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PubMedDate not supplied

Simplified antiviral prophylaxis with or and without artificial feeding to reduce mother-to-child transmission of HIV in low and middle income countries: modelling positive and negative impact on child survival.

BACKGROUND: Antiviral prophylaxis is recommended for HIV positive mothers to prevent mother-to-child transmission of HIV. To date UNAIDS and WHO policy has been based on a study in Thailand which showed a reduction in transmission by half with short course AZT (Zidovudine) treatment together with artificial feeding. We modelled the possible positive and negative effects on child deaths in low and middle resource developing country settings of two interventions to reduce mother to child transmission (MTCT) of HIV: antenatal testing, short-course antivirals (zidovudine or nevirapine), firstly with and then without artificial feeding. MATERIAL AND METHODS: Estimates are made of child lives likely to be saved by the programme by age ten years, balanced against increases in deaths due to more uninfected mothers choosing to use artificial feeds where these are part of the intervention. Mid-point values for variables affecting the balance of mortality gains and losses are taken from recent published data for low and middle income developing countries and a sensitivity analysis is undertaken. RESULTS: In low income settings the use of antivirals alone would result in an estimated gain in child survival of around 0.36%, representing 360 deaths avoided from a birth cohort of 100,000 by age 10 years. Adding artificial feeding could reduce the gain to 0.03% (30 deaths avoided). In middle income settings the gain from antivirals alone would be 0.26% but as 'spill-over' of artificial feeding to uninfected women was more likely it could result in a net increase of child deaths of up to 1.08% (1,080 additional deaths). A sensitivity analysis emphasised this potential for regimens using artificial feeding if progamme participation was low, and under most circumstances in middle income settings. CONCLUSIONS: HIV testing and use of antivirals by infected mothers, if well implemented, will be effective at a population level in reducing MTCT. However the addition of artificial feeding is potentially be a high risk strategy, especially in middle income countries.

Anti-HIV Agents↗
PubMed1988

Income Tax (Amendment) Act 1988 (No. 1 of 1988), 21 January 1988.

This Singapore Act does the following, among other things: 1) authorizes the deduction from income taxes of the delivery and hospitalization expenses incurred with respect to the birth of a legitimate fourth child, up to $3000; 2) authorizes a deduction of payments made to a person's or that person's parent's retirement fund, up to $6000; 3) grants a rebate of $20,000 against tax payable to a person who has a third legitimate child, spread over up to five years, with an additional rebate against tax payable of 15% of her income for a married woman electing to be charged in her own name; and 4) sets deductions from taxable income at $750 for the first, second, and third child; and $300 for the fourth and fifth child, if born before 1 August 1973. In addition to these deductions, a married woman electing to be charged in her own name and having achieved certain educational qualifications is authorized to deduct 5% of her earned income for her first child up to $10,000, 10% for her second child up to $10,000, and 15% for her third child up to $10,000. For a fourth child born after 1 January 1987, she may deduct $750 and 15% of her earned income up to $10,000. In a message to Singapore citizens to mark the new year, the Prime Minister of Singapore urged citizens not to use lunar signs to plan the birth of their children. He stated, "Have your babies any year, including the snake year." See International Herald Tribune, 10 February 1989.

Asia↗
PubMedDate not supplied

Determinants of healthy eating among low-income Canadians.

This paper draws on four bodies of literature to consider the determinants of healthy eating for low-income Canadians: a) the social determinants of health; b) socio-economic gradients in diet; c) food security; and d) the sociology of food. Though there is a paucity of data for Canada, it is very likely that, as in other industrialized countries, there are socio-economic gradients in diet such that those who are better off consume healthier diets than those less well-to-do. The available evidence suggests that income affects food intake both directly and indirectly through the dispositions associated with particular social class locations. Thus, there may be both economic and cultural thresholds for some food groups or particular foods in food groups. Understanding these thresholds is especially important in addressing the issues facing those who are the most vulnerable among Canadians with low incomes: the food insecure. The literature reviewed suggests that improved nutrition for low-income Canadians may be difficult to achieve a) in isolation from other changes to improve their lives; b) without improvement in the nutrition of the general population of Canadians; and c) without some combination of these two changes. Four major areas of research need were identified: a) national data on socio-economic gradients in diet; b) sociological research on the interaction of income and class with other factors affecting food practices; c) sociological research on Canadian food norms and cultures; and d) research on the costs of healthy eating.

