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PubMed2000

State income inequality, household income, and maternal mental and physical health: cross sectional national survey.

OBJECTIVE: To examine the association of state income inequality and individual household income with the mental and physical health of women with young children. DESIGN: Cross sectional study. Individual level data (outcomes, income, and other sociodemographic covariates) from a 1991 follow up survey of a birth cohort established in 1988. State level income inequality calculated from the income distribution of each state from 1990 US census. SETTING: United States, 1991. PARTICIPANTS: Nationally representative stratified random sample of 8060 women who gave birth in 1988 and were successfully contacted (89%) in 1991. MAIN OUTCOME MEASURES: Depressive symptoms (Center for Epidemiologic Studies depression score >15) and self rated health RESULTS: 19% of women reported depressive symptoms, and 7.5% reported fair or poor health. Compared with women in the highest fifth of distribution of household income, women in the lowest fifth were more likely to report depressive symptoms (33% v 9%, P<0.001) and fair or poor health (15% v 2%, P<0. 001). Compared with low income women in states with low income inequality, low income women in states with high income inequality had a higher risk of depressive symptoms (odds ratio 1.6, 95% confidence interval 1.0 to 2.6) and fair or poor health (1.8, 0.9 to 3.5). CONCLUSIONS: High income inequality confers an increased risk of poor mental and physical health, particularly among the poorest women. Both income inequality and household income are important for health in this population.

Adolescent↗
PubMed1996

Socioeconomic status and weight control practices among 20- to 45-year-old women.

OBJECTIVES: This study examined the relationship between socioeconomic status (SES) and weight control practices in women. METHODS: SES, defined by family income, was examined in an economically diverse sample of 998 women in relation to dieting practices by means of multivariate regression analyses controlling for age, ethnicity, smoking, and body mass index. RESULTS: SES was positively associated with healthy, but not unhealthy, weight control practices; inversely related to energy and fat intake; and positively associated with weight concern and perceived social support for healthy eating and exercise. SES gradients were particularly striking at the low end of the income distribution (i.e., family income < or = $10,000 per year). The SES gradient in body mass index persisted in analyses controlling for attitudes and behaviors. CONCLUSIONS: Economic deprivation may contribute to high rates of obesity among lower SES women. The reasons for this require further research.

Adult↗
PubMed1999

[Social class index in the Federal Health Survey].

Since the first scaling of social status for the German National Health Interview and Examination Survey, relevant socio-economical circumstances and constraints have changed. This prompted an examination of relevant developments such as changes in income distribution and increasing income in the West and since 1990 in the East of Germany, changes in educational levels, and changes in social prestige of professional groups. In spite of these changes we must assume that the relations between social strata remained constant over time. The task is to assess how and to what extend the developments mentioned above have been reflected and to examine the necessity of bringing social status scaling in line with these developments, as well as to adjust social status scaling.

Adolescent↗
PubMed1990

[Changes in economic well-being of families with children in Canada and Quebec over the last 15 years].

"This study analyses changes in the average real income of families with children [in Canada] over the 1971-1987 period. It presents the factual basis with which to evaluate changes in incomes at a variety of positions along the income distribution, focusing on poverty and income inequality. The study presents the sources of family income changes by emphasizing: the contributions of wives' earnings which affect total family income, the incidence of poverty as well as time available for leisure and child care; the role of government's cash transfers and personal income taxes." (SUMMARY IN ENG AND SPA)

Americas↗
PubMed2001

Defusing the baby boomer time bomb: projections of after-tax income in the twenty-first century.

There has been a major national policy debate over the prospective tax burden facing future generations of workers as a result of the impending retirement of the baby boom generation. However, the real determinant of well-being is after-tax income, not the tax rate on before-tax income. This study constructs a series of projections of after-tax income, for workers and families at different points in the income distribution, to examine the effects of several different trends. The author first calculates the extent to which after-tax income can be expected to decline as the result of the aging of the baby boomers, then calculates the impact on after-tax income for families at different points in the income distribution of a continuation of recent trends in wage inequality. He also constructs a category of "after-tax, after-health-care spending" income, which examines the impact of the continued rapid growth in health care costs. The findings suggest that the continuation of recent trends in inequality and health care cost growth will have a much larger effect on future living standards than will the aging of the baby boomers.

Actuarial Analysis↗
PubMed1994

Distributive effects of benefits and taxes.

In light of the growing federal deficit, pressure is mounting to cut federal spending. If the budget for social security programs is cut, who will suffer? This article presents the results of a study that investigated the degree to which taxes and public income transfers change the level of income, the degree of inequality in income distribution, and the poverty rates of various demographic groups. Major findings are that public income transfers are more powerful than taxes in equalizing the income distribution and that poverty reduction through non-means-tested transfer programs is more effective among elderly people, white people, and people in married-couple families, whereas poverty reduction through means-tested transfer programs is more effective among nonelderly people, black people, and people in female-headed families. Implications for social work practice are discussed.

Black or African American↗
PubMed2000

Social comparisons of income in one's community: evidence from national surveys of income and happiness.

