Higher Average Income Research Articles

Association between Medicaid expansion status and lung cancer screening exam growth: findings from the ACR lung cancer registry

PurposeTo determine if Medicaid expansion is associated with increased volumes of lung cancer screenings. MethodsA quasi-experimental study was performed to compare the annual growth rates in lung cancer screenings between states that expanded Medicaid (n = 31) versus those that did not (n = 17). Using the American College of Radiology Lung Cancer Screening Registry, we calculated the average annual growth rate between 2016 and 2019 for both groups. Secondary analyses between these two groups also included calculations of the percentages of studies considered appropriate by USPSTF criteria. ResultsNo significant difference was identified in the average annual growth in lung cancer screenings between Medicaid expanding and non-expanding states (57.6%, 50.3%, P = 0.51). No difference was observed in the percentage of studies considered appropriate (Medicaid expanding = 89.6%, non-expanding = 90.2%, P = 0.72). At baseline, there were socioeconomic differences between both groups of states. Medicaid expanding states had a more urban population (76.5% versus 67.9%, P = 0.05) and higher average incomes ($56,947, $49,876, P < 0.05). ConclusionNo association is found between Medicaid expansion and increasing volumes of lung cancer screening exams. Although no data is available in the registry for screening exams before the implementation of Medicaid expansion (2014), most nationwide estimates of lung screening rates report a low baseline (<5%). Furthermore, despite being advantaged in other ways, such as with a more urban population or with higher incomes, the Medicaid expansion cohort does not demonstrate a higher growth rate. These findings suggest Medicaid expansion alone will not increase lung cancer screenings.

Analysis of the Impact of the Existence of Tano Tubu Office on the Emergence of a New Community Business Sector

The aims of this study is to analysis the impact of existence of Tano Tubu Office on the Emergence of a New Community Business Sector. This study uses a descriptive method with a quantitative approach. The result shows that there is a difference between the average income of business people around the Tano Tubu Office in the period before the Tano Tubu office and after the Tano Tubu office. The average income in the period before the establishment of the Tano Tubu Office was Rp. 2,163,382.93, - , while the average value of income in the period after the establishment of Tano Tubu Office was Rp. 4,183,333.33 ,. The existence of Tano Tubu Offices has a positive impact on increasing the income of the business community around it. This is indicated by the higher average income in the period after the establishment of Tano Tubu Office compared to the average income in the period before the establishment of Tano Tubu Office.

How Waste Is Managed in Urban and Rural Areas: Evidence from China

Waste disposal method has long been one of the severe environmental problems in China. A few previous researches suggest that the waste disposal method may related to the awareness, education and the willingness of participation of people. However, an overview of the waste disposal of China from the community level is lacked. As a result, China Health and Retirement Longitudinal Study (CHARLS) is used in this research to show the correlation between waste disposal method demographical information. In the research, we find that communities/villages with denser population tend to adopt the cleaner waste disposal method. We also find that fundamental socioeconomic factors such as education and income are closely related to waste management. Communities/villages with higher average education level and higher average income are more likely to adopt a cleaner waste disposal method.

EQ-5D-5L Bulgarian population norms.

The present study aimed to provide normative data for the EQ-5D-5L questionnaire in Bulgaria, based on a nationally representative sample. Random sampling was used. In September 2018, a total of 1005 respondents (aged 18-89years) completed the self-administered paper-based EQ-5D-5L questionnaire, including a visual analogue scale (EQ VAS). Health state utility index scores were derived using the directly measured Polish value set. The study sample was representative of the general Bulgarian population in terms of age, sex, geographical region, educational level, social and professional status. Mean EQ-5D-5L and EQ VAS values decreased from 0.986 and 89.7 (age group 18-24years) to 0.789 and 53.6 (age group ≥ 75years), respectively. Perfect health (the "11,111" health state) was reported by half of the population (50.1%), more often by men than women (55.8% vs 44.9%). The most frequently reported complaints characterised pain/discomfort dimension (39.1%), followed by anxiety/depression (34.5%). Although the least commonly reported health limitations concerned the self-care dimension, their frequency (13.6%) was the highest among the seventeen identified EQ-5D-5L population norm studies. The mean severity index score for the whole study sample was 6.96. EQ-5D-5L index was higher in respondents from lower age groups and with a higher average income per household member. Bulgarian population norms, which were developed for the descriptive part of the EQ-5D-5L and EQ VAS, can be used as reference values. The availability of such normative data should encourage the use of the EQ-5D-5L questionnaire in health-related quality-of-life studies in Bulgaria.

