Income and Education Impact Family Health
By Dr. James Palermo // May 17, 2012
Healthcare Annual Report
Add the latest findings of the Center for Disease Control’s (CDC) annual report card on the nation’s health, Health, United States, 2011, 
to the long list of reasons to stay in school.
A special highlight “Socioeconomic Status and Health” section of the almost 600 page CDC report released last week states that a higher income and educational level for the head of a household is associated with a wide range of health improvements for their children and themselves.
Personal and Family Health Tied To Education and Socioeconomic Levels
According to the report, which covers virtually every health statistic tracked by the federal government, when adults in the household are poor or didn’t finish college, children are far more likely to be obese, have Attention Deficit Hyperactivity Disorder (ADHD), miss dental checkups, be sedentary and spend too much time in front of the TV or on the computer playing video games.
In households with income below 400% of the federal poverty level, which is about $92,000 in 2012, 40% of children spent more than 2 hours a day watching TV or playing video games, compared to about 30% of children in more affluent households.
For children who live in households where the income is below twice the poverty level (about $46,000) the likelihood of being diagnosed with ADHD was about 50% higher compared with children from wealthier families.
75% of babies born to mothers who had finished college or gone on to grad school gleaned the benefits of being breast fed, while fewer than half the infants born to women with less than a bachelor’s degree were breast fed.
Certain health choices, behaviors and outcomes in adults, such as obesity in women, colorectal cancer screening, smoking, depression and life expectancy, were also found to be associated with socioeconomic and educational levels.
According to the report, the life-expectancy gap between high school dropouts and college graduates has been increasing. Although the relationship has long been recognized, the numerical findings may still be surprising.
Between 1996 and 2006, the gap in life expectancy at age 25 between those with less than a high school education and those with a Bachelor’s degree or higher education increased by 1.9 years for men and 2.8 years for women. So on average, in 2006, a 25-year-old man without a high school diploma had a life expectancy 9.3 years less than a man with a Bachelor’s degree or higher, and a woman without a high school diploma had a life expectancy 8.6 years less than her counterpart with a Bachelor’s degree or higher.
The Good News
With a few exceptions, the report indicated that Americans’ health has generally continued to improve.
Infant mortality, of which the most recent available data is from 2008, continues a progressive albeit slow decline, with life expectancy climbing up a few months and mortality rates trending down.
Certain risk factors have also shown improvement, which reflects a population more focused on controlling those behaviors and conditions that contribute to preventable chronic disease.
The prevalence of uncontrolled high blood pressure among adults with hypertension decreased dramatically from 74% to 49% over roughly the past fifteen years. Also, over that time period the percentage of adults with a high serum total cholesterol level (defined as greater than or
equal to 240 mg/dL) declined from 20% to 14%.
The Bad News
Unfortunately it’s not all good news. The report affirmed what has been declared a health crisis by many–the prevalence of overweight and obese Americans is increasing at an alarming and very costly rate.
The percentage of adults with grade 1 obesity (a body mass index [BMI] of 30.0–34.9) increased from 14% to 20% over the past fifteen years Those with grade 2 obesity (BMI of 35.0–39.9) nearly doubled, from 5% to 9%, and those with grade 3 or higher obesity (BMI of 40 or higher) rose from 3% to 6%.
Obesity is also on the rise in children and teens in the past fifteen years, with the prevalence of obesity among preschool-age children 2–5 years of age increased from 7% to 12%, and among school-age children and adolescents increased from 11% to18%.
According to data taken from the National Health and Nutrition Examination Survey from 2009-2010, more than one-third of adults and almost 17% of youth were obese.
Health Economics Trends
Measures of health economics showed mixed trends and reflected the overall state of the U.S. economy.
The percentage of children without any medical insurance coverage declined steadily from about 13% in 2000 to 8% in 2010, but, as expected with the recession and unemployment numbers, lack of insurance among adults rose over the same period, affecting both the young and the middle-aged.
Personal expenditures on health showed continued straight-line growth in every category of health spending: hospital care, physician and clinical services, prescription drugs, nursing homes, and home healthcare.
It was recently reported in the 2012 Milliman Medical Index that the national annual cost of medical care for a typical family of four with PPO coverage has edged up over $20,000 for the first time, with estimates of annual cost at $20,728. That’s a record $1,335 increase in the total cost of care compared with 2011.
In 2000, about 10% of Americans with private insurance, 12% of Medicaid recipients, and 25% of the uninsured said they delayed or didn’t get needed medical care because of costs. By 2009, the corresponding figures were 19%, 13%, and 36%, the CDC report indicated.
According to the Milliman report, in what may be an indicator of economic recovery, the percentage of Americans who said they skimped on healthcare because of costs dipped slightly in 2010 from the year before, however, with the exception of people on Medicaid, the drop did not come close to erasing the increases seen from 2000 to 2009. Through a combination of copayments, deductions, and premiums, the prototypical family of four will be responsible for a record share—42%—of its medical costs.
