Income

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. Princeton: Robert Wood Johnson Foundation (RWJF); 2011. Exploring the Social Determinants of Health Issue Brief No. 4. 
[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 Q. 2004;82(2):355-400.

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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.

When it comes to developing and implementing solutions to problems that affect communities, evidence matters. The strategies below give some ideas of ways communities can harness evidence to make a difference locally. You can learn more about these and other strategies in What Works for Health, which summarizes and rates evidence for policies, programs, and systems changes.

Provide financial assistance to working parents, or parents attending school, to pay for center-based or certified in-home child care
Support subsidized asset accumulation programs in which deposits by low and moderate income participants are matched by program sponsors; withdrawals must be used for qualified expenses to retain matching funds
Provided work supports for low income individuals and families (e.g., job search assistance, transitional jobs, subsidized child care, health insurance, etc.); participants worked at least 30 hours/week
Establish dedicated child development accounts (CDAs) to build assets over time with contributions from family, friends, and sometimes, supporting organizations; also called children’s savings accounts (CSAs)

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