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PubMed2001

Birth weight and income: interactions across generations.

This paper attempts to answer a series of questions regarding the interaction of income and birth weight across generations. First, does the effect of the income of a mother during her pregnancy on her infant's birth weight depend on the family's birth weight history (genetic predisposition)? Second, does the effect of low birth weight status on adult life chances depend on income during early childhood? These questions have implications for the way we envision the biological and social worlds as interacting across generations. To address these issues, this study uses intergenerational data from the Panel Study of Income Dynamics, survey years 1968 through 1992. Results of sibling comparisons (family-fixed-effects models) demonstrate that maternal income has a significant impact on birth weight for those infants who are already at high risk hereditarily (i.e., who have a low birth weight parent). However, it is not clear whether income acts as a developmental buffer for low birth weight infants as their lives progress. These findings suggest the existence of biosocial interactions between hereditary predisposition and socio-economic environment.

Adolescent↗

PubMed2002

Firearm availability and female homicide victimization rates among 25 populous high-income countries.

OBJECTIVE: to determine the association between firearm availability and female homicide victimization among high-income countries. METHODS: Data were assembled for the most recent available year (1994-1999) from the official reports of the ministries of health for those countries that had more than 2 million inhabitants and were dassified as high income by the World Bank. Twenty-five nations provided sufficient information for the analysis. Rates of female victimization from homicide, firearm homicide, and nonfirearm homicide were compared with a validated proxy for household firearm ownership (the percentage of total national suicides that are committed with firearms). Possible confounding variables included in the analysis were the percentage of the population living in urban areas and income inequality. RESULTS: The United States is an outlier. It had the highest level of household firearm ownership and the highest female homicide rate. The United States accounted for 32% of the female population in these high-income countries, but for 70% of all female homicides and 84% of all female firearm homicides. Female homicide victimization rates were significantly associated with firearm availability largely because of the United States. CONCLUSION: Among high-income countries, where firearms are more available, more women are homicide victims. Women in the United States are at higher risk of homicide victimization than are women in any other high-income country.

Adult↗

PubMed1992

Differences in neonatal mortality by race, income, and prenatal care.

To determine the extent to which the social and physical environment affects the association between prenatal care and black pregnancy outcome in Chicago, we performed a stratified analysis of 1982-1983 Illinois vital records and 1980 United States census income data. Median family income of the mother's census tract was used as the ecologic variable. In very-low-income census tracts (less than $10,000 per year), 40% of blacks and 47% of whites received adequate prenatal care. There was no racial disparity in the percentage of low-birth-weight infants attributed to inadequate prenatal care among poor mothers. For mothers who resided in moderate-income areas ($20,001 to $30,000 per year), 50% of blacks and 67% of whites received adequate prenatal care. Although adequate (compared to inadequate) prenatal care was associated with improved birthweight distribution independent of community income, only in moderate-income areas was it related to black neonatal survival. For term black infants who received adequate prenatal care, residence in impoverished areas was associated with a nearly fourfold greater neonatal mortality rate (deaths per 1000 live births): 5/1000 vs 1/1000; RR = 3.8 (1.3-11.0). We conclude that place of residence is an important risk factor for black neonatal mortality.

Black or African American↗

PubMed2005

[Influence of smoking on the prevalence of chronic diseases among people with different income levels].

OBJECTIVE: To explore the influence of smoking on chronic diseases among people with various income levels in China. METHODS: Cross-sectional study on smoking behavior, chronic disease and income level was performed using database of the Second National Health Service Study (1998) provided by the Ministry of Health in China. RESULTS: Compared to never-smokers, smokers (including current smokers and former smokers) had a higher rate of having chronic diseases, after adjusted in age, income, educational level, employment status and type of jobs with corresponding countryside (OR = 1.185, 95% CI: 1.121 - 1.253 and town OR = 1.083, 95% CI: 1.010 - 1.161). Smoking had a more serious effect on having chronic illness in males from the countryside (former-smoker OR = 2.764, 95% CI: 2.471 - 3.092) than in town (former-smoker OR = 2.112, 95% CI: 1.844 - 2.419). Smokers at the lowest income level had a higher possibility of having chronic illness (town OR = 2.076, 95% CI: 1.551 - 2.780; countryside OR = 2.903, 95% CI: 2.248 - 3.749) than those at the highest income level (town OR = 1.785, 95% CI: 1.285 - 2.479 in the countryside OR = 2.466, 95% CI: 1.941 - 3.134). CONCLUSION: Smoking might cause more serious health problems to people at lower income level in China.

