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At least 649 records · Page 36Linked to original sources
PubMed2003

Effects of ethnicity, family income, and education on dietary intake among adolescents.

BACKGROUND: The aim of the study is to describe the overall diet and potential effects of gender, ethnicity, family income, and parents' education on dietary patterns in adolescents aged 11 to 20 years who participated in a cohort study in 12 Southern California communities. METHODS: A validated 131-item youth/adolescent food frequency questionnaire was administrated among 3,201 participants in the Children's Health Study at follow-up visits between 1998 and 2000. Sociodemographic characteristics included ethnicity, family income, and parents' education. Stratified analysis and analysis of covariance were used to describe the intakes of selected nutrients and food groups. RESULTS: Mean intakes for all nutrients except calcium met 100% of the Recommended Dietary Allowances. Average daily food intakes were below the minimum recommended number of servings for all major food groups. The majority of subjects had an excessive intake of added sugar. A gender difference was found in intakes of energy, total fat (TF), saturated fat (SF), monounsaturated fat (MUSF), and calcium (P < 0.05). Non-Hispanic Whites had the lowest intakes of fruits while Blacks and Asians had significantly higher intakes of vegetables (P < 0.05). Subjects from higher income families had significantly higher intakes of polyunsaturated fat, protein, calcium, and folate and more frequently consumed dairy products. Intakes of TF, SF, MUSF, and cholesterol decreased as parents' education levels increased. Subjects from families with parents who had higher educational attainment were more likely to meet the recommendations of dairy products, fruits, and vegetables. CONCLUSION: Overall, subjects in our study did not have healthy eating habits. Dietary patterns varied by sex, ethnicity, income, and education.

Adolescent↗
PubMed2004

Income inequality at neighbourhood level and quality of life--a contextual analysis.

OBJECTIVE: Associations were examined between neighbourhood income inequality and neighbourhood socioeconomic deprivation on the one hand and (mental) health related quality of life (QoL) on the other, in Maastricht, the Netherlands. METHODS: Three different data sources were used: 1) neighbourhood socioeconomic indicators, 2) house prices per postal code area aggregated to an inequality measure at neighbourhood level, and 3) individual data measured in a family cohort study. Maastricht families with children aged approximately 11 years received questionnaires including the parents' QoL and family socioeconomic status (response rate: 60%). Multilevel analyses were conducted using neighbourhood level, family level, and individual level data. RESULTS: Income inequality at neighbourhood level was not associated with QoL, whereas socioeconomic deprivation was associated with environment-related QoL. CONCLUSION: The relative income hypothesis, according to which it is the contrast in deprivation rather than the absolute level of deprivation that influences health outcomes, does not hold at the neighbourhood level. Income inequality may only have an effect in larger areas containing sufficient socioeconomic contrast.

Adult↗
PubMed2005

The impact of NTFP sales on rural households' cash income in India's dry deciduous forest.

In recent years, researchers and policy makers have recognized that nontimber forest products (NTFPs) extracted from forests by rural people can make a significant contribution to their well-being and to the local economy. This study presents and discusses data that describe the contribution of NTFPs to cash income in the dry deciduous forests of Orissa and Jharkhand, India. In its focus on cash income, this study sheds light on how the sale of NTFPs and products that use NTFPs as inputs contribute to the rural economy. From analysis of a unique data set that was collected over the course of a year, the study finds that the contribution of NTFPs to cash income varies across ecological settings, seasons, income level, and caste. Such variation should inform where and when to apply NTFP forest access and management policies.

Commerce↗
PubMed2006

A decomposition of income-related health inequality applied to EQ-5D.

Income-related inequality in health and its relationship to sociodemographic characteristics have received considerable attention in the health economic literature. Recently a method was suggested for decomposing income-related health inequality to contributions from individual characteristics via additive dimensions, and this was applied to a Finnish case based on 15D health scores, where health is considered to be a sum of 15 individual health dimensions. The present study adds to this literature in several ways. First, we apply the decomposition approach to a Danish case which can be benchmarked to the Finnish. Second, we show how to apply the method to EQ-5D scores, which deviate from 15D scores by expressing health as individual depreciations of an equal endowment of perfect health. Third, we add life-style factors to the determinants of income-related health inequality. The empirical part of the study reveals discrepancies which can be attributed to differences between Finland and Denmark and to differences between the construction of 15D and EQ-5D scores. Finally, evidence of impact of life-style factors on income-related health inequality is found.

