Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Income”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources
PubMed2004

Confidence in the ability to communicate with physicians among low-income patients with prostate cancer.

OBJECTIVES: To describe the confidence of low-income patients with prostate cancer in interacting with physicians. Men with prostate cancer need to communicate easily with their physicians when facing treatment decisions and symptom management; however, little is known about whether low-income men are confident in these interactions. METHODS: We used validated instruments to measure self-efficacy in patient-physician interactions, emotional well-being, symptom distress, satisfaction with care, and health-related quality of life among low-income men receiving prostate cancer treatment through a statewide public assistance program. We abstracted clinical variables from medical records. We dichotomized self-efficacy scores empirically on the basis of the sample distribution and conducted univariate and multivariate analyses. RESULTS: The self-efficacy scores were skewed toward the high scores, with 77% in the high range. Those (23%) with low self-efficacy were more likely to have poor emotional well-being, symptom distress, role limitations--emotional, low social function, and poor urinary, sexual, and bowel outcomes. In multivariate analysis, low-income men were more likely to have low self-efficacy if they were less satisfied with their care, did not have confidence in their provider, or had more symptom distress. CONCLUSIONS: Among low-income patients with prostate cancer, low self-efficacy for interacting with physicians was best predicted by diminished overall satisfaction with care, low confidence in providers, and worse symptom distress. Men with low self-efficacy fared worse over a range of psychosocial outcomes and both general and disease-specific health-related quality of life.

Adenocarcinoma↗
PubMed2004

Effectiveness of a quit and win contest with a low-income population.

BACKGROUND: In a two-group quasi-experimental study, we evaluated the impact of a quit and win contest on quitting among low-income tobacco users and identified contest elements used by successful quitters. Low-income tobacco users have been largely untouched by tobacco cessation approaches. METHODS: A volunteer sample of 248 low-income tobacco users were recruited from quit and win contest registrants (treatment group). A random sample of 290 low-income tobacco users who had not entered the contest were recruited using random digit dialing (control group). Telephone interviews were conducted with both groups at baseline, 3, 6, and 12 months. Seven-day point prevalence measured self-reported quitting and urine cotinine assessed confirmed quitting. RESULTS: On average, quit and win study participants were 3.5 times more likely than controls to self-report quitting and 12.8 times more likely to demonstrate confirmed quitting after controlling for baseline differences in stage of change, age, education, and marital status. The use of specific contest elements was not related to successful quitting. CONCLUSIONS: The overall quit rates in the treatment group were higher than those in the control group. The results are promising given that low-income tobacco users are generally less likely to succeed in quitting.

Adolescent↗
PubMed2001

Self-reports of safe driving behaviors in relationship to sex, age, education and income in the US adult driving population.

This study analyzed the data of a health and safety survey conducted on a representative sample of the adult driving population. The analysis focused on the relationships between self-reported safe driving behaviors (including belt use, observing speed limits, and abstaining from drinking and driving), and demographic characteristics (including sex, age, education and income). The results showed that the three behaviors are quite independent of each other, and, contrary to some stereotypes, there is no single high-risk group that is most likely to violate all three safe driving behaviors. The only consistent effect was that of sex: women reported higher observance rates of all three behaviors. Reported use of safety belts increases with age and education for both men and women. However while for women the reported use increases with income, for males the reported use does not change with income. Complete avoidance of drinking and driving was reported by most drivers in all groups, and the high rates hardly varied across the different age, education, and income groups. The number of people who reported that they observe the speed limit all the time increased with age, but decreased with increasing education and income. The results have implications for identifying violation-specific high-risk groups, and stressing different factors for each.

Adult↗
PubMed1997

Energy and nutrient inadequacies in the diets of low-income women who breast-feed.