China↗

PubMed2005

[More social exclusion of chronically ill patients with lower incomes].

OBJECTIVE: To determine whether income is connected with the variation in the social exclusion of chronically ill patients. DESIGN: Descriptive. METHOD: In 223 chronically ill patients that had been detected via patients' associations, general practitioners and outpatient clinics, a structured interview was administered during a home visit 4 times during a period of 7 months (October 2003-April 2004). Due to dropouts, the actual number of patients interviewed at each of the 4 times was 223, 176, 143 and 105, respectively. Social exclusion was measured with the aid of the 'Autonomy outside the home' subscale of the 'Impact on participation and autonomy' questionnaire. The possible total score varied from 5 (little social exclusion) to 25 (much social exclusion). In order to explain a possible effect of income, various other patient characteristics were added to the analysis model: type of primary disease (rheumatism, multiple sclerosis, pulmonary emphysema, other), duration of the primary disease, comorbidity, educational level, whether or not the patient was employed or engaged in volunteer work, whether or not the patient lived together with a partner, the self-rated health, physical functioning, social functioning, mental functioning, and the subjective pain. The data were analysed by means of multilevel repeated regression analysis. RESULTS: A low income was associated with social exclusion at all 4 times of measurement. The regression coefficient of income was -1.47 (95% CI: -2.28- -0.65), indicating that the score on the scale for social exclusion decreased by 1.47 for every euro 544,- (= 1 x SD) increase in net monthly income. This relationship could not be explained by the other patient characteristics, not even by a low educational level. CONCLUSION: The supportive care intended for the prevention of social exclusion of chronically ill patients should be concentrated sufficiently on those who have too little income to organise such care for themselves.

Adolescent↗

PubMed2005

Correlation between hypertension and income distribution among United Arab Emirates population.

To determine the correlation between hypertension and income distribution among United Arab Emirates (UAE) population. Case-control study matched for age, sex, nationality and education. The survey included 500 hypertensive adults aged 20-65 years ascertained from Primay Health Care (PHC) Clinics along with a randomly selected sample of 500 control subjects from the community. Face-to-face interviews were done where data were gathered on socio-demographic-economic status (SES) and lifestyle habits. Hypertension was defined according to WHO criteria as having Systolic Blood Pressure (SBP) > or = 140 mm Hg and/or Diastolic Blood Pressure (DBP) > or = 90 mm Hg and/or being on antihypertensive treatment. The survey was carried out in urban and semi-urban PHC Clinics. A total of 818 subjects were included in this study from a sample of 1000; 409 cases and 409 controls. There were 422 males and 396 females in this study, with 255 UAE nationals and 438 expatriates. Hypertension was found to be significantly higher among the low income group (35.2% vs. 24.9% controls, p = 0.002; while mean SBP in the low income group was 130.2 +/- 17.6 vs. 128.0 +/- 17.4 controls, p = 0.022). Among males, smoking and alcohol consumption were higher among the group with low income level but only smoking showed significant difference (p value = 0.016). Activity level was higher among the low income groups. This study supports the importance of socio-economic factors as an income distribution effect on life-style habits and hypertension.

Adult↗

PubMedDate not supplied

[Potentially avoidable hospitalisation in Bologna, 1997-2000: temporal trend and differences by income level].