Activities of Daily Living↗
PubMed1994

Physician labor supply: do income effects matter?

This paper estimates a model of physician labor supply, focusing on the impacts of wage and non-wage income. We find evidence of significant income effects. For male physicians, the income effect of a wage change on labor supply is negative, with an elasticity of -0.26. The pure substitution effect of a wage change increases labor supply: a 1% increase in wages leads to a 0.49% increase in labor supply, controlling for income effects. The results also suggest that the labor supply decisions of females are more responsive to variations in their earnings than are those of males.

Adult↗
PubMed1996

New evidence on the relationship between income and health.

Using data from the National Survey of Families and Households, the Survey of Income and Program Participation, and the National Health Interview Survey, I estimate the structural impact of income on the following measures of health: self-assessed health status, work and functional limitations, bed days, average daily consumption of alcohol, and scales of depressive symptoms and alcoholic behavior. Both ordinary and IV estimates indicate that increases in income significantly improve mental and physical health but increase the prevalence of alcohol consumption. Cost-benefit analyses of government policies that may reduce disposable income should take into account potential effects on morbidity.

Activities of Daily Living↗
PubMed1996

Health care and income distribution in Finland.

This paper examines the effects of health care on income redistribution in Finland. In contrast to earlier studies in this area, the redistributive effect is analysed with noncash transfers from health care utilisation included in household income. Distributional consequences of changing health care financing towards one system or another are analysed in terms of municipality provided public services and sickness insurance based public services. Our results show that, overall, the public health care system distributed income from the rich to the poor. The poorest one-third of the population financed only about one-third of the public health care services they utilised. The distributional implications were, however, markedly different depending on the definition of income used. Whereas health care financing had only a marginal redistributive effect, the effect was substantially increased as noncash transfers from health care utilisation were taken into account.

Data Collection↗
PubMed1995

The effects of race, household income, and parental education on nutrient intakes of 9- and 10-year-old girls. NHLBI Growth and Health Study.

Nutrient intakes of 2149 black and white, 9- and 10-year-old girls varied by race, household income, and parental education. Of the three variables, higher education was most consistently associated with more desirable levels of nutrient intakes, that is, lower percentage of dietary fat and higher levels of vitamin C, calcium, and potassium. Higher income was related to higher intakes of vitamin C, but lower intakes of calcium and iron. Higher income was associated with lower percentage of dietary fat. After adjustment for income and education, race was associated with intakes of calcium, vitamin C, and to a lesser extent, percentages of kilocalories from total fat and polyunsaturated fat, and potassium. Black girls had a significantly lower intake of calcium (720 versus 889 mg) and a higher intake of vitamin C (91 versus 83 mg). Proportions of the cohort with inadequate or excessive intakes of micronutrients and macronutrients were also estimated. A high proportion of girls exceeded the recommended intake level of 30% of kilocalories from total fat (90% of black girls; 84% of white girls) and 10% of kilocalories from saturated fat (92 and 93%, respectively). Low intakes of calcium (40% of black girls and and 20% og white girls) and zinc (36 and 38%, respectively) commonly were found for girls of both names.

Black or African American↗
PubMed2005

Socioeconomic pattern of smoking in Japan: income inequality and gender and age differences.

PURPOSE: To elucidate the influence of individual socioeconomic status on smoking in Japanese adults. METHODS: Using a nationally representative sample (20,206 men and 21,093 women aged 18 to 54 years), the relation between smoking and socioeconomic characteristics was analyzed by sex and age group (18 to 24, 25 to 39, and over 40 years). RESULTS: The smoking prevalence was 57.0% for men and 16.6% for women. Living in an urban area was a negative factor for smoking in men, while a positive factor in women. Being married was positively associated with smoking in the younger population, but negatively associated in the older population. A relation between lower income and smoking was found in all groups, except in men aged 18 to 24 years. The income-related difference was most pronounced in the population aged 25 to 39 years: OR of smoking for the highest income quintile compared with the lowest was 0.60 (95% CI, 0.51-0.71) for men and 0.29 (95% CI, 0.23-0.35) for women. CONCLUSIONS: Socioeconomic status, especially income, substantially predicted smoking in the Japanese population, while the impact differed according to sex and age groups. Effective anti-smoking strategies require consideration of the gender and age differences in the socioeconomic pattern of smoking.

