Systematic assessment of the correlations of household income with infectious, biochemical, physiological, and environmental factors in the United States, 1999-2006.

A fuller understanding of the social epidemiology of disease requires an extended description of the relationships between social factors and health indicators in a systematic manner. In the present study, we investigated the correlations between income and 330 indicators of physiological, biochemical, and environmental health in participants in the US National Health and Nutrition Examination Survey (NHANES) (1999-2006). We combined data from 3 survey waves (n = 249-23,649 for various indicators) to search for linear and nonlinear (quadratic) correlates of income, and we validated significant (P < 0.00015) correlations in an independent testing data set (n = 255-7,855). We validated 66 out of 330 factors, including infectious (e.g., hepatitis A), biochemical (e.g., carotenoids, high-density lipoprotein cholesterol), physiological (e.g., upper leg length), and environmental (e.g., lead, cotinine) measures. We found only a modest amount of association modification by age, race/ethnicity, and gender, and there was no association modification for blacks. The present study is descriptive, not causal. We have shown in our systematic investigation the crucial place income has in relation to health risk factors. Future research can use these correlations to better inform theory and studies of pathways to disease, as well as utilize these findings to understand when confounding by income is most likely to introduce bias.

[1]  J. William Ahwood,et al.  CLASSIFICATION , 1931, Foundations of Familiar Language.

[2]  John P A Ioannidis,et al.  Placing epidemiological results in the context of multiplicity and typical correlations of exposures , 2014, Journal of Epidemiology & Community Health.

[3]  Xuefeng Bruce Ling,et al.  Investigation of maternal environmental exposures in association with self-reported preterm birth. , 2014, Reproductive toxicology.

[4]  J. M. Oakes,et al.  Methodologic Innovations and Advances in Social Epidemiology , 2014, Current Epidemiology Reports.

[5]  Chirag J Patel,et al.  Systematic evaluation of environmental and behavioural factors associated with all-cause mortality in the United States national health and nutrition examination survey. , 2013, International journal of epidemiology.

[6]  Bruce G. Link,et al.  Six paths for the future of social epidemiology. , 2013, American journal of epidemiology.

[7]  D. Rehkopf,et al.  Income Gains and Very Low-Weight Birth among Low-Income Black Mothers in California , 2013, Biodemography and social biology.

[8]  Lars Lind,et al.  An environmental wide association study (EWAS) approach to the metabolic syndrome. , 2013, Environment international.

[9]  Atul J. Butte,et al.  A Nutrient-Wide Association Study on Blood Pressure , 2012, Circulation.

[10]  R. Garfein,et al.  Effect of a cash transfer programme for schooling on prevalence of HIV and herpes simplex type 2 in Malawi: a cluster randomised trial , 2012, The Lancet.

[11]  Atul J Butte,et al.  Systematic evaluation of environmental factors: persistent pollutants and nutrients correlated with serum lipid levels , 2012, International journal of epidemiology.

[12]  M. Munafo,et al.  Socioeconomic status and smoking: a review , 2012, Annals of the New York Academy of Sciences.

[13]  T. Seeman,et al.  The Biological Consequences of Socioeconomic Inequalities , 2012 .

[14]  D. Hellhammer,et al.  Stress exposure in intrauterine life is associated with shorter telomere length in young adulthood , 2011, Proceedings of the National Academy of Sciences.

[15]  Trivellore E Raghunathan,et al.  Deeper and wider: income and mortality in the USA over three decades. , 2011, International journal of epidemiology.

[16]  D. Rehkopf,et al.  Effects of Prenatal Poverty on Infant Health , 2010, American sociological review.

[17]  W. Evans,et al.  Giving Mom a Break: The Impact of Higher EITC Payments on Maternal Health , 2010 .

[18]  Atul J. Butte,et al.  An Environment-Wide Association Study (EWAS) on Type 2 Diabetes Mellitus , 2010, PloS one.

[19]  N. Adler,et al.  Money, schooling, and health: Mechanisms and causal evidence , 2010, Annals of the New York Academy of Sciences.

[20]  N. Krieger,et al.  Biologic Risk Markers for Coronary Heart Disease: Nonlinear Associations With Income , 2010, Epidemiology.

[21]  Maximilian D. Schmeiser,et al.  Expanding Wallets and Waistlines: The Impact of Family Income on the BMI of Women and Men Eligible for the Earned Income Tax Credit , 2008, Health economics.

[22]  Dean S. Karlan,et al.  Small individual loans and mental health: a randomized controlled trial among South African adults , 2008, BMC public health.

[23]  B. Coull,et al.  The non-linear risk of mortality by income level in a healthy population: US National Health and Nutrition Examination Survey mortality follow-up cohort, 1988–2001 , 2008, BMC public health.

