scholarly journals Disparities in Vulnerability to Severe Complications from COVID-19 in the United States

2020 ◽  
Author(s):  
Emily E. Wiemers ◽  
Scott Abrahams ◽  
Marwa AlFakhri ◽  
V. Joseph Hotz ◽  
Robert F. Schoeni ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Low Income ◽  
Respiratory Infections ◽  
Panel Study ◽  
The United States ◽  
Adverse Outcomes ◽  
Income Dynamics ◽  
High School Degree ◽  
Race Ethnicity ◽  
Nationally Representative

AbstractThis paper provides the first nationally representative estimates of vulnerability to severe complications from COVID-19 overall and across race-ethnicity and socioeconomic status. We use the Panel Study of Income Dynamics (PSID) to examine the prevalence of specific health conditions associated with complications from COVID-19 and to calculate, for each individual, an index of the risk of severe complications from respiratory infections developed by DeCaprio et al. (2020). We show large disparities across race-ethnicity and socioeconomic status in the prevalence of conditions which are associated with the risk of severe complications from COVID-19. Moreover, we show that these disparities emerge early in life, prior to age 65, leading to higher vulnerability to such complications. While vulnerability is highest among older adults regardless of their race-ethnicity or socioeconomic status, our results suggest particular attention should also be given to the risk of adverse outcomes in midlife for non-Hispanic Blacks, adults with a high school degree or less, and low-income Americans.

scholarly journals Intergenerational Mobility in the United States: What We Have Learned from the PSID

2018 ◽  
Vol 680 (1) ◽  
pp. 213-234 ◽  
Author(s):  
Bhashkar Mazumder
Keyword(s):  
United States ◽  
Socioeconomic Status ◽  
Life Cycle ◽  
Intergenerational Mobility ◽  
Panel Study ◽  
The United States ◽  
Group Differences ◽  
Income Dynamics ◽  
Mobility Studies ◽  
Advanced Economies

This article reviews the contributions of the Panel Study of Income Dynamics (PSID) to the study of intergenerational mobility. The PSID enables researchers to track individuals as they form new households and covers many dimensions of socioeconomic status over large portions of the life cycle, making the data ideal for studying intergenerational mobility. Studies have used PSID data to show that the United States is among the least economically mobile countries among advanced economies. The PSID has been instrumental to understanding various dimensions of intergenerational mobility, including occupation; wealth; education; consumption; health; and group differences by gender, race, and region. Studies using the PSID have also cast light on the mechanisms behind intergenerational persistence.

Damages Done: The Longitudinal Impacts of Natural Hazards on Wealth Inequality in the United States

2018 ◽  
Vol 66 (3) ◽  
pp. 448-467 ◽  
Author(s):  
Junia Howell ◽  
James R Elliott
Keyword(s):  
United States ◽  
Natural Hazards ◽  
Large Scale ◽  
Natural Hazard ◽  
Panel Study ◽  
Wealth Inequality ◽  
The United States ◽  
Income Dynamics ◽  
Nationally Representative ◽  
Research And Policy

Abstract This study investigates a largely ignored contributor to wealth inequality in the United States: damages from natural hazards, which are expected to increase substantially in coming years. Instead of targeting a specific large-scale disaster and assessing how different subpopulations recover, we begin with a nationally representative sample of respondents from the restricted, geocoded Panel Study of Income Dynamics. We follow them through time (1999–2013) as hazard damages of varying scales accrue in the counties where they live. This design synthesizes the longitudinal, population-centered approach common in stratification research with a broad hazard-centered focus that extends beyond disasters to integrate ongoing environmental dynamics more centrally into the production of social inequality. Results indicate that as local hazard damages increase, so does wealth inequality, especially along lines of race, education, and homeownership. At any given level of local damage, the more aid an area receives from the Federal Emergency Management Agency, the more this inequality grows. These findings suggest that two defining social problems of our day – wealth inequality and rising natural hazard damages – are dynamically linked, requiring new lines of research and policy making in the future.

scholarly journals Lifetime Disadvantages after Childhood Adversity: Health Problems Limiting Work and Shorter Life