Two studies provide evidence for social comparison effects of income on subjective well-being (SWB). The 1st study of 7,023 persons from nationally representative samples in the United States shows that the range and skew of the income distribution in a community affects a person's happiness, as predicted by range-frequency theory. The 2nd study of 8 nations over a period of 25 years shows that decreasing the skew (inequality) of the income distribution in a country increases average national SWB. Both studies strongly support social comparison effects of income within a community, and both results are predicted by range-frequency theory. These studies are the first to successfully extend earlier results of R. H. Smith, E. Diener, and D. H. Wedell (1989) from the laboratory into naturalistic situations. The magnitude of the social comparison effects is smaller than the main effect of income, which implies that nations can avoid creating a "hedonic treadmill."

Data Collection↗
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↗
PubMed2003

[Social inequality and health in Brazil].

This paper studies the relationship between social inequality and health in Brazil. The strategy adopted by the authors was to analyze needs and uses of medical care as well as access to health insurance plans according to income distribution. Determinants of health care consumption were also studied by means of logistic regression. The main source of data was the 1998 National Sample Household Survey of the Brazilian Institute of Geography and Statistics (PNAD-IBGE). In general, individuals in the lowest income distribution deciles had less access to health insurance, greater need for medical care, and lower consumption of such services. Other determinants of health care consumption were heavily associated with the most privileged social strata (greater access to schooling, water supply, sewerage, electricity, garbage collection, and health insurance) and with factors pointing to the capacity to supply these services in country.

Adolescent↗
PubMedDate not supplied

Physician compensation based on performance appraisal.

Physician compensation in a group practice setting has long been a subject of discussion and time investment, both on the part of managers and physicians. With a changing external environment, including Medicare fee freeze, capitation, and other forms of discounted, contractual medicine, former income distribution plans may not serve group practices well anymore. The ability of group practices to attract, retain, and develop physicians is at least partially dependent upon physician compensation structure. Taking into consideration marketplace characteristics for different specialties and offering equity in the compensation process are important features of any income distribution plan. This paper emphasizes a longstanding business tool, performance appraisal, which may be a key future determinant of physician compensation. The utilization of performance appraisal in establishing physician compensation is discussed and a sample performance appraisal instrument is included as a model.

Employee Performance Appraisal↗
PubMed1996

Urban ozone plumes and population distribution by income and race: a case study of New York and Philadelphia.

Who lives in the downwind areas of urban ozone plumes? Location theory suggests that the poor should disaproportionately populate the downwind area, while the rich are most likely to live outside urban ozone plumes. Dynamically, we would expect that the downwind area would become poorer over time because the rich would "vote with their feet" under the serious impacts of urban ozone plumes. However, the importance of urban ozone pollution could be discounted due to the public's risk perception. According to risk and air quality perception literature, one would expect that the public would likely perceive ozone air pollution as a relatively low risk, compared with other environmental risks and social concerns. Therefore, actual population distribution might not follow what location theory suggests. Who actually does live in the downwind areas of urban ozone plumes? The results from a case study of New York and Philadelphia show that the ozone downwind areas are currently populated by a considerably larger proportion of upper income households and whites than the source areas. Furthermore, the population dynamics data do not provide any evidence for the "vote with their feet" hypothesis. While these findings deviate from the hypotheses prescribed by location theory, they are consistent with what we could expect from theories of risk perception.

Air Pollutants↗
PubMed1996

Incidence of dog bites in Milwaukee, wis.

Dogs are everywhere. The incidence of and injuries caused by dog bites have grown to such epidemic proportions in certain parts of the United States that they are now considered a major public health concern. Playful Rover is no longer a harmless pet. Uncontrolled, he now can be considered a public nuisance. In this study, we evaluated the epidemiology of dog bites recorded in Milwaukee, for calendar years 1989-1991. This assessment included anatomical location of bites, victims' ages, behavioral antecedents, leading up to the bite incidents, season of the year, and animal ownership. The evaluation also measured the correlation coefficient between the frequency of dog bite incidents and median household income distribution within the city. During the 3-year period, a total of 3,926 animal bites, including 3,244 (83%) dog bites, were reported to the City of Milwaukee Department of Health. Of all the dog bites reported, 60% were on the upper extremities. Children less than 15 years old sustained 44% of the injuries, mostly to the head and face. Provocation by the victim accounted for 19% of the cases. The majority of the incidents (67%) occurred during the spring and summer months. In 49% of all cases, the victims families or neighbors owned the animals involved in the biting. Researchers also observed a significant negative correlation between bites and median household income distribution. Study results suggest a need to educate the public about the magnitude of dog-bite problems, enforce leash laws and impound stray dogs as an integral part of prevention programs.

Adolescent↗
PubMed1999

Income and health: what is the nature of the relationship?

The aim of this article is to examine the relationship between income and morbidity, both before and after controlling for other socio-economic variables. We use data from the Health and Lifestyle Survey (first wave), a national sample survey of adults, aged 18 upwards, in England, Wales and Scotland, conducted in 1984-1985. In total, 9003 interviews were achieved. We examine the shape of the relationship between household equivalised income and height, waist-hip ratio, respiratory function (FEV1), malaise, limiting longterm illness. These indices of morbidity, both self-reported and measured, are approximately linearly related to the logarithm of income, in all except very high and low incomes (this means that increasing income is associated with better health, but that there are diminishing returns at higher levels of income). A doubling of income is associated with a similar effect on health, regardless of the point at which this occurs, providing this is within the central portion (10-90%) of the income distribution. The effect of income on the health measures is comparable to that of the other socio-economic variables in combination. The shape of the relationship found between income and health is compatible with worse health in countries with greater income inequality, without the need to postulate any direct effect of income inequality itself.

Adult↗