More than a century of research has found strong connections between income and health. As a group, people with higher incomes live longer lives and experience better physical and mental health outcomes. Understanding how income influences health can inform policies, programs and resource allocation to improve the health and economic wellbeing of