The Impact of Socioeconomic Factors on Health Disparities (original) (raw)
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Health Affairs, 2011
Health disparities by racial or ethnic group or by income or education are only partly explained by disparities in medical care. Inadequate education and living conditions-ranging from low income to the unhealthy characteristics of neighborhoods and communities-can harm health through complex pathways. Meaningful progress in narrowing health disparities is unlikely without addressing these root causes. Policies on education, child care, jobs, community and economic revitalization, housing, transportation, and land use bear on these root causes and have implications for health and medical spending. A shortsighted political focus on reducing spending in these areas could actually increase medical costs by magnifying disease burden and widening health disparities.
Socioeconomic Status and Health Disparity in the United States
Journal of Human Behavior in the Social Environment, 2007
Low socioeconomic status (SES) has been associated with high rates of many chronic diseases. This study was a cluster analysis of data from 9,830 adults in the 1994-96 Continuing Survey of Food Intakes by the Individuals (1994-96 CSFII) in order to characterize more fully the biologic and social factors that might be associated with
Impact of Income Inequality on the Nation's Health
Journal of the American College of Surgeons, 2016
Income inequality in the United States has been increasing in recent decades. It is unclear whether income inequality has an independent effect on health outcomes, or whether it simply correlates with increasing levels of poverty. The goal of this study was to evaluate whether income inequality is significantly associated with US county healthcare expenditures and healthcare utilization. Cross-sectional analysis of county health expenditure data from the Health Resources and Services Administration's Area Resources File, county income inequality measures (Gini coefficient) from the Census' American Community Survey, and estimates of potentially preventable admissions and potentially discretionary procedures from the Nationwide Inpatient Sample (1998-2011). Datasets were linked via county Federal Information Processing Standard (FIPS) codes. Multivariable linear and Poisson regression analyses were performed at the county level adjusting for county characteristics. 1,237 coun...
Health inequalities by class and race in the US: What can we learn from the patterns?
Social Science & Medicine, 2012
Social determinants of health Health determinants USA health disparities USA health inequality Class Race A classless society? Throughout most of the world, the term "health inequalities" generally refers to differences in health by social class, unless specified otherwise. In the United States, however, the most comparable term, "health disparities", has generally referred to differences in health by race or ethnic group. Historically, public health data in the U.S. have been reported by race and far less frequently by class, reflecting a deeply-rooted belief that we have an essentially classless society. That notion may seem preposterous to anyone familiar with the wide and widening economic inequalities within the US. Nevertheless, the belief that this is a classless society is pervasive. It reflects long-and deeply-held beliefs in the U.S. as "the land of opportunity," where hard work and ability almost always pay off, and, conversely, those who are unsuccessful must not have worked hard or been smart enough. Inadequate consideration of socioeconomic factors is a massive obstacle to understanding the role of non-medical influences on health. Also, it reinforces scientifically unfounded assumptions about the role of genetic differences in racial or ethnic disparities in health, a convenient justification for accepting racial disparities in health, wealth, and well-being as inevitable. The patterning of health by race/ethnicity and class in the U.S Large and persistent racial or ethnic disparities in health in the U.S. have repeatedly been documented, with Blacks and American Indians generally having the worst, and Whites generally the best health; Latinos (particularly some subgroups) and some Asian subgroups also have worse health on some measures (The Office of Minority Health, 2010). Although less information on socioeconomic inequalities in health has been available routinely in the U.S. than in many other affluent countries, recent data have demonstrated that, as in Europe, health inequalities by class in the U.S. more often than not follow stepwise gradient patterns, with health improving incrementally with higher income or educational levels (the standard socioeconomic measures in the U.S.) (Braveman, Cubbin, Egerter, Williams, & Pamuk, 2010; Minkler, Fuller-Thomson, & Guralnik, 2006). Gradients are seen both overall and within racial or ethnic groups e often among non-Latino Whites and Blacks (hereafter: Whites and Blacks), and less consistently among Latinos. Striking gradients in self-rated adult health according to educational attainment have been observed within Blacks, Latinos, American Indians/Alaskan Natives, Native Hawaiians/Pacific Islanders, other Asians, and Whites, examining each racial/ethnic group separately (Braveman et al., 2010). The incremental socioeconomic gradients within multiple different racial/ethnic groups make it clear that socioeconomic inequalities cannot be reduced to racial/ethnic differences, although conflating class with race still
Public health reports (Washington, D.C. : 1974)
To evaluate the potential for and obstacles to routine monitoring of socioeconomic inequalities in health using U.S. vital statistics and disease registry data, the authors surveyed current data collection and reporting practices for specific socioeconomic variables. In 1996 the authors mailed a self-administered survey to all of the 55 health department vital statistics offices reporting data to the National Center for Health Statistics (NCHS) to determine what kinds of socioeconomic data they collected on birth and death certificates and in cancer, AIDS, and tuberculosis (TB) registries and what kinds of socioeconomic data were routinely reported in health department publications. Health departments routinely obtained data on occupation on death certificates and in most cancer registries. They collected data on educational level for both birth and death certificates. None of the databases collected information on income, and few obtained data on employment status, health insurance...
