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PubMed2000

Predictors of anticipated breastfeeding in an urban, low-income setting.

BACKGROUND: Although the proportion of women who breastfeed is known to vary by demographic group, breastfeeding practices have not been sufficiently studied among urban, lower income African American populations seen in family medicine centers. METHODS: A cross-sectional design was used to examine demographic, clinical, and attitudinal factors that affect anticipated infant feeding practices reported by postpartum women from a low-income, urban family practice setting. Data was analyzed using chi-square, odds ratios (OR), and multiple logistic regression techniques. RESULTS: Among 66 respondents, only 3 subjects (4.5%) indicated that they planned to breastfeed exclusively, while an additional 11 subjects (16.7%) reported plans to use a combination of bottle-feeding and breastfeeding. Based on univariate analyses, women with less than 12 years of education were less likely to report anticipated breastfeeding. Otherwise, breastfeeding plans were not associated with subject demographic features or with reproductive characteristics. Respondents planning to bottle-feed noted that breastfeeding was too complicated. Logistic regression demonstrated an inverse relationship between level of maternal education and anticipated breastfeeding (OR=0.13, 95% confidence interval [CI], 0.05-0.35), and a direct association for encouragement from the baby's father or the woman's mother to breastfeed and anticipated breastfeeding (OR=12.4; 95% CI, 4.92-31.4). CONCLUSIONS: This study reports unique data regarding anticipated infant feeding practices among patients from an urban, low-income community served by a family medicine center. Findings from this study will be used to develop a family-centered educational intervention involving the mothers, grandmothers, and partners of pregnant patients to promote the benefits of breastfeeding in this community.

Adolescent↗
PubMed2000

Growth in family income inequality, 1970-1990: industrial restructuring and demographic change.

Industrial restructuring and changing population composition frequently have been treated as competing explanations of growing U.S. income inequality. Using the Gini coefficient, we employ a model of conditional change to explore the relative effects of each on changes of family income distribution between 1970 and 1990, across 784 metropolitan areas and public use microdata areas (PUMAs). Changes in both industrial structure and population characteristics are found to have significant and opposite effects on family income distribution, although there are sharp differences by decade in the dynamics that underlie increasing inequality. Our central conclusion is that it is too soon to eliminate deindustrialization as a significant cause of increased earnings inequality.

Adolescent↗
PubMed2000

Does the disbursement of income increase psychiatric emergencies involving drugs and alcohol?

OBJECTIVE: To determine if the incidence of psychiatric emergencies involving drugs or alcohol supports the argument that mentally ill persons contribute to elevated mortality during the days following disbursement of private earnings and public income transfers. STUDY DESIGN: Interrupted time-series using Box-Jenkins methods. DATA COLLECTION/EXTRACTION METHODS: Daily counts of adults admitted to psychiatric emergency services in San Francisco after using drugs or alcohol were derived from medical records for the period January 1 through June 30, 1997. PRINCIPAL FINDINGS: Psychiatric emergencies among males who had used drugs or alcohol were elevated in the early days of the month. Such emergencies among females were not similarly elevated. Emergencies among females who had not used drugs or alcohol were elevated in the early days of the month. CONCLUSION: Elevated mortality in the first week of the month may be attributable, in part, to the "check effect" or use of drugs and alcohol by mentally ill males in the days after they receive income. The contribution of women is more complex and may be induced by drug or alcohol abuse among persons in their social networks. The check effect suggests that persons with a history of substance abuse and mental illness should be offered the opportunity to have their income managed by someone who can monitor and influence how the money is being spent. The fact that drug- or alcohol-related admissions among males exhibit temporal patterns suggests that the provision of preventive as well as treatment services may be strategically scheduled.

Adult↗
PubMed2001

Do income questions and seeking consent to link medical records reduce survey response rates? A randomised controlled trial among older people.

Traditional measures of socioeconomic status may not be reliable for older people and income may be a useful measure for research into inequalities in health. At the same time, researchers increasingly wish to link survey findings to individual data taken from medical records. For this, consent must be sought. To examine whether questions on household income and seeking consent for medical record linkage affected response rates, a postal health survey of patients aged 65 to 74 was undertaken in an inner London practice. The overall response rate was 62.8%. In this study, the inclusion of an income question or seeking consent to access medical records did not reduce response rates to a health survey among older people.

Aged↗
PubMed2001

Effective screening programmes for cervical cancer in low- and middle-income developing countries.

