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PubMedDate not supplied

The upper part of the earnings distribution in the United States: how has it changed?

This article uses Social Security Administration data to examine changes in the upper end of the earnings distribution over the period 1982-1995. These data provide a unique opportunity for analyzing those changes because they come directly from W-2 forms and are not topcoded--obvious advantages over data typically provided by surveys such as the Current Population Survey. Although they do not provide some of the information necessary to explain what one observes occurring at the top of the earnings distribution (no educational attainment information, for example), these data are sufficient for describing in great detail what happened to high earners through the 1980s and into the 1990s. This analysis clearly demonstrates the extent to which earnings are concentrated at the top of the distribution. The study's findings reinforce those of Feenberg and Poterba (2000) by showing that the very highest earners--those in the upper 1 percent--experienced the largest relative increase in earnings share from 1982 to 1995. Even within that upper 1 percent, those with earnings in the upper 0.1 percent were the ones driving the increase in the group's earnings share. Perhaps not surprisingly, the overwhelming majority of the highest earners are white men who are in the middle to latter part of their working lives. Women have made strides toward entering this elite group of earners but still form a very small percentage of the group relative to their size in the working population. Very few blacks are in the extreme upper tail of the earnings distribution, and they have made very little progress (in absolute terms) over the period 1982-1995 in increasing their numbers. In contrast, persons of racial/ethnic backgrounds other than white or black have increased their presence among top earners. They went from being relatively underrepresented in the top 0.1 percent in 1982 to being overrepresented by 1995; that is, they accounted for a larger share of the top 0.1 percent of earners than they did of the entire working population. Finally, the study also finds that the percentage of overall wage and salary earnings from Social Security-covered employment that is not taxed for the purposes of Old-Age, Survivors, and Disability Insurance because of the taxable maximum generally increased over the 1982-1995 period. Wage and salary earnings above the taxable maximum rose at a faster rate than is the average wage.

Adolescent↗
PubMed2005

Collaboration between Oregon's chronic disease programs and Medicaid to decrease smoking among Medicaid-insured Oregonians with asthma.

BACKGROUND: Environmental tobacco smoke is a leading environmental asthma trigger and has been linked to the development of asthma in children and adults. Smoking cessation and reduced exposure to secondhand tobacco smoke are key components of asthma management. We describe a partnership involving two state agencies and 14 health plans; the goal of the partnership was to decrease smoking and exposure to environmental tobacco smoke among Medicaid-insured Oregonians with asthma. CONTEXT: Oregon's asthma rate is higher than that of the national population, and approximately one third of Oregonians with asthma smoke. The Health Promotion and Chronic Disease Prevention Program (HPCDP) in the Oregon Department of Human Services has collaborated with the Office of Medical Assistance Programs (OMAP) to promote preventive care at the population level. METHODS: Two HPCDP programs--the Oregon Asthma Program and the Oregon Tobacco Prevention and Education Program--worked with OMAP to launch the statewide Asthma-Tobacco Integration Project in 2003. A primary focus of the project is the development of partnerships among health plans, health care providers, and large health care organizations to integrate asthma management and smoking control through systems innovations and provider education. OMAP and its participating health plans also decided to focus cessation efforts on its members with chronic diseases. In addition, HPCDP has collaborated with OMAP to distribute educational tools and information about tobacco's impact on asthma morbidity to Oregon's health care providers who serve low-income Oregonians. CONSEQUENCES: The partnership between OMAP and HPCDP program staff members has allowed them to discuss problems, leverage resources, and obtain support for many public health initiatives. In addition, OMAP-HPCDP collaboration on educational workshops and outreach to health care providers has helped convince quality improvement specialists and administrators about the importance of addressing smoking among patients with asthma. The Asthma-Tobacco Integration Project has also led to formative research aimed at increasing community involvement in promoting tobacco-free environments. INTERPRETATION: Collaboration between HPCDP and OMAP has been an important factor in Oregon's successful smoking cessation efforts in general and in recent efforts to address tobacco use among Oregonians with asthma.