Adult↗
PubMed2005

Prevalence of childhood asthma in urban communities: the impact of ethnicity and income.

PURPOSE: The goal of this study was to assess the relationship between hospitalization rates and asthma prevalence in New York City children and investigate the role that sociodemographic factors play in asthma. METHODS: A parent-report questionnaire was distributed in 26 randomly selected New York City public elementary schools, stratified according to neighborhood hospitalization rates. RESULTS: The overall student response rate was 76.9% (5250 students). Prevalence of current asthma was 17.9%, 9.59%, 6.39% (p < .001) in areas of high, median, and low asthma hospitalization rates, respectively. The overall prevalence of current asthma was 13.0%. Children living in predominantly low socioeconomic status (SES) communities had a 70% greater risk of current asthma, independent of their own ethnicity and income level. Asthma prevalence within different ethnic and income groups was consistently lower in neighborhoods of greater socioeconomic status, except among Puerto Rican children, who had high asthma prevalence, regardless of school attended or income. CONCLUSIONS: Prevalence of current asthma is strongly associated with attending a school in a low-income neighborhood. Although hospitalization rates have been used as an indicator of the burden of asthma in a neighborhood, it alone does not reflect the level of disparities that exist among communities with different socioeconomic backgrounds.

Asthma↗
PubMed2005

Development of a simulation program for estimating hospital incomes under the prospective payment system.

A prospective payment system based on diagnosis procedure combination (DPC/PPS) was introduced to acute care hospitals in Japan in April 2003. In order to increase hospital income, hospitals must shorten the average length of stay (ALOS) and increase the number of patients. We constructed a simulation program for evaluating the relationships among ALOS, bed occupation rate (BOR) and hospital income of hospitals in which DPC/PPS has been introduced. This program can precisely evaluate the hospital income by regulating the ALOS and the number of patients for each DPC. By using this program, it is possible to predict the optimum ALOS and optimum number of inpatients for each DPC in order to increase hospital income.

Bed Occupancy↗
PubMed2005

Household income is strongly associated with health-related quality of life among Japanese men but not women.

OBJECTIVES: As socio-economic status (SES) strongly reflects individual economic status, evaluating the association between SES and health could provide information that is important for planning integrated economic and public health policies. We examined the association between annual household income as a measure of SES and the eight scale scores of the Medical Outcomes Study Short Form-36 Health Survey (SF-36) as a quantifier of health-related quality of life (HRQOL) in Japan. STUDY DESIGN: Cross-sectional survey. METHODS: Data were from the SF-36 national survey in Japan. A total of 4500 people aged 16 years or older were selected from the entire population of Japan using stratified-random sampling, and 3395 responded to the survey. RESULTS: Men with lower levels of annual household income had lower scores in all SF-36 domains. However, only 'general health perceptions' and 'social functioning' showed statistically significant trends among the women surveyed. In the subgroup of women working full-time, there were no domains that showed significant trends. CONCLUSIONS: A strong association exists between annual household income and SF-36 scores among men, but there is only a limited association among women. The employment and economic policies that affect annual household income potentially influence HRQOL.

Adult↗
PubMed2006

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

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

Adolescent↗
PubMed2002

Increasing inequalities in health care utilisation across income groups in Sweden during the 1990s?

Swedish health policy emphasises equity in health and health care. During the 1990s considerable changes have taken place in the organisation and delivery of Swedish health care and user fees have increased. Did patterns of health care utilisation across income groups change during the 1990s? Health care utilisation was measured from three questions in the Swedish Survey of Living Conditions 1988/89 and 1996/97: having seen a doctor in the last 3 months; having been hospitalised in the last 3 months; and having sought emergency care in the last 3 months. An additional question concerned having needed but not sought medical care in the last 3 months. Age standardised prevalence rates and adjusted odds ratios for utilisation were calculated for the whole sample and among persons with limiting longstanding illness, by income quintiles. Results suggest a possible increase in inequalities in utilisation of health services, to the disadvantage of low income groups. An inverse income gradient which was not evident in 1988/89 appeared in 1996/97 in having needed but not sought medical care. Further specific studies are warranted to monitor emerging inequalities in access to and utilisation of health care in Sweden.