OBJECTIVE: To assess the energy and nutrient intakes of women who are breast-feeding in relation to the Recommended Dietary Allowances (RDAs) for energy and nutrients during lactation. DESIGN: Survey using a interviewer-administered questionnaire and a 24 dietary recall. SUBJECTS: The subjects were 183 women breast-feeding at 3 months postpartum. All were living in low-income communities in Ontario, Canada, that were participating in the longitudinal prevention initiative, Better Beginnings, Better Futures. STATISTICAL ANALYSES: Mann-Whitney U test to compare energy and nutrient intakes of women with incomes above and below the Statistics Canada poverty line. RESULTS: Median intake of energy (2,148 kcal) was below the RDA of 2,700 kcal. Compared with the RDAs, intakes of calcium (928 vs 1,200 mg), folate (222 vs 280 microns), iron (13 vs 15 mg), thiamin (1.4 vs 1.6 mg), vitamin A (846 vs 1,300 retinol equivalents), and zinc (10 vs 19 mg) were below recommended values for women who are lactating. Although household income for 70% of the women was below the poverty line, differences in energy and nutrient intakes according to income group were not statistically significant. APPLICATIONS: Lactating women are at high risk of energy and nutrient inadequacies. Programs to increase breast-feeding rates, particularly among low-income communities, must include strategies to ensure adequate diets during lactation.

Adolescent↗
PubMed1992

Patients with a low income have reduced renal allograft survival.

The impact of socioeconomic factors on long-term outcome after renal transplantation is unknown. We examined the effects of family income among 202 patients transplanted between 1976 and 1982 who had an allograft that functioned for at least 1 year. Compared with patients with an adequate income, recipients of medical assistance at the time of transplantation were more likely to return to dialysis after 1 year (16/45 [36%] v 26/157 [17%], P less than 0.01), or after 5 years of graft function (10/38 [26%] v 12/116 [10%], P less than 0.01). Patients who complied with fewer than 85% of visits during the first 2 years were also more likely to return to dialysis after 1 year (17/49 [35%] v 25/153 [16%], P less than 0.01), or after 5 years (8/31 [26%] v 14/123 [11%], P less than 0.05) than were more compliant patients. However, noncompliance was not different in patients with and without a low income (37/157 [24%] v 12/45 [27%], P greater than 0.05). The relative risk for returning to dialysis after 5 years was 2.4 (P less than 0.05) for low income and 3.0 (P less than 0.05) for less than 85% compliance using a Cox proportional hazards model. These effects were independent of prior transplantation, mismatches, pre-formed antibodies, delayed graft function, age, sex, diabetes, alcohol or drug abuse, education, race, distance from the transplant center, and living in an urban environment (relative risk = 2.5, P less than 0.05). Neither income nor compliance could be linked to death.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Can individual competence factors prevent adult substance and alcohol abuse in low- and high-income areas?

This study investigates the role of individual competence factors as modifiers of the risk for adult substance and alcohol abuse in relation to living in high- or low-income areas. The study group consisted of 7,577 18-year-old Swedish conscripts followed for substance and alcohol abuse until the age of 45 ears. Records of alcohol and substance abuse were obtained from official registers. In the 25-year follow-up period, 166 (2.2%) persons were identified as substance abusers and 286 (3.8%) as alcohol abusers. Subjects with many (from five to nine) behavioral risk factors and many (from four to five) competence factors had significantly less adult alcohol and substance abuse in low-income areas compared with those who had few competencies. This finding was also true for alcohol abuse in high-income areas. Experimentation with drugs and alcohol use before conscription was the most powerful risk factor for adult alcohol abuse and substance abuse in both income areas. The results of this study indicate that knowledge of competence factors is important in preventing abuse, especially among high-risk persons coming from low-income areas.

Adolescent↗
PubMedDate not supplied

Breastfeeding duration among low income women.

Breastfeeding has been identified as a possible deterrent to the development of osteoporosis and breast cancer in women. In addition, infants who are breastfed exclusively for at least 4 months reportedly have fewer incidence of SIDS, ear infection, diarrhea, and allergies. Further, low income women who breastfeed may be empowered by the experience. Increasing the frequency and duration of breastfeeding is recognized as a national priority, particularly for low income, minority women. Yet, recent national data indicate that in 1997, only 16.5% of low income mothers breastfed for at least 6 months. Short breastfeeding duration in low income women may be due to problems unique to them; thus, consistent and comprehensive breastfeeding support should be provided by midwives, nurses, lactation consultants, and peer counselors who are skilled in culturally sensitive management of lactation within the context of limited financial and social resources. This article focuses on the benefits of breastfeeding, and factors that may influence its duration. It also explores culturally relevant strategies as well as suggested interventions to increase breastfeeding duration among low-income women.

Attitude to Health↗
PubMed2004

How children with special health care needs affect the employment decisions of low-income parents.

