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PubMed1986

Ethnic group differences in nutritional status of young children from low-income areas of an urban county.

A nutrition assessment survey was undertaken among 566 preschool children from randomly selected low income households located within an urban county. The purpose of the survey was to determine the prevalence of selected nutrition problems and to identify relationships among ethnic and economic variables and nutritional status. Underweight was identified in 1.8%, overweight in 15.4%, and short stature in 13.1% of children. Southeast Asian children had a higher prevalence of short stature than the other ethnic groups. Low hemoglobin values were identified in 4.3%, low hematocrit in 6.9%, and elevated erythrocyte protoporphyrin in 6.0% of children. The prevalence of elevated EP was significantly higher among Southeast Asian children than non-Southeast Asians and likely was due to iron deficiency. Results of the survey suggest that Southeast Asian children constitute the group at highest nutritional risk in the low income areas surveyed.

Child↗
PubMed1991

Is race associated with weight change in US adults after adjustment for income, education, and marital factors?

We examined the 10-y change in body mass index (BMI, in kg/m2) of black and white adults who entered the First National Health and Nutrition Examination Survey Epidemiologic Followup Study at ages 25-44 y. In women the mean change in BMI was greater for blacks than for whites despite multiple adjustments. However, the risk of major weight gain (MWG; BMI change greater than or equal to + 5) was nearly identical in black and white women. Womens' MWG was independently associated with low income [odds ratio (OR) = 1.7] and with becoming married (OR = 1.8). The risk of major weight loss (MWL; BMI change less than or equal to -2.5) was lower in black women than in white women (OR = 0.6). In men mean BMI change, MWG (BMI change greater than or equal to + 4) and MWL (BMI change greater than or equal to -2) were not associated with race, but there were effects associated with low income, low education, and marital changes. Black race does not increase the risk of weight gain; in women it may be associated with a reduced likelihood of weight loss.

Adult↗
PubMed2006

Are American children and adolescents of low socioeconomic status at increased risk of obesity? Changes in the association between overweight and family income between 1971 and 2002.

BACKGROUND: A good understanding of the association between obesity and socioeconomic status (SES) has many important public health and policies implications, particularly for the prevention and management of obesity. OBJECTIVE: The objective was to examine secular trends in the relations between overweight (body mass index > or = 95th percentile) and SES. DESIGN: We examined secular trends in the relation between overweight and SES using nationally representative data collected in the National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2002 for 30 417 US children aged 2-18 y. Poverty income ratio tertiles at each survey were used to indicate low, middle, and high SES. RESULTS: Considerable race, sex, and age differences were observed in the association between overweight and SES. A reverse association only existed in white girls; African American children with a high SES were at increased risk. Socioeconomic disparities in overweight have changed over time, with an overall trend of weakening. Compared with the medium-SES group, the adjusted odds ratios and 95% CIs were 0.79 (0.47, 1.33), 1.08 (0.73, 1.61), 1.24 (0.73, 2.09), and 1.04 (0.82, 1.33) in NHANES I, II, and III and in the 1999-2002 NHANES for the low-SES group and 0.66 (0.43, 1.00), 0.60 (0.35, 1.03), 0.42 (0.23, 0.76), and 0.99 (0.68, 1.43) for the high-SES group, respectively. Between 1988-1994 and 1999-2002, the ratio in the prevalence of overweight between adolescent boys with a low or high SES decreased from 2.5 to 1.1 and from 3.1 to 1.6 in girls. Consistently across almost all SES groups, the prevalence of overweight was much higher in blacks than in whites. CONCLUSIONS: Complex patterns in the association between SES and overweight exist. Efforts solely targeting reductions in income disparities probably cannot effectively reduce racial disparities in obesity.

Adolescent↗
PubMed2001

GP income in relation to workload in deprived urban areas in The Netherlands. Before and after the 1996 pay review.

