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PubMed1992

Child survival and health care among low-income African-American families in the United States.

This paper provides an assessment and analysis of the increasing rates of mortality among the children of low-income African-American families in the United States and the intensifying problem of improper health care that seems to have given rise to it. The paper first documents the nature and determinants of the problem and then addresses the issue of policy prescriptions for eradicating the dilemma. The primary problem underlying the health-care access of low-income African-Americans is that there is neither a system of universal entitlement that ties their health care in with the rest of the population nor an explicit and comprehensive strategy for care outside the dominant private system.

Adult↗

PubMedDate not supplied

Developing an income distribution methodology for cardiovascular physician groups and networks.

Developing an income-distribution model that rewards physicians equitably and fairly for cost-effective patient care services provided, practice building efforts, and complying with practice guidelines and standards is an important step which all practices must take to align the payment-mechanism incentives with the physician income-distribution methodology. Recalibrating the compensation arrangement to the market requires open dialogue, the identification of shared values and convictions, and the development of compensation components that align compensation and payment incentives. Through the aligning of incentives, networks and group practices will be better positioned for changes in the market. As changes occur, compensation arrangements may have to be adjusted to ensure that payment-arrangement incentives are being rewarded and to ensure the network's or group's long-term profitability and viability.

Algorithms↗

PubMed1985

Cut income taxes with reorganization planning.

It is necessary to plan when reorganizing a corporate structure, to minimize taxes at the tax-exempt parent organization level and avoid unexpected tax consequences at year-end. With an awareness of the income tax rules, proper debt structuring during the reorganization phase is possible and should enable the financial manager to minimize total income tax.

Financial Management↗

PubMed1989

Medicaid program; targeting information for income and eligibility verification systems--HCFA.

This rule revises regulations text that is now obsolete because of section 9101 of the Omnibus Budget Reconciliation Act of 1986 (Pub. L. 99-509); this section allows State Medicaid Agencies flexibility to use selectively (target) certain information about a Medicaid recipient's income obtained through their income and eligibility verification systems (IEVS). In addition, this rule implements a congressional directive to revise the timeliness standards for use of IEVS information to grant States more time to obtain and use the data.

Centers for Medicare and Medicaid Services, U.S.↗

PubMed1976

Income group differences in relationships among survey measures of physical and mental health.

The present research tested the hypothesis that the experience of health is hierarchically organized such that gratification of physical health needs must precede gratification of mental health needs. It was reasoned that because the nondisadvantaged possess greater resources for the gratification of health needs in general, symptoms of mental illness would be more salient for this group and thus better able to explain variance in both mental and physical illness. On the other hand, it was reasoned that symptoms of physical illness would be more salient and thus better able to explain variance in both mental and physical illness for the disadvantaged. Results of the study indicate income group differences in patterns of relationships among health variables, supporting the hypothesis and suggesting important differences in the validity of health measures across income groups. The results are related to previous findings in medical sociology, and suggestions for future research are made.

Activities of Daily Living↗

PubMed1999

Retirement income security in the United Kingdom.

This article examines the U.K. retirement income security system from the American perspective. It addresses issues that most concern U.S. analysts: how the United Kingdom has kept its future public pension costs at a manageable level, the extent to which privatization of public pensions has contributed to low pension costs, the popular appeal of individual pension accounts, and the impact of privatization on retirement income. These issues are best understood in the context of the U.K. pension program's particular institutional structure and policies, two of which--"contracting out" of public pensions, and strong reliance on means-tested benefits--have been largely rejected in the evolution of U.S. policy to date. Particular use is made of recently available data on coverage rates for public and private pension programs over the total working population and administrative records on inactive personal pension accounts.

Contract Services↗

PubMed2000

Factors related to noncompliance with screening mammogram appointments among low-income African-American women.

