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PubMed1989

Postcensal estimates of household income distributions.

This article develops and evaluates a method for deriving postcensal estimates of household income distributions for counties. A modified lognormal probability curve is used as a model of income distribution. The function is closely related to the classical lognormal model, but it contains a nonlinear component in its derivation. Simulated postcensal estimates of household income distributions are compared with 1980 census data for the counties in California. The results indicate that the modified lognormal curve approximates observed income distributions well and produces reliable postcensal estimates for areas with a wide variety of median income levels and numbers of households.

Family↗
PubMed1989

Household income and child survival in Egypt.

This article uses household-level economic and fertility survey data to examine the relationship between household income and child survival in Egypt. Income has little effect on infant mortality but is inversely related to mortality in early childhood. The relationship persists with other associated socioeconomic variables controlled. The mechanisms underlying the income effects are not evident from this analysis: income differentials in sources of household drinking water, type of toilet facilities, and maternal demographic characteristics do not explain the net impact of income on child mortality. The absence of effects on child survival of the size of the place of residence and the relatively weak effects of maternal schooling are also notable.

Child↗
PubMed1979

Dentists' incomes, fees, practice costs, and the Economic Stabilization Act: 1952 to 1976. Bureau of Economic and Behavioral Research.

Throughout the 20-year period from 1952 to 1972, dentists' net incomes, adjusted for inflation, increased and provided greater monetary rewards to the practice of dentistry. Evidence discloses a close association between the purchasing power of dentists' net incomes and the general level of economic activity (measured by the GNP inconstant dollars). Dentists are not immune to temporary recessions. The period from 1972 to 1974, with the imposed fee guidelines of Nixon's Economic Stabilization Act, was unusual. With effective fee guidelines during the latter two phases coupled with freely fluctuating input prices, dentists were caught in an income squeeze. During 1972 to 1974, the purchasing power of dentists' net incomes fell at a rate of 10.1% per year as the price index of practice costs outpaced dentists' fees. After the Economic Stabilization Act expired in 1974, trends returned to normal. Dentists' net incomes increased at rates consistent with changes in the GNP and dentists' fees increased slightly faster than the "Price Index of Cost of Conducting a Dental Practice."

Costs and Cost Analysis↗
PubMed1984

[Relation between familial income, expenditure and food consumption in marginal urban zones of Sonora, Mexico].

This research project in urban marginal areas of the City of Hermosillo in Sonora, Mexico, analyzes certain socioeconomic factors taking into consideration the relationship between household income, expense and consumption of food. The study is based on information collected in a 24-hour recall survey carried out for all members of the family, frequency of consumption of foods, and a socioeconomic questionnaire. Expense and consumption of foods was divided into five different income groups and into three classes of foods: basic foods, fresh meat and high-protein foods. The results of the research study show a direct relationship between household income level and expense and consumption of the foods. The income-elasticity of the demand of basic foods was lower than that estimated for high-protein foods, and there was a marked tendency to increase consumption of high-protein foods as family income increased. More than 50% of the calories and proteins were obtained from the basic foods group, even though a large percentage of family food expense was destined for high-protein foods. The study concludes that more research is needed at a macroeconomic level to understand the basic underlying causes of the nutritional problems.

Costs and Cost Analysis↗
PubMed1984

Food consumption and dietary adequacy according to income in 1,200 families, Manaus, Amazonas, Brazil, 1973-1974.

Data from a household expenditure survey of 1,200 Manaus families performed by the Amazonas State Government in 1973-74 are analyzed by income group. The per cent frequency of families buying different foods and the daily per capita consumption of each were calculated. The daily per capita intakes of energy, protein, vitamin A, thiamine, riboflavin, nicotinic acid, ascorbic acid, calcium, phosphorus, iron and zinc were estimated and their adequacy evaluated. In contrast to the south and northeast of Brazil, the main bulk of the diet was derived from cereals and fish. The quantities of eggs, meats, fruit and vegetables consumed per person, increased 50-100% as income improved, whereas fish consumption decreased 30%. The nutrients quantitatively most deficient were zinc, vitamin A, calcium, thiamine and riboflavin, with 60-80% of low and middle income families not achieving safe levels of intake for zinc and vitamin A. The beneficial effect of income on the adequacy of calcium, thiamine and riboflavin intake was quantitative. For zinc and vitamin A, increased income was associated with a qualitative improvement in the diet, principally due to the increased consumption of meat and liver. These results are discussed in relation to existing clinical evidence of deficiency states in the region.

Brazil↗
PubMed1980

Association of breast cancer and cervical cancer incidence with income and education among whites and blacks.

