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At least 829 records · Page 46Linked to original sources
PubMed2005

The health status and health promotion behavior of low-income elderly in the Taipei area.

The purpose of this study was to understand health promotion behaviors and their correlated factors among low-income elderly in the Taipei area. This study used a cross-sectional design with a descriptive correlation approach. A total of 89 low-income elderly from Peitou District of Taipei participated in the study. Structured questionnaires, the primary sources of measurement, were read to study subjects by a trained research assistant. The mean age of low-income elderly in the study was 76.85 year-old. A plurality were single (41.6%) and 31.5% lived alone. Subject IADLs (instrumental activities of daily living) were not as good as their ADLs (activities of daily living). Their psychosocial health status was worse than their physical health status. Among health promotion behaviors, regular exercise appears to be the most prevalent. The most significant factor among subjects for failing to follow health-promoting behaviors was their IADLs. Homebound elderly who lived alone and had poor IADL were less likely to have health promoting behaviors. A proposal to encourage health promotion behaviors for low-income elderly derived from study results is the initiation of formal personal assistance programs to remedy the inability of many elderly, especially those living alone, to leave the home due to ADL-related or other limitations.

Activities of Daily Living↗
PubMedDate not supplied

A racial and ethnic comparison of family formation and contraceptive practices among low-income women.

Low-income women's histories of pregnancies, their use or nonuse of contraception, and their marital status showed racial and ethnic differences in family formation patterns and fertility control practices. Data were analyzed from a survey of 918 low-income women in Los Angeles County. The sample contained about equal numbers of non-Hispanic whites, blacks, and Hispanics. The use of stratified samples equalized the poverty-level composition of the three racial and ethnic groups. First pregnancies for white and black women resulted primarily from nonuse of contraception while unmarried, but almost half of first pregnancies among Hispanics were intentional. Marital dissolution following pregnancy or childbearing was common among low-income whites and blacks, but Hispanics were more likely to have an intact marriage along with a higher average parity. Analyses of histories of pregnancies while controlling for demographic characteristics showed that racial and ethnic differences in rates of different types of pregnancies (classified as intended, accidental, or unprotected) and rates of abortion did not remain significant after adjustment for respondent characteristics and years of exposure to possible pregnancy. Actual parity, however, remained significant when these factors were controlled. Thus, results document distinctive patterns of family formation for low-income women in racial and ethnic subgroups of this population. Implications of these patterns of family formation for economic well-being are discussed.

Adolescent↗
PubMed1991

A brief dietary assessment to guide cholesterol reduction in low-income individuals: design and validation.

Low-income Americans are at greatest risk for coronary heart disease. Dietary assessment methods are needed that can efficiently and effectively guide diet counseling to reduce serum cholesterol in this population. The Dietary Risk Assessment is a brief food frequency questionnaire designed to guide an intervention program for cholesterol reduction. It can easily be administered and scored in 10 to 15 minutes by persons who are not trained in nutrition. The assessment is culturally specific for a low-income southern population, identifies positive as well as problematic dietary behaviors, is easily interpreted, and measures potential barriers to dietary change. The assessment was validated against 3 days of dietary recall data in a sample of 42 low-income individuals recruited from the waiting room of an ambulatory care clinic. A Keys score, which measures the serum-cholesterol-raising potential of the diet, was calculated for each patient from their recall data. The Keys and Dietary Risk Assessment scores were significantly correlated (r = .60, P less than .001). We conclude that the Dietary Risk Assessment can rank individuals by level of dietary atherogenic risk adequately to guide a dietary treatment program for low-income patients, an underserved population with a high prevalence of diet-induced elevations in serum cholesterol.

Cholesterol↗
PubMed1995

A comparison of various methods of collecting self-reported health outcomes data among low-income and minority patients.

In a randomized trial of different data collection methods, we challenged the untested assumption that reliable data cannot be obtained from lower-income and/or minority patients by self-administered questionnaires. We tested three methods of data collection among a sample of lower-income and minority patients (n = 697) in Indianapolis at a site for the Type II Diabetes Patient Outcomes Research Team. The study included a questionnaire literacy screening instrument to assess patients' functional literacy. Based on their functional literacy, patients were randomized to one of three methods of data collection: mail-out/mail-back, hand-out/assisted, or the in-home interview. We constructed a tiered system for reassigning nonresponders to alternative methods of data collection, using the in-home interview as the fall-back strategy. We compared the response rates, item completion rates, and internal consistency reliabilities of self-reported health status measures between patients with and without literacy limitations and across the three methods of data collection. Patients with and without literacy limitations, across methods of data collection, provided high-quality data, as evidenced by high item completion rates (> 84%) and high reliability assessments (internal consistency reliability coefficients > .80) for each health status measure. As part of the tiered study design, nonresponders randomized to either the mail-out/mail-back or the hand-out/assisted method were interviewed. These patients were significantly older, had significantly lower education and income levels, and had significantly poorer self-reported visual function as compared with those who responded to the originally assigned method. We conclude that expensive, labor-intensive data collection methods, such as in-home interviews, are not necessary for many low-income, minority patients to generate high-quality, reliable health status data. Using appropriate screening instruments, those patient subgroups needing special help can be screening instruments, those patient subgroups needing special help can be identified and targeted for more expensive data collection methods. This tiered approach has policy implications for the cost, feasibility, and quality of data collection in health outcomes research.