Despite current mammography recommendations, screening rates among African-American women are suboptimal. The purpose of this case-control study was to identify the psychological, demographic, and health care system barriers to screening mammography use among low-income African-American women. A total of 574 women with screening mammogram appointments at an urban hospital were interviewed to determine the predictors of mammogram appointment noncompliance. Predictor variables included: demographics; breast cancer knowledge, attitudes, beliefs, and screening practices; and type of health care provider making the referral. Age was inversely related to mammogram appointment noncompliance. Relative to women 40 to 49 years old, women 70 years of age and older were the least likely to miss their appointments (odds ratio [OR], 0.3; 95% confidence interval [CI], 0.2, 0.5). Women referred for mammography by a physician's assistant or nurse practitioner were less likely to miss their appointments than women referred by a physician (OR, 0.3; 95% CI, 0.1, 0.8). Embarrassment, lack of breast symptoms, and forgetfulness also contributed to noncompliance. Key demographic, attitudinal, and health care system factors hinder low-income African-American women from obtaining screening mammograms. These findings have significant health education and policy implications for health care delivery to women in this population.

Adult↗

PubMed2000

Effects of parental marital status, income, and family functioning on African American adolescent self-esteem.

This study examined the effects of marital status, family income, and family functioning on African American adolescents' self-esteem. One hundred sixteen adolescents participated, 64% of whom were female. Compared with boys with nonmarried parents, boys with married parents had higher overall self-esteem, even when family income and family functioning were controlled. Parental marital status had no effect on girls' self-esteem. Family functioning was a very strong predictor of self-esteem for both sexes. However, family relational factors were more important to girls' self-esteem, whereas structural and growth factors were more important for boys. It was concluded that African American adolescent boys with nonmarried parents are at risk for developing low self-esteem compared with other African American adolescents, but a more controlled and structured environment may buffer the effects of having nonmarried parents.

Adolescent↗

PubMed1992

[Income, labor, and population reproduction].

"The interrelations between...income, labour stimuli and population reproduction in Bulgaria are analyzed. The change of consumer price rates and purchasing power are considered and their impact on...living conditions is estimated. The economic relation 'work--consumption--motivation' is studied in regard to its influence on the demographic processes. The conclusion is that the fall of the average per capita income in the country to the social minimum level creates acute social problems." The article concerns the period 1990-1991. (SUMMARY IN ENG AND RUS)

Bulgaria↗

PubMed1985

International migration, remittances and real incomes: effects on the source country.

"This article deals with the impact of remittances from emigrants on real incomes for different groups in their country of origin in a two-by-two model with one traded and one nontraded good. It is shown that emigration does not necessarily raise the real income of the emigrants themselves. If the traded good is capital intensive, nonmigrant workers gain and capitalists lose, whereas if it is labor intensive, the outcome depends on what happens to the price of the nontraded good. The result of a rise is that capitalists gain and workers lose, while a fall has the opposite effect."

Demography↗

PubMedDate not supplied

Differences in household characteristics by income distribution in Pakistan.

The authors examine household characteristics by income distribution in Pakistan using data from the 1979 Population, Labour Force and Migration (PLM) Survey. Tabular data, organized by measures of income and expenditure, are presented on average household size, dependency ratios, average number of children and average number of adults, proportion of female household members, labor force participation rates for various ages, and occupational status of heads of households. The authors conclude that "the findings for Pakistan generally are in consonance with those for other Third World countries and confirm that certain characteristics are associated with poverty." Comments by Karol J. Krotki are also included (pp. 668-9).

Adolescent↗

PubMed1990

Living arrangements of young adults living independently: evidence from the Luxembourg Income Study.

A cross-country comparison of the impact of socioeconomic factors on household formation by young adults in the 15-24 age group is presented. "Of those young people living independently (not in their parental homes), how do incomes from various sources affect their decision whether to live alone or with others? The sample did not include all persons in the 15-24 age group, only those living independently. A logit analysis of the living alone question was conducted using data from five countries (Canada, the Federal Republic of Germany, the United Kingdom, Australia, and the United States) included in the LIS [Luxembourg Income Study] data base to determine whether differences across countries exist."