2018 ◽  
Vol 680 (1) ◽  
pp. 259-277 ◽  
Author(s):  
James N. Laditka ◽  
Sarah B. Laditka
Keyword(s):  
African American ◽  
Heart Disease ◽  
Life Expectancy ◽  
Work Disability ◽  
White Women ◽  
Panel Study ◽  
Childhood Adversity ◽  
Income Dynamics ◽  
Race Ethnicity ◽  
Nationally Representative

We examine how childhood adversity relates to work disability and life expectancy, using 1999 to 2015 data from the Panel Study of Income Dynamics. We estimate the probabilities of work disability and death, adjusting for age, sex, race/ethnicity, and education in a nationally representative sample of African American, Hispanic, and white women and men. We find that people in all these groups who experienced high-adversity childhoods (individuals with four or more of six adversity indicators) had significantly more work disability and shorter lives than those who experienced no adversity. These findings provide evidence that childhood adversity is associated with substantial disability and a reduction in life expectancy of at least a decade. Childhood adversity was generally associated with more lost years of life for men than for women, and more disability for women than for men. The results are robust, even when controlling for diabetes, heart disease, depression, obesity, and sedentary behavior.

scholarly journals New rail transit stations and the out-migration of low-income residents

Urban Studies ◽  
2019 ◽  
Vol 57 (1) ◽  
pp. 134-151 ◽  
Author(s):  
Elizabeth Delmelle ◽  
Isabelle Nilsson
Keyword(s):  
Low Income ◽  
Panel Study ◽  
The United States ◽  
Rail Transit ◽  
Income Dynamics ◽  
Housing Values ◽  
Transit Systems ◽  
Census Tracts ◽  
Close Proximity ◽  
In Transit

This article tests the hypothesis that low-income residents disproportionately move out of neighbourhoods in close proximity to new rail transit stations. This transit-induced gentrification scenario posits that the development of rail transit will place an upward pressure on land and housing values and that higher-income residents will outbid low-income residents for this new amenity. The most transit-dependent population may therefore be displaced from the most accessible locations, forming a paradox in the investment in new transit systems. We test this hypothesis using the Panel Study on Income Dynamics (PSID) dataset to trace the out-migration of residents across the United States from census tracts within five years of the opening of a new station, between 1970 and 2014. We find that low-income individuals are more likely to move, regardless of their neighbourhood. However, we do not find significant evidence that low-income individuals are more likely to move out of transit neighbourhoods, after controlling for both individual and other neighbourhood characteristics. The odds of moving out of a transit neighbourhood for low-income residents is statistically insignificant. In other words, they do not have a heightened probability of leaving new transit neighbourhoods compared with other residents. Our results are robust across decades, when examining renters alone, for different time spans and for varying definitions of transit neighbourhoods. We further find that those living in transit neighbourhoods are not more likely to live in a crowded dwelling. Our results therefore suggest that, on average, across the nation, low-income residents do not disproportionately exit new transit neighbourhoods.

scholarly journals Associations of Race/Ethnicity and Other Demographic and Socioeconomic Factors with Vaccination During the COVID-19 Pandemic in the United States

2021 ◽  
Author(s):  
Daniel Kim
Keyword(s):  
United States ◽  
Socioeconomic Factors ◽  
Vaccine Dose ◽  
The United States ◽  
Adverse Outcomes ◽  
Vaccine Hesitancy ◽  
Vaccine Initiation ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Socioeconomic Data