OBJECTIVE: To describe the temporal trend of hospitalisations for Ambulatory Care Sensitive Conditions (ACSCs) from 1997 to 2000 in Bologna (Italy) and to analyze the association with the income level. DESIGN AND SETTING: We have selected two panels of ACSCs: eight conditions for the paediatric/young population (<20 years of age) and fourteen for the adult population (> or =20 years of age). All discharges for ACSCs of residents in Bologna from Emilia-Romagna hospitals have been selected in the years 1997-2000. An indicator of social position was computed: the median per capita equivalent income by census block, obtained through record linkage between the Italian Tax Register (income earned in 1998) and the Population Register of Bologna. MAIN OUTCOME MEASURES: The direct age-standardized rates and the rate ratio by income level have been calculated. The Poisson regression model has been used to calculate the relative risk (RR) of hospitalizations for ACSCs. RESULTS: 2359 (17.6% of the total) hospitalisations have been selected among the paediatric/young population and 27822 (11.1% of the total) among the adult population. The annual age-adjusted rate of ACSC is 122.68 per 10000 persons among children and 176.60 among adults. The hospitalisation forACSCs among children is associated with a middle-low level of income (RR 1.55; CI 95% 1.35-1.78 for the lowest level vs. highest level), male gender and age <5 years old. In the adult population the risk of hospitalisation for ACSCs is higher among those with lower levels of income (RR 1.80; CI 95% 1.66-1.95 for the lowest level vs. highest level), moreover the RR is higher for men at every age. The admissions forACSCs among adults show a decreasing temporal trend. CONCLUSIONS: The disadvantaged groups of the population experience the highest risk of hospitalisation for ACSCs, with differences by gender and age groups. Although it is difficult to specifically identify the mechanisms potentially involved in the relationship between socioeconomic status and excess of hospitalisation, the admissions for ACSCs may represent an interesting indicator of quality ofprimary care.

Adult↗

PubMed2006

Medicare Part B income-related monthly adjustment amount. Final rules.

We are adding to our regulations a new subpart, Medicare Part B Income-Related Monthly Adjustment Amount, to contain the rules we will follow for Medicare Part B income-related monthly adjustment amount determinations. The monthly adjustment amount represents the amount of decrease in the Medicare Part B premium subsidy, i.e. the amount of the Federal Government's contribution to the Federal Supplementary Medical Insurance (SMI) Trust Fund. This new subpart implements section 811 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (the Medicare Modernization Act or MMA) and contains the rules for determining when, based on income, a monthly adjustment amount will be added to a Medicare Part B beneficiary's standard monthly premium. These final rules describe: What the new subpart is about; what information we will use to determine whether you will pay an income-related monthly adjustment amount and the amount of the adjustment when applicable; when we will consider a major life-changing event that results in a significant reduction in your modified adjusted gross income; and how you can appeal our determination about your income-related monthly adjustment amount.

Humans↗

PubMedDate not supplied

Income and survival in chronic dialysis patients.

The relationship between income and survival rates for chronic dialysis patients in Michigan was examined. To evaluate the relative risk (RR) of dying, by income, a Cox survival regression model was used to adjust for age, race (black versus white), gender, dialytic treatment modality, year of first end-stage renal disease (ESRD) therapy, and primary cause of ESRD. The average household income reported from census data for the ZIP Code of residence for each patient was analyzed as a socioeconomic indicator. Treatment modality on day 120 of ESRD was classified as either center hemodialysis (HD) or CAPD. All new patients, aged 20-59 and registered at the Michigan Kidney Registry between 1/1/80 and 12/31/87 were included in the study. Patients were followed from day 180 of ESRD until death, censoring at transplant, or 12/31/87. The adjusted relative risk of dying decreased for black patients by 3.3% per $1,000 increase in income (p less than 0.01), while the trend by income for white patients was negligible (p greater than 0.10). The difference in trends for the two groups was statistically significant (p less than 0.01). This is a surprising result, since white patients have higher death rates, overall, than do black patients, particularly among subgroups with diabetes and hypertension whose RR was 1.77 and 1.82, respectively. Poor socioeconomic status of the area of residence has a strongly negative effect on survival for black patients, but not for white patients. The reasons for the relationship of death rates with income, especially for black patients, need to be examined in greater detail.

