Literature Review: Income's Impact on Health Outcomes (ENL0079)

This literature review examines the association between income and health outcomes, focusing on income as a social determinant. The review synthesizes findings from multiple studies using databases like MEDLINE, PsycINFO, and Scopus, with inclusion criteria of studies from the last five years. The review explores how factors like low socioeconomic status, income inequality, and government healthcare policies affect health outcomes. Key findings highlight the complex relationship between income and health, emphasizing the need to understand how income influences health positively or negatively, and its impact on healthcare delivery. The review includes references to several studies that support the understanding of income as a critical determinant in shaping health outcomes and patient perceptions of healthcare.

Association of Income as a Social Determinant in Health Outcome
A Review of Literature
Name

Concept map
HEALTH
OUTCOME
LIFESTYLE INCOME
AFFORDABILITY
SERVICES
AWARENESS
DETERMINANTS
INFLUENCE
SOCIAL
FACTORS

Studies selected
Authors Focus of study Research
design
Sample methods Results
Arpey, N. C.,
Gaglioti, A. H., &
Rosenbaum, M.
low SES patients
perceive clinician
bias might affect
their health care
Cross sectional
survey
80 enrollees In-depth
interviews
SES affected their
health care
Daniel, H.,
Bornstein, S. S.,
& Kane, G. C
role of social
determinants in
health
Systematic
review
Various
studies
Thematic
analsyis
screening is essential
in identifying social
determinants of
health
Matthew, P., &
Brodersen, D. M.
correlation
between income
inequality, and
individual
behavioral,
physical, and
mental health
outcomes
An empirical
analysis
Various
studies
Systematic
review
income inequality
was found to have
significant
relationships with
behavioral, physical,
and mental health
outcomes,
Lenhart, O. relationship
between income
and health by using
an expansion of the
Earned Income Tax
Credit
An empirical
analysis
Various
studies
Thematic
analysis
income improves the
likelihood of health
outomces
Kim, T. J., & von
dem Knesebeck,
O.
lower income
association with
and obesity reverse
causality
Systematic
review and meta-
analysis
21 studies
Logistic
regression
Cochran’s Q test
and Higgin’s
Egger’s
regression test
consistent evidence
for reverse causality

Methodology
• A search strategy was employed using various
databases such as MEDLINE, PsycINFO, MEDLINE,
and Scopus.
• The key words used are ‘Income’ or ‘social
determinants’, ‘Health’ and ‘outcome’
• Inclusion criteria entailed studies undertaken in
the last five years
• Extracted and quality assessed independently for
inclusion and relevancy purposes

Literature review
• Low SES patients perceive clinician bias might affect their
health care (Daniel, Bornstein & Kane, 2018)
• Role of social determinants in health, (Arpey, Gaglioti &
Rosenbaum 2017).
• Matthew & Brodersen (2018) correlated aspects of income
inequality on health outcome
• Kim & von dem Knesebeck (2018), undertook a systematic
review and meta analysis on the interplay of income and
obesity
• Aspect of reverse causality observed
• Lenhart (2019), focuses the underlying effects on health
based on government related health care polices

Objectives
• All studies met the set objectives
• Studies met the set criteria and aims of the
study

Literature review impact
• Essential in shaping the overall understanding of
health care outcomes
• Inherent and complex relationship across settings of
the interplay income has on outcome of health
• Understanding how income can influence health
either negatively or positively and vice versa is
essential in shaping the cognizance of these factors in
the delivery of care services in the health care arena
• need to understand how communities and individuals
perceive health outcomes

References
Arpey, N. C., Gaglioti, A. H., & Rosenbaum, M. E. (2017). How socioeconomic status
affects patient perceptions of health care: a qualitative study. Journal of primary
care & community health, 8(3), 169-175.
Daniel, H., Bornstein, S. S., & Kane, G. C. (2018). Addressing social determinants to
improve patient care and promote health equity: an American College of
Physicians position paper. Annals of internal medicine, 168(8), 577-578.
Kim, T. J., & von dem Knesebeck, O. (2018). Income and obesity: what is the
direction of the relationship? A systematic review and meta-analysis. BMJ open,
8(1), e019862.
Lenhart, O. (2019). The effects of income on health: new evidence from the Earned
Income Tax Credit. Review of Economics of the Household, 17(2), 377-410.
Matthew, P., & Brodersen, D. M. (2018). Income inequality and health outcomes in
the United States: An empirical analysis. The Social Science Journal, 55(4), 432-
442.