County Health Rankings Model

Income

In the model

Use County Health Rankings’ model of health to explore the measures that influence how long and how well we live.

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About

Income provides economic resources that shape choices about housing, education, child care, food, medical care, and more. Wealth, the accumulation of savings and assets, helps cushion and protect us in times of economic distress. As income and wealth increase or decrease, so does health.

Why Is Income Important to Health?

Income can come from jobs, investments, government assistance programs or retirement plans. Income allows families and individuals to purchase health insurance and medical care, but also provides options for healthy lifestyle choices. Poor families and individuals are most likely to live in unsafe homes and neighborhoods, often with limited access to healthy foods, employment options, and quality schools.

While the starkest difference in health is between those with the highest and lowest incomes, this relationship persists throughout all income brackets. Adults in the highest income brackets are healthier than those in the middle class and will live, on average, more than six years longer than those with the lowest incomes [1]. 

The ongoing stress and challenges associated with poverty can lead to cumulative health damage, both physical and mental. Chronic illness is more likely to affect those with the lowest incomes, and children in low income families are sicker than their high income counterparts. Low income mothers are more likely than higher income mothers to have pre-term or low birthweight babies, who are at higher risk for chronic diseases and behavioral problems [1]. 

Income inequality is a measure of the divide between the poor and the affluent. Income inequality in our communities affects how long and how well we live and is particularly harmful to the health of poorer individuals [2]. Income inequality within US communities can have broad health impacts, including increased risk of mortality, poor health, and increased cardiovascular disease risks. Inequalities in a community can accentuate differences in social class and status and serve as a social stressor. Communities with greater income inequality can experience a loss of social connectedness, as well as decreases in trust, social support, and a sense of community for all residents.

Communities can adopt and implement policies that help reduce and prevent poverty, now and for future generations. The greatest health improvements may be made by increasing income at the lower levels, where small increases can have the greatest impacts.

References

[1] Braveman P, Egerter S, Barclay C. Income, wealth and health. Exploring the Social Determinants of Health Issue Brief No. 4. Princeton: Robert Wood Johnson Foundation (RWJF); 2011.  
[2] Lynch J, Smith GD, Harper S, Hillemeier M. Is income inequality a determinant of population health? Part 2. U.S. National and regional trends in income inequality and age- and cause-specific mortality. Milbank Quarterly. 2004; 82(2):355-400.

Measures

Our Rankings show how healthy a community is as well as indicators for future health. This provides a starting point for action on improving health for all. Dig deeper into the measures below to learn more about our approaches to measuring health.

Ratio of women's median earnings to men's median earnings for all full-time, year-round workers, presented as "cents on the dollar."
The hourly wage needed to cover basic household expenses plus all relevant taxes for a household of one adult and two children.