Cervical cancer is an important public health problem among adult women in developing countries in South and Central America, sub-Saharan Africa, and south and south-east Asia. Frequently repeated cytology screening programmes--either organized or opportunistic--have led to a large decline in cervical cancer incidence and mortality in developed countries. In contrast, cervical cancer remains largely uncontrolled in high-risk developing countries because of ineffective or no screening. This article briefly reviews the experience from existing screening and research initiatives in developing countries. Substantial costs are involved in providing the infrastructure, manpower, consumables, follow-up and surveillance for both organized and opportunistic screening programmes for cervical cancer. Owing to their limited health care resources, developing countries cannot afford the models of frequently repeated screening of women over a wide age range that are used in developed countries. Many low-income developing countries, including most in sub-Saharan Africa, have neither the resources nor the capacity for their health services to organize and sustain any kind of screening programme. Middle-income developing countries, which currently provide inefficient screening, should reorganize their programmes in the light of experiences from other countries and lessons from their past failures. Middle-income countries intending to organize a new screening programme should start first in a limited geographical area, before considering any expansion. It is also more realistic and effective to target the screening on high-risk women once or twice in their lifetime using a highly sensitive test, with an emphasis on high coverage (>80%) of the targeted population. Efforts to organize an effective screening programme in these developing countries will have to find adequate financial resources, develop the infrastructure, train the needed manpower, and elaborate surveillance mechanisms for screening, investigating, treating, and following up the targeted women. The findings from the large body of research on various screening approaches carried out in developing countries and from the available managerial guidelines should be taken into account when reorganizing existing programmes and when considering new screening initiatives.

Adult↗
PubMed2000

[Study on the epidemiology of diabetes mellitus in peasants with different income in Binzhou prefecture Shandong province].

OBJECTIVE: In order to study the morbidity of diabetes mellitus (DM), impaired glucose tolerance (IGT), and main effective factors of peasants with different income in poor area and to provide scientific data for strategy development. METHODS: The regions of investigation were divided into five parts: east, south, west, north and centre with two and three villages randomly selected for study from each region. Glucose - oxidase method was used to measure blood sugar and urine sugar. The classification and diagnosis standard were referred from the Beijing conference in 1980. RESULTS: The morbidity rates of non - insulin - dependent diabetes mellitus (NIDDM) and IGT were 1.21% and 2.35% in peasants who earned 800 and 2,500 yuan every year respectively. The standardized morbidity of NIDDM and IGT were 0.96% and 1.98%. We found that morbidity of NIDDM and IGT was very low among those younger than 20 years old but increased with age until reaching the top at the age of 70 to 80 years. DM patients were prominently seen at 30 to 40 year olds and IGT at 20 to 30 year olds. There was no difference of morbidity between male and female seen (chi(2) = 0.19 and 0.12; P > 0.05 and 0.05). The morbidity rates of DM and IGT in poverty type peasants who earned less than 1,200 yuan every year were 2.23% and 3.55% respectively, higher than those with adequate food and clothing type peasants who earned 2,000 to 2,500 yuan every year (morbidity rates were 0.39% and 1.18%; chi(2) = 18.11 and 18.10, P < 0.05 and 0.005) and those with common type of peasants who earned 1 200 to 1,900 yuan every year (morbidity rates were 0.80% and 1.92%; chi(2) = 25.85 and 18.20, P < 0.005 and 0.005). CONCLUSION: These results showed that sex did not obviously relate to morbidity of DM and IGT while age was one of the risk factors. The differences of income and unhealthy food intake played an role in the difference of morbidity to DM and IGT. It is important to increase the income of peasants and to change the unhealthy life style.

Adolescent↗
PubMed1996

Income, self-selection, and return and onward interprovincial migration in Canada.

"Estimated returns to migration based on comparison of individual migrants may be biased owing to self-selection in the migration process. Using data derived from the 1986 Canadian census, I will study the effects of expected wage differentials in determining the return or onward migration decision of nonnative adults aged 20 to 64 years. Evidence was found that return migrations were in the 'right' direction, as they are observed to respond to provincial economic variables (that is, average employment growth and income levels) in a rational manner. After accounting for self-selectivity, I found that...return migrants...are negatively selected, and experience lower income levels, following the return migration, than onward migrants would have, had they chosen the return migration option. This drop in expected wages decreases the propensity associated with making a return migration. Despite this drop in income, the large proportion selecting the return migration option suggests the importance of the province of birth in the mental map of nonnative migrants."