Relationship between social inequality indicators and the spatial distribution of Zika Virus cases.

The aim of this article was to analyze the possible relationship between social inequality indicators and the spatial distribution of ZIKV cases in a state in Northeastern Brazil in 2015-16. This is an ecological study with the data of notified ZIKV cases and the sociodemographic indicators of Rio Grande do Norte state (RN), based on information from the State Public Health Department (SESAP-RN) and DATASUS. The data were analyzed in Terraview version 4.2.2, Geoda version 1.12 and IBM SPSS Statistics 21. Both the average incidence rate (AIR) of ZIKV cases in 2015-16 (Moran = 0.139; p= 0.03) and the AIR of violence (Moran= 0.295; p= 0.02), average household income (Moran= 0.344; p=0.01) and unemployment rate (Moran= 0.231; p=0.01) exhibited a geographic spatial distribution pattern. In multiple linear regression analysis, the variables AIR of violence and average household income explained 55% of the variation in the AIR of ZIKV in 2015-16 (adjusted R2 = 0.55). Municipalities with more notifications of violence and higher average income, such as the state capital, reported a higher number of ZIKV cases, possibly due to better organization, greater awareness of socioenvironmental problems and easier access to health services.

Housing prices and carbon emissions: a dynamic panel threshold model of 60 Chinese cities

ABSTRACT In the past two decades, both housing prices and carbon emissions have risen dramatically in China. However, it is unclear whether there is a nexus between them. This study employs a dynamic panel threshold regression model using residents' income levels as the threshold variable to investigate the relationship between housing prices and per capita carbon emissions. By considering 60 Chinese housing price-monitored cities, a threshold effect of income on carbon emissions was identified with a threshold value of 2.448, which divided the full sample into two regimes to further analyse the impacts of housing prices on per capita carbon emissions at each income level. The empirical results show that housing prices have a slight but positive effect on per capita carbon emissions both at two income levels. Specifically, a 10% change in housing prices can lead to a change in the same direction in per capita carbon emissions by 0.7% and 0.2% at lower and higher average income levels, respectively. However, in small cities, limited population may contribute to the negative impact of housing prices on carbon emissions. Furthermore, the results also confirm that the urbanization rate is an important factor of per capita carbon emissions.

Income and out-of-pocket health expenditure in living arrangements of families with older adults in Brazil

The main objective of this study was to characterize household sociodemographic and economic patterns of different living arrangements of families with older adults in Brazil and their relationship with income and out-of-pocket health expenditure. Data were extracted from the 2008-2009 Brazilian Household Budget Survey (POF, in Portuguese) database of the Brazilian Institute of Geography and Statistics. Families with older adults represented 28% of all families, being smaller and having higher average income when compared to families without older adults. Older adults were head of the household in 85% of the families, with income based mainly on social protection policies. The families with older adult or couple as head of the household had significantly higher average monthly income. The proportion of out-of-pocket health expenditure per income quintile per capita was higher for families with one older adult or couple as head of the household, when compared to families without older adult as head of the household and even more in families without older adults at all. These findings allow the identification of potential positive impacts on the quality of life of families with older adults in Brazil. The higher household income of families with older adults is a consequence of the expansion of inclusive social protection policies for this population in the 2000s in Brazil, especially for families with lower average income levels, representing 4/5 of this population. The economic and political crisis in the 2010s have probably reduced these families' relative advantage, and this study will compare with results of the next survey.

