolute income matters more for the subjective wellbeing of people at low income levels. In this article, we use a large sample of people in rural areas of developing countries with relatively low income levels to test whether subjective wellbeing an increasing function of absolute income in our sample, and to analyze the existence of adaptation and social comparison effects on subjective wellbeing. Our sample includes 6973 rural households in 23 countries throughout Asia, Africa, and Latin America. The average total income per adult equivalent in our sample was US$1555, whereas levels of subjective wellbeing resembled levels found in previous research using cross-country data. We find that, despite low levels of absolute income, levels of subjective wellbeing of our respondents resemble levels found in previous research using cross-country data. We also find remarkable similarities in many of the determinants of subjective wellbeing previously tested. Our data show that absolute income covariates with subjective wellbeing, but -as for richer samples- the magnitude of the association is lower once we control for adaptation and social comparison. Finally, our results suggest that social comparison has a stronger effect than adaptation in explaining the subjective wellbeing of our sample. Our findings highlight the importance of adaptation and social comparison even at low levels of absolute income.

The Income Volatility See-Saw: Implications for School Lunch. Economic Research Report Number 23

ERIC Educational Resources Information Center

Newman, Constance

2006-01-01

Income volatility challenges the effectiveness of the safety net that USDA food assistance programs provide low-income families. This study examines income volatility among households with children and the implications of volatility for eligibility in the National School Lunch Program (NSLP). The results show that income volatility was higher for…

Caregiver's education level, not income, as determining factor of dietary intake and nutritional status of individuals cared for at home.

PubMed

Correa, B; Leandro Merhi, V A; Pagotto Fogaca, K; Marques de Oliveira, M R

2009-08-01

Home care should intervene in the nutritional status of the elderly. To analyze the nutritional status of the elderly assisted by a Home Care Program (PAD) and associate it with income and education level of the caregiver. Thirty-four individuals of both genders who received home care from PAD. The MNA (Mini Nutritional Assessment) was used along with arm circumference. Dietary intake assessment was done with three 24-hour recalls in non-consecutive days. We collected data on income, education level of the caregiver and user in years of formal education and autonomy of user. The differences between the proportions of the nominal variables were tested by the chi-square test. The continuous variables were tested for normality and if normal, the Student's t-test or ANOVA was applied. The adopted significance level was P < 0.05. The studied sample represented individuals older than 65 years, assisted by PAD and 100% dependent on the caregiver. MNA revealed that 38.2% of the users were malnourished and 61.8% were at risk for malnourishment. Energy, fiber, vitamin E, calcium and zinc intakes were inadequate. Education level of the caregivers was a determining factor (P=0.01) for the nutritional status of the elderly while no association was found with respect to income. These findings allows us to conclude that the nutritional status of this population is worrisome and that it may be associated with low quality of life influenced by the education level of the caregiver, but also by age, economic conditions and limited autonomy of this population.

County level socioeconomic position, work organization and depression disorder: a repeated measures cross-classified multilevel analysis of low-income nursing home workers.

PubMed

Muntaner, Carles; Li, Yong; Xue, Xiaonan; Thompson, Theresa; O'Campo, Patricia; Chung, Haejoo; Eaton, William W

2006-12-01

This study simultaneously tests the effect of county, organizational, workplace, and individual level variables on depressive disorders among low-income nursing assistants employed in US nursing homes. A total of 482 observations are used from two waves of survey data collection, with an average two-year interval between initial and follow-up surveys. The overall response rate was 62 percent. The hierarchically structured data was analyzed using multilevel modeling to account for cross-classifications across levels of data. Nursing assistants working in nursing homes covered by a single union in three states were asked about aspects of their working conditions, job stress, physical and mental health status, individual and family health-care needs, household economics and household strain. The 241 nursing assistants who participated in this study were employed in 34 nursing homes and lived in 49 counties of West Virginia, Ohio and Kentucky. The study finds that emotional strain, related to providing direct care to elderly and disabled clients, is associated with depressive disorder, as is nursing home ownership type (for-profit versus not-for-profit). However, when controlling for county level socioeconomic variables (Gini index and proportion of African Americans living in the county), neither workplace nor organizational level variables were found to be statistically significant associated with depressive disorder. This study supports previous findings that emotional demand in health-care environments is an important correlate of mental health. It also adds empirical evidence to support a link between financial strain and depression in US women. While this study does not find that lack of a seniority wage benefits--a factor that can conceivably exacerbate financial strain over time--is associated with depressive disorder among low-income health-care workers, it does find county level measures of poverty to be statistically significant predictors of depressive

Race and socioeconomic disparities in national stoma reversal rates.