AbstractBACKGROUNDTo date, there has been limited data available to understand the associations between race/ethnicity and socioeconomic and related characteristics with COVID-19 vaccine initiation and planned vaccination in the United States. To better characterize COVID-19 vaccinations nationally, the present study leveraged nationally-representative data with relatively complete race/ethnicity and socioeconomic data to estimate levels of vaccine initiation and the adjusted relative odds of vaccine initiation and planned vaccination among adults by race/ethnicity and socioeconomic and other characteristics.METHODSUsing pooled cross-sectional data from 66,994 adults aged 18-85 years in nationally-representative surveys by the U.S. Census Bureau administered between January 6, 2021 and January 18, 2021 and multivariable logistic regression, this study estimated the associations between race/ethnicity, education, and pre-pandemic (2019) household income with the self-reported: 1) receipt of ≥1 dose of a COVID-19 vaccine; and 2) either receipt of ≥1 dose of a COVID-19 vaccine or the plan to definitely receive a vaccine once available to the respondent.RESULTSIn Hispanics and Black non-Hispanics, the estimated prevalences of vaccine initiation were 6.1% and 6.2%, respectively, compared to 8.7% in White non-Hispanics and 15.1% in Asian non-Hispanics. Controlling for demographic and socioeconomic factors, Hispanics and Black non-Hispanics were no more or less likely than White non-Hispanics to have received ≥1 vaccine dose. However, for the combined outcome of either vaccine initiation or planned vaccination, Black non-Hispanics were 52% less likely than White non-Hispanics to have reported either outcome (P<.001). Meanwhile, both education and pre-pandemic income levels exhibited evidence of positive dose-response relationships with vaccine initiation (P for linear trend = .01 and <.001, respectively). Substantial (vs. no) financial hardship was linked to 44% lower odds of vaccination (P<.001). The most common reasons for vaccine hesitancy were concerns about side effects and safety.CONCLUSIONSIn this large, nationally-representative study with relatively complete race/ethnicity and socioeconomic data, we find that being Black non-Hispanic and having the least education and income were each independently associated with a markedly lower likelihood of definitely planning to get vaccinated or having been vaccinated. In the ensuing months of the pandemic, addressing racial/ethnic and socioeconomic inequities in vaccination due to differential access and vaccine hesitancy will be critical to mitigate the pandemic’s disproportionately higher risks of infection and adverse outcomes in Black non-Hispanics and socioeconomically disadvantaged groups and to help maximize vaccination coverage nationwide.

Testing the Effects of Collectively Expected Durations of Migration: The Naturalization of Mexicans and Cubans

2002 ◽  
Vol 36 (1) ◽  
pp. 103-124 ◽  
Author(s):  
Benigno E. Aguirre ◽  
Rogelio Saenz
Keyword(s):  
United States ◽  
Socioeconomic Status ◽  
Logistic Regression ◽  
Panel Study ◽  
The United States ◽  
National Sample ◽  
Income Dynamics ◽  
Foreign Born ◽  
Urban Residence ◽  
The 1960S

This study tests a hypothesis that Mexican foreign-born immigrants who came to the United States for economic reasons naturalize less often than Cubans who immigrate for political reasons. It uses information from the Panel Study of Income Dynamics, Latino Sample, a national sample of 7,453 respondents from the 1989 Latino National Political Survey (LNPS) and the 1990 Panel Study of Income Dynamics (PSID). Ordinal logistic regression is used to examine the hypothesis. The results indicate that while more Mexicans plan to apply or have applied for naturalization, proportionately more Cubans than Mexicans have naturalized. Cuban political immigrants who came to the United States during the first half of the 1960s naturalize more often than their Mexican counterparts. However, the effect of ethnic identity on naturalization is mediated by a number of other predictors of naturalization such as gender, race, urban residence, socioeconomic status and acculturation.

scholarly journals The convergence of racial and income disparities in health insurance coverage in the United States

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
De-Chih Lee ◽  
Hailun Liang ◽  
Leiyu Shi
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Insurance Coverage ◽  
Health Insurance Coverage ◽  
The United States ◽  
Combined Effect ◽  
Medical Expenditure ◽  
The Us ◽  
Race Ethnicity ◽  
Vulnerability Measure

Abstract Objective This study applied the vulnerability framework and examined the combined effect of race and income on health insurance coverage in the US. Data source The household component of the US Medical Expenditure Panel Survey (MEPS-HC) of 2017 was used for the study. Study design Logistic regression models were used to estimate the associations between insurance coverage status and vulnerability measure, comparing insured with uninsured or insured for part of the year, insured for part of the year only, and uninsured only, respectively. Data collection/extraction methods We constructed a vulnerability measure that reflects the convergence of predisposing (race/ethnicity), enabling (income), and need (self-perceived health status) attributes of risk. Principal findings While income was a significant predictor of health insurance coverage (a difference of 6.1–7.2% between high- and low-income Americans), race/ethnicity was independently associated with lack of insurance. The combined effect of income and race on insurance coverage was devastating as low-income minorities with bad health had 68% less odds of being insured than high-income Whites with good health. Conclusion Results of the study could assist policymakers in targeting limited resources on subpopulations likely most in need of assistance for insurance coverage. Policymakers should target insurance coverage for the most vulnerable subpopulation, i.e., those who have low income and poor health as well as are racial/ethnic minorities.

