The 130th Annual Meeting of APHA

Abstract #38470

Ning Lu, PhD, MPH and Richard W. Wilson, DHSc, MPH. Department of Public Health, Western Kentucky University, 1 Big Red Way, Bowling Green, KY 42101-3576, 270-745-5260, ning.lu@wku.edu

To achieve our nation's goal of eliminating health disparities among socioeconomic groups, policymakers and public health workers have been focusing on improving individual health behaviors and access to medical care among the population of lower socioeconomic status (SES). However, the contribution of risk behaviors and access to medical care to socioeconomic differences in health is less well understood.

Using Kentucky Behavioral Risk Factor Surveillance System data of year 2000, our study demonstrated and examined 1) the relationship between socioeconomic factors of income and education and risk behaviors, such as cigarettes smoking, inadequate consumption of fruits/vegetables, physical inactivity and overweight, and access to care; 2) the effect of income, education, health behaviors, and access to care on health status; 3) the extent to which health behaviors and access to care account for socioeconomic differences in health.

Controlling for age, sex, race, marital status, employment status, and education, the odds ratio of poor and fair health was 4.06 (95%CI, 2.79-5.90) for those with lowest level of income and 2.21 (95%CI, 1.64-2.98) for those with middle level of income. When risk behaviors and access to care were adjusted, the odds ratios remained strong and significant for both lowest- and middle-level income groups (OR=3.70; 95%CI, 2.53-5.42 and OR=1.91; 95%CI, 1.41-2.59, respectively).

Although improving health behaviors and access to care among people with lower SES is an important strategy to achieve our nation's health goal, without addressing a broader array of SES pathway factors the socioeconomic disparities in health will persist and even increase.

Learning Objectives:

• The participants will realize that health behaviors and access to medical are account for a small proportion of the socioeconomic differnces in health. The SES effects of income and education on health remain strong and signifcant after adjusting for behavior factors and access to medical care.
• The participants will also realize that improving health behaviors and access to medical care in people with low SES, though important, may not by itself reduce socioeconomic disparities in health. The socioeconomic gaps in health are persisting and increasing.

Keywords: Social Inequalities, Adult Health

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.