Low-income employees' choices regarding employment benefits aimed at improving the socioeconomic determinants of health.
OBJECTIVE
Socioeconomic factors are associated with reduced health status in low-income populations. We sought to identify affordable employment benefit packages that might ameliorate these socioeconomic factors and would be consonant with employees' priorities.


METHODS
Working in groups (n = 53), low-income employees (n = 408; 62% women, 65% Black) from the Washington, DC, and Baltimore, Md, metropolitan area, participated in a computerized exercise in which they expressed their preference for employment benefit packages intended to address socioeconomic determinants of health. The hypothetical costs of these benefits reflected those of the average US benefit package available to low-income employees. Questionnaires ascertained sociodemographic information and attitudes. Descriptive statistics and logistic regression analysis were used to examine benefit choices.


RESULTS
Groups chose offered benefits in the following descending rank order: health care, retirement, vacation, disability pay, training, job flexibility, family time, dependent care, monetary advice, anxiety assistance, wellness, housing assistance, and nutrition programs. Participants varied in their personal choices, but 78% expressed willingness to abide by their groups' choices.


CONCLUSIONS
It is possible to design employment benefits that ameliorate socioeconomic determinants of health and are acceptable to low-income employees. These benefit packages can be provided at the cost of benefit packages currently available to some low-income employees.
Department of Clinical Bioethics, National Institutes of Health Clinical Center, Bethesda, Md 20982-1156, USA. mdanis@nih.gov
Marion
M
Danis
Francis
F
Lovett
Lindsay
L
Sabik
Katherin
K
Adikes
Glen
G
Cheng
Tom
T
Aomo
D000328:Adult; D001741:Black or African American; D015142:Baltimore; D003258:Consumer Behavior / Q000191:economics* / Q000706:statistics & numerical data; D004219:District of Columbia; D017049:Employer Health Costs; D005260:Female; D006264:Health Benefit Plans, Employee / Q000145:classification / Q000191:economics*; D007722:Health Knowledge, Attitudes, Practice; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000208:ethnology*; D012959:Socioeconomic Factors; D012962:Sociology, Medical / Q000191:economics*; D011795:Surveys and Questionnaires; D014504:Urban Health