Aged↗
PubMed1995

Hospitalization charges, costs, and income for firearm-related injuries at a university trauma center.

OBJECTIVE: To quantify the actual cost of inpatient medical care for firearm-related injuries at a university trauma center. DESIGN: Retrospective case series of all hospital admissions for firearm-related injuries for the 3 years 1990 through 1992. Total inpatient financial data were examined by means of a recently instituted cost-accounting methodology. SETTING: Level I trauma center at a university hospital that provides trauma care and tertiary care to 3.7 million residents of 23 counties. PATIENTS: A total of 787 consecutive patients were admitted to the hospital with firearm-related injuries. Information from the trauma registry and hospital finance records were linked for 750 (95%) of these patients. MAIN OUTCOME MEASURES: Total inpatient hospital charges, costs, revenues, and net income according to payer source. RESULTS: Men aged 15 to 44 years accounted for 77% of patients with firearm-related injuries. The overall mean and median hospital charges per admission were $52,271 and $28,033, respectively, whereas the overall mean and median hospital costs per admission were $13,794 and $7964, respectively. The net income per patient ranged from an average loss of $6980 for each patient having no insurance to an average profit of $28,557 for each patient with a health maintenance organization contract. The losses sustained on nonsponsored and Medicaid patients were more than offset by net income from patients having private health insurance, Medicare, or other insurance coverage such that there was an average profit of $5809 per admission for a firearm-related injury. CONCLUSIONS: Treatment of firearm-related injuries produces net income for this university trauma center by virtue of the cost shifting built into its pricing structure. If data from this institution are extrapolated to the nation, then the actual cost of providing medical care for firearm-related injuries in the United States in 1995 is projected to be $4.0 billion. The majority of this cost will be paid indirectly by private health insurance.

Adolescent↗
PubMed1994

Social competence among low-income preschoolers: emotion socialization practices and social cognitive correlates.

Two studies were designed to investigate the relation between emotion socialization variables, social cognitive knowledge, and children's social competence. In Study 1, the expression and situation knowledge of 46 low-income preschoolers were assessed. Peer competence within the preschool setting was also evaluated. Mothers completed questionnaires designed to assess negative emotion socialization practices. Results showed that maternal reports of their emotion socialization practices were related to sad and angry situation knowledge. The aggregate measure of situation knowledge predicted peer competence. In Study 2, 41 low-income preschoolers were observed in a caregiving situation with their younger siblings. The preschoolers' rate of caregiving behavior was recorded and measures of their situation knowledge, emotional role taking, and caregiving script knowledge were obtained. Mothers completed emotion socialization questionnaires. Situation knowledge was the social cognitive variable that predicted sibling caregiving behavior. However, only the maternal emotion socialization variables were directly related to sibling caregiving behavior. These findings highlight the importance of situation knowledge and emotion socialization practices for low-income children's social competence with peers and siblings and provide much needed information on the social development of low-income children.

Black or African American↗
PubMed1997

Medicaid and managed care: implications for low-income women.

This commentary reviews Medicaid's role for low-income women and examines the implications of Medicaid managed care on the delivery of health services to this vulnerable population. Today 40% of the Medicaid population, mostly poor women and their children, is enrolled in managed care. Medicaid agencies are hoping managed care will control spending and address longstanding problems with access to care. Low-income women have a number of characteristics that make them doubly vulnerable to access to care and place them at high risk of health problems. Furthermore, many beneficiaries have historically experienced nonfinancial barriers to care under fee-to-service Medicaid. While many look to managed care to overcome these obstacles, the evidence suggests that it does not offer a great improvement over fee-to-service in terms of improved access or reduced long-term costs for low-income women. For Medicaid managed care to realize its potential, it must assure that financing is adequate, resources for monitoring and oversight are sufficient, and systems and benefits are responsive to the complex and diverse health care needs of low-income women.