BACKGROUND: General practitioner workload is higher in deprived urban areas and for the elderly. This led to the introduction of additional GP payments regarding these patients, in the UK and in the Netherlands. This study examines whether this has resulted in more equal payment for work done in the Netherlands. METHODS: GP workload and income have been assessed on the basis of a survey among 1154 GPs (response: 62%). RESULTS: Suggest that total GP income is still lower in deprived areas, but per hour and per patient contact the additional payments gave equity. CONCLUSION: It is thus concluded that Dutch deprivation payments effectively compensate GPs in deprived areas for their higher workload.

Health Services Research↗
PubMed1999

Description of a mixed ethnic, elderly population. I. Demography, nutrient/energy intakes, and income status.

BACKGROUND: Elderly participants in the Title III-C Nutrition Program, 60-103 years of age, were assessed for nutrient/energy intakes, relationship of income status to intakes, and comparison with data from the National Evaluation of the Elderly Nutrition Program (ENP). METHOD: Nonrandomized volunteers were interviewed in senior centers or in their homes. Chi-square, t test, and ANOVA were used to test for differences in dietary intakes with regard to ethnicity, gender, age, type of meal (congregate dining or home delivered), socialization factor (lived alone or with others), and income status. A new method of looking at diet quality, which conjoins nutrients and energy, was developed for this study. RESULTS: Six percent of the sample had adequate energy and nutrient intakes over a 3-day period; 53% were rated tenuous or marginal, and 41% submarginal or inadequate. The Title III-C noon meal provided 38%-44% of the average daily energy intake and 33%-65% of the average intake of selected nutrients. Diets of men were better than those of women (p < .05). Calcium (p < .01) and potassium (p < .05) were higher in diets of female elders above the poverty line than those below. Black women were most affected by poverty, with 92% below the poverty line. A trend was observed for higher intakes of fatty components (total fat, cholesterol, % fat calories) for both men and women in the below-poverty than in above-poverty groups. DeKalb Community Council on Aging subjects had higher intakes of Vitamin A than those in the ENP, but overall most nutrients were higher in both congregate and home delivery clients of ENP. CONCLUSIONS: Title III-C Nutrition Programs have been implemented since 1973, and nutrition education is an obligatory component. The high incidence of nutrient/energy inadequacy in this study was surprising, but consistent with previous reports. New ways of implementing better food intakes of senior citizens are needed. In addition, research is needed to establish differences in nutrient profiles of elderly clients below and above the poverty level.

Black or African American↗
PubMed1994

The elasticity of demand for health care in Burkina Faso: differences across age and income groups.

Like many other developing countries, Burkina Faso has been exploring how community resources can be tapped to co-finance health services. Although revenue generation is important for the viability of health services, effects on utilization and on equity of access to health care must also be considered. The authors present a logistic regression model to derive price elasticities of demand for health care based on cross-sectional survey data. While demand for health care appears inelastic overall (-0.79), subgroup analysis reveals differences in elasticity across age and income groups. Elasticities of demand for infants and children (-3.6 and -1.7) and for the lowest income quartile (-1.4) are substantially greater than overall elasticity. The method used is unusual in that it allows estimation of elasticities before the introduction of user fees. This increases the value of the information to policy makers.

Adolescent↗
PubMed1985

Clusters of cancer mortality in New Jersey municipalities; with special reference to chemical toxic waste disposal sites and per capita income.

The state of New Jersey (NJ), USA, has been thought to have an unusually high cancer mortality rate; this assumption has been based on 1950-1969 mortality data for NJ counties. This study presents an analysis of mortality from major cancers for NJ municipalities during 1968-1977, and correlates cancer mortality rates with several potentially relevant variables. Age-adjusted mortality rates for 13 major cancer sites for 194 municipalities of 10 000 or more people in 21 NJ counties were compared with cancer mortality in the US. Municipality rates were correlated with: distribution of chemical toxic waste disposal sites (CTWDS); annual per capita income; the rates of low birth weight, birth defects and infant mortality of NJ municipalities. Clusters of cancer mortality were observed in 23 municipalities in 10 counties in which a total of 98 age-adjusted cancer death rates were at least 50% above the national rate, and each of these municipalities had at least two race-sex-specific cancers in which the observed number of cancer deaths was greater than the expected number of deaths at the p less than 0.0005 level. Of these 98 excessive cancer death rates, 72% involved the gastrointestinal tract. Most of the municipalities are located in the highly industrialized densely populated northeastern part of the State. Correlation analyses showed a consistent and significant (p less than 0.05) negative correlation between income and cancer mortality in 11 of 12 cancers studied. These analyses also showed a significant positive association between 8 of 12 cancers studied and CTWDS in one or more subgroup populations and lesser associations with birth defects, low birth weight and infant mortality.