Adult↗

PubMed1979

Frequency of selection of food groups by low-income families in southwestern Mississippi.

Food resources and frequency of food use of 1,000 households in Claiborne County in southwestern Mississippi were studied and related to income and educational level of the family heads. Income and educational levels of the family heads were much lower than the national average. The data on food frequency use indicated that the meal patterns of these households could not provide sufficient nutrients for individual family members. Income and educational levels of the family heads correlated highly with food frequency scores. The households with higher incomes and more education had better food consumption patterns than those with lower incomes and less education. However, income had more effect on low nutrient intake than education.

Adolescent↗

PubMed1984

Income changes at and after Social Security benefit receipt: evidence from the Retirement History Study.

This article details the changes in total income and the composition of its sources that occur upon initial receipt of Social Security benefits, and in the first 4 years thereafter. The study shows that, for many persons, "retirement" is a gradual process rather than an immediate cessation of all paid work. About half the persons entering the rolls continue at least some paid employment after benefit receipt. Even more do so if previous earnings were low or if they have no pension to supplement their benefits. In real terms, the average couple initially loses about one-third of its previous income, while nonmarried women, with less to begin with, lose somewhat less. In the time period studied, inflation was high in historical terms: the Consumer Price Index rose by approximately one-third in the 4-year period following benefit receipt. During that time, the real income of beneficiaries declined by about 10 percent from the levels immediately after benefit receipt. Fewer beneficiaries continued to work 4 years later, so earnings played a smaller role in total income. The real value of private pensions declined by about 20 percent in the 4-year period, but because most persons with such pensions had other, better-protected sources of income, their total income declined by less than 10 percent.

Aged↗

PubMed1984

Incomes of the aged and nonaged, 1950-82.

This article discusses the results of previous studies, both supportive and nonsupportive of the conclusion that the aged are as well-off as the nonaged, and then presents a range of figures from Bureau of the Census reports over the period 1950-82 that measure both the incomes of the aged and nonaged and those of subgroups within these populations. Census figures indicate that the aged and nonaged have about equal levels of average per capita family income and that about the same proportions of these groups have incomes below the poverty line. However, aged unrelated individuals, who account for about a third of all aged persons, have less than three-fifths the income of nonaged unrelated individuals. When the per capita family income of the aged is compared separately with that of families headed by persons aged 25-44 and 45-64, aged persons receive more than those under age 45 but less than those aged 45-64. Trends in the economic status of the aged and nonaged over the period 1950-82 indicate numerous fluctuations rather than a consistent improvement in the income of either group in relation to the other.

Adult↗

PubMed1983

Relative importance of various income sources of the aged, 1980.

This article looks at the extent to which aged couples and nonmarried persons rely on earnings, retirement pensions, assets, and public assistance. The study notes the importance of these various sources to aged units with different levels of both total money income and retirement income, then examines changes in the relative importance of the different sources over time. The data indicate that 23 percent of all aged units had some income from earnings in 1980 and that 90 percent had income from Social Security. Asset income also was widely received. Twenty-two percent of the aged units had private pension income, and 12 percent had government-employee pensions. Public assistance was received by 10 percent of the aged units.

Aged↗

PubMed1993

The role of pensions in retirement income: trends and questions.

Pensions are an important and increasingly common supplement to Social Security benefits for persons aged 65 or older--particularly for those in the the middle and upper income quintiles. By 1990, pension income was reported by 44 percent of all elderly units--57 percent of the couples and 34 percent of unmarried persons. This article discusses the role of pensions in the income of the elderly; private pension coverage, vesting, and types of plans among active workers; how the shift toward defined contribution plans poses new problems in assessing the role of private pensions in providing retirement income security; and expected pension receipt rates for the future elderly. Pension receipt among the elderly is expected to continue to grow over the next 20-30 years because of past growth in coverage and vesting. Microsimulation models are a relatively new tool for forecasting the future distribution of pension income. The models offer a framework for considering the research questions that, if answered, would help improve our understanding of the impact of the pension system on future income security.