Americas↗
PubMedDate not supplied

Acculturation, education, and income as determinants of cigarette smoking in New Mexico Hispanics.

Surveys of cigarette smoking among Hispanics in the Southwest have shown a pattern of smoking distinct from that of non-Hispanic whites, but determinants of smoking by Hispanics remain inadequately characterized. We have assessed household income, education, and language preference as predictors of cigarette smoking in 1072 Hispanic adults residing in a community in New Mexico. Cigarette smoking status (never, former, or current smoker) varied strongly with educational attainment, showing the anticipated gradient of increasing smoking as level of education declined. In contrast, cigarette smoking status did not vary in a consistent pattern with reported language preference. A composite measure of socioeconomic status, combining education and household income, predicted continued smoking among ever smokers, whereas language preference had no effect. In males, the age at which subjects started to smoke increased significantly with increasing education; a similar trend in females did not reach statistical significance. Determinants of numbers of cigarettes smoked daily were not identified. The findings suggest that, as in other U.S. populations, Hispanics in the Southwest with lower education and less income should be targeted for smoking prevention and cessation.

Acculturation↗
PubMedDate not supplied

Ecologic proxies for household income: how well do they work for the analysis of health and health care utilization?

BACKGROUND: Researchers often use census-derived measures of socioeconomic status (SES) when personal information is not available. Theory predicts that the resulting misclassification will blunt associations between outcomes and SES and that control for confounding by SES will be less effective. The purpose of this paper was to examine the magnitude of this problem using data from the National Population Health Survey (NPHS). METHODS: Subjects were 4,037 respondents to the NPHS who were linked to the Ontario Health Insurance Plan. An ecologic measure of income was obtained by linkage of subjects' postal codes to the Census. RESULTS: The relationships between the ecologic-level measure and health outcomes or health services utilization were attenuated in comparison to the relationships relative to the direct measure of household income. The ecologic measure also produced poorer control for confounding by income in the analysis of other health relationships. CONCLUSIONS: Many interesting public health and health services questions can be addressed only with the use of ecologic level socioeconomic information. While most of the results were qualitatively similar when the direct and ecologic measures were compared, researchers and users of research findings should be aware that attenuated or potentially misleading findings may result from the use of these methods.

Female↗
PubMed2004

How asset tests block low-income Medicare beneficiaries from needed benefits.

The Medicare Savings Programs and Medicaid help elderly Medicare beneficiaries with their cost-sharing responsibilities and provide much-needed additional benefits. But 40 to 50 percent of eligible low-income Medicare beneficiaries are not enrolled in the Medicare Savings Programs. One persistent barrier is the use of asset tests, which greatly complicate the application process for applicants and program staff. Older people with low incomes generally have few assets and the income and assets of older people who qualify for public programs do not change substantially over time. Findings suggest that use of asset tests should be eliminated or asset limits should be increased; at a minimum, cost-of-living adjustments should be made. Findings also indicate that the renewal process should be simplified, and use of verification documents should be reduced or eliminated.

Aged↗
PubMed2004

Predicting the effect of disability on employment status and income.

Research shows that participation in employment contributes to life satisfaction for persons with disabilities [18]. Title I of the Americans with Disabilities Act (ADA) sought to prohibit discrimination against persons with disabilities in the workplace, however, the ADA's effectiveness remains controversial. This research utilizes data from the disability supplement of the 2000 Behavioral Risk Factor Surveillance System to examine the impact of disability status on predicting employment status and income. Confounding variables such as gender, age, educational level, race and marital/parental status are examined regarding their influence on results. Results from analysis utilizing zero-order correlation, linear and logistic regression analysis techniques revealed that disability status has a significant predictive effect on inability to work. Furthermore, results continue to show that despite legislation, the higher the level of disability, the lower the employment status (those employed for wages) and income. Finally, disability status, coupled with being female or decreased educational level, consistently shows significance in predicting lower employment status and income than men or non-minorities with disabilities. Future research opportunities and policy implications are discussed with regard to the results presented.

Adolescent↗
PubMed2004

The myth of income and the economy.

Just because the economy fluctuates does not mean your practice has to do the same. You can take steps to ensure that your practice secures optimal income during a weak economic cycle. By performing "WOW" customer service, cutting down on accounts receivable, increasing case presentation, and motivating your staff, your practice can secure a steady, if not increasing, flow of income during a weak economy. A determined positive attitude by you and your entire staff will result in success and will keep you immune from the myth of income and the economy.