PubMed

Zafar, Syed Nabeel; Changoor, Navin R; Williams, Kibileri; Acosta, Rafael D; Greene, Wendy R; Fullum, Terrence M; Haider, Adil H; Cornwell, Edward E; Tran, Daniel D

2016-04-01

Many temporary stomas are never reversed leading to significantly worse quality of life. Recent evidence suggests a lower rate of reversal among minority patients. Our study aimed to elucidate disparities in national stoma closure rates by race, medical insurance status, and household income. Five years of data from the Nationwide Inpatient Sample (2008 to 2012) was used to identify the annual rates of stoma formation and annual rates of stoma closure. Stomas labeled as "permanent" or those created secondary to colorectal cancers were excluded. Temporary stoma closure rates were calculated, and differences were tested with the chi-square test. Separate analyses were performed by race/ethnicity, insurance status, and household income. Nationally representative estimates were calculated using discharge-level weights. The 5-year average annual rate of temporary stoma creation was 76,551 per year (46% colostomies and 54% ileostomies). The annual rate of stoma reversal was 50,155 per year that equated to an annual reversal rate of 65.5%. Reversal rates were higher among white patients compared with black patients (67% vs 56%, P < .001) and among privately insured patients compared with uninsured patients (88% vs 63%, P < .001). Reversal rates increased as the household income increased from 61% in the lowest income quartile to 72% in the highest quartile (P < .001). Stark disparities exist in national rates of stoma closure. Stoma closure is associated with race, insurance, and income status. This study highlights the lack of access to surgical health care among patients of minority race and low-income status. Copyright © 2016 Elsevier Inc. All rights reserved.

Does Your Neighbor’s Income Affect Your Happiness?1

PubMed Central

Firebaugh, Glenn; Schroeder, Matthew B.

2014-01-01

The relative income or income status hypothesis implies that people should be happier when they live among the poor. Findings on neighborhood effects suggest, however, that living in a poorer neighborhood reduces, not enhances, a person’s happiness. Using data from the American National Election Study linked to income data from the U.S. census, the authors find that Americans tend to be happier when they reside in richer neighborhoods (consistent with neighborhood studies) in poorer counties (as predicted by the relative income hypothesis). Thus it appears that individuals in fact are happier when they live among the poor, as long as the poor do not live too close. PMID:20503742

For All Kids: How Kentucky Is Closing the High School Graduation Gap for Low-Income Students

ERIC Educational Resources Information Center

Fox, Joanna Hornig; Ingram, Erin S.; Depaoli, Jennifer L.

2016-01-01

In the 2012-13 school year, Kentucky led the nation with an 85.4 percent high school graduation rate for low-income students and a one-percentage-point graduation gap between low-income and non-low-income students. In 2013-14 the state ranked fourth in the nation with a seven-percentage-point incomebased graduation rate gap. Even though Kentucky's…

Assessing income redistributive effect of health financing in Zambia.

PubMed

Mulenga, Arnold; Ataguba, John Ele-Ojo

2017-09-01

Ensuring an equitable health financing system is a major concern particularly in many developing countries. Internationally, there is a strong debate to move away from excessive reliance on direct out-of-pocket (OOP) spending towards a system that incorporates a greater element of risk pooling and thus affords greater protection for the poor. This is a major focus of the move towards universal health coverage (UHC). Currently, Zambia with high levels of poverty and income inequality is implementing health sector reforms for UHC through a social health insurance scheme. However, the way to identify the health financing mechanisms that are best suited to achieving this goal is to conduct empirical analysis and consider international evidence on funding universal health systems. This study assesses, for the first time, the progressivity of health financing and how it impacts on income inequality in Zambia. Three broad health financing mechanisms (general tax, a health levy and OOP spending) were considered. Data come from the 2010 nationally representative Zambian Living Conditions and Monitoring Survey with a sample size of 19,397 households. Applying standard methodologies, the findings show that total health financing in Zambia is progressive. It also leads to a statistically significant reduction in income inequality (i.e. a pro-poor redistributive effect estimated at 0.0110 (p < 0.01)). Similar significant pro-poor redistribution was reported for general taxes (0.0101 (p < 0.01)) and a health levy (0.0002 (p < 0.01)). However, the redistributive effect was not significant for OOP spending (0.0006). These results further imply that health financing redistributes income from the rich to the poor with a greater potential via general taxes. This points to areas where government policy may focus in attempting to reduce the high level of income inequality and to improve equity in health financing towards UHC in Zambia. Copyright © 2017 Elsevier Ltd. All rights

