Associations Among Reduced Income, Unhealthy Habits, the Prevalence of Non-Communicable Diseases, and Multimorbidity in Middle-Aged and Older US Adults: A Cross-Sectional Study

Overview

Journal Healthcare (Basel)

Specialty Health Services

Date 2024 Dec 17

PMID 39685021

Authors

Damian Pereira-Payo

Raquel Pastor-Cisneros

Maria Mendoza-Munoz

Lucia Carrasco-Marcelo

Affiliations

Soon will be listed here.

Abstract

Introduction: Evidence supports the relationships between socioeconomic status and access to health care, incidence of pathologies, and lifestyle.

Objective: The aim of this research was to investigate whether there are associations between having a household income below the poverty line, and participation in unhealthy lifestyle habits, the prevalence of non-communicable diseases, and the number of comorbidities in US middle-aged and older adults.

Methods: This cross-sectional study is based on the NHANES 2011-2020. A total of 10,788 US middle-aged and older adults (5653 males and 5135 females) participated in this research. Associations were studied through the Chi-squared test, and odds ratios were calculated using a binary logistic regression model.

Results: There were associations between a household income below the poverty line and physical inactivity, unhealthy diet, and being or having been an alcoholic. Associations were found between this adverse economic situation and having hypertension, diabetes, liver disease, kidney problems, arthritis, congestive heart failure, angina pectoris, heart attack, stroke, and also with having two or more, three or more, four or more, and five or more comorbidities. Increased odds of being involved in these unhealthy habits and of suffering these diseases and multimorbidity were found for those with a family income below the poverty threshold.

Conclusions: The existence of associations between having a family income under the poverty threshold and having unhealthy habits, suffering non-communicable diseases, and having multimorbidity is confirmed in US middle-aged and older adults. Increased odds for various non-communicable diseases, multimorbidity, and for being involved in these unhealthy habits were found for this low-income group. These findings should serve to draw the attention of policy makers to the increased health vulnerability of the adult population below the poverty line in the US.

References

Sortso C, Lauridsen J, Emneus M, Green A, Jensen P . Socioeconomic inequality of diabetes patients' health care utilization in Denmark. Health Econ Rev. 2017; 7(1):21. PMC: 5446432. DOI: 10.1186/s13561-017-0155-5. View

Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P . Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet. 2019; 395(10226):795-808. PMC: 8006904. DOI: 10.1016/S0140-6736(19)32008-2. View

Lopez A, Adair T . Is the long-term decline in cardiovascular-disease mortality in high-income countries over? Evidence from national vital statistics. Int J Epidemiol. 2019; 48(6):1815-1823. DOI: 10.1093/ije/dyz143. View

de Mestral C, Stringhini S . Socioeconomic Status and Cardiovascular Disease: an Update. Curr Cardiol Rep. 2017; 19(11):115. DOI: 10.1007/s11886-017-0917-z. View

Major J, Sargent J, Graubard B, Carlos H, Hollenbeck A, Altekruse S . Local geographic variation in chronic liver disease and hepatocellular carcinoma: contributions of socioeconomic deprivation, alcohol retail outlets, and lifestyle. Ann Epidemiol. 2013; 24(2):104-10. PMC: 3946391. DOI: 10.1016/j.annepidem.2013.11.006. View

Abba M, Nduka C, Anjorin S, Mohamed S, Agogo E, Uthman O . Influence of contextual socioeconomic position on hypertension risk in low- and middle-income countries: disentangling context from composition. BMC Public Health. 2021; 21(1):2218. PMC: 8647420. DOI: 10.1186/s12889-021-12238-x. View

Salvy S, Miles J, Shih R, Tucker J, DAmico E . Neighborhood, Family and Peer-Level Predictors of Obesity-Related Health Behaviors Among Young Adolescents. J Pediatr Psychol. 2016; 42(2):153-161. PMC: 6075537. DOI: 10.1093/jpepsy/jsw035. View

Langenberg C, Kuh D, Wadsworth M, Brunner E, Hardy R . Social circumstances and education: life course origins of social inequalities in metabolic risk in a prospective national birth cohort. Am J Public Health. 2006; 96(12):2216-21. PMC: 1698170. DOI: 10.2105/AJPH.2004.049429. View

Benais M, Duprey M, Federici L, Arnaout M, Mora P, Amouretti M . Association of socioeconomic deprivation with outcomes in critically ill adult patients: an observational prospective multicenter cohort study. Ann Intensive Care. 2024; 14(1):54. PMC: 11004098. DOI: 10.1186/s13613-024-01279-1. View

10.

Brennan-Olsen S, Taillieu T, Turner S, Bolton J, Quirk S, Gomez F . Arthritis in adults, socioeconomic factors, and the moderating role of childhood maltreatment: cross-sectional data from the National Epidemiological Survey on Alcohol and Related Conditions. Osteoporos Int. 2018; 30(2):363-373. DOI: 10.1007/s00198-018-4671-x. View

11.

Stewart J, Manmathan G, Wilkinson P . Primary prevention of cardiovascular disease: A review of contemporary guidance and literature. JRSM Cardiovasc Dis. 2017; 6:2048004016687211. PMC: 5331469. DOI: 10.1177/2048004016687211. View

12.

Kraus M, Adler N, Chen T . Is the association of subjective SES and self-rated health confounded by negative mood? An experimental approach. Health Psychol. 2012; 32(2):138-45. PMC: 3565057. DOI: 10.1037/a0027343. View

13.

Ssewanyana D, Abubakar A, van Baar A, Mwangala P, Newton C . Perspectives on Underlying Factors for Unhealthy Diet and Sedentary Lifestyle of Adolescents at a Kenyan Coastal Setting. Front Public Health. 2018; 6:11. PMC: 5811639. DOI: 10.3389/fpubh.2018.00011. View

14.

Chapel J, Ritchey M, Zhang D, Wang G . Prevalence and Medical Costs of Chronic Diseases Among Adult Medicaid Beneficiaries. Am J Prev Med. 2017; 53(6S2):S143-S154. PMC: 5798200. DOI: 10.1016/j.amepre.2017.07.019. View

15.

Mendenhall E, Kohrt B, Norris S, Ndetei D, Prabhakaran D . Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. Lancet. 2017; 389(10072):951-963. PMC: 5491333. DOI: 10.1016/S0140-6736(17)30402-6. View

16.

Mishra S, Carleton R . Subjective relative deprivation is associated with poorer physical and mental health. Soc Sci Med. 2015; 147:144-9. DOI: 10.1016/j.socscimed.2015.10.030. View

17.

Almubarak A, Albkiry Y, Alsalem A, Elkrim Saad M . The association of low socioeconomic status with advanced stage thyroid cancer. J Taibah Univ Med Sci. 2021; 16(4):482-490. PMC: 8348293. DOI: 10.1016/j.jtumed.2021.04.006. View

18.

Mosca I, Ni Bhuachalla B, Kenny R . Explaining significant differences in subjective and objective measures of cardiovascular health: evidence for the socioeconomic gradient in a population-based study. BMC Cardiovasc Disord. 2013; 13:64. PMC: 3765886. DOI: 10.1186/1471-2261-13-64. View

19.

Wood W, Quinn J, Kashy D . Habits in everyday life: thought, emotion, and action. J Pers Soc Psychol. 2002; 83(6):1281-97. View

20.

Hsu Y, Cheng S, Chien M, Cheng S . Impact of social and economic factors on global thyroid cancer incidence and mortality. Eur Arch Otorhinolaryngol. 2023; 280(9):4185-4193. DOI: 10.1007/s00405-023-07992-0. View