Data from the 1969-71 Third National Cancer Survey were used to study the association of cancer incidence with income and education as indicated by census tract of residence. Also considered was the effect of adjustment for differences in socioeconomic distribution on the observed excess risk of cervial cancer and lower risk of breast cancer among black women compared to white women. Strong positive associations with both income and education were found, with the rates based on 19,344 breast cancer cases among white women. These observations were noted in most geographic areas studied. The relative risk showed little apparent relationship to age. The rates based on 1,570 cases among black women indicated a strong positive association with education but not with income. Socioeconomic adjustment reduced by almost one-half the black-white difference in breast cancer rates, and education had a stronger effect than did income. White women continued to have a significantly higher rate after such adjustment. Conversely, the incidence of cancer of the cervix showed strong negative associations with each of the two variables among both the 3,802 cases in white women and 954 cases in black women. The negative gradient decreased with age and was apparent in almost all the areas. The excess risk among black women was reduced by two-thirds with socioeconomic adjustment, though the rates remained significantly different. Income had a stronger association than did education with cervical cancer incidence.

Adult↗
PubMed1995

The relationship between parental income and academic performance of medical students.

PURPOSE: To test the hypothesis that family financial status is associated with the academic performance of a medical student. METHOD: The relationships between parental income and mean scores on the Medical College Admission Test (MCAT) and United States Medical Licensing Examination (USMLE) Step 1 were examined for the students in the 1994 and 1995 graduating classes at the UMDNJ-New Jersey Medical School who had applied for financial aid in 1991 and reported annual parental income. Pearson correlations were used to analyze separately the data for minority and majority students, for men and women, and for the four subgroups by gender and race-ethnicity. RESULTS: The final study cohort consisted of 192 students (55% of all students). Significant positive correlations were found between the (1) MCAT and USMLE Step 1 for the women, men, majority, and minority students, (2) MCAT and parental income for the subgroups of majority men and minority women, and (3) USMLE Step 1 and parental income for the subgroup of minority women. CONCLUSION: Parental income was correlated significantly with performances on the MCAT and USMLE Step 1. These relationships may be particularly strong and persistent for minority women.

Cohort Studies↗
PubMed1996

Family unit incomes of the elderly and children, 1994.

The economic status of the elderly and that of children are analyzed using a comprehensive definition of income that takes selected types of noncash income and taxes into account. Estimates are presented for detailed age groups over the entire age range and for socioeconomic classifications within the elderly subgroup and within the subgroup of children. The article finds that children and the elderly are less well-off than the middle age groups. This result is obtained using median incomes and the percentage of the group that has low income, as defined in this article. When results obtained with the measures presented in this article are compared with those obtained with more commonly used measures, there are important differences for both the elderly and for children. For both groups, the composition of the low-income population differs in important ways from the composition of the official poverty population.

Adolescent↗
PubMed1997

The earnings, income, and assets of persons aged 51-61 with and without musculoskeletal conditions.

OBJECTIVE: To describe the personal and family earnings, income, and assets of persons with musculoskeletal conditions. METHODS: This study uses the Health and Retirement Survey, a national, community based probability sample of persons 51-61 years of age and their spouses in 1992 to estimate earnings, income, and assets (by kind) in the years immediately prior to the normal age of retirement. RESULTS: Fifty-nine percent of persons 51-61 years of age (13.76 million) report one or more musculoskeletal condition; of these 38% (8.74 million) also report at least one comorbid condition and 21% (5.02 million) report no such comorbidity. Persons with musculoskeletal conditions and comorbidity report 18% lower family earnings, 15% lower family income, and 35% fewer assets than the average among all persons these ages. Persons with musculoskeletal conditions and no comorbidity have earnings, incomes, and assets closer to the average among their peers. CONCLUSION: Persons with musculoskeletal conditions and comorbidity have lower earnings and incomes now and fewer assets with which to face the future than the remainder of their peers.

Comorbidity↗
PubMed1989

Intraregional income distribution and poverty: some investigations for the Netherlands, 1960-81.

"This paper is addressed to intraregional income inequalities in the Netherlands. Various concepts are used to measure the degree of regional poverty. In addition, dissimilarity between intraregional income distributions is studied. At the provincial level, relatively small and decreasing dissimilarities are observed. However, at lower spatial levels (especially within metropolitan areas) much larger dissimilarities in mean income and income distribution occur. In the Netherlands, urban poverty has become a more intense and widespread phenomenon than rural poverty."

Demography↗
PubMed1987

Remittances and income distribution.

"The paper studies the effects of [foreign] remittances on the pattern of income distribution in Yugoslavia. It is found that remittances raise the Gini coefficient, although unequally as between different social groups. One reason may be that in social groups where the diffusion of information is relatively even (as among urban households) migration is more uniform across income groups than it is in social groups where the access to information depends primarily on the level of income (e.g. rural households). In the latter groups distribution of migrants is more skewed towards higher income groups and remittances increase the level of inequality more substantially." Data are from household surveys conducted in Yugoslavia in 1973, 1978, and 1983.