National Pride: War Minus the Shooting

ERIC Educational Resources Information Center

Kavetsos, Georgios

2012-01-01

This study focuses on the determinants of self-reported measures of national pride. Using pooled cross-sectional data for European countries obtained from the Eurobarometer, it is estimated that pride is not correlated with GDP per capita nor with household income levels. Using the 2000 UEFA European Championship as a natural experiment, it is…

National Incomes Policy and Manpower Problems. Proceedings of the Annual Research Conference in Industrial Relations (14th, Los Angeles, California, March 16, 1971).

ERIC Educational Resources Information Center

California Univ., Los Angeles. Inst. of Industrial Relations.

Two current economic dilemmas concern how to increase the supply of money without risking further inflation and how to influence wage-price decisions. The major purposes of the conference presented in this document were to define a national incomes policy, to explore alternative approaches to wage-price decisions, and to assess their implications…

Serum 25-hydroxyvitamin D level is associated with myopia in the Korea national health and nutrition examination survey.

PubMed

Kwon, Jin-Woo; Choi, Jin A; La, Tae Yoon

2016-11-01

The aim of this article was to assess the associations of serum 25-hydroxyvitamin D [25(OH)D] and daily sun exposure time with myopia in Korean adults.This study is based on the Korea National Health and Nutrition Examination Survey (KNHANES) of Korean adults in 2010-2012; multiple logistic regression analyses were performed to examine the associations of serum 25(OH)D levels and daily sun exposure time with myopia, defined as spherical equivalent ≤-0.5D, after adjustment for age, sex, household income, body mass index (BMI), exercise, intraocular pressure (IOP), and education level. Also, multiple linear regression analyses were performed to examine the relationship between serum 25(OH)D levels with spherical equivalent after adjustment for daily sun exposure time in addition to the confounding factors above.Between the nonmyopic and myopic groups, spherical equivalent, age, IOP, BMI, waist circumference, education level, household income, and area of residence differed significantly (all P < 0.05). Compared with subjects with daily sun exposure time <2 hour, subjects with sun exposure time ≥2 to <5 hour, and those with sun exposure time ≥5 hour had significantly less myopia (P < 0.001). In addition, compared with subjects were categorized into quartiles of serum 25(OH)D, the higher quartiles had gradually lower prevalences of myopia after adjustment for confounding factors (P < 0.001). In multiple linear regression analyses, spherical equivalent was significantly associated with serum 25(OH)D concentration after adjustment for confounding factors (P = 0.002).Low serum 25(OH)D levels and shorter daily sun exposure time may be independently associated with a high prevalence of myopia in Korean adults. These data suggest a direct role for vitamin D in the development of myopia.

Effect of Medicaid Expansions on Health Insurance Coverage and Access to Care among Low-Income Adults with Behavioral Health Conditions.

PubMed

Wen, Hefei; Druss, Benjamin G; Cummings, Janet R

2015-12-01

To examine the effect of Medicaid expansions on health insurance coverage and access to care among low-income adults with behavioral health conditions. Nine years (2004-2012) of individual-level cross-sectional data from a restricted-access version of National Survey on Drug Use and Health. A quasi-experimental difference-in-differences design comparing outcomes among residents in 14 states that implemented Medicaid expansions for low-income adults under the Section §1115 waiver with those residing in the rest of the country. The analytic sample includes low-income adult respondents with household incomes below 200 percent of the federal poverty level who have a behavioral health condition: approximately 28,400 low-income adults have past-year serious psychological distress and 24,900 low-income adults have a past-year substance use disorder (SUD). Among low-income adults with behavioral health conditions, Medicaid expansions were associated with a reduction in the rate of uninsurance (p < .05), a reduction in the probability of perceiving an unmet need for mental health (MH) treatment (p < .05) and for SUD treatment (p < .05), as well as an increase in the probability of receiving MH treatment (p < .01). The ongoing implementation of Medicaid expansions has the potential to improve health insurance coverage and access to care for low-income adults with behavioral health conditions. © Health Research and Educational Trust.