Adult↗
PubMedDate not supplied

The effect of income on anaphylaxis preparation and management plans in Toronto primary schools.

BACKGROUND: Outcomes of serious allergic reactions are worse at school than at home. Prompt administration of epinephrine is the first-line treatment for anaphylactic reactions, and the EpiPen device is not subsidized by Ontario public health insurance. This study examines the relationship between the proportion of low-income households in Toronto neighbourhoods and the adequacy of anaphylaxis management plans in primary schools. METHODS: A survey was administered to principals of primary schools. It addressed the areas of: prevalence of food allergy, the presence of EpiPen at school and staff training in its use, and exposure prevention policy. The results were correlated to 2001 Canadian Census data for percentage of low-income households in each school's area. RESULTS: Children with reported severe food allergy attending schools in areas with greater than 20% low-income households were less likely to have medication at school than those in neighbourhoods with less than 20% (relative risk 2.2, 95% confidence interval 1.1-4.4). Other aspects of the anaphylaxis action plan, including staff EpiPen training and parental provision of information to the school, showed no significant correlation to income. Overall, about 50% of schools have their entire teaching staff trained to administer the EpiPen. INTERPRETATION: The lack of medication at school for anaphylaxis is a limiting factor in optimal anaphylaxis management in the school setting. Government support in the purchase of EpiPen in low-income households may be indicated.

Anaphylaxis↗
PubMed1995

[Does income effect health? Analysis with data by the socioeconomic panel].

To determine the influence of income on health, the per capita weighted income is computed for every respondent of the German Socio-economic Panel. The effect of this income variable on health satisfaction and utilisation of medical services is examined via cross-sectional analysis, considering age and gender and taking the life circumstances under account (operationalized via professional activity level of qualification, partner and parenthood). Analysis of variance and regression show that health satisfaction grows with increasing income, while there is no evidence for similar effects of income on the utilisation of medical services.

Adolescent↗
PubMed1996

The association between parental smoking and the diet quality of low-income children.

OBJECTIVE: To assess the association between parental smoking and the diet quality of children residing in low-income housholds in the United States. MTHODS: Data from 515 low-income children (less than or equal to 185% of the poverty line), ages 2 to 17, who participated in the 1989 and 1990 United States Department of Agriculture Continuing Survey of Food Intakes of Individuals were examined. Diet quality was assessed by examining the average daily amount of nutrients consumed per 1000 kcal for protein, fiber, and 14 essential vitamins and minerals as well as total energy, percent of energy from total fat and saturated fat, and cholesterol and sodium intakes using the 3-day average of one 24-hour recall and 2 days of diet records. Parental smoking was categorized as four levels (nonsmoker; 1 to 10, 11 to 20, and more than 20) on the basis of the average number of cigarettes smoked per day by the sample child's parents. Analysis of covariance examined differences in the children's nutrient intake among the four smoking categories while controling for race, mother's age and occupation, child age, and sex. RESULTS: Low-income children with parents who smoked (n = 235) were more likely to be white (P <.001), had younger mothers (P <.05) and were more likely to have mothers employed in blue-collar occupations (P <.001) than children whose parents were nonsmokers (N = 280). Children whose parents smoked more than 20 cigarettes per day had a higher level of energy from saturated fat, and children whose parents smoked 11 to 20 cigarettes per day had the highest cholesterol intakes in comparison with the rest of the sample. Parental smoking was also related to total fiber intake per 1000 kcal, with children of smokers having lower fiber intakes than children of nonsmokers. CONCLUSIONS: On average, low-income children of smokers had a poorer diet quality than low-income children of nonsmokers, thus increasing their future risk of chronic disease.

Adolescent↗
PubMed1993

The distribution of urban population and income: explorations using six Asian cases.

"Urban concentration (or primacy) and inequality (in size distribution of income) are expected to follow bell shaped curves through the development process. Spatial convergence (through investments in transportation etc.) is expected to precede income convergence. Using longitudinal data from six Asian countries (Japan, Taiwan, Malaysia, the Philippines, Sri Lanka and India) this paper shows that (i) the bell shapes for urban concentration and income inequality generally hold, and (ii) the temporal relationship between the curve peaks is determined by geographical factors (for urban concentration); income inequality is seen to be more policy amenable."