Breast Neoplasms↗
PubMed1998

Gender-based income differences for physical therapist managers.

BACKGROUND AND PURPOSE: The purpose of this study was to determine whether income differences associated with gender exist for therapists in management positions and whether such differences also exist for salaried and self-employed individuals after adjusting for differences due to hours worked, years worked full-time, leave taken from the profession, number of years at a facility, and number of years in a position. SUBJECTS: The subjects were 969 physical therapists who held management positions throughout the United States. METHODS: Subjects responded to a survey designed for male and female administrators. Respondents were assigned to groups of salaried therapists or self-employed therapists, t tests were used to compare characteristics based on gender, and analysis of covariance was used to compare income based on gender after controlling for certain variables. RESULTS: After adjusting for the set of five covariates, the data showed that self-employed female therapists earned 77% of the average salary earned by the self-employed male therapists. A similar analysis revealed that the salaried female managers earned 89% of the average salary earned by male managers. Within the five practice subgroups of salaried managers, salary differences existed only for those therapists working in acute care settings. CONCLUSION AND DISCUSSION: For the physical therapist managers who responded to the survey, there were gender-based salary differences. Regardless of whether the therapists were salaried or self-employed, salary differences existed for some areas of practice but did not appear to exist in other areas of practice.

Administrative Personnel↗
PubMed1978

Effects of work scheduling on time-income tradeoffs.

Existing theory and data on work--leisure preferences suggest that how work and free time are scheduled may influence workers' preferences regarding the exchange of income for free time. In general, hours and income are not traded in a strict one-to-one fashion; rather, the value of leisure time is in part a function of the "lumps" in which free time is made available. Exploratory research on an accidental sample of 248 employees in ten work organizations supports this hypothesis. Some societal implications of these findings are discussed.

Attitude↗
PubMed1980

Work patterns, practice characteristics, and incomes of male and female physicians.

The purpose of this study was to examine differences in work patterns and practice characteristics of male and female physicians using data from the American Medical Association's Twelfth Periodic Survey of Physicians conducted in 1978. Following are some of the major findings: Male physicians were more likely than female physicians to work either in the traditional solo, fee-for-service practice or in a group-practice setting. Female physicians were more likely to be found in some other setting such as a clinic, student health center, local government agency, or corporation and were more frequently reimbursed on a salary basis. Male physicians worked more hours per week (50.9 versus 43.7) and more weeks per year (47.1 versus 45.9) and were reimbursed at a higher annual level ($62,700 versus $43,700) than their female counterparts. Even if women worked the same number of hours per week and weeks per year as men, the mean income from medical practice for females would be 83% of the mean income for males. The differential, however, diminished over the five-year period between 1972 and 1977.

Female↗
PubMed1995

Convergence or divergence of male and female physicians' hours of work and income.

This article verifies if the increase in the percentage of women in the medical profession led to the convergence of male and female physicians' hours of work as well as income. Active physicians in Quebec in 1978 were compared to the ones in 1988. Data were obtained from the computerized files of the Quebec Corporation of Physicians and the Régie d'assurance-maladie du Quebec. Despite the increasing representation of women in the medical profession, gender differences in hours worked and income remained. However, results also showed a tendency toward a convergence in total hours of work, more behavioral variation among women physicians and some behavioral change among men. The experience of the past should thus not be used as the basis for projections of future physician productivity or for medical manpower planning purposes without a careful analysis of trends in behavioral changes.

