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APHA Scientific Session and Event Listing

Andreas Muller, PhD, Department of Health Policy and Management, UAMS, Fay W. Boozman College of Public Health, 4301 West Markham, #820, Little Rock AR, AR 72205, 501-526-6645, amuller@uams.edu

Problem: Higher income is known to be associated with better health with income considered to be the driving force. However, the inability to work due to poor health also deserves attention since it is a conceivable contributor to the income health relationship. The purpose of the presentation is to determine how self-reported work disability affects the income-health relationship for working age persons.

Data: The March 2005 Supplement of the Current Population Survey asks respondents about their general health, work disability, family income and age among other items. Respondents' report their general health as either excellent, very good, good, fair, or poor. The scale is recoded into two broader classes (first 3 categories vs. remaining 2) to form the binary dependent variable. Family income is measured in reference to the poverty line and expressed in 6 classes ranging from below poverty line to more than 5 times of the poverty line. Work disability is determined by a “yes” or “no” response to the question: “Does … have a health problem or disability which prevents work or which limits the kind of work?” The analysis controls for age by several dummy variables representing 10-year age groups. The analysis sample consists of n=107,738 individuals between the ages of 25 and 65 responding to all survey items in March of 2005.

Method: Logistic regression models relate the log-odds ratio of good/poor health to 6 income classes, 4 age groups and 2 disability status groups. A model including age group, disability status, and family income as predictors provides a reasonable good fit to the observed data. For ease of interpretation, the maximum likelihood estimates are converted into proportions of respondents reporting “good health.”

Findings: (1) The proportion of respondents reporting “good health” increases with higher family income at a declining rate. (2) The strength of the family income-health relationship increases with increasing age for persons without work limitations (3) The family income health gradient is substantial for work disabled respondents at any age. All relationships are statistically significant due to the large sample size.

Conclusion: The substantial income health gradient observed for work disabled respondents and for older working age respondents suggests that higher family income has a health protective effect benefiting more vulnerable population groups.

Learning Objectives:

• 1. Identify reason for the non-linear appearance of the income health relationship
• 2. Identify reasons for the strengthening of the income health relationship with increasing age
• 3. Determine how work limitations modify the income health relationship in working age adults in the U.S.

Keywords: Social Inequalities, Poverty

Presenting author's disclosure statement:

Any relevant financial relationships? No