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PubMed2005

Race/ethnicity, income, major risk factors, and cardiovascular disease mortality.

OBJECTIVES: We explored differences between Black and White men for cardiovascular disease (CVD) mortality across major risk factor levels. METHODS: Major CVD risk factors were measured among 300,647 White and 20,223 Black men aged 35 to 57 years who were screened for the Multiple Risk Factor Intervention Trial (MRFIT). Hazard ratios for CVD deaths for Black and White men over 25 years of follow-up were calculated for subgroups stratified according to risk factor levels. RESULTS: CVD was responsible for 2518 deaths among Black men and 30,772 deaths among White men. The age-adjusted Black-to-White CVD hazard ratio was 1.35 (95% confidence interval [CI]=1.29, 1.40); the risk- and income-adjusted ratio was 1.05 (95% CI=1.01, 1.10). CVD mortality rates were dramatically lower in cases of favorable risk profiles. However, fully adjusted Black-to-White CVD hazard ratios within groups at low, intermediate, high, and very high levels of overall risk were 1.76, 1.20, 1.10, and 0.94, respectively. Similar gradients were evident for individual risk factors. CONCLUSIONS: Higher CVD mortality rates among Black men were largely mediated by risk factors and income. These data underscore the need for sustained primordial risk factor prevention among Black men.

Adult↗
PubMed1989

Barriers to implementation of a prenatal care program for low income women.

By the middle of the second year of the Michigan Prenatal/Postpartum Care (PPC) program to provide pregnancy-related services to low income women who were ineligible for Medicaid or other insurance, only 25 per cent of the participating health departments were enrolling greater than 90 per cent of contracted potential clients. Using a survey of program directors and relevant state documents, we identified several barriers to successful implementation: institutional (program complexity, high levels of administrative concerns along with low levels of communication between local health departments and providers); economic (inadequate resources for provider reimbursement, outreach, transportation, high-risk pregnancies, or administrative overhead); psychological (servicing populations with multiple and hard to care for problems, potential discomfort of low income women with traditional providers); and informational (insufficient information about the program infiltrating the target community).

Female↗
PubMed1990

City directories as sources for survey work in low- and middle-income black communities.

Commercial directories and governmental lists of dwelling units in low income urban Black communities in four eastern cities were evaluated for completeness. With rare exceptions, less than 90 percent of dwelling units were included in any one list and no list adequately identified multiple dwelling unit structures. Since household income is likely to be lower among households in such structures, all lists tend to miss the very poor, i.e., those who may be at highest health risk.

Black or African American↗
PubMed1992

Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease.

BACKGROUND: Socioeconomic status (SES) is usually measured by determining education, income, occupation, or a composite of these dimensions. Although education is the most commonly used measure of SES in epidemiological studies, no investigators in the United States have conducted an empirical analysis quantifying the relative impact of each separate dimension of SES on risk factors for disease. METHODS: Using data on 2380 participants from the Stanford Five-City Project (85% White, non-Hispanic), we examined the independent contribution of education, income, and occupation to a set of cardiovascular disease risk factors (cigarette smoking, systolic and diastolic blood pressure, and total and high-density lipoprotein cholesterol). RESULTS: The relationship between these SES measures and risk factors was strongest and most consistent for education, showing higher risk associated with lower levels of education. Using a forward selection model that allowed for inclusion of all three SES measures after adjustment for age and time of survey, education was the only measure that was significantly associated with the risk factors (P less than .05). CONCLUSION: If economics or time dictate that a single parameter of SES be chosen and if the research hypothesis does not dictate otherwise, higher education may be the best SES predictor of good health.

Adult↗
PubMed1994

High temporal, geographic, and income variation in body mass index among adults in Brazil.

OBJECTIVES: Population-based data on body mass index for developing countries are scarce. Body mass index data from two Brazilian surveys were examined to determine regional and temporal variations in the prevalences of underweight, overweight, and obesity. METHODS: Nationwide surveys in 1974/75 and 1989 collected anthropometric data in Brazil from 55,000 and 14,455 households, respectively. Trained interviewers used the same methods to measure weight and stature in both surveys, and survey designs were identical. Prevalences of underweight, overweight, and obesity were determined for persons 18 years of age and older. RESULTS: In the 1989 survey, body mass index varied greatly according to region of the country, urbanization, and income. In the wealthier South, the prevalence of overweight/obesity was the highest and the prevalence of underweight was the lowest; in the poorer rural Northeast, these patterns were reversed. For both surveys, overweight/obesity was more common among women than among men and peaked at age 45 to 64 years in both sexes. Over the 15 years between surveys, the prevalence of both overweight and obesity increased strikingly. CONCLUSIONS: In contrast to findings in developed countries, obesity in Brazil was positively associated with income and was much more prevalent among women than among men. For Brazilian women, the overall prevalence of overweight was nearly as high as that among women in the United States.