Adult↗
PubMedDate not supplied

Cancer screening behaviors of low-income women: the impact of race.

Cancer mortality rates are greater for African Americans than for whites. Reasons for this are due in part to the disproportionate number of the poor who are African American. Of particular concern are breast, cervical, and colorectal cancer, as screening exams, when used regularly, can reduce mortality. As part of an National Cancer Institute-funded study to improve breast and cervical cancer screening among low-income, predominately African American women, a survey was done to collect data on knowledge, attitudes, and practices related to breast, cervical, and colorectal cancer. A total of 300 women, African American and white residents of low-income housing communities, completed the survey. More African American women than white women had a mammogram within guidelines (52% vs. 40%), a clinical breast exam within the last year (60% vs. 56%), a Pap smear within the last 3 years (80% vs. 59%), and a Fecal Occult Blood Test within the last year (21% vs. 17%). Slightly more white women had a flexible sigmoidoscopy (FS) exam within the last 5 years (31% vs. 24%). When adjusted for age differences in the two populations, the differences in receiving regular screening exams were not statistically significant. Variables related to receiving these tests for all women included receiving regular check-ups (breast cancer); beliefs (breast and colorectal cancer screening), and knowledge (cervical cancer). Among African American women, barriers to screening were important for breast screening and regular checkups were related to Pap smear screening (odds ratio [OR] = 13.9, p < .01). High perceived risk of colorectal cancer was related to recent FS only for white women (OR = 47.9, p = .012). Women in this homogenous income group had similar rates of screening and had similar barriers to receiving recommended screening tests; thus, interventions should address beliefs and knowledge of risk targeted to all low-income women.

Adult↗
PubMed1995

Lifetime income redistribution by social security.

"This paper discusses the redistributive impact of the Dutch social security system on lifetime basis. Net benefits appear to be positive for the birth generations up to 1960. Social insurances show a declining net benefit, whereas for occupational pensions the reverse holds. It is generally assumed that flat-rated social security schemes are more redistributive ones than wage-related schemes. However, the Dutch social security system shows that on a lifetime basis the redistributive impact of flat-rated general insurances does not necessarily largely differ from the wage-related employee insurances. Social assistance schemes result in a very large income redistribution in view of the small amounts involved. Social insurances and social assistance schemes have an income equalizing effect. On the contrary, occupational pensions increase income inequality."

Developed Countries↗
PubMed1998

Migration, remittances, and inequality: estimating the net effects of migration on income distribution.

"This paper examines the net effects of migration and remittances on income distribution. Potential home earnings of migrants are imputed, as are the earnings of non-migrants in migrant households, in order to construct no-migration counterfactuals to compare with the observed income distribution including remittances. The earnings functions used to impute migrant home earnings are estimated from observations on non-migrants in a selection-corrected estimation framework which incorporates migration choice and labor-force participation decisions. For a sample of households in Bluefields, Nicaragua, migration and remittances increase income inequality when compared with the no-migration counterfactual."

Americas↗
PubMed1988

Interregional income differentials and migration: their interrelationships.

"The major objective of this paper is to demonstrate that interregional income differential is exogenous to interregional net migration, but not conversely. Utilizing Japanese prefectural-based data for 1954-82, we conduct the following three kinds of analyses to confirm this statement. Firstly, a simple comparison of the crests of interregional time-series plots was made to see which occurred first. Secondly, Sims', 1972, test of causality was done to investigate causation between urban/rural income differential and net migration. Finally, per capita income and population share were examined by two-dimensional phase diagram for nine regions." (SUMMARY IN FRE AND GER)

Asia↗
PubMed1995

[International migration and income redistribution: a trade-theoretic analysis].

"We analyze the income-redistribution effects of international migration in the host and source country in a general equilibrium framework. The well-known result that marginal migration leaves the welfare of nonmigrants unaffected is discussed in more detail with regard to shifts in national income distributions. With endogenous goods' prices the consequences for the income distribution are in general ambiguous--we show possibilities for an estimation of their magnitude. As long as wage disparities determine the direction of migration it increases world efficiency. However, redistributive policies may generate migration towards the low-wage country." (SUMMARY IN ENG)

Demography↗
PubMed1992

Multinomial logistic models explaining income changes of migrants to high-amenity counties.

"A survey of residents of and migrants to 15 fast-growing wilderness counties [in the United States] showed that only 25 percent of the migrants increased their income, while almost 50 percent accepted income losses upon their moves to high-amenity counties. Concomitantly, amenities and quality of life were more important factors in the migration decision than was employment, for instance. We focused on migrants in the labor force and employed multinomial logistic regression to identify the impact of migrants' characteristics, their satisfaction/dissatisfaction with previous location (push), and the importance of destination features (pull) on income change."