Economics, Dental↗
PubMed2004

The impact of income, education and health on lifestyle in a large urban population of Poland (Cindi programme).

OBJECTIVES: The objective of our study was to examine the impact of income, education chronic diseases and self-rated health on health behavior (smoking, alcohol consumption, physical activity, diet) in a large urban population of Poland. MATERIALS AND METHODS: The data were collected in Lódź, a large industrial city of Poland, between 2001 and 2002, as a part of the Countrywide Integrated Noncommunicable Diseases Intervention Programme. The surveys were directed at random samples of the adult population (1837 men and women, aged 18-64 years). A questionnaire completed during a doctor's visit was used for data collection. RESULTS: Smoking was more prevalent in men then in women, and its prevalence was lower among the better-educated people. The older men drank the most. Strong alcohol consumption was more prevalent in women with a higher education and the highest income. The presence of any of the studied chronic illness decreased daily smoking and the frequency of alcohol consumption among men. Use of vegetable oil in food preparation was less prevalent among older men. Married men in the "medium" education group and widows used vegetable oil most frequently. Healthy physical activity was most prevalent among men in the higher income group; lower rates were observed among persons with skilled education and in men with chronic illnesses. CONCLUSIONS: Based on our findings, we may conclude that education has a strong impact on our lifestyles. It is also evidenced that people who suffer from chronic illness show stronger motivation for healthy behavior. However, we found no relationship between health status and food habits.

Adult↗
PubMed2006

A closer look at the Medicare part D low-income benchmark premium: how low can it go?

This issue brief explains how the Medicare Part D low income benchmark premium is calculated, what factors influence the level of the low-income benchmark premium in any given year, and the implications of the benchmark amount for Medicare drug plans and beneficiaries as it changes from year to year. The paper provides a simplified, two-year example of how the low-income benchmark premium is calculated in order to illustrate the key factors that influence it.

Benchmarking↗
PubMed1990

Predominant methods and issues regarding physician income distribution and incentive compensation plans.

This paper discusses physician income distribution within a group practice setting. In this discussion, factors affecting physician-income generation and distribution are explored, including objectives of incentive programs, overall economics of group practices, methods of distributing income which are most commonly employed, and other issues that affect incentive compensation.

Economics, Medical↗
PubMed1989

Comparison of breastfeeding attitudes and practices: low-income adolescents and adult women.

Breastfeeding attitudes and practices of two independent samples of low-income adolescents were compared to a third sample of low-income, adult women. Low-income status was based on subject eligibility for the Special Supplemental Food Program for Women, Infants, and Children (WIC). Breastfeeding attitudes were significantly related to setting, race, and age. Other factors, such as previous exposure to breastfeeding, also influenced breastfeeding attitudes. Breastfeeding rates were 16.7% and 32.4% for the two teen samples, and 35.4% for the sample of adult women. Choice of infant feeding method post delivery was significantly related to intention regarding feeding method during pregnancy. Implications of these findings for health care professionals are discussed.

Adolescent↗
PubMed1985

Home equity conversion plans as a source of retirement income.

This article describes in detail a variety of home equity conversion plans and discusses their relevance for social security beneficiaries, as well as for the aged in general. Under these plans, a dormant asset--accumulated home equity--is converted into current retirement income. The plans vary: Some are debt instruments; others involve the sale and leaseback of the residence. Some provide income for a fixed term; others offer a lifetime annuity. Some include a public subsidy; others are free of governmental involvement. The advantages and disadvantages of these plans, as well as examples of how they operate and their respective income potential, are discussed in this article. The relevance of home equity conversion plans for social security beneficiaries is illustrated by means of data from the Retirement History Study. These data allow comparison of various demographic groups in terms of their dependence on social security benefits. Each group is examined in terms of available home equity and home equity potential under several conversion plans.

Aged↗
PubMed1979

Fertility and income consumption aspirations, and child quality standards.

Data from a 1975 national survey of the American population were used to investigate the relationships between childbearing and aspirations for consumption goods, child quality standards, and income. The data were consistent with the hypothesis that preferences for child quality are negatively related to fertility. Aspirations for consumer goods which are related to the home were not found to be negatively related to childbearing while aspirations for nonhome goods were negatively related to fertility as hypothesized. Several indicators of income and subjective economic well-being were examined, and the overall pattern of results was not supportive of the hypothesized effect of income on fertility.

Adolescent↗