Communication↗
PubMedDate not supplied

Low-income women with early-stage breast cancer: physician and patient decision-making styles.

BACKGROUND: Poor women have low rates of breast conservation therapy not explained by differences in insurance status or treatment preferences. The purpose of this study was to explore how low-income women make decisions about breast cancer treatment. METHODS: Twenty-five women diagnosed with early-stage breast cancer through the Nebraska Every Woman Matters program were interviewed about their experiences selecting treatment options. These interviews were transcribed and then analysed using established qualitative techniques. RESULTS: More than half of the women (n=16) described playing a passive role in decision making. Choice was determined by medical factors or not offered by their physicians. Intense emotional distress affected some women's ability to compare options. The women who did engage in a rational decision-making process (n=9) based their choices on concerns about body image and fear of recurrence. CONCLUSIONS: When presented with a choice, and when able to objectively weigh treatment options, low-income women base their treatment decisions on the same issues as those of higher income. Whether differences in income strata alter the doctor-patient power dynamic in favor of physician control over decision making, or whether low-income women are less prepared to engage in a rational deliberative process warrants further study.

Adult↗
PubMed2000

Asthma and the home environment of low-income urban children: preliminary findings from the Seattle-King County healthy homes project.

OBJECTIVES: Childhood asthma is a growing public health concern in low-income urban communities. Indoor exposure to asthma triggers has emerged as an important cause of asthma exacerbations. We describe indoor environmental conditions related to asthma triggers among a low-income urban population in Seattle/King County, Washington, as well as caregiver knowledge and resources related to control of these triggers. METHODS: Data are obtained from in-person, structured, closed-end interviews with the caretakers of children aged 4-12 years with persistent asthma living in households with incomes less than 200% of poverty. Additional information is collected during a home inspection. The children and their caregivers are participants in the ongoing Seattle-King County Healthy Homes Project, a randomized controlled trial of an intervention to empower low-income families to reduce exposure to indoor asthma triggers. We report findings on the conditions of the homes prior to this intervention among the first 112 enrolled households. RESULTS: A smoker was present in 37.5% of homes. Mold was visible in 26.8% of homes, water damage was present in 18.6% of homes, and damp conditions occurred in 64.8% of households, while 39.6% of caregivers were aware that excessive moisture can increase exposures to allergens. Dust-trapping reservoirs were common; 76.8% of children's bedrooms had carpeting. Cockroach infestation in the past 3 months was reported by 23.4% of caregivers, while 57.1% were unaware of the association of roaches and asthma. Only 19.8% of the children had allergy-control mattress covers. CONCLUSIONS: Many low-income urban children with asthma in King County live in indoor environments that place them at substantial risk of ongoing exposure to asthma triggers. Substandard housing and lack of resources often underlie these exposures. Initiatives involving health educators, outreach workers, medical providers, health care insurers, housing agencies, and elected officials are needed to reduce these exposures.

Asthma↗
PubMed2004

The effectiveness of a health promotion program for the low-income elderly in Taipei, Taiwan.

This study assessed the effectiveness of a health promotion program for low-income elderly provided by trained low-income home health aides. Indicators of the effectiveness of this program included improvement in physical health, psychosocial health and functional status, including activities of daily living (ADL) and instrumental activities of daily living (IADL) as well as changes in perceived health promotion needs. This evaluation study used a single group pre- and post-test experiment design. After informed consent forms were signed by participants, 89 purposively selected low-income elderly (aged 64-96) completed pre-test structured surveys, while 60 participants (aged 68-96) completed post-test surveys. Post-test scores indicated improved nutritional status (paired t = 2.64, p < .05) and chore management of IADL abilities (paired t = 2.83, p < .01). No significant difference in psychosocial status were found between pre- and post-test scores. Perceived needs for health promotion services decreased after the intervention. The results show that the health promotion services were effective in improving health status and decreasing perceived needs for services among low-income elderly in Taipei. Recommendations based on this study for developing services for the low-income elderly must take health promotion intervention into consideration.

Activities of Daily Living↗
PubMed2005

Factors associated with intention to breastfeed among low-income, inner-city pregnant women.