Americas↗
PubMedDate not supplied

[Family structure and income: a first analysis on cross-section data].

"In the paper the hypothesis of differences in household incomes depending on the sex of the householder is investigated. The data come from the 1991 Bank of Italy Survey on Household Income....A multiple regression model has been formulated in order to appreciate the contribution of the householder's sex to the family and per-capita income differentials." (SUMMARY IN ENG)

Demography↗
PubMed1990

Income distributions in an international perspective--the case of Hungary and the Netherlands.

"This article describes the comparison of the income distributions of Hungary and the Netherlands. In this comparison harmonised micro-data have been used to reach a high degree of comparability. The empirical results show that the inequality of household incomes was the same in both countries in the early eighties. After adjustments for differences in size and composition of households the income distribution was less equal in the Netherlands than in Hungary. The equivalence scales used were based on national budget surveys."

Developed Countries↗
PubMed1996

Influence of family functioning and income on vaccination in inner-city health centers.

OBJECTIVES: To assess family functioning and consumer decision-making about vaccinations and to compare the results with age at vaccination. DESIGN: Self-administered survey that was mailed to parents with comparison to vaccination records from chart audits. SETTINGS: Two inner-city health centers in Pittsburgh, Pa, that receive free vaccine supplies. PARTICIPANTS: Systematic sample from the billing computer records of parents whose children were aged 2 to 4 years as of July 2, 1993. INTERVENTIONS: The survey used simplified versions of the Family Profile and the Triandis model of consumer decision-making that includes perceived consequences of vaccinations, attitude about vaccinations, social influences, and facilitating conditions (eg, ease of obtaining an appointment). MAIN OUTCOME MEASURES: Variables associated with age at vaccination for third diphtheria and tetanus toxoids and pertussis vaccine immunization and first measles-mumps-rubella immunization. RESULTS: Of 395 families, 167 responded. Higher family dysfunction scores and lower family concordance scores each were associated with receiving first measles-mumps-rubella vaccination (P < or = .02) and third diphtheria and tetanus toxoids and pertussis vaccination (P < = .02) at later ages. Many (30%-54%) of the respondents reported that they knew little about the risks and benefits of vaccination. However, knowledge about vaccines was not associated with vaccination status. Those respondents with an annual income of less than $10000 received the first measles-mumps-rubella vaccination later than those with an annual income $10000 or greater (P < .02) when the data were analyzed by age at vaccination but not when the data were analyzed as on-time vs late vaccinations. CONCLUSIONS: To increase vaccination rates in innercity clinics, strategies need to consider family dysfunction and income and not merely focus on education. The use of age at vaccination as a continuous variable offers advantages over the dichotomy of immunized vs not immunized.

Age Factors↗
PubMed1991

Occupation, income, and education as independent covariates of arthritis in four national probability samples.

The strong associations between education level and prevalence and severity of arthritis have recently been investigated, with some suggestion that the relationships might be causal. Data from 4 national probability samples were analyzed, in which occupation and income were measured currently and prior to the development of arthritis. These data indicate that previous studies overestimated the strength of the association between schooling and arthritis because income and, especially, occupation were not analyzed as separate covariates. The overestimate appears to be especially high for persons currently employed, for men, and for persons employed in dangerous jobs. Health policy strategies directed toward reducing arthritis rates require not simply a focus on education, but the additional socioeconomic status dimensions of income and occupational safety and health.

Arthritis↗
PubMed1993

Health care expenditure and income in Europe.

In this work we have tried to analyse the variations in health care expenditure in all the countries of the European Community except Greece and Portugal. We have wanted to provide additional evidence on the empirical relationship between expenditure on health care and income. Our analysis, starting from the approach of Fuchs and Baumol, has been an extension of the traditional studies on health care international comparisons, in at least three directions: we have not imposed any restrictions on the price effects, we have analysed dynamic models instead of the cross-sectional analysis and we have used proper deflators. We have deflated health care expenditure in each country by means of its sectoral price index and by the purchasing parity power of its currency, to allow international comparisons. In the former case we express health care in terms of 'expenditure', in the latter we express health care in terms of 'weighted quantity'. Income elasticities, in the short and in the long-run, have been estimated using econometric methods that allow us to obtain simultaneously equilibrium long-run relationships, if any, and adjustment processes in the short-run. We have found cointegrating relationships and we have estimated consistent estimators of the elasticities. The estimated income elasticities are greater than one in all the models analysed.

Bias↗