Adult↗
PubMed1990

Mortality in the hispanic population of Suffolk County, New York.

In the 1980 census, the "Spanish-origin" or "Hispanic" population of Suffolk County, New York (predominantly of Puerto Rican origin), had a lower median family income and a higher prevalence of poverty than the "all white" population of that county. Mortality among Hispanics, however, was not greater than expected on the basis of age-specific death rates for "all whites" in 1979-1983. The standardized mortality ratios for ischemic heart disease and all neoplasms were less than 1.00 for each sex, but were significantly elevated for diabetes mellitus in females and for both infectious diseases and homicides in males. Comparisons were made with mortality patterns in other American Hispanic populations predominantly of Puerto Rican origin, but with lower income levels (including those from New York City), and with data from Puerto Rico. The limitations of routinely reported mortality data are discussed, along with the value of such data in suggesting leads for more in-depth studies.

Adolescent↗
PubMed1985

[Topography and hydrodynamic heterogeneity in the terminal bed of the vessels of the gastrocnemius muscle of the cat].

The cine-TV technique acided to reconstruct the in vivo pattern of the vascular bed surface in the m. gastrocnemius of anesthetized cats. Existence of microvascular elements (modules) was confirmed as regularly repeated every 400-500 mus along the muscular fibers. A module includes transversal (oblique) precapillary arteriole and postcapillary venule interconnected with 3-12 parallel capillaries. Mean blood velocity in the capillaries was initially 0.73 +/- 0.12 mm/sec and during postelongation hyperemia it was 0.91 +/- 0.13 mm/sec, the velocity being slower in distal capillaries. This diversity was reduced in postelongation hyperemia. Mathematical modelling of blood flow distribution over different types of modules showed the blood flow velocity in the capillaries to depend on the ratio: total resistance of incoming and outgoing vessels against the resistance of the capillary part. Along with diminishing of the ratio, the diversity of perfusion must also diminish which has been corroborated in the course of experiments.

Animals↗
PubMed2001

Supporting the habit: income generation activities of frequent crack users compared with frequent users of other hard drugs.

US Federal sentencing guidelines punish possession of crack cocaine very differently from powder cocaine, based partially upon the assumption that crack users engage more frequently in criminal behavior to pay for their habit. This article analyzed frequent users (those who have used at least 15 of the last 30 days) of crack with subgroups of less frequent hard drug users in terms of various income generation activities reported during the past 30 days. The sample consists of 602 African-Americans who were current (in past 30 days) users or sellers of cocaine powder, crack, and heroin. They were carefully recruited from randomly selected blocks in the Central Harlem area of New York City and interviewed extensively in 1998-1999. Their IGAs were classified into six categories. Compared with not-frequent (less than 15 days) hard drug users, frequent crack and multiple hard drug users were equally likely to be involved in drug distribution activities, but were significantly less likely to have full-time jobs, part-time jobs, aid to families with dependent children or welfare support. They had much higher odds ratios for non-drug related illegal (theft mainly) income generation activities and sex work among women. Often, gender and birth cohort variables had higher odds ratios with specific income generation activities than the frequent use of the primary drug(s). This evidence suggests that very frequent crack users have been stigmatized by, are largely excluded from, and perform very marginal economic roles in the legal economic system (jobs and welfare), the illegal economic system, and even in the hard drug distribution system.

Adult↗
PubMed2000

Managed care, deficit financing, and aggregate health care expenditure in the United States: a cointegration analysis.