Adult↗
PubMedDate not supplied

The effects of maternal psychosocial factors on parenting attitudes of low-income, single mothers with young children.

BACKGROUND: Although recent evidence implies linkages among depression or depressive symptoms, self-esteem, history of childhood abuse, and parenting attitudes, the evidence does not clearly elucidate the relationships among these variables. OBJECTIVES: To investigate the relationships among maternal psychosocial factors (history of childhood abuse, everyday stressors, self-esteem, and depressive symptoms) and parenting attitudes of low-income, single mothers who have young children. METHODS: Secondary analyses of data from in-home interviews with 206 low-income, single mothers from a southeastern United States urban area were conducted. A variety of scales, including the Adult-Adolescent Parenting Inventory (AAPI), were used to measure maternal psychosocial factors. RESULTS: Using the AAPI, a Modified Parenting Attitudes Measure (MPAM), and subscales, a three-stage regression procedure was used to test the model. For stages 1 and 2, everyday stressors were the strongest predictor of self-esteem. Childhood sexual abuse, everyday stressors, low self-esteem, and control variables accounted for 58% of variance in depressive symptoms. In the third stage for the AAPI, only control variables were retained except in the Lack of Empathy subscale, where depressive symptoms and control variables accounted for 16% of the variance. The third stage for the MPAM yielded, by subscale: Only control variables predicted Corporal Punishment Beliefs; depressive symptoms were the strongest predictor for the total MPAM (19% of variance) and of the Inappropriate Emotional Expectations subscale (17%); and childhood physical abuse was the only predictor of Role Reversal. CONCLUSIONS: Depressive symptoms mediated the effects of childhood abuse, everyday stressors, and self-esteem and provided the linkage between these variables and at-risk parenting attitudes. Self-esteem decreased as everyday stressors increased but did not directly affect parenting attitudes. A relationship was not found between childhood abuse and low self-esteem. This study highlights the complexity of parenting and the need to identify other factors of at-risk parenting not accounted for in this study.

Adolescent↗
PubMed1993

Urban, low-income, African-American and Hispanic youths' negative experiences with condoms. Implications for nursing intervention.

Research suggests that the rate of HIV infection is increasing dramatically in African-American and Hispanic youths who live in low-income, urban areas. Nurses need information about these youths' negative experiences with condoms to intervene effectively in the spread of acquired immune deficiency syndrome. This article discusses negative experiences with using condoms that were reported by a subsample of condom users (n = 975) from a household probability sample of low-income, urban, African-American and Hispanic youths. Condom users were asked about 12 different negative experiences with condoms. Results from this household survey highlight a need for nurses to provide clients with specific directions about how to use condoms correctly and to encourage clients to practice putting on condoms.

Adolescent↗
PubMed1999

Sexual experiences and condom use of heterosexual, low-income African American and Hispanic youth practicing relative monogamy, serial monogamy, and nonmonogamy.

BACKGROUND AND OBJECTIVES: To describe (a) demographic characteristics, (b) sexual history, (c) perceived HIV susceptibility, and (d) current sexual behavior, condom use, and alcohol and marijuana use of heterosexual, low-income African American and Hispanic youth categorized as relatively monogamous (n = 577), serial monogamous (n = 171), or nonmonogamous (n = 278). STUDY DESIGN: Data were drawn from personal interviews with a probability sample of low-income youth, age 15 to 24 years, conducted in Detroit in 1991. RESULTS: Many group differences were found. For example, relatively monogamous youth were most likely to be female and Hispanic and to have engaged in unprotected intercourse. Serial monogamous youth were younger and most likely to have used condoms at last intercourse. Nonmonogamous youth initiated intercourse earlier and were most likely to have experienced oral and anal intercourse and to have used alcohol and marijuana. CONCLUSION: Risk reduction programs may need to be tailored differently to accommodate the needs of these three distinct subgroups of youth.

Adolescent↗
PubMed2002

Potential carbon mitigation and income in developing countries from changes in use and management of agricultural and forest lands.