OBJECTIVES: To examine the relationship between sociodemographic factors, maternal characteristics, and intention to breastfeed among low-income, inner-city pregnant women. METHODS: English and Spanish speaking low-income women recruited from local Philadelphia health centers were surveyed at the time of their first prenatal care visit. At the time of the visit, respondents were asked whether or not they planned to breastfeed their infant. The responses of 2,690 women were included in these analyses. Multivariate logistic regression was used to assess the independent associations of race/ethnicity, nativity status, education, and other factors on the odds of intending to breastfeed. RESULTS: About half (53%) of the respondents reported that they intended to breastfeed their infant. In adjusted logistic regression models, immigrant black (adjusted OR [aOR] 5.82; 95% confidence interval [CI] 3.86, 8.77), other Hispanic (who were predominantly foreign-born) (aOR 6.05; 95% CI 3.92, 9.33), and island-born Puerto Rican (aOR 3.48; 95% CI 2.04, 5.95) women were significantly more likely to report that they intended to breastfeed than non-Hispanic whites. Somewhat surprisingly, non-Hispanic, US-born African Americans in this low-income sample were more likely to report that they intended to breastfeed than non-Hispanic white respondents (aOR 1.59; 95% CI 1.20, 2.11). Lower education, not living with the baby's father, multiparous pregnancy, and smoking were negatively and independently associated with intention to breastfeed. Maternal age, household income, public housing, and depressive symptoms were not significant predictors of breastfeeding intention in adjusted multivariate models. CONCLUSIONS: Significant differences were documented in breastfeeding intention in our sample of low-income, inner-city women. Most notable was the higher likelihood of anticipated breastfeeding among our immigrant sub-groups when compared with non-Hispanic white women. An unexpected finding was the higher likelihood of anticipated breastfeeding among native-born, non-Hispanic African American women than among non-Hispanic white respondents. Because intentions are important predictors of future behavior, more focus needs to be directed towards breastfeeding promotion during the prenatal period and towards a better understanding of why some mothers intend to breastfeed while others do not.

Adolescent↗
PubMed2005

Fruit and vegetable intake in African Americans income and store characteristics.

BACKGROUND: The purpose of this study was to examine whether the characteristics of retail food stores where African-American women shopped mediated the association between their income and intake of fruits and vegetables. Food store characteristics included store type (supermarket, specialty store, limited assortment store, independent grocer), store location (suburbs, city of Detroit), and perceptions of the selection/quality and affordability of fresh produce for sale. METHODS: The analysis drew upon data from a probability sample of 266 African-American women living in 2001 in eastside Detroit, which had no supermarkets. Structural equation modeling was used to calculate a path model of direct and indirect effects. RESULTS: Women shopping at supermarkets and specialty stores consumed fruit and vegetables more often, on average, than those shopping at independent grocers. More positive perceptions of the selection/quality, but not affordability, of fresh produce at the retail outlet where they shopped was positively associated with intake, independent of store type and location as well as age, per capita income, and years of education. The results suggested an indirect association between income and fruit and vegetable intake; women with higher per capita incomes were more likely to shop at supermarkets than at other grocers, which in turn was associated with intake. CONCLUSIONS: Previous studies have shown that few supermarkets are located in the city of Detroit, a symptom of economic divestment over the past several decades. Results of this study suggest this may have negative implications for dietary quality, particularly among lower-income women.

Adult↗
PubMed2005

Low-income Canadians' experiences with health-related services: implications for health care reform.

This study investigated the use of health-related services by low-income Canadians living in two large cities, Edmonton and Toronto. Interview data collected from low-income people, service providers and managers, advocacy group representatives, and senior-level public servants were analyzed using thematic content analysis. Findings indicate that, in addition to health care policies and programs, a broad range of policies, programs, and services relating to income security, recreation, and housing influence the ability of low-income Canadians to attain, maintain, and enhance their health. Furthermore, the manner in which health-related services are delivered plays a key role in low-income people's service-use decisions. We conclude the paper with a discussion of the health and social policy implications of the findings, which are particularly relevant within the context of recent health care reform discussions in Canada.

Alberta↗
PubMed2005

A comparative appraisal of the relationship of education, income and housing tenure with less than good health among the elderly in Europe.

The objective of this study was to determine the strength of various socio-economic indicators for predicting less than good health among elderly people aged 60-79 years. Data were obtained from national health surveys from 10 European countries. Education, income and housing tenure were examined in relation to less than good health using standardised prevalence rates and (multiple) logistic regression analyses. The results illustrated that there are substantial health differences among the elderly according to education and income in each country. Both education and income (with men) showed a strong independent relationship with health status. Health differences according to housing tenure were generally somewhat smaller. However, in Great Britain and the Netherlands housing tenure demonstrated large health differences, even after adjustment for education and income. It is recommended that more refined socio-economic measures are developed and that in the meantime both education and income are used when studying socio-economic health differences among the elderly. In some countries, like Great Britain and the Netherlands, however, housing tenure has an additional value.

Aged↗