title: Primary care, income inequality, and self-rated health in the United States: a mixed-level analysis.
abstract: Using the 1996 Community Tracking Study household survey, the authors examined whether income inequality and primary care, measured at the state level, predict individual morbidity as measured by self-rated health status, while adjusting for potentially confounding individual variables. Their results indicate that distributions of income and primary care within states are significantly associated with individuals' self-rated health; that there is a gradient effect of income inequality on self-rated health; and that individuals living in states with a higher ratio of primary care physician to population are more likely to report good health than those living in states with a lower such ratio. From a policy perspective, improvement in individuals' health is likely to require a multi-pronged approach that addresses individual socioeconomic determinants of health, social and economic policies that affect income distribution, and a strengthening of the primary care aspects of health services.
authors: Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205-1996, USA.
authors: L
authors: L
authors: Shi
authors: B
authors: B
authors: Starfield
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000145:classification* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011203:Poverty / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D020377:Self Efficacy; D014481:United States / Q000453:epidemiology