scholarly journals Real-World Utilization of Oral Anticancer Agents Costs in Older Adults with Metastatic Renal Cell Carcinoma in the United States

Kidney Cancer ◽  
2021 ◽  
pp. 1-13
Author(s):  
Lauren E. Wilson ◽  
Lisa Spees ◽  
Jessica Pritchard ◽  
Melissa A. Greiner ◽  
Charles D. Scales ◽  
...  
Keyword(s):  
United States ◽  
Anticancer Agents ◽  
Patient Characteristics ◽  
The United States ◽  
Socioeconomic Indicators ◽  
Economic Implications ◽  
Southern Us ◽  
Race Ethnicity ◽  
Nationally Representative ◽  
Oral Anticancer Agents

Background: Substantial racial and socioeconomic disparities in metastatic RCC (mRCC) have persisted following the introduction of targeted oral anticancer agents (OAAs). The relationship between patient characteristics and OAA access and costs that may underlie persistent disparities in mRCC outcomes have not been examined in a nationally representative patient population. Methods: Retrospective SEER-Medicare analysis of patients diagnosed with mRCC between 2007–2015 over age 65 with Medicare part D prescription drug coverage. Associations between patient characteristics, OAA receipt, and associated costs were analyzed in the 12 months following mRCC diagnosis and adjusted to 2015 dollars. Results: 2,792 patients met inclusion criteria, of which 32.4%received an OAA. Most patients received sunitinib (57%) or pazopanib (28%) as their first oral therapy. Receipt of OAA did not differ by race/ethnicity or socioeconomic indicators. Patients of advanced age (>  80 years), unmarried patients, and patients residing in the Southern US were less likely to receive OAAs. The mean inflation-adjusted 30-day cost to Medicare of a patient’s first OAA prescription nearly doubled from $3864 in 2007 to $7482 in 2015, while patient out-of-pocket cost decreased from $2409 to $1477. Conclusion: Race, ethnicity, and socioeconomic status were not associated with decreased OAA receipt in patients with mRCC; however, residing in the Southern United States was, as was marital status. Surprisingly, the cost to Medicare of an initial OAA prescription nearly doubled from 2007 to 2015, while patient out-of-pocket costs decreased substantially. Shifts in OAA costs may have significant economic implications in the era of personalized medicine.

Predictors of Unmet Dental Health Needs in US Adults in 2018: A Cross-Sectional Analysis

2021 ◽  
pp. 238008442110356
Author(s):  
D.J. Gaskin ◽  
H. Zare ◽  
R. McCleary ◽  
O. Kanwar ◽  
A.L. Davis
Keyword(s):  
Socioeconomic Status ◽  
Oral Health ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
The United States ◽  
Permanent Teeth ◽  
Dental Visit ◽  
Low Socioeconomic ◽  
The Past ◽  
Dental Needs

Objective: To identify predictors of unmet dental needs for adults 18 y of age or older in the United States. Method: Using the Aday and Andersen framework and data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS), we ran logistic regression to estimate predictors for adults of not having a dental visit within 5 y and having lost any teeth using a national sample of 155,060 survey respondents. Results: Results showed that predisposing factors (age, race/ethnicity, gender, and educational attainment) and enabling factors (income and health insurance status) are important predictors for losing teeth due to decay or gum disease. Men, the elderly, and less educated and low-income residents were less likely to have seen a dentist within the past 5 y and more likely to have lost their permanent teeth. Compared to non-Hispanic White adults, Hispanics adults were more likely to have had a dental visit within the past 5 y. Unmet dental needs varied across states. People living in states with extensive Medicaid dental care benefit coverage were less likely to lose their teeth and more likely to have had a dental visit within the past 5 y. Conclusion: Efforts to improve oral health should address unmet dental needs of men and adults with low socioeconomic status. Studying the variation between state oral health care programs could further our understanding of how public policy can improve population oral health. Knowledge Transfer Statement: Men, non-Hispanic Blacks, mixed and other race minorities, and low socioeconomic status adults are most at risk of unmet dental needs. States can address these needs by expanding Medicaid coverage for adults.

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