We applied a battery of cointegration tests comprising those of Johansen and Juselius [19], Phillips and Hansen [35], and Engle and Granger [6], to model aggregate health care expenditure using 1960-96 US data. The existence of a stable long-run economic relationship or cointegration is confirmed, in the United States, between aggregate health care expenditure and real GDP, population age distribution, managed care enrollment, number of practicing physicians, and government deficits. The evidence of cointegration among these variables, chosen on the theoretical basis of prior studies, implies that while they are individually non-stationary in levels, together they are highly correlated and move, in the long run to form an economic equilibrium relationship of US aggregate health care expenditure. More specifically, and for the first time in this line of inquiry, (i) managed care enrollment is found to be negatively associated with the level of health care spending, (ii) supply disinduced demand effects of physicians tend to moderate health expenditure, and (iii) government deficit financing is positively related to health care spending. The observed sign and magnitude of the income coefficient are consistent with health care being a luxury good.

Age Distribution↗
PubMed2006

Socio-demographic influences on food purchasing among Canadian households.

OBJECTIVE: To characterize the relationships between selected socio-demographic factors and food selection among Canadian households. DESIGN: A secondary analysis of data from the 1996 Family Food Expenditure survey was conducted (n=10,924). Household food purchases were classified into one of the five food groups from Canada's Food Guide to Healthy Eating. Parametric and non-parametric modelling techniques were employed to analyse the effects of household size, composition, income and education on the proportion of income spent on each food group and the quantity purchased from each food group. RESULTS: Household size, composition, income and education together explained 21-29% of the variation in food purchasing. Households with older adults spent a greater share of their income on vegetables and fruit (P<0.0001), whereas households with children purchased greater quantities of milk products (P<0.0001). Higher income was associated with purchasing more of all food groups (P<0.0001), but the associations were nonlinear, with the strongest effects at lower income levels. Households where the reference person had a university degree purchased significantly more vegetables and fruit, and less meat and alternatives and 'other' foods (P<0.0001), relative to households with the lowest education level. CONCLUSIONS: Household socio-demographic characteristics have a strong influence on food purchasing, with the purchase of vegetables and fruit being particularly sensitive. Results reinforce concerns about constraints on food purchasing among lower income households. Furthermore, the differential effects of income and education on food choice need to be considered in the design of public health interventions aimed at altering dietary behaviour.

Adolescent↗
PubMed2004

Effect of prolonged birth spacing on maternal and perinatal outcome.

BACKGROUND: Researchers have held varied opinions on the effect of prolonged birth spacing on maternal and perinatal outcome. OBJECTIVES: To determine the reasons for prolonged birth spacing and to compare the maternal and perinatal outcome compared to shorter normal birth spacing. DESIGN: Comparative case - controlled study between January 1st, 2001 to December 31st, 2002. SETTING: Obstetric Unit of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. SUBJECTS: Fifty cases consisted of multiparae with prolonged birth spacing (> or =6 years) and controls consists of similar number of multiparae with shorter normal birth spacing (2 - 5 years) matched for age, parity and socio-economic status. MAIN OUTCOME MEASURES: Labour outcome, Apgar scores, operative and vaginal delivery rates, perinatal and maternal outcome, reasons for prolonged birth spacing. RESULTS: There was no significant difference observed with respect to spontaneous onset of labour, induction or argumentation of labour, duration of labour, spontaneous vaginal delivery rates, Caesarean section rates, instrumental vaginal deliveries, analgesic requirement, postpartum haemorrhage, and Apgar scores in both groups. There were no perinatal or maternal deaths. The commonest reason adduced for prolonged birth spacing is failed contraception (56%), followed by secondary infertility (24%) and to a lesser extent re-marriage, improved income and sheer desire. CONCLUSION: There was no significant difference in maternal and perinatal outcome in pregnancy between women with prolonged birth spacing and those with normal shorter birth spacing.

Adult↗
PubMed2001

High body mass index does not predict mortality in older people: analysis of the Longitudinal Study of Aging.