Data Collection↗
PubMed2001

[Surgical procedures of the urinary tract and male genital organs. Rates of surgical intervention: variability and its relationship with distance and income].

OBJECTIVE: To valorate the existence of the variability, in surgical rates on urinary tract and masculine genital organs, between the population of Health Centres (HC) adscribed to the Hospital of Ciudad Real. It so, quantify the influence of the distance (from Health Center to Hospital) or the income have in the variability of these rates. MATERIAL AND METHOD: Surgical activity of the period 1996-98. It has been analyzed for every procedure: residence, sex, age and type (coded by CIE 9th MC). The surgical rates, standardized for age and sex, (TFQ) for every HC has been compared whit the mean (t alpha/2 n-1 alpha = 0.99) of the distribution of rates by HC. The relation between the TFQ and distance or income has been analyzed by lineal regression and ANOVA test for one variable, using the Newman Keuls test to assess the difference of the rates between the HC at different distance or income. It has been considered as significative every p < 0.05. RESULTS: The population studied has a TFQ significatively different (p < 0.01). significant relationship exists between the TFQ and the distance. There were no relations between the TFQ for HC and the income. CONCLUSIONS: 42% of the variance (variability) of the distribution of TFQ for HC is due to the distance.

Adolescent↗
PubMedDate not supplied

Income inequality and population health.

A number of studies have suggested that inequalities in the distribution of income may be an important cause of variations in the average level of population health among rich industrial nations. However, what is missing from the debate so far is any systematic review of evidence about the relationship between different measures of income distribution and indicators of population health. This paper aims to bridge that gap. First, it summarizes the recent English language literature on this topic and illustrates the methodological problems that weaken the inferences that can be derived from it. Secondly, it presents new empirical estimates of the relationship between different measures of income distribution, infant mortality and life expectancy based on the most authoritative data published to date. In contrast to most earlier studies, we find very little support for the view that income inequality is associated with variations in average levels of national health in rich industrial countries. Some possible explanations for these differences are outlined.

Developed Countries↗
PubMed2002

The growth of managed care and changes in physicians' incomes, autonomy, and satisfaction, 1991-1997.

Using survey data collected in 1991 and 1997 from a panel of almost 1,500 physicians, we analyzed the relationship between changes in physicians' incomes, practice autonomy, and satisfaction, and the growth of HMOs and physicians' perceived financial incentives. Both the growth of HMOs and financial incentives to reduce services were significantly related to lower income growth, reductions in practice autonomy, and decreases in satisfaction. Changes in income and autonomy were both positively and significantly related to changes in satisfaction. Controlling for changes in income and autonomy, HMO growth was no longer significantly related to changes in satisfaction. Having a perceived financial incentive to reduce services remained a negative and significant determinant of the change in career satisfaction.

Attitude of Health Personnel↗
PubMed1999

Patient satisfaction with care in programs for low income individuals.

Although a variety of public and private programs provide care for low-income individuals, little is known about patient satisfaction across these programs. The objective of this study was to examine patient satisfaction across a variety of health insurance programs. A survey was conducted of randomly selected adults in Kentucky who had an outpatient visit in the past 12 months (616 with private insurance, 683 Medicaid recipients, 287 in private sector charity program for uninsured indigents). Patient satisfaction with multiple dimensions of their most recent outpatient visit was assessed. All insurance groups were generally satisfied with the care received in their most recent visit. For all 8 dimensions of patient satisfaction, the private insurance group was significantly higher than the other groups. In a model controlling for standard demographic and health status variables, higher overall satisfaction with the visit was positively related to higher income and higher mental health functional status. The insurance category variable had no significant relationship to overall satisfaction with the visit. Although patients receiving care through health insurance programs for low-income individuals are generally satisfied with the services, there is an indication that low-income individuals, regardless of insurance type, are less satisfied with the care they receive.

Adult↗