[24]  B. Graubard,et al.  Ethnic and socioeconomic differences in variability in nutritional biomarkers. , 2008, The American journal of clinical nutrition.

[25]  N. Adler,et al.  U.S. disparities in health: descriptions, causes, and mechanisms. , 2008, Annual review of public health.

[26]  N. Adler,et al.  Disparities in Health : Descriptions , Causes , and Mechanisms , 2008 .

[27]  L. Berkman,et al.  Socioeconomic position and the metabolic syndrome in early, middle, and late life: evidence from NHANES 1999-2002. , 2007, Annals of epidemiology.

[28]  M. Shafer,et al.  Predictors of urinary cadmium levels in adult females. , 2007, The Science of the total environment.

[29]  C. Victora,et al.  Socioeconomic and racial/ethnic differentials of C-reactive protein levels: a systematic review of population-based studies , 2007, BMC public health.

[30]  Lindsay McLaren,et al.  Socioeconomic status and obesity. , 2007, Epidemiologic reviews.

[31]  J. Lynch,et al.  Measuring socioeconomic position in health research. , 2007, British medical bulletin.

[32]  B. Graubard,et al.  Secular trends in the association of socio-economic position with self-reported dietary attributes and biomarkers in the US population: National Health and Nutrition Examination Survey (NHANES) 1971–1975 to NHANES 1999–2002† , 2007, Public Health Nutrition.

[33]  Ichiro Kawachi,et al.  Socioeconomic disparities in metabolic syndrome differ by gender: evidence from NHANES III. , 2007, Annals of epidemiology.

[34]  S. Kunitz.  The Health of Populations: General Theories and Particular Realities. First Edition , 2008 .

[35]  M. Metzler,et al.  Socioeconomic status in health research: one size does not fit all. , 2005, JAMA.

[36]  Thomas Lumley,et al.  Analysis of Complex Survey Samples , 2004 .

[37]  E. Gee,et al.  Gender Differences in the Influence of Economic, Lifestyle, and Psychosocial Factors on Later-life Health , 2003, Canadian journal of public health = Revue canadienne de sante publique.

[38]  D. Krewski,et al.  Gender-related differences in the association between socioeconomic status and self-reported diabetes. , 2003, International journal of epidemiology.

[39]  G. Duncan,et al.  The Long and Short of Asking Questions about Income, Wealth, and Labor Supply , 2001 .

[40]  K. Judge,et al.  Income and health: the time dimension. , 2001, Social science & medicine.

[41]  Jane E. Miller,et al.  The effects of race/ethnicity and income on early childhood asthma prevalence and health care use. , 2000, American journal of public health.

[42]  B E Ainsworth,et al.  Race/ethnicity, social class and their relation to physical inactivity during leisure time: results from the Third National Health and Nutrition Examination Survey, 1988-1994. , 2000, American journal of preventive medicine.

[43]  M. Denton,et al.  Gender differences in structural and behavioral determinants of health: an analysis of the social production of health. , 1999, Social science & medicine.

[44]  P. J. Callahan,et al.  Polycyclic aromatic hydrocarbon exposures of children in low-income families. , 1999, Journal of exposure analysis and environmental epidemiology.

[45]  G. Poppel,et al.  Epidemiological evidence for beta-carotene in prevention of cancer and cardiovascular disease. , 1996 .

[46]  G. van Poppel.  Epidemiological evidence for beta-carotene in prevention of cancer and cardiovascular disease. , 1996, European journal of clinical nutrition.

[47]  P. Sorlie,et al.  The shape of the relationship between income and mortality in the United States. Evidence from the National Longitudinal Mortality Study. , 1996, Annals of epidemiology.

[48]  Y. Benjamini,et al.  Controlling the false discovery rate: a practical and powerful approach to multiple testing , 1995 .

[49]  S. Korenman,et al.  Poverty and children's nutritional status in the United States. , 1994, American journal of epidemiology.

[50]  K. Flegal,et al.  Blood lead levels in the US population. Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1991) , 1994, JAMA.

[51]  K. Smith,et al.  Patterns of economic change surrounding the death of a spouse. , 1991, Journal of gerontology.

[52]  Deborah S. Smith.  Differential mortality in the United States before 1900. , 1983, The Journal of interdisciplinary history.

[53]  S. Holm.  A Simple Sequentially Rejective Multiple Test Procedure , 1979 .

[54]  E. Sydenstricker,et al.  A Study of the Relation of Factors of a Sanitary Character to Pellagra Incidence in Seven Cotton-Mill Villages of South Carolina in 1916. , 1920 .

[55]  J. Goldberger.  A Study of the Relation oí Family Income and other Economic Factors to Pellagra Incidence in Seven Cotton-Mill Villages of South Carolina in 1916. , 1920 .