Americas↗

PubMed2002

Can 401(k) accumulations generate significant income for future retirees?

This Issue Brief develops a model that project the proportion of an individual's preretirement income that might be replaced by 401(k) plan accumulations at retirement, under several different projected scenarios. The 401(k) participant behaviors in the model are based on the year-end 2000 database collected by the Employee Benefit Research Institute (EBRI) and the Investment Company Institute (ICI) in their collaborative effort known as the EBRI/ICI Participant-Directed Retirement Plan Data Collection Project. The most significant factor affecting projected replacement rates at retirement is having access to a 401(k) plan. Projected replacement rates from 401(k) accumulations at retirement are reduced significantly when participants are not offered a 401(k) plan in all portions of their careers. Most 401(k) participants tend to have contributions in any given year. Thus, projecting that participants always have contributions (their own and/or employer contributions) every year raises projected replacement rates, but not by much compared with the importance of being offered a plan to begin with. The model simulations show that participant activities such as taking loans, taking preretirement withdrawals, or cashing out account balances at job change reduce projected 401(k) accumulations and thus replacement rates at age 65. Because loans are forecast to be paid back to the account in full, their effect on replacement rates at retirement in the model is the smallest. Even if equity returns in the future are projected to replicate the worst 50-year segment in the Standard & Poor's (S&P) 500 history (1929 to 1978), 401(k) accumulations are still projected to replace significant proportions of projected preretirement income. Another projection scenario forecasts participants experiencing a simulated three-year bear market (negative equity returns) either early in their careers, near the middle of their careers, or at the end of their careers. Forecasts of the effects of bear markets on 401(k) balances show that a bear market in equities is projected to have the largest effect the closer it occurs to age 65 (retirement), even though older participants typically have diversified their portfolios away from equities. A three-year bear market for those early in their careers would reduce median replacement rates from 401(k) accumulations by an estimated 2.9-3.7 percentage points, compared with 13.4-17.7 percentage points for those immediately before retirement. Similarly, a simulated three-year bull market (positive equity returns) is projected to have a larger positive effect on projected account balances and replacement rates the closer it occurs to retirement.

Actuarial Analysis↗

PubMed2003

Is the DOTS strategy sufficient to achieve tuberculosis control in low- and middle-income countries? 1. Need for interventions in universities and medical schools.

Now that progress is gradually being made in the implementation of the DOTS strategy in low-income countries, we must take into account the fact that nearly 30% of all tuberculosis (TB) cases worldwide occur in middle-income countries, which usually have an adequate health infrastructure and sufficient economic resources for TB control. These countries nevertheless have other limitations that make it necessary to develop other aspects in addition to the DOTS strategy. These can be summarised in three main themes: 1) adequate coordination of all health structures involved in TB management, ensuring that they follow the basic norms of the National Tuberculosis Programme (NTP), 2) direct intervention in universities and medical schools, which are ubiquitous in such countries, and 3) specific collaboration with specialists and physicians in private practice, an important obstacle to the success of NTPs in several countries. A detailed analysis is presented of strategies that need to be implemented in different countries depending on their economic resources and their TB situation. The need to carry out specific interventions in addition to training in DOTS in universities and medical schools in order to improve TB control is discussed. A specific project in this area developed by the IUATLD in Latin America is described.

Directly Observed Therapy↗

PubMedDate not supplied

Prosthodontic status among old adults in Pomerania, related to income, education level, and general health (results of the Study of Health in Pomerania, SHIP).