When Does Money Matter Most? Examining the Association between Income and Life Satisfaction over the Life Course

PubMed Central

Cheung, Felix; Lucas, Richard E.

2015-01-01

Previous research shows that the correlation between income and life satisfaction is small to medium in size. We hypothesized that income may mean different things to people at different ages, and therefore, that the association between income and life satisfaction may vary at different points in the life course. We tested this hypothesis in three nationally representative panel studies. Multilevel modeling techniques were used to test whether age moderated both the within- and between-person associations. Consistent with past research, we found that individuals who earned more on average and individuals who earned more over time reported higher levels of life satisfaction. Importantly, these effects were strongest for midlife individuals (those in their 30s–50s) compared to individuals who were younger or older. PMID:25621741

Income inequality and cardiovascular disease risk factors in a highly unequal country: a fixed-effects analysis from South Africa.

PubMed

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

2018-03-06

Chronic stress associated with high income inequality has been hypothesized to increase CVD risk and other adverse health outcomes. However, most evidence comes from high-income countries, and there is limited evidence on the link between income inequality and biomarkers of chronic stress and risk for CVD. This study examines how changes in income inequality over recent years relate to changes in CVD risk factors in South Africa, home to some of the highest levels of income inequality globally. We linked longitudinal data from 9356 individuals interviewed in the 2008 and 2012 National Income Dynamics Study to district-level Gini coefficients estimated from census and survey data. We investigated whether subnational district income inequality was associated with several modifiable risk factors for cardiovascular disease (CVD) in South Africa, including body mass index (BMI), waist circumference, blood pressure, physical inactivity, smoking, and high alcohol consumption. We ran individual fixed-effects models to examine the association between changes in income inequality and changes in CVD risk factors over time. Linear models were used for continuous metabolic outcomes while conditional Poisson models were used to estimate risk ratios for dichotomous behavioral outcomes. Both income inequality and prevalence of most CVD risk factors increased over the period of study. In longitudinal fixed-effects models, changes in district Gini coefficients were not significantly associated with changes in CVD risk factors. Our findings do not support the hypothesis that subnational district income inequality is associated with CVD risk factors within the high-inequality setting of South Africa.

Weight of nations: a socioeconomic analysis of women in low- to middle-income countries.

PubMed

Subramanian, S V; Perkins, Jessica M; Özaltin, Emre; Davey Smith, George

2011-02-01

The increasing trend in body mass index (BMI) and overweight in rapidly developing economies is well recognized. We assessed the association between socioeconomic status and BMI and overweight in low- to middle-income countries. We conducted a cross-sectional analysis of nationally representative samples of 538,140 women aged 15-49 y drawn from 54 Demographic and Health Surveys conducted between 1994 and 2008. BMI, calculated as weight in kilograms divided by height squared in meters, was specified as the outcome, and a BMI (in kg/m(2)) of ≥25 was additionally specified to model the likelihood of being overweight. Household wealth and education were included as markers of individual socioeconomic status, and per capita Gross Domestic Product (pcGDP) was included as a marker of country-level economic development. Globally, a one-quartile increase in wealth was associated with a 0.54 increase in BMI (95% CI: 0.50, 0.64) and a 33% increase in overweight (95% CI: 26%, 41%) in adjusted models. Although the strength of this association varied across countries, the association between wealth and BMI and overweight was positive in 96% (52 of 54) of the countries. Similar patterns were observed in urban and rural areas, although SES gradients tended to be greater in urban areas. There was a positive association between pcGDP and BMI or overweight, with only weak evidence of an interaction between pcGDP and wealth. Higher BMI and overweight remain concentrated in higher socioeconomic groups, even though increasing BMI and overweight prevalence are important global public concerns.

Contingent Repayment Education Loans Related to Income.

ERIC Educational Resources Information Center

Brannon, Gerard M.

This paper explores some questions about the use of income for determining repayment of educational loans. The plans generally call for a level of repayment to cover the initial advances, plus interest for a college graduate with average income, but would require less than full repayment for the students with low income, and over full repayment…

Income Inequality and U.S. Tax Policy

ERIC Educational Resources Information Center

Crocco, Margaret S.; Marri, Anand R.; Wylie, Scott

2011-01-01

Many social scientists have recently commented on the high levels of income inequality in the United States. Indeed, the last time income inequality was as great as it is today was 1928, the year before the stock market crash ushered in the Great Depression. In this article, the authors offer a historical look at income inequality and taxation in…

Early-life income inequality and adolescent health and well-being.