The relationship of Oxford Houses across heterogeneous house and setting characteristics.

Oxford Houses (OH) are democratically run, self-funded, substance-use recovery homes that operate across the United States and internationally. Previous research shows the OHs are present in diverse neighborhoods. The current study examined the neighborhoods of 42 OHs located in Oregon, Texas, and North Carolina to better quantify and understand house and neighborhood characteristics that are related to relapse rates. Independent variables were participants' length of stay in OH, wages earned from employment, and income/education neighborhood characteristics. Neighborhood characteristics were related to relapse rates, with higher relapse rates occurring in neighborhoods with lower income and education levels. This finding supports the OH organization's premise that while OHs may work across community settings, they perform better in neighborhoods with higher average income and education levels. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Development and Changes in the Human Capital Index among Pre-Retirement Population in Thailand - 2011 through 2017

Thailand has become an ageing society and has several plans to promote human resources as the key for continued national development. This study developed and measured human capital among the pre-retirement population in Thailand, since the goals of this study were to measure and compare the levels of individuals’ human capital in a different group. To do so, we created a new instrument, a Human Capital Index (HCI) for the pre-retirement population in Thailand, which is consistent with human capital theory, and the World Health Organization (WHO)’s concept of functional ability. This study used secondary data from the National Statistical Office (NSO)’s Survey of Older Persons in Thailand conducted in 2011, 2014, and 2017 to gauge the level of HCI of pre-retirement population in Thailand. Results showed that the level of HCI in males is higher than that of females in every survey. Second, people who lived in urban areas had a better HCI than people who lived in rural areas. Third, people who lived in Bangkok had a higher HCI when compared with those living in other regions. Lastly, people who earned a high average annual income tended to have a higher HCI in every survey. The Thai public sector should therefore support the human capital of Thai people, such as promoting lifelong learning and skill development in order to meet the needs and demands of the labor sector. This is especially necessary for females, those living in rural areas and in the North, South, Central, and Northeast regions, and for people who earn a lower average annual income.

Socioeconomic Status, Health Inequalities, and Solidarity Trends in a Mass Vaccination Campaign

Abstract Background In July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity. Methods The study is based on data gathered from the Israeli Ministry of Health’s administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013. Results The higher the SES level of the area where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake. As time passed in the vaccination campaign, vaccination uptake increased regardless of the location of the mother-and-child clinics. The highest vaccination uptake rate was found among populations of low SES and low Gini inequality index. The lowest vaccination uptake rate was found among populations of high SES/high Gini inequality index. Conclusions Public health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities. Key messages The higher the SES in municipalities with mother-and-child clinics, the less likely children were to be vaccinated. The lower the Gini inequality index, there is a higher polio vaccination uptake among of children.

Household carbon footprint patterns by the degree of urbanisation in Europe

Urbanisation increases household carbon footprints in developing economies. However, the results from developed countries have varied, particularly in Europe. This study provides a coherent comparison of the impact of the degree of urbanisation on income, expenditure and carbon footprints in Europe. On average, carbon footprints are 7% lower in cities than in rural areas when income and household characteristics are controlled. However, this is compensated by the 6% higher average income in cities. The patterns are not uniform in all countries. In Eastern Europe, the pattern is similar to other developing regions. In some Western European countries, both the income level and the carbon footprints are lower in urban areas than in rural areas. In the rest of Europe, the differences in income level between rural and urban areas are small, but they still largely compensate for the efficiency benefits of urban areas. We call for more systemic emissions accounting and climate strategies.