Adult↗
PubMed2003

Parent's socioeconomic status, adolescents' disposable income, and adolescents' smoking status in Massachusetts.

OBJECTIVES: This study examined the association between parental socioeconomic status (SES) and adolescent smoking. METHODS: We conducted telephone interviews with a probability sample of 1308 Massachusetts adolescents aged 12 to 17 years. We used multiple-variable-adjusted logistic regression models. RESULTS: The risk of adolescent smoking increased by 28% with each step down in parental education and increased by 30% for each step down in parental household income. These associations persisted after adjustment for age, sex, race/ethnicity, and adolescent disposable income. Parental smoking status was a mediator of these associations. CONCLUSIONS: Parental SES is inversely associated with adolescent smoking. Parental smoking is a mediator but does not fully explain the association.

Adolescent↗
PubMed2004

Implications of family income dynamics for women's depressive symptoms during the first 3 years after childbirth.

OBJECTIVES: We examined within-person associations between changes in family income and women's depressive symptoms during the first 3 years after childbirth. METHODS: Data were analyzed for 1351 women (mean baseline age = 28.13 years) who participated in the National Institute of Child Health and Human Development Study of Early Child Care. Nineteen percent of these women belonged to an ethnic minority, and 35% were poor at some time during the study. RESULTS: Changes in income and poverty status were significantly associated with changes in depressive symptoms. Effects were greatest for chronically poor women and for women who perceived fewer costs associated with their employment. CONCLUSIONS: Given that women head most poor households in the United States, our findings indicate that reductions in poverty would have mental health benefits for women and families.

Adult↗
PubMed1976

Implementing an income strategy for the elderly: studies in organizational change.

The organizational dimensions of the shift in aging policy from a services strategy to an income strategy are examined. With data from the first year of a longitudinal study of the impact of the new Supplemental Security Income program in the United States, hypotheses about the local-level effect of federally mandated changes in the relationships between organizations and in the adaptation of focal organization staff are tested. Domain consensus, differential prestige and complementarity of function are identified as important factors in the implementation of change.

Aged↗
PubMedDate not supplied

The relative effects of health and income on life satisfaction.

The relative effects of health and income on life satisfaction were analyzed using data collected in three recent national surveys. Financial situation was a slightly stronger predictor of life satisfaction for persons under age sixty-five, whereas health condition had a stronger impact on the life satisfaction of persons over age sixty-four. An attempt was made to quantify the relative impact of health and income on life satisfaction through an analysis of conjoint influence with contingency tables.

Adult↗
PubMedDate not supplied

Effects of health and income on control orientation and life satisfaction among aged public housing residents.

Researchers have recently begun to focus to a greater degree on personality factors in old age. One such factor is locus of control. This investigation examines the relationship between life satisfaction and locus of control within the context of health and income, two variables that pervade numerous aspects of the older person's life. The data are derived from a randomly selected sample of people sixty-five years of age and older residing in high-rise public housing complexes (N = 74). The findings of the investigation are consistent with most of the previous research, which had shown internal locus of control and higher life satisfaction to be significantly associated. This association remained stable and significant when controlling on the effects of self-rated health and income, suggesting that internal control is related to life satisfaction independent of health level or monetary resources.

Aged↗
PubMed1996

Social class and behavior: simultaneous class positions yield different amounts of income.

We used data from the Panel Study of Income Dynamics to present preliminary findings on the social class behavior of the poor and general populations in the USA. Analysis supported the potion that individuals are engaged simultaneously in multiple class positions, e.g. self-employed and welfare recipient, that yield different amounts of income. Moreover, no single label or explanation, e.g., "underclass" of "the poor are marginal to the economy," seems appropriate to describe the complexity or the economic behavior of poor individuals.

Hierarchy, Social↗
PubMed1987

Predictors of 2.5-year outcome in opioid addicts: pretreatment source of income.

A recent 6-month follow-up of methadone maintenance (MM) suggested that addicts supported by public assistance before seeking MM have a globally poor prognosis compared to addicts supported by employment or illegal activities. We therefore examined 2.5-year outcome among addicts prognostically stratified by three major sources of pretreatment income: employment (n = 48), welfare (n = 46), and criminal activities (n = 57). Significant improvements in substance abuse, family, legal, and psychological problems were reported by all three groups. Furthermore, the welfare group showed the most improvement in medical status and on the Social Adjustment, Maudsley neuroticism, and Beck Depression scales. Thus, the welfare patients did not appear to have a globally poorer prognosis, although they showed the least improvement in employment and legal problems. To examine whether welfare patients on MM had no more than "expected" improvement in legal and employment problems, patients treated with MM (n = 83) were compared to those getting only detoxification (DT) (n = 40). Welfare patients showed no more improvement in these two areas from MM treatment than from DT alone, while at follow-up the "employed" and "criminal" groups had substantially less illegal income and unemployment with MM than with DT alone. Thus, welfare patients may do relatively poorly in some areas when treated on MM.