OBJECTIVE: To determine the excess mortality associated with obesity (defined by body mass index (BMI)) in older people, with and without adjustment for other risk factors associated with mortality and for demographic factors. DESIGN: Retrospective cohort analysis of the Longitudinal Study of Aging (LSOA). SETTING: Nationally representative sample of community-dwelling older people. PARTICIPANTS: Seven thousand five hundred and twenty-seven participants age 70 and older in 1984. MEASUREMENTS: We used Cox regression to calculate proportional hazards ratios for mortality over 96 months. We tested the hypothesis that increased BMI (top 15%) increased mortality rates in older people. RESULTS: Death occurred in 38% of the cohort: 54% of the thin (lowest 10% of the population, BMI <19.4 kg/m(2)), 33% of the obese (highest 15%, BMI> 28.5 kg/m(2)), and 37% of the remaining participants (normal) died. Adjustment for demographic factors, health services utilization, and functional status still demonstrated reduced mortality in obese older people (hazard ratio 0.86, 95% confidence interval (CI) = 0.77-0.97) compared with normal. After adjustment, thin older people remained more likely to die (hazard ratio 1.46, 95% CI = 1.30-1.64) than normal older people. Sensitivity analyses for income, mortality during the first two years of follow-up, and medical comorbidities did not substantively alter the conclusions. CONCLUSION: Obesity may be protective compared with thinness or normal weight in older community-dwelling Americans.

Activities of Daily Living↗
PubMedDate not supplied

[Effect of the primary structure of RNA on the pulse character of RNA elongation in vitro by Escherichia coli RNA polymerase: a model].

The elongation rate of RNAs synthesized from AI promoters of T7 phage DNA and its deletion mutant delta DIII T7 DNA by E. coli RNA polymerase was analyzed. The distribution of incorporation rates of any definite nucleotides at any definite position along the two RNA chains was studied. The minimal structure which reproducibly forms pauses seems to be trinucleotide. Two main groups of trinucleotides could be distinguished: 1) those mostly associated with pauses and; 2) those usually found in pause free regions. The first group consists of AUG, AUA, AUC, AAU, GUG, GUA, CGU, CGC, UUA, UUU; the second one comprises AAA, CAA, CCC, UCC, CUA, CUG, CUC, GGG, ACU, GAG, GAA, GGA. A model accounting for intermittent elongation has been developed. It is based on the hypothesis that the kinetic constants of each nucleotide incorporation to and pyrophosphorolysis from the 3'-end of the growing RNA chain depend on the nature of the incoming nucleotide as well as on the nature of a nucleotide residue situated at the 3'-end of the growing RNA. A general equation describing the pause distribution along the RNA of a known nucleotide sequence is proposed.

Base Sequence↗
PubMedDate not supplied

Optimal power deposition in hyperthermia. I. The treatment goal: the ideal temperature distribution: the role of large blood vessels.

Improved hyperthermia heating systems that have flexibility in their deposition patterns are becoming available commercially, and even more flexible systems are being developed in research laboratories. To best use these devices one must determine how to deposit the power optimally, for which one needs a clear thermal treatment goal including an ideal temperature distribution. This paper presents definitions for these quantities, and theoretically investigates the relative effects of thermal conduction and blood convection cooling on them. It is shown that both cooling mechanisms can be important clinically, and that the presence of 'large' blood vessels can have a major impact on the optimal power deposition patterns. In particular, an ideal heating system would deposit enough power both outside the treatment volume in order to preheat the incoming blood to the desired treatment temperature, and at the treatment volume boundary in order to overcome thermal conduction effects. The degree to which any heating system can approach the ideal temperature distribution is shown to be strongly influenced by the size and shape of its power deposition field, i.e. its conformability, or ability to conform to the boundary of the desired treatment volume.

Animals↗
PubMedDate not supplied

A simulation model to estimate a distribution of lipid intake from breast milk during the first year of life.

This article brings together data on the proportion of mothers who breastfed their newborn infants, the duration of breastfeeding, infants' intake of breast milk, and the lipid content of breast milk, and presents a simulation model that estimates a distribution of lipid intake from breast milk during the first year of life. The simulation results may be translated into two assumptions useful for public health risk assessments. First, at any given time, approximately 22% of infants under one year are being breastfed; the remaining 78% have no exposure to chemicals via their mothers' breast milk. Second, lipid intake for the nursing infants may be characterized by a normal distribution with a mean of 26.81 g/day and a standard deviation of 7.39 g/day. In combination with measured or estimated concentrations of chemicals in the fat of breast milk, this distribution is suitable for estimating nursing infants' exposures to lipophilic chemicals. These results are based on data for probability and duration of breastfeeding which were standardized to the United States population, and on data for lipid intake from a sample of white, middle- to upper-income, highly educated women living in or near Davis, California.