Asia↗
PubMed1986

Unobservable family and individual contributions to the distributions of income and wealth.

"This paper uses combinations of full brothers, half brothers, and fathers and sons to measure the effect of common family background on a household's income and wealth. While the data are drawn from a nineteenth-century [U.S.] population, the intraclass correlation for income ranges from .13 to .18, which is similar to that found in modern samples. Intraclass correlations for wealth are significantly higher (.18-.35) than are those for income. Intraclass correlations of half brothers compared to those for full brothers suggest that fathers play a dominant role in the transmission of the common family effect. When unobserved background is decomposed into individual and family effects, the individual effect dominates the family effect for income, while the family effect dominates the individual effect for wealth." A comment by Sherwin Rosen is included (pp. 80-2).

Americas↗
PubMed1996

The effect of immigration on residents' incomes in Australia: some issues reconsidered.

"This article outlines the standard neoclassical model (SNM) of the impact of immigration on the incomes of the resident (pre-immigration) population. We augment the SNM to allow for foreign ownership of and government equity in the capital stock. Using the expanded model, the sensitivity of residents' incomes to immigration is tested in four scenarios.... In our preferred long-run scenario, the 1991-92 Australian immigrant intake reduced residents' incomes. We believe the results based on the expanded SNM justify a more comprehensive study incorporating a range of other influential factors determining the impact of immigration on residents' incomes."

Australia↗
PubMedDate not supplied

Income distribution in rural Sagar.

"The study makes an attempt to identify the pattern of household income distribution in rural areas, based on the socio-economic surveys in Sagar district [in India]." Factors affecting family income include "occupational structure, distance from nearby urban centers and general accessibility.... The rural settlements under urban influence or with proper accessibility have a greater percentage of high-income families. The major source of income for over a third of the rural families of the district is agricultural labour, while another third earns its living by other agricultural work and the rest are either petty businessmen or are engaged in services."

Asia↗
PubMed1988

Act on income assistance for formerly self-employed persons who are elderly and partially incapacitated, 11 June 1987.

This Act establishes an income assistance scheme for formerly self-employed persons in the Netherlands who are elderly and partially incapacitated for work, whose income is substantially below the minimum social standard, and who have, therefore, ceased their economic activity or enterprise. It provides for an allowance for self-employed persons who have not attained 65 years of age and who have ceased their economic activity after reaching age 55 or interrupted it because of incapacity to work. The main requirement for entitlement to an allowance is having engaged in an income-generating activity for more than three consecutive years which resulted in an average income not exceeding 32,300 florins.

Age Factors↗
PubMed1989

[Demographic change and state income support: an incidence analysis].

"Starting from a simple, descriptive life-cycle model of individual income, an explicit link between the age composition of a population and the personal distribution of incomes is established. Demographic effects on income inequality are derived. Next, two income maintenance programs are introduced: a redistributive tax-transfer scheme and a pay-as-you-go financed state pension system. The resulting government budget constraints entail interrelations between fiscal and demographic variables, causing an additional, indirect demographic impact on the distribution. This is shown not only to change, but in some cases even to reverse the distributional incidence of demographic trends. Several policy conflicts arise." (SUMMARY IN ENG)

Age Distribution↗
PubMed1995

[Immigration, income distribution, and social welfare].

"This paper explores the consequences of immigration for aggregate income and income distribution. On the one hand, immigration generally increases the residents' aggregate income, on the other hand, it makes income distribution more unequal if immigrants bring little capital with them. These two effects can be analyzed jointly using a measure of social welfare. In general, the arrival of immigrants owning little capital lowers social welfare of residents and immigration of capital-rich persons increases it." (SUMMARY IN ENG AND GER)

Demography↗
PubMed1981

Family Social Security taxes compared with Federal income taxes, 1979.

Increases in Social Security taxes during the past decade or so have prompted frequent comparisons of Social Security taxes and Federal personal income taxes. In this article, new evidence is brought to bear on this issue. Two specific questions are addressed: For 1979, what percentage of family units paid more in Social Security tax than in Federal income tax? How did this relationship between Social Security and income tax payments vary with family unit income and other family unit characteristics?

Adolescent↗
PubMed1993

Race, income, and survival from breast cancer at two public hospitals.