PubMed

Elgar, Frank J; Gariépy, Geneviève; Torsheim, Torbjørn; Currie, Candace

2017-02-01

A prevailing hypothesis about the association between income inequality and poor health is that inequality intensifies social hierarchies, increases stress, erodes social and material resources that support health, and subsequently harms health. However, the evidence in support of this hypothesis is limited by cross-sectional, ecological studies and a scarcity of developmental studies. To address this limitation, we used pooled, multilevel data from the Health Behaviour in School-aged Children study to examine lagged, cumulative, and trajectory associations between early-life income inequality and adolescent health and well-being. Psychosomatic symptoms and life satisfaction were assessed in surveys of 11- to 15-year-olds in 40 countries between 1994 and 2014. We linked these data to national Gini indices of income inequality for every life year from 1979 to 2014. The results showed that exposure to income inequality from 0 to 4 years predicted psychosomatic symptoms and lower life satisfaction in females after controlling lifetime mean income inequality, national per capita income, family affluence, age, and cohort and period effects. The cumulative income inequality exposure in infancy and childhood (i.e., average Gini index from birth to age 10) related to lower life satisfaction in female adolescents but not to symptoms. Finally, individual trajectories in early-life inequality (i.e., linear slopes in Gini indices from birth to 10 years) related to fewer symptoms and higher life satisfaction in females, indicating that earlier exposures mattered more to predicting health and wellbeing. No such associations with early-life income inequality were found in males. These results help to establish the antecedent-consequence conditions in the association between income inequality and health and suggest that both the magnitude and timing of income inequality in early life have developmental consequences that manifest in reduced health and well-being in adolescent girls

A Portrait of Low-Income Young Adults in Education. Portraits

ERIC Educational Resources Information Center

Institute for Higher Education Policy, 2010

2010-01-01

This brief takes a broad look at low-income young adults in an effort to contribute to the national discussion on improving degree completion by increasing participation among all disadvantaged populations--especially those who attempt to succeed in postsecondary settings under financial stress. Understanding the linkages between low-income young…

Inequalities in full immunization coverage: trends in low- and middle-income countries

PubMed Central

Barros, Aluísio JD; Wong, Kerry LM; Johnson, Hope L; Pariyo, George; França, Giovanny VA; Wehrmeister, Fernando C; Victora, Cesar G

2016-01-01

Abstract Objective To investigate disparities in full immunization coverage across and within 86 low- and middle-income countries. Methods In May 2015, using data from the most recent Demographic and Health Surveys and Multiple Indicator Cluster Surveys, we investigated inequalities in full immunization coverage – i.e. one dose of bacille Calmette-Guérin vaccine, one dose of measles vaccine, three doses of vaccine against diphtheria, pertussis and tetanus and three doses of polio vaccine – in 86 low- or middle-income countries. We then investigated temporal trends in the level and inequality of such coverage in eight of the countries. Findings In each of the World Health Organization’s regions, it appeared that about 56–69% of eligible children in the low- and middle-income countries had received full immunization. However, within each region, the mean recorded level of such coverage varied greatly. In the African Region, for example, it varied from 11.4% in Chad to 90.3% in Rwanda. We detected pro-rich inequality in such coverage in 45 of the 83 countries for which the relevant data were available and pro-urban inequality in 35 of the 86 study countries. Among the countries in which we investigated coverage trends, Madagascar and Mozambique appeared to have made the greatest progress in improving levels of full immunization coverage over the last two decades, particularly among the poorest quintiles of their populations. Conclusion Most low- and middle-income countries are affected by pro-rich and pro-urban inequalities in full immunization coverage that are not apparent when only national mean values of such coverage are reported. PMID:27821882

7 CFR 3430.53 - Program income.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 7 Agriculture 15 2011-01-01 2011-01-01 false Program income. 3430.53 Section 3430.53 Agriculture Regulations of the Department of Agriculture (Continued) NATIONAL INSTITUTE OF FOOD AND AGRICULTURE COMPETITIVE AND NONCOMPETITIVE NON-FORMULA FEDERAL ASSISTANCE PROGRAMS-GENERAL AWARD ADMINISTRATIVE PROVISIONS...