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PubMed2005

Income distribution, public services expenditures, and all cause mortality in US States.

INTRODUCTION: The objective of this paper is to investigate the relation between state and local government expenditures on public services and all cause mortality in 48 US states in 1987, and determine if the relation between income inequality and mortality is conditioned on levels of public services available in these jurisdictions. METHODS: Per capita public expenditures and a needs adjusted index of public services were examined for their association with age and sex specific mortality rates. OLS regression models estimated the contribution of public services to mortality, controlling for median income and income inequality. RESULTS: Total per capita expenditures on public services were significantly associated with all mortality measures, as were expenditures for primary and secondary education, higher education, and environment and housing. A hypothetical increase of 100 US dollars per capita spent on higher education, for example, was associated with 65.6 fewer deaths per 100,000 for working age men (p<0.01). The positive relation between income inequality and mortality was partly attenuated by controls for public services. DISCUSSION: Public service expenditures by state and local governments (especially for education) are strongly related to all cause mortality. Only part of the relation between income inequality and mortality may be attributable to public service levels.

Adult↗
PubMed1986

The effect of immigration quotas on the average quality of migrating labor and income distribution.

In this paper, the authors develop "a simple two-country, single-period model to study the effect of quota restrictions on the composition of migrating labor. [They] have divided the migrant population in two general categories called high skilled and low skilled and have shown that free migration of any category of labor occurs if and only if the country's share of world resources is different from its share of the world labor endowment in that category." Two possible outcomes, given differing labor endowments and income differentials, are considered. The potential effect of illegal immigration is also noted. The authors conclude that their model "is applicable not only to 'brain drain' problems, but also to guest worker programs and/or the mass migration of low skilled workers from poor countries to rich countries."

Demography↗
PubMed1989

Class mortality differentials, income distribution and trends in poverty 1921-1981.

The official figures which appear to show a widening of class differences in health in England and Wales during the post-war period have been controversial partly because they do not fit with common perceptions of what has happened to differences in the standard of living. As a result, a great deal of effort has gone into investigating suggested weaknesses in the decennial social class mortality data. Though initially plausible, the artifactual and selective explanations of the widening mortality differences which were put forward have not usually been borne out by closer investigations. The only fault in the broad picture presented by the official data which we do perhaps need to bear in mind is the tendency for a narrowing of mortality differentials among younger women to be masked by the widening among older women. This paper is an attempt to look at the other side of the coin--namely, to investigate trends in differences in the standard of living in relation to mortality differentials. It concludes that trends in mortality differences have not been related to trends in class differences in average earnings, but have been fairly clearly related to trends in relative poverty. Relative poverty and class differences in mortality declined before the war but have both increased, decade by decade, since the war. Younger women have perhaps been protected from the increase in relative poverty during much of the post-war period by their increased economic activity rates and the relative improvement in earnings of women in poorly paid manual occupations.

Adult↗
PubMed1997

Physician profiling and capitated income distribution.

Increasingly, gastroenterologists are addressing the practice issues of physician profiling and capitation. This article describes a method to easily create practice-generated physician profiles that are used in quality of care management and contracting decisions. These profiles are also used as part of a method for capitation revenue distribution that is described and that has been used by the author's practice for over 3 years. This capitation revenue distribution methodology properly rewards the provision of cost-effective care and bonuses desirable to physician-patient relationships, while protecting against under- or over-utilization.

Capitation Fee↗