OBJECTIVES: To better understand the impact of having a child with special health care needs (CSHCN), on low-income parents' employment decisions. METHODS: Using data from the 1999 and 2000 National Health Interview Survey (NHIS), we estimate multivariate statistical regressions (logit and tobit models) to estimate the relationship between having a CSHCN and the likelihood of employment and hours of employment for a sample-of low-income single parents. RESULTS: Controlling for differences in demographic and family characteristics, we find no significant association between having a CSHCN and the probability of work or the number of hours worked among low-income single-parent families. Separate analysis of different dimensions of special health care needs shows that parents of children with activity limitations are significantly less likely to work and work fewer hours. This result does not hold true for the group of children defined based on elevated or special service use, or for the group of children with specific chronic conditions. CONCLUSIONS: These results indicate that only a specific subset of children with special needs present difficulties for low-income parents' work. This suggests that policies to help low-income single parents of children with disabilities move into work should target this specific subset of children with special health care needs.

Adolescent↗
PubMedDate not supplied

Enhancing low-income parents' capacities to promote their children's health: education is not enough.

In 1996 the Capital Heath Region in Edmonton, Alberta integrated a primary health care component into Head Start programs. One aspect of the primary health care component (PHC-HS) was a series of education sessions aimed at strengthening parents' capacities to enhance their children's health. To make the education sessions relevant, 10 focus groups with 65 parents of children who attended Head Start were conducted prior to the sessions. Findings indicated that participants' ability to enhance their children's health and manage their children's illnesses was limited as much by low incomes, inadequate health care coverage, and lack of transportation as it was by a lack of knowledge. Results provide evidence that health education sessions alone are not adequate to significantly enhance low-income parents' capacities to promote their children's health. Efforts to strengthen the abilities of low-income individuals and families to promote their health will be most effective if health education is accompanied by policy advocacy and social action strategies that challenge the socioeconomic and political conditions that negatively affect health. Public health nursing's commitment to social justice, as well as findings about the limitations that low incomes, inadequate health care benefits, and lack of transportation placed on participants' ability to enhance their children's health, underscore the need for public health nurses (PHNs) to address structural conditions contributing to health inequities. As such, an overview of literature that details strategies and theoretical models for challenging socioeconomic and political conditions which restrict the ability of low-income individuals and families to enhance their health is provided.

Adult↗
PubMedDate not supplied

Equity dimensions of road traffic injuries in low- and middle-income countries.

Globally, poorer population groups bear a disproportionate burden of avoidable morbidity and mortality from road traffic injuries. The distribution of road traffic injuries is generally influenced by socioeconomic factors. Poor countries bear a disproportionate burden of injuries and fatalities, and within countries, poor people account for a disproportionate portion of the ill health due to road traffic injuries. The main source of data for this paper was the road traffic injury database of the WHO World Health Report for 1999 supplemented by the WHO Global Burden of Disease Study 2000 report, and published and unpublished works. Fatality rates for 0-4 and 5-14 year olds in low- and middle-income regions, measured as deaths per 100,000 population, were six times the rates for high-income regions, while within low- and middle-income regions the rates varied widely. Within poor countries, poor people--represented by pedestrians, passengers in buses and trucks, and cyclists--suffer a higher burden of morbidity and mortality from traffic injuries. In rich countries, children from poor socioeconomic classes suffer more injuries and deaths from road crashes than their counterparts from high-income groups. The disproportionate burden of morbidity and mortality in low- and middle-income countries, and among low socioeconomic groups in those countries, illustrates problems of global inequities in health. The problems can be addressed through policies that focus on the road safety of vulnerable groups.

Accidents, Traffic↗
PubMed2006

Parallel deficits in linear growth and mental development in low-income Mexican infants in the second year of life.

OBJECTIVE: To explore anthropometric indicators and mental development in very-low-income children in the second year of life. DESIGN: Cross-sectional survey. SETTING: Low-income areas (income <20th percentile) in semi-urban Mexico (defined as towns or cities with 2,500-50,000 inhabitants). SUBJECTS: Eight hundred and ninety-six children aged 12.5-23.5 months surveyed from September to December 2001. METHODS: Questionnaire survey and anthropometric survey of households. Multivariate regression models evaluated differences across age in anthropometry (height-for-age Z-score (HAZ) and weight-for-height Z-score) and cognitive function (Mental Development Index (MDI) of the Bayley Scales of Infant Development) while controlling for socio-economic and parental characteristics. RESULTS: There was a significant decline in HAZ and in age-adjusted MDI score across the second year of life. Although the children showed MDI scores close to the mean, normed US values at 13-14 months, the scores were significantly lower than expected in older children (P < 0.0001), even after controlling for socio-economic status and parental characteristics. At 13-14 months, only 3% of children received scores below 70 (less than minus two standard deviations), whereas by 19-20 months, almost 17% of children were performing below this level. No socio-economic or parental characteristics were significant predictors of HAZ or MDI. CONCLUSIONS: Parallel deficits are evident in both height-for-age and cognitive functioning during the second year of life in low-income Mexican infants. The consistency of these growth and development findings further stresses the need for targeted interventions to reduce the vulnerability of low-income Mexican children very early in life.