Breast Feeding↗
PubMed2005

Comparative psychosocial analysis of patients on maintenance hemodialysis and transplanted patients.

OBJECTIVE: Many previous studies have shown that renal transplantation is associated with superior psychosocial rehabilitation than patients on dialysis. Our objective was to test if the same findings apply in Saudi patients. PATIENTS AND METHODS: Questionnaires probing demographic data, income, mental status, literacy and unemployment rates, family support, home ownership, satisfaction with previous transplantation and views and preferences about different types of transplantation were distributed to transplanted patients (n= 150) and patients on maintenance hemodialysis (HD) (n=210) at the Jeddah Kidney Center, King Fahd Hospital, Jeddah, Saudi Arabia. Illiterate patients were helped in completing the questionnaires by the social worker. RESULTS: We found that the male to female ratio in the transplanted group was 1.7:1 whereas it was 1:1 in the HD group. It was also found that more people in the transplant group owned houses than in the HD group (52% vs. 36.7%). Twice as many transplanted patients earned more than 7000 Saudi Riyals monthly. The unemployment rates were equal in the two groups (25-26%). Interestingly, the rate of illiteracy in the transplant group was almost half the rate in the HD group. More transplanted patients were assessed as being mentally balanced and, rational (92%) as compared to 66.2% in the HD group. Gratifyingly, however, both groups reported solid family support in the majority of patients (>80%). Of particular interest was the finding that well over one third (37%) of the patients on dialysis preferred to have live-unrelated transplants. This is far higher than those wishing for live-related (16.7%) or cadaveric (17.1%). CONCLUSION: Many of our findings coincide with what has been reported earlier. More patients with higher income were transplanted and there was no detected improvement in the employment rate associated with transplantation. Moreover, the vast majority of patients (92.7%) had no objection to receiving a living unrelated kidney and, in fact, as many as 37.6% actually felt preference for a living unrelated kidney over other types of transplantations.

Adult↗
PubMed1994

The body mass index of Chinese adults in the 1980s.

Patterns and trends in the body composition of Chinese adults are studied with data from the 1982 China Nationwide Nutrition Survey (CNS-82) and the 1989 China Health and Nutrition Survey (CHNS-89). The CNS-82 showed rural inhabitants were approximately 3 kg lighter than urban residents and approximately 2.2 cm shorter. Males were heavier (55.2 +/- 7.4 vs 50.7 +/- 8.0 kg) and taller (165.3 +/- 7.3 and 153.5 +/- 6.3 cm). Using a cut-off for underweight of a body mass index (BMI: kg/m2) < 18.5 and for obesity of > 25, 11.6% and 12.9% of the urban and rural sample were underweight and 9.8% and 6.9% respectively were overweight. The CHNS-89 surveyed 5138 adults aged 20-45 in eight selected provinces. The proportion of underweight in both urban and rural samples declined slightly (approximately 1.3%) but the proportion of obesity increased considerably (4.8% for the urban sample and 2% for the rural one). Increased income was significantly associated with reduced low body mass index (BMI: kg/m2) in the urban sample while, for the rural and overall samples, the opposite was found for obesity. Provincial patterns in energy intake were not associated with the distribution of BMI while occupation was. In particular, government officials and housewives were much more likely to be obese as also were subpopulation groups consuming greater proportions of energy from animal sources. Over 80% of the population fell in the normal BMI range (18.5-25). This may relate to the relatively even distribution of food in China during the past several decades.

Adult↗
PubMed2004

Education and the changing shape of the income gradient in health.