Adult↗

PubMed1993

Income growth among nonresident fathers: evidence from Wisconsin.

This study examines the changes over time in the personal incomes of nonresident fathers--whether divorced or nonmarital--in Wisconsin. Using data from the Wisconsin Court Record data base and the Wisconsin Department of Revenue, the authors examine the incomes of these fathers over the first seven years following a divorce or the initiation of a paternity suit. They also study separately the income patterns of initially poor nonresident fathers and fathers whose nonresident children receive welfare. The most important finding is that the incomes of nonmarital fathers, which typically are low in the beginning, increase dramatically over the years after paternity establishment--often to a level comparable with the incomes of divorced fathers. On the basis of their findings, the authors conclude that failing to establish child support obligations for nonresident fathers simply because their incomes are initially low does not appear justified.

Divorce↗

PubMedDate not supplied

A look at income and wealth in America.

Diverse forces in the U.S. economy have led to a tendency for increased concentration of income and wealth in the upper income brackets. Some mobility within classes helps to mitigate the problem, but sluggish growth of real incomes has heightened awareness of this trend. Even though the vast majority of Americans continue to identify themselves as "middle class," this slowed growth contributes to the concerns about the shrinking size of this group. Between 1975 and 1995 the highest quintile of households was the only one to experience a growing share of money income, with virtually all of the increase occurring within the top 5 percent. Education and training in our high-technology society are two key elements in improving income. Demographic forces may also change income and wealth dynamics in the future particularly as the population ages and the ratio of workers to the elderly retired affects the supply demand forces in the labor markets.

Age Distribution↗

PubMed1998

The effect of managed care on the incomes of primary care and specialty physicians.

OBJECTIVE: To determine the effects of managed care growth on the incomes of primary care and specialist physicians. DATA SOURCES: Data on physician income and managed care penetration from the American Medical Association, Socioeconomic Monitoring System (SMS) Surveys for 1985 and 1993. We use secondary data from the Area Resource File and U.S. Census publications to construct geographical socioeconomic control variables, and we examine data from the National Residency Matching Program. STUDY DESIGN: Two-stage least squares regressions are estimated to determine the effect of local managed care penetration on specialty-specific physician incomes, while controlling for factors associated with local variation in supply and demand and accounting for the potential endogeneity of managed care penetration. DATA COLLECTION: The SMS survey is an annual telephone survey conducted by the American Medical Association of approximately one percent of nonfederal, post-residency U.S. physicians. Response rates average 60-70 percent, and analysis is weighted to account for nonresponse bias. PRINCIPAL FINDINGS: The incomes of primary care physicians rose most rapidly in states with higher managed care growth, while the income growth of hospital-based specialists was negatively associated with managed care growth. Incomes of medical subspecialists were not significantly affected by managed care growth over this period. These findings are consistent with trends in postgraduate training choices of new physicians. CONCLUSIONS: Evidence is consistent with a relative increase in the demand for primary care physicians and a decline in the demand for some specialists under managed care. Market adjustments have important implications for health policy and physician workforce planning.

Age Distribution↗

PubMedDate not supplied

Reducing economic disparity to achieve better health: modelling the effect of adjustments to income adequacy on self-reported morbidity among the elderly in Canada.

Class differentials in health have been documented extensively in the sociological literature of the past two decades. Although sociologists have been concerned with analyzing the relationship between social class and health, less attention has been paid to modelling the effects of minimizing social disparities on health outcomes. From a sub-sample (N = 1,943) of elderly respondents aged 65 and over, four logistic regression equations where income adequacy was shown to be correlated with morbidity were selected. By adjusting the scores on the income adequacy variable, we were able to model the effect of shifting individuals from lower to higher income groups. The most dramatic results were obtained after all respondents were shifted into the highest income adequacy classification. A more realistic hypothetical model, the transfer of individuals from the lowest income group to the next category, produced the least attractive reduction in morbidity. Obviously, income adjustment alone is insufficient. Findings are discussed in terms of interventions to prevent economic disparity in old age.

Aged↗