Anthropometry↗
PubMed1993

Trends and patterns in height and weight status of low-income U.S. children.

To better define the trends and patterns of growth for low-income children, we studied the anthropometry data collected by the second National Health and Nutrition Examination Survey (NHANES II) and the CDC Pediatric Nutrition Surveillance System (PNSS). Based on NHANES II, we found that low-income children appear to have a greater prevalence of shortness (low height-for-age), but do not have a greater prevalence of overweight (high weight-for-height) when compared with children from higher income families. Based on 12 states that were monitored continuously by the PNSS from 1980 to 1989, low-income children under 5 years of age appear to have a stable trend of height and weight status, with the exception of Asian children, most of whom were from Southeast Asian refugee background, showed a dramatic improvement in height status. However, based on PNSS data for the years 1977 to 1990 from Louisiana and Michigan, school-aged children and adolescents appear to have become slightly taller as well as having significant increases in body weight in relation to height. An additional investigation is needed to verify this trend of increasing excess weight among older, low-income children.

Adolescent↗
PubMed2005

The relationship between active living and health-related quality of life: income as a moderator.

This study used a moderator model to examine the relationship between active living and the physical components of health-related quality of life [i.e. overall physical component of quality of life (PQOL), physical functioning and ability to fulfill physical role] among a randomly selected sample of rural residents (n = 407) from the Midwestern US. Results showed that active living was associated with greater increases in health-related quality of life for those reporting lower income. The effect size of the relationship between active living and the PQOL for the low-income group was over 2 times the effect size for the high-income group. For physical functioning, the effect size of active living for the low-income group was greater than 3 times the effect size for the high-income group. Although active living behaviors have been demonstrated to be less prevalent among those of low socioeconomic status, this group may have the most to gain from these activities. Findings highlight the need for increased and specifically targeted promotion of active living interventions.

Adult↗
PubMed2005

Changes in women's use of hormones after the Women's Health Initiative estrogen and progestin trial by race, education, and income.

BACKGROUND: We examined the impact of race, education, and household income on changes in rates of discontinuation and initiation of hormone therapy before and after release of the Women's Health Initiative estrogen plus progestin trial results. METHODS: We conducted an observational cohort study of 221 378 women aged 40-80 years enrolled in five health maintenance organizations to estimate the prevalence and rates of discontinuation and initiation of estrogen plus progestin and estrogen only between September 1, 1999, to June 31, 2002 (baseline), and December 31, 2002 (follow-up). We identified the census block group for each participant by geocoding her 2003 residential address. We categorized women into racial, education, and income groups based on the distribution of these characteristics in her community from year 2000 census data and the distributions of these characteristics within her HMO. RESULTS: There were significant differences in estrogen plus progestin and estrogen only prevalence by race, education level, and household income, and in estrogen plus progestin initiation by race and education level, but not by household income at follow-up. However, there were no differences by community race, education, or household income in change in the prevalence of either hormone therapy use at follow-up or in the rates of hormone therapy discontinuation or initiation from baseline to follow-up. CONCLUSIONS: Given the wide spread media attention to the Women's Health Initiative estrogen plus progestin trial results, our findings suggest comparable dissemination of this information across diverse socioeconomic groups.

Adult↗
PubMedDate not supplied

Hospital and emergency department use by young low-income children.