Research on the social determinants of health has increasingly sought to understand the relative importance of different features of socioeconomic status. Much of the ensuing debate has wavered between education and income, with recent research leaning increasingly toward income. This research has not, however, consistently explored interactions between different features of socioeconomic status and, in trying to understand the independent effects of different components of socioeconomic status, may have missed important features of socioeconomic position. With an eye toward examining how features of socioeconomic status combine and coalesce, this paper examines variation in the income-health association by level of education. Theories derived both from medical sociology and health economics suggest synergistic interactions between income and education, but they are unclear as to the direction and magnitude of these interactions. Results from two large and nationally representative data sets (the 1996-1997 Community Tracking Study and the 1972-2000 General Social Survey) indicate that the positive relationship between income and health varies substantially in both its strength and shape by level of education. Education improves health, and its effects are larger at lower levels of income. Moreover, education reduces the strength and curvature of the income-health relationship. Consequently, those with more education have better health for all levels of income, and fewer income-based disparities exist among the well educated than among the less well educated. The linear "gradient" relationship between income and health is, thus, more characteristic of groups with higher levels of education. Additional analyses indicate that these interactions existed in the United States in each of the last three decades. The results are discussed in light of theory regarding the perpetuation of health disparities, as well as current debates regarding the apparent incompatibility of distributive versus aggregative goals in health policy.

Adolescent↗
PubMed2004

The effect of the Family Case Management Program on 1996 birth outcomes in Illinois.

OBJECTIVES: The purpose of this study was to determine if birth outcomes for Medicaid recipients were improved with participation in the Illinois Family Case Management Program. METHODS: Health program data files were linked with the 1996 Illinois Vital Records linked birth-death certificate file. Logistic regression was used to characterize the variation in birth outcomes as a function of Family Case Management participation while statistically controlling for measurable factors found to be confounders. RESULTS: Results of the logistic regression analysis show that women who participated in the Family Care Management Program were significantly less likely to give birth to very low birth weight infants (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.75, 0.99) and low birth weight infants (OR = 0.83, CI = 0.79, 0.89). For infant mortality, however, the adjusted OR (OR = 0.98, CI = 0.82, 1.17), although under 1, was not statistically significant. CONCLUSIONS: These results suggest that the Family Case Management Program may be effective in reducing very low birth weight and low birth weight rates among infants born to low-income women.

Adult↗
PubMed1985

Sample attrition and multivariate analysis in the Retirement History Study.

The attrition of respondents in panel studies of older people can create bias in data analysis. Changes in the examination of attrition are suggested. Bivariate and multivariate tests comparing those eligible to respond and those actually continuing in the panel are reported for five waves of data from the Retirement History Study. The results indicate that variable relationships in the data examined are relatively free of the bias that can be created by respondent attrition. Thus, attrition from samples of older respondents probably is less of a factor than suggested by previous studies reporting on frequency distributions.

Aging↗
PubMed2003

Willingness to participate in clinical treatment research among older African Americans and Whites.

PURPOSE: Using a health services utilization conceptual framework, the purpose of this analysis was to examine race differences in factors predictive of the behavioral intention of older persons to participate in a clinical treatment trial should they have a diagnosis of cancer. In addition, the analysis sought to determine if older African Americans were less likely than Whites to express willingness to participate, given knowledge of the Tuskegee syphilis study and greater fatalistic cancer beliefs. DESIGN AND METHODS: Data were drawn from a community-based telephone survey of 216 African Americans and 222 Whites, 50 years of age and older. RESULTS: Findings show that willingness to participate was significantly higher among males, persons of younger age, higher incomes, and with nonfatalistic cancer beliefs. Race differences were only apparent for the two significant interactions of race with age and high income. Neither knowledge of the Tuskegee study nor fatalistic cancer beliefs were more important for African Americans than for Whites. IMPLICATIONS: Study findings suggest that recruitment strategies need to be tailored to racial differences in factors affecting willingness to participate, particularly those related to age and income level.

Black or African American↗