Prevalence and risk factors of HIV infection among people who inject drugs in Cambodia: findings from a national survey

BackgroundGlobally, people who inject drugs (PWID) continue to be among the most vulnerable populations to acquire infection of human immunodeficiency virus (HIV). The most recent national survey found that nearly a quarter of PWID in Cambodia were infected with HIV in 2012. The aim of this study is to estimate the current prevalence of and factors associated with HIV infection among PWID in Cambodia.MethodsThis national integrated biological and behavioral survey was conducted from June to December 2017. Participants were recruited from the capital city and 11 major provinces using the respondent driven sampling method. Face-to-face interviews were conducted using a structured questionnaire, and blood samples were collected for HIV, syphilis, and hepatitis C virus (HCV) testing. Multiple logistic regression analysis was conducted to identify risk factors for HIV infection. All analyses were estimated with sampling weights that corrected for non-response and sample design.ResultsA total of 310 PWID participated in the study, and the mean age was 31.8 years (SD = 7.8). The prevalence of HIV was 15.2%. More than half (57.4%) of the HIV-positive participants were co-infected with HCV, and 44.7% were not aware of their HIV status prior to this study. After adjustment for other covariates, HIV infection remained positively associated with being female (AOR = 1.88, 95% CI = 1.03–4.04), being in the older age group of ≥35 (AOR = 2.99, 95% CI 1.33–9.22), being widowed, divorced or separated (AOR = 2.57, 95% CI = 1.04–6.67), living on the streets (AOR = 2.86, 95% CI 1.24–4.37), and HCV infection (AOR = 3.89, 95% CI 1.86–1.15). The HIV infection remained negatively associated with having higher level of formal education of ≥10 years (AOR = 0.44, 95% CI 0.13–0.83) and higher average income of ≥US$200 per month (AOR = 0.20, 95% CI = 0.05–0.74).ConclusionsThe prevalence of HIV among PWID in Cambodia remains high, but is reducing compared with the 24.8% reported in the 2012 national survey. Findings from this study provide critical information for tailoring interventions based on identified vulnerabilities and risk factors for HIV. Our findings underline the importance of socio-structural factors in HIV epidemiology among PWID in Cambodia, which require mitigation.

Pemetaan Prospek Pasar Wisatawan Nusantara di Indonesia

Utilizing the Tourism Potential Market Matrix (PPP) which is a modification of the Boston Consulting Group (BCG) Matrix, this study resulted in a mapping of the prospects of the domestic tourist market in Indonesia. From this study, it was identified the market potential that besides on the ability of a provinces to produce the number of trips for domestic tourists, and also has the potential of the prospect of spending while traveling. There are 5 Provinces which are included in the most potential market quadrant in the development of domestic tourist because they have a high average income, and the high on travel propensity, namely: Bangka Belitung Islands, DKI Jakarta, Riau Islands, North Sulawesi and DI Yogyakarta. These provinces can be optimized by other provinces to be developed as a tourism market, so that they are expected to bring quality tourists.

Vaccination uptake and income inequalities within a mass vaccination campaign

BackgroundIn July 2013, Israel was swept with fear of a polio outbreak. In response to the importation of wild polio virus, the Ministry decided to take preventive action by administering oral poliovirus vaccine (OPV) to all children born after 1 January 2004 who had received at least one dose of inactivated poliovirus vaccine (IPV) in the past. This study analyzes the vaccination uptake rates resulting from the mass polio vaccination campaign on the basis of health inequality parameters of socioeconomic status (SES), principles of solidarity, and the Gini inequality index. The research explores understanding the value of the Gini inequality index within the context of SES and solidarity.MethodsThe study is based on data gathered from the Israeli Ministry of Health’s administrative records from mother-and-child clinics across Israel. The research population is comprised of resident infants and children whom the Ministry of Health defined as eligible for the OPV between August and December 2013 (the “campaign period”). The analysis was carried out at the municipality level as well as the statistical area level.ResultsThe higher the SES level of the municipality where the mother-and-child clinic is located, the lower the OPV vaccination uptake is. The greater the income inequality is in the municipality where the mother-and-child clinic is situated, the lower the vaccination uptake.ConclusionsPublic health professionals promoting vaccine programs need to make specially-designed efforts both in localities with high average income and in localities with a high level of income diversity/inequality. Such practice will better utilize funds, resources, and manpower dedicated to increasing vaccination uptake across varying populations and communities.