BACKGROUND: Some studies have shown that adjustment for socioeconomic status reduces breast cancer survival differences between blacks and whites. The purpose of this study is to evaluate the effect of age, race, stage, treatment, and income status on breast cancer survival among women attending public hospitals in Chicago, Illinois. METHODS: Hospital Cancer Registry data on 887 black women and 265 white women with breast cancer onset between 1973-1985 were analyzed using Cox regression and Kaplan-Meier techniques. The purpose was to examine the effect of age, race, stage, treatment, and income on breast cancer survival. RESULTS: Black women with breast cancer were younger and poorer than white women with breast cancer. There were no significant differences between blacks and whites with regard to stage, estrogen receptor status, or type of treatment. Black women had lower 5-year breast cancer survival rates compared to white women (50.2% versus 60.2%; P = 0.05), and survival was lower when adjusted for stage and age. However, when adjusted for income in addition to stage and age, the effect of race on survival was reduced (from relative risk = 1.26; 95% confidence interval = 1.02, 1.57 to relative risk = 1.17%; 95% confidence interval = 0.95, 1.38). CONCLUSIONS: Income influences breast cancer survival differences between blacks and whites in this population.

Black or African American↗
PubMed2007

Family income, parenting styles and child behavioural-emotional outcomes.

A positive relationship between income and child outcomes has been observed in data from numerous countries. A key question concerns the extent to which this association represents a causal relationship as opposed to unobserved heterogeneity. We use data from the National Longitudinal Survey of Children and Youth to implement a series of empirical strategies for estimating the existence and size of the effect of income on behavioural-emotional outcomes. We also examine the role of parenting style. Our results indicate that there is little evidence of an effect of income on behavioural-emotional scores. The exclusion of parenting style from the models was found to not bias the estimated income effect, but parenting style was found to have a consistent impact on child outcomes.

Adolescent↗
PubMed2005

Is silence golden? A test of the incorporation of the effects of ill-health on income and leisure in health state valuations.

The objective of the present study was to evaluate whether people include the effects of ill-health on income and leisure in quality of life valuation when the measure is silent on both. A convenience sample of 20 health professionals had to rate a health status on a visual analogue scale (VAS) without being explicitly asked to consider the effects of ill-health on income and leisure. A majority of respondents (60%) does not consider income effects and 75% does consider the effects on leisure. Explicitly asking respondents to incorporate these effects lowers the valuation. Our results indicate that whatever separation between costs and effects is preferred, using quality of life measures which are silent on income and leisure, leads to either double-counting or ignoring real costs or effects.

Adult↗
PubMed2004

Outcome of liver transplantation in adult recipients: influence of neighborhood income, education, and insurance.

Poor socioeconomic status (SES) may be associated with lower survival after liver transplantation. In a previous study, we showed that African-American race was an independent predictor of poor survival, and one of the major criticisms of our study was that we had not adjusted the survival for SES as a confounding variable. The objective of the present study was to determine the posttransplant outcome of adult liver transplant recipients based on neighborhood income, education, and insurance using the United Network for Organ Sharing (UNOS) database from 1987 to 2001. Patients (n = 29,481) were divided into 5 groups based on median income as determined by zip code: <30,000 dollars, 30,001-40,000 dollars, 40,001-50,000 dollars, 50,001-60,000 dollars, and >60,000 dollars). Patients (n = 14,814) were divided into 4 groups based on level of education: higher than bachelor's degree; college attendance or technical school; high school education (grades 9-12); less than high school education. Insurance payer status (n = 23,440) was divided into Medicaid, Medicare, government agency, HMO/PPO, and private. Cox regression analysis was used to adjust the survival for other known independent predictors such as age, race, UNOS status, diagnosis, and creatinine. Results showed that neighborhood income had no effect on graft or patient survival either in the entire cohort or within different racial groups. Education had only marginal influence on the outcome; survival was lower in those with a high school education than in those with graduate education. Patients with Medicaid and Medicare had lower survival when compared to those with private insurance. African-Americans had a lower 5-year survival when compared to white Americans after adjusting for SES and other confounding variables. In conclusion, neighborhood income does not influence the outcome of liver transplantation. Education had minimal influence, but patients with Medicare and Medicaid had lower survival compared to those with private insurance.

Adult↗