BACKGROUND: Limited data are available concerning determinants of health care service usage by low-income young children. OBJECTIVES: To explore predictors of hospitalization and emergency department (ED) use by young children of low-income families by using the Aday and Andersen Access Framework. METHODS: Low-income women (n = 474) with a child younger than 6 years completed a structured face-to-face interview at human service offices or Women, Infants, and Children (WIC) clinics in four central Ohio counties. Women were considered low-income if they or their child were Medicaid eligible or uninsured. Data were collected for both the mother and the index child on sociodemographic status, health services use, health status, and access to care. RESULTS: Fifteen percent of the children had been hospitalized the previous year, and half had an ED visit. Hospitalization was significantly related to maternal hospitalization the previous year (OR = 2.5), child age younger than 1 year old (OR = 2.1) and more than two chronic conditions (OR = 2.2). Maternal ED usage in the last year (OR = 2.2), Medicaid fee for service plan (OR = 1.7), and rural residence (OR = 2.0) were predictive of ED use. CONCLUSIONS: Predisposing characteristics (maternal hospital/ED use) were predictive of both hospitalization and ED use by the index child. Enabling characteristics (fee-for-service Medicaid plan, rurality) were only predictive of ED use, and need characteristics (child's health) were only predictive of hospitalization. Further research to explore linkages between maternal and child use of health care services as well as the effect of changes in health care access, managed care, and other innovations on hospitalization and ED use in young, low-income children is recommended.

Adult↗
PubMedDate not supplied

Change in family income-to-needs matters more for children with less.

Hierarchical linear modeling was used to model the dynamics of family income-to-needs for participants of the National Institute of Child Health and Human Development Study of Early Child Care (N = 1,364) from the time that children were 1 through 36 months of age. Associations between change in income-to-needs and 36-month child outcomes (i.e., school readiness, receptive language, expressive language, positive social behavior, and behavior problems) were examined. Although change in income-to-needs proved to be of little importance for children from nonpoor families, it proved to be of great importance for children from poor families. For children in poverty, decreases in income-to-needs were associated with worse outcomes and increases were associated with better outcomes. In fact, when children from poor families experienced increases in income-to-needs that were at least 1 SD above the mean change for poor families, they displayed outcomes similar to their nonpoor peers. The practical importance and policy implications of these findings are discussed.

Child Behavior Disorders↗
PubMedDate not supplied

Determinants of physical activity and low-fat diet among low income African American and Hispanic middle school students.

African Americans, Hispanics, and those with low income experience disproportionate health problems that can be prevented by physical activity and a lower fat diet. In this descriptive cross-sectional study, antecedents of diet and exercise within the Health Promotion/Transtheoretical Model were examined among low-income African American and Hispanic seventh-grade students (n = 127). Total support was associated with higher physical activity for girls. African Americans perceived greater social support for activity than Hispanics. Family models and support for physical activity and low-fat diet were greater as family income increased. However, higher family role models and lower dietary fat were found among the lowest income Hispanic students' residing ZIP code with a higher concentration of Hispanics and greater availability of Hispanic foods and culture. A school-based approach may be useful to build peer support for physical activity and lower dietary fat. Parish nurse or clinic settings may be most appropriate for building family role models and support. Living in a neighborhood with traditional Hispanic culture and foods appears to have ameliorated the harmful effects of lower income, although further study with larger samples followed over time is needed.

Adolescent↗
PubMed2006

A critical analysis of UK public health policies in relation to diet and nutrition in low-income households.

Diet and nutrition, particularly among low-income groups, is a key public health concern in the UK. Low levels of fruit and vegetable consumption, and obesity, especially among children, have potentially severe consequences for the future health of the nation. From a public health perspective, the UK government's role is to help poorer families make informed choices within healthy frameworks for living. However, the question is - to what extent are such policies in accordance with lay experiences of managing diet and nutrition on a low-income? This paper critically examines contemporary public health policies aimed at improving diet and nutrition, identifying the underlying theories about the influences on healthy eating in poor families, and exploring the extent to which these assumptions are based on experiential accounts. It draws on two qualitative systematic reviews - one prioritizing low-income mothers' accounts of 'managing' in poverty; and the other focusing on children's perspectives. The paper finds some common ground between policies and lay experiences, but also key divergencies. Arguably, the emphasis of public health policy on individual behaviour, coupled with an ethos of empowered consumerism, underplays material limitations on 'healthy eating' for low-income mothers and children. Health policies fail to take into account the full impact of structural influences on food choices, or recognize the social and emotional factors that influence diet and nutrition. In conclusion, it is argued that while health promotion campaigns to improve low-income families' diets do have advantages, these are insufficient to outweigh the negative effects of poverty on nutrition.

Choice Behavior↗