Nonlinearity in Demographic and Behavioral Determinants of Morbidity
- 18 December 2003
- journal article
- Published by Wiley in Health Services Research
- Vol. 38 (6p2), 1791-1818
- https://doi.org/10.1111/j.1475-6773.2003.00203.x
Abstract
To examine nonlinearity of determinants of morbidity in the United States A secondary analysis of data on individuals with dietary data from the Cancer Epidemiology Supplement and National Health Interview Survey (NHIS) 1987, a cross-sectional, stratified random sample of the U.S. population (n = 22,080). A statistical exploration using additive multiple regression models. A Morbidity Index (0-30 points), derived from 1987 National Health Interview Survey data, combines number of conditions, hospitalizations, sick days, doctor visits, and degree of disability. Behavioral (health habits) variables were added to multivariate models containing demographic terms, with Morbidity Index and Self-assessed Health outcomes (n = 17,612). Tables and graphs compare models of morbidity with self-assessed health models, with and without behavioral terms. Graphs illustrate curvilinear relationships. Morbidity and health are associated nonlinearly with age, race, education, and income, as well as alcohol, diet change, vitamin supplement use, body mass index (BMI), marital status/living arrangement, and smoking. Diet change and supplement use, education, income, race/ethnicity, and age relate differently to self-assessed health status than to morbidity. Morbidity is strongly associated with income up to about dollars 15,000 above poverty. Additional income predicts no further reduction in morbidity. Better health is strongly related to both higher income and education. After controlling for income, black race does not predict morbidity, but remains associated with lower self-assessed health. Good health habits, as captured in these models, are associated with a 10-20-year delay in onset and progression of morbidity.This publication has 26 references indexed in Scilit:
- Income dynamics and adult mortality in the United States, 1972 through 1989.American Journal of Public Health, 1997
- A Complete Guide to the Freshwater Fishes of Southern AfricaIchthyology & Herpetology, 1996
- The shape of the relationship between income and mortality in the United States: Evidence from the National Longitudinal Mortality StudyAnnals of Epidemiology, 1996
- Panel III: Behavioral risk factors related to chronic diseases in ethnic minorities.Health Psychology, 1995
- Educational Status and Active Life Expectancy among Older Blacks and WhitesThe New England Journal of Medicine, 1993
- Health Practices and Disability: Some Evidence from Alameda CountyPreventive Medicine, 1993
- Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease.American Journal of Public Health, 1992
- Quitting Smoking in the United States in 1986JNCI Journal of the National Cancer Institute, 1990
- Determinants of Health Services Utilization Among the Black and White ElderlySocial Work in Public Health, 1990
- Diet and chronic disease issues for minority populationsJournal of Nutrition Education, 1990