Adult↗
PubMed1993

Alcohol, tobacco, and father's aggressive behavior in relation to socioeconomic variables in Cretan low versus medium income families.

In order to identify socioeconomic factors affecting parents' alcohol and cigarette consumption and father's aggressiveness toward other family members, 87 low-income and 92 medium-income Greek families were tested. Father's alcohol consumption correlated positively with his smoking (p < .0008) and aggressive behavior (p < .00005), while mother's alcohol correlated positively with her smoking (p < .0001) and number of marriages (p < .01), and negatively with the family's overcrowding index (p < .006). Furthermore, father's smoking correlated positively with his alcohol (p < .01), and mother's smoking with her alcohol (p < .0004) and tenancy (p < .01). Finally, father's aggressiveness was found to be positively related to his alcohol consumption and negatively to his work and level of education.

Adult↗
PubMed1994

Effects of calving season and milk yield on pregnancy risk and income in North Carolina Holstein cows.

Effects of season of calving and milk yield and their potential interaction on days from calving to last breeding were investigated using survival analysis and an economic model in 2000 Holstein cows that calved during 1989 and 1990. The final Cox proportional hazards model included lactation number, calving season, and herdmate deviation FCM. The interval from calving to last breeding ranged from 40 to 570 d. Compared with cows that calved in fall, cows that calved in summer were two-thirds as likely to become pregnant. Conversely, cows calving in winter or spring were more likely to become pregnant. Milk yields beyond approximately 8025 kg lowered the risk of pregnancy. The interaction of season and yield was nonsignificant, suggesting that these factors may act independently to affect reproduction. Lower pregnancy rates associated with high yield were detected earlier postpartum than were lower rates associated with calving in summer. Within each season, higher yield offset the lower income over feed costs associated with poorer reproductive performance. Nevertheless, summer calving lowered income over feed costs per cow per year by $98, $2, $176, and $68 for low, medium to low, medium to high, and high yielding cows, respectively.

Animal Feed↗
PubMed1998

Nutrition management, nitrogen efficiency, and income over feed cost on dairy farms in Costa Rica.

Twenty-two dairy farms in two ecologically different zones were visited repeatedly during the dry and wet seasons of 1995 to evaluate nutrition and pasture management, N efficiency on the farm, and income over feed costs with the use of a management support program. Excessive amounts of concentrates were fed, and no differences in amounts were detected between seasons. Utilization of forage was consequently low and even negligible on some farms. The amount of crude protein in the diet was generally too high. The removal of N from the farms via milk and culling represented 27 and 31% of the total N input for the two regions, respectively. The income over feed costs per cow ($3.04 and $1.84/d, respectively) was considered reasonable despite the high amount of concentrates.

Animal Feed↗
PubMed2003

Resilience and successful aging. Comparison among low and high income older adults.

1 Resilience, a personality characteristic that moderates the negative effects of stress and promotes adaptation, has been associated with better health in prior studies. 2 Successful aging can be defined as the enjoyment of health and vigor of the mind, body, and spirit into middle age and beyond. 3 Individuals with lower incomes may be less likely to achieve successful aging because of a higher prevalence of health risk factors. 4 Resilience appears to be positively and significantly associated with indicators of successful aging regardless of income.

Adaptation, Psychological↗
PubMed1999

Are low income countries targets of the tobacco industry? Plenary lecture given during the Conference on Global Lung Health and 1997 Annual Meeting of the International Union Against Tuberculosis and Lung Disease, Palais des Congrès, Paris, France, 1-4 October 1997.

Estimations show that tobacco consumption is steadily increasing in low income countries already deprived of basic human needs, such as adequate food and water supplies and education. Among the many factors affecting this, the most significant is the aggressive marketing strategies of the tobacco industry. The tobacco industry operates by denying health evidence, sponsoring scientific research that diverts attention to other fields, investing heavily in promotion and advertising, interfering with national public health laws, forming joint ventures with national monopolies, and persuading governments on the risks of smuggling. Turkey, a tobacco-growing country, opened its markets to the multinational tobacco industry after 1984. This paper presents examples of the marketing strategies used by the tobacco industry in the last two decades, and shows the consequences for Turkey in the hope that this information can help other low income countries that are not yet targets of the invasion of the tobacco industry.

Agriculture↗
PubMed1991

Income guarantee is hospitals' lure of choice.

Income guarantees are hospitals' lure of choice when trying to reel in physicians to their facilities. More than 90% of hospitals responding to a recent survey offer the income guarantees, which recruiters say physicians have grown to expect. Some 74% of the hospitals require physicians to repay the loan but will forgive the loan if the physician agrees to take on administrative or clinical duties at the hospital.

Data Collection↗