The many opportunities for mitigating atmospheric carbon emissions in developing countries include reforesting degraded lands, implementing sustainable agricultural practices on existing lands and slowing tropical deforestation. This analysis shows that over the next 10 years, 48 major tropical and subtropical developing countries have the potential to reduce the atmospheric carbon burden by about 2.3 billion tonnes of carbon. Given a central price of $10 per tonne of carbon and a discount rate of 3%, this mitigation would generate a net present value of about $16.8 billion collectively for these countries. Achieving these potentials would require a significant global effort, covering more than 50 million hectares of land, to implement carbon-friendly practices in agriculture, forest and previously forested lands. These estimates of host-country income potentials do not consider that outside financial investment may or may not be available. Our calculations take no account of the additional benefits of carbon sequestration in forest soils undergoing reforestation, increased use of biomass and reduced use of fossil-fuel inputs and reduced agricultural emissions. In all events, realizing these incomes would necessitate substantially greater policy support and investment in sustainable land uses than is currently the case.

Africa↗
PubMed1991

Tobacco advertising restrictions, price, income and tobacco consumption in OECD countries, 1960-1986.

Factors affecting tobacco consumption per adult in 22 countries of the OECD between 1960 and 1986, were studied using pooled cross-section time-series analysis. The resulting log-linear model was estimated using Generalized Least Squares. The severity of tobacco advertising restrictions in each country and year was scored from published legislation and information from health agencies. Tobacco advertising restrictions have since 1973 increasingly been associated with lower tobacco consumption. Lower consumption levels were also associated with higher real tobacco prices, and with increased female labour force participation. Higher levels of consumption were associated with higher per capita real income and with a larger fraction of tobacco consumed as manufactured cigarettes. The model explains 99.5% of the variance in the average annual level of tobacco consumption across these countries. Ten-fold differences in purchasing power for tobacco products were found across the countries and years studied. In all countries tobacco products became more affordable between 1960 and 1986. In 1986 either a 36% inflation-indexed increase in real tobacco prices, or legislation to end tobacco promotion in those countries without a total ban, would have lowered average consumption by 6.8% and both together, by 13.5%. Across the OECD, if in 1986 all governments had raised tobacco product prices relative to income to Irish levels, and had banned all tobacco promotion, tobacco products consumption per adult would have fallen by 40% in that year.

Advertising↗
PubMed2001

Managed care, professional autonomy, and income: effects on physician career satisfaction.

CONTEXT: Career satisfaction among physicians is a topic of importance to physicians in practice, physicians in training, health system administrators, physician organization executives, and consumers. The level of career satisfaction derived by physicians from their work is a basic yet essential element in the functioning of the health care system. OBJECTIVE: To examine the degree to which professional autonomy, compensation, and managed care are determinants of career satisfaction among physicians. DESIGN: Cross-sectional analysis using data from 1996-97 Community Tracking Study physician telephone survey. SETTING AND PARTICIPANTS: A nationally representative sample of 12,385 direct patient care physicians. The survey response rate was 65%. MAIN OUTCOME MEASURE: Overall career satisfaction among U.S. physicians. RESULTS: Bivariate results show that physicians with low managed care revenues are significantly more likely to be "very satisfied" than are physicians with high managed care revenue (P < .05), and that physicians with low managed care revenues are significantly more likely to report higher levels of clinical freedom than are physicians with high managed care revenue (P < .05). Multivariate analyses demonstrate that, among our measures, traditional core professional values and autonomy are the most important determinants of career satisfaction after controlling for all other factors. Relative income is also an important independent predictor. Multiple dimensions of professional autonomy hold up as strong, independent predictors of career satisfaction, while the effect of managed care does not. Managed care appears to exert its effect on satisfaction through its impact on professional autonomy, not through income reduction. CONCLUSIONS: Our results suggest that when managed care (or other influences) erode professional autonomy, the result is a highly negative impact on physician career satisfaction.

Attitude of Health Personnel↗