Socioeconomic Determinants of Healthcare Quality and Outcomes in U . S . States
2018
As healthcare becomes a more fundamental and increasingly discussed political issue, healthcare quality lies at the foundation of creating an ideal healthcare system. What socioeconomic factors influence the quality of healthcare and efficacy of treatments in U.S. states? This paper uses a linear regression in an attempt to uncover determinants of a lower colorectal cancer mortality rate and improved healthcare outcomes in U.S. states from 2004 and 2014. Our regression results indicate that, contrary to this paper’s hypothesis, the uninsured rate and real GDP per capita were not statistically significant indicators of colorectal cancer mortality and healthcare outcomes. Despite this, the results support the hypothesis that both higher educational attainment and a higher urban share of counties would be associated with a lower colorectal cancer mortality rate, ultimately concurring with the findings of the studies by Ross et al. (1995) and Aboagye et al. (2014) cited within this pape...
Summarizing Social Disparities in Health
Milbank Quarterly, 2013
Reporting on health disparities is fundamental for meeting the goal of reducing health disparities. One often overlooked challenge is determining the best way to report those disparities associated with multiple attributes such as income, education, sex, and race/ethnicity. This article proposes an analytical approach to summarizing social disparities in health, and we demonstrate its empirical application by comparing the degrees and patterns of health disparities in all fifty states and the District of Columbia (DC).
MPRA Paper, 2007
Using self-assessed health status together with several indicators of individual morbidity and socio-demographic characteristics, we study the quality of health and income related health disparity in five racial/ethnic groups as well as across 17 geographic areas of New York State. The American Indian/Alaskan Natives and Hispanics are found to do the worst, whereas, geographically, the North Country in Upstate New York and Bronx County in Downstate score the worst on both counts. Three major contributing factors to income related health disparity are found to be household income, employment status, and education. However, the contribution of each of these determinants varies significantly among racial/ethnic groups as well as across geographic areas, suggesting targeted public policy initiatives to eliminate health disparity between rich and poor. are gratefully acknowledged. We, however, are responsible for all remaining errors and omissions.
Socioeconomic Indicators That Matter for Population Health
2010
Increasing research and policy attention is being given to how the socioeconomic environment influences health. This article discusses potential indicators or metrics regarding the socioeconomic environment that could play a role in an incentive-based system for population health. Given the state of the research regarding the influence of socioeconomic contextual variables on health outcomes, the state of data and metrics for these variables at the local level, and the potential for program and policy intervention, we recommend a set of metrics related to the socioeconomic composition of a community (including poverty, unemployment, and public assistance rates); educational attainment and achievement; racial segregation; and social-capital indicators such as density of voluntary organizations and voter turnout. These indicators reflect the evidence that population health gains depend on improvements in many of the fundamental social determinants of health, including meaningful employment, income security, educational opportunities, and engaged, active communities.