Effects of Physical Activity on Income

A growing number of publications indicate that being physically active can aff ect various aspects of life, including professional work. The aim of the article is to present the relationship between physical activity and income levels. The research involved the use of the integrated Social Diagnosis database. Social Diagnosis is a comprehensive survey of households and the conditions and quality of life of Polish people. The results of the conducted study show that there is a signifi cant diff erence in the income of people who practice sport and those who do not. This research is also unique because it examines how taking up and discontinuation of practicing sport aff ects income. It can be concluded that undertaking of physical activity is connected with a higher average income, and to the contrary, a discontinuation of physical activity is connected with lower income.

Global market and income gaps between industries: evidence from finance industry and manufacturing industry

The income gap among industries in China is usually explained by the theory of segmented labor market. However, this perspective cannot explain why the finance industry has the highest average income among the monopoly industries, while the manufacturing industry has much lower incomes than any other competitive industry. This paper argues that it can be explained by the way China participates in the economic globalization. Liberalization of the manufacturing industry and protection of the finance industry are China’s strategies in dealing with opportunities and challenges of economic globalization. This paper compares the average incomes of monopoly and competitive industries, as well as that of finance and manufacturing. Analyses of panel data spanning from 2000 to 2014 show that the bigger the size of foreign trade, the higher the average income of the finance industry, and the lower the average income of the whole monody industries; at the same time, FDI reduces the average income of the manufacturing industry. This research advances the literature of segmented labor market by pointing out that income inequality between industries in China should be understood in the context of economic globalization.

The effects of trainings in soil and water conservation on farming practices, livelihoods, and land-use intensity in the Ethiopian highlands

Smallholder farmers in the Ethiopian Highlands face increasingly difficult farming conditions. Agricultural intensification to feed the growing rural population, livestock pressure on native vegetation, and climate change converge to exacerbate soil erosion, creating a significant threat to crop productivity and rural livelihoods. Farmer trainings can be a potent strategy to increase farmer awareness of the larger causes of soil loss, help farmers adapt to or mitigate environmental challenges, and improve crop outputs and incomes. However, evaluations of farmer training programs rarely assess socioeconomic and environmental outcomes simultaneously. Our study uses multiple methods to estimate the socio-ecological effects of a soil and water conservation training program for farmers implemented by ADHENO Integrated Rural Development Association, an Ethiopian non-governmental organization. We asked: (a) did farmers use practices taught in trainings; (b) did these strategies lead to improved agricultural productivity or livelihoods; and (c) how did land-use intensity change in areas with more participation in farmer trainings? To address questions (a) and (b), our study and results are based on 449 household surveys, collected between June and August 2017, in two rural kebeles in Ethiopia in which ADHENO has been active since 2003. We used remote sensing analysis of high resolution satellite images to measure land-use change over a period of nine years, addressing question (c) for one of the kebeles. Analysis of household surveys with propensity score matching and robustness checks suggests that participation in farmer trainings predicts the implementation of four out of seven soil conservation farming methods. Participants in training sessions also had higher average incomes from agriculture than non-participants. Linear models of land-use change in the area around villages did not depict a clear relationship between participation in farmer trainings and change in land-use intensity. These results indicate that farmer trainings focusing on soil and water conservation have the potential to influence farming practices and livelihoods and have implications for soil conservation efforts in the Ethiopian Highlands. This study highlights the importance of evaluating the impacts of small, localized development interventions, of which there are many in sub-Saharan Africa, to better understand the ways in which myriad types of programs influence both land use and livelihoods.