PURPOSE: The aim of the study was to evaluate associations among prosthetic status, socioeconomic factors, and general health of subjects aged 55 to 79 years. The data were taken from the Study of Health in Pomerania (SHIP). MATERIALS AND METHODS: Socioeconomic information (age, sex, education level), medical information (number of diseases), and details on smoking and alcohol consumption were obtained. Prosthetic status in the maxilla and mandible was classified into complete denture (CD), removable partial denture (RPD), > or = 10 natural teeth or teeth replaced with fixed prosthodontics (10T+), and < or = nine natural teeth including fixed prosthodontics (9T-). RESULTS: The data of 1,877 subjects were evaluated. CDs in the maxilla were more frequent than in the mandible. RPDs were more frequent in the mandible and in the group aged 65 to 74 years. Of the individuals with a low education level, 47% had a CD in the maxilla, and only 21% had 10T+. However, of subjects with a high education level, 22% had a CD in the maxilla, and 54% had 10T+. The odds ratio of having a CD in the maxilla increased to 11.9 at the age of 75 to 79 years, compared to 0.6 at the age of 55 to 59 years. Logistic regression analyses showed that the risk of wearing a CD was significantly associated with old age, low education level, low income, smoking, and alcohol abuse, whereas the number of diseases (used as an indicator of general health) was not. CONCLUSION: Alcohol abuse, smoking, low education level, low income, and old age were significant predictors of wearing CDs.

Age Factors↗

PubMedDate not supplied

[Evolution of adolescent fertility and its association with evolution of income in the Spanish provinces during the period 1975-1985].

BACKGROUND: Fertility rates in women under 21, during the period 1975-1985 in Spain, have analyzed, as well as their association with the evolution of the socioeconomic indicators in order to study the distribution and associated factors to adolescent maternity in our environment. METHODS: The fertility rates have been elaborated from the Official Demographic Statistics. The socioeconomic indicators have been obtained from the Statistics Year Book of the National Institute of Statistics and from other complementary sources. The method of weighted linear regression has been used to analyze the association between the indicators and the rates at the provincial level. RESULTS: The fertility rates have decreased a 16% in mothers from 15 to 19 years old in Spain, between 1975 and 1985. The highest accumulated rates belong to the Communities of Canarias (42.8 births by 1000 women of 15 to 19, Galicia (38.1) Murcia (33.7) and Andalucía (30.3). In the regression analysis, the income evolution shows an association with the fertility evolution in the group from 15 to 19 years old, and this association remains when we take into account unemployment, index of provincial development and birth rate, which allows to explain a 49% of the variance. Fertility of adolescent under 15 is only associated with the income evolution, with a determination coefficient of 0.29. CONCLUSIONS: Results indicate that early maternity has decreased in Spain, although there are geographical differences, which cam, in some measure, be related with social-economic factors.

Adolescent↗

PubMed1977

The survey of the low-income aged and disabled: an introduction.

As 1974 began, the Social Security Administration started distributing supplemental security income (SSI) payment checks to aged, blind, and disabled poor persons throughout the Nation. Shortly before the first SSI checks were issued, the Bureau of the Census completed personal interviews with 17,551 individuals from which SSI's clientele would be drawn--aged and disabled welfare recipients and the aged and disabled poor persons in the general population. These data, collected for the Social Security Administration is late 1973, and comparable information gathered from the same respondents in late 1974 make up the Survey of the Low-Income Aged and Disabled (SLIAD). Its findings will be used to describe the circumstances of needy aged and disabled persons before SSI, determine the program's success in attracting those who qualified for its benefits during the first year of operations, and assess the effect of participation on the well-being of recipients.

Aged↗

PubMed1992

Feathered nest/gilded cage: parental income and leaving home in the transition to adulthood.

The growing study of leaving home in young adulthood in the United States has been hampered by data and measurement problems, which are producing a major theoretical confusion about the role of parental resources in influencing young adults' leaving home. Does high parental income retain young adults in the home or subsidize their leaving (and parental privacy)? This paper uses the 1984 panel of Survey of Income and Program Participation to clarify this issue, and shows that the effects of parental resources differ depending on the route out of the home under consideration (marriage or premarital residential independence). Effects change substantially over the nest-leaving ages, but relatively few differences are found between young men and young women.

Adolescent↗