Income change after cruciate ligament injury — A population-based study

ObjectivesTo investigate the association between choice of treatment and patients' income after cruciate ligament (CL) injury and assess the effect of different covariates such as sex, age, comorbidities and type of work. MethodsThis entire-population cohort study in Sweden included working patients with a diagnosed CL injury between 2002 and 2005, identified in The National Swedish Patient Register (n = 13,662). The exposure was the treatment choice (operative or non-operative treatment). The main outcome measure was average yearly income five years after CL diagnosis, adjusted for the following covariates: sex, age, comorbidities, type of work, region, calendar year, education and income. ResultsRelative to non-operative treatment, operative treatment was associated with greater average yearly incomes (nine to 15%) after injury among patients between 20 and 50 years, patients with partial university education, patients living in large cities and patients with one comorbidity, despite no overall significant association in the national cohort. Delayed operative treatment (>1 year) had no significant association with income change, whereas early operative treatment (<1 year) was associated with higher average yearly incomes (11 to 16%) among females, patients between 20 and 50 years, patients living in large cities and patients with one comorbidity. ConclusionsIn a broad sense, treatment choice was not associated with changes in income five years after CL injuries among patients in the workforce, however earlier operative treatment was associated with higher average incomes among patients with ages between 20 and 50, females, living in large cities, with one comorbidity and with a high level of education.

Determinants of knowledge, attitude and practice in patients with both type 2 diabetes and chronic kidney disease in Fiji.

Background: In Fiji, Type 2 diabetes mellitus (T2DM) and Chronic kidney disease (CKD) are amongst the top four causes of premature mortality, disability and death. This study aims to identify the determinants of knowledge, attitude and practice (KAP) in T2DM patients with CKD in Fiji in 2018. Methods: A cross-sectional study was conducted at Sigatoka Sub-divisional Hospital (SSH) in Fiji in July-August, 2018 using a self-structured questionnaire to test KAP of 225 patients. The inclusion criteria were confirmed T2DM patients (Fijian citizens) with CKD, aged 30 years or above and attending Special Out-Patient's Department (SOPD) at SSH. Independent t-test and ANOVA was used to test differences between demographic variable and practice score while non-parametric tests were used for knowledge and attitude. Spearman correlation and multiple linear regressions were conducted. All tests were set at 5% level of significance. Results:From 249 questionnaires distributed, 225 responded thus response rate was 95%. The mean KAP level was high: knowledge, 23.3/30 (SD±3.25); attitude, 23.1/30 (SD±2.73) and practice, 7.1/10 (SD±2.04). A high level of knowledge was seen in those with university-level education (p<0.001), unemployed (p=0.05) and high average monthly income (p=0.03). Those aged 61-70 years had a 0.53-point lower attitude score (p=0.05) than other age categories, while those >70 years had a 1.78-point lower attitude score (p=0.01) than other age categories. Fijians of Indian descent (FID) had lower attitude (p=0.002) and higher practice (p=0.001) scores. Conclusion: Patients with both T2DM and CKD at SSH have high levels of KAP. The determinants of KAP have been shown and thus, this study identified high-risk groups for low KAP, which can become the focus of future public health intervention.

Survey mode effects and insurance coverage estimates in the redesigned Gallup well-being index.

To test whether a change from a telephone to mail and Internet survey in January 2018 affected the sample composition and uninsured estimates in the Gallup-Sharecare Well-Being Index. Gallup-Sharecare Well-Being Index (2013-2018). Regression discontinuity analysis identified changes after the survey redesign in the estimated U.S. uninsured rate (adults 18-64) and in the sample's demographic composition. After the survey redesign, the estimated uninsured rate fell 5.3 percentage points (P<0.001), respondents were older and disproportionately white, more likely to have a college degree, and had higher average incomes. These changes were modestly reduced by survey weights. The shift to a mail survey (with a web option) led to an older, more educated sample with fewer minorities, and a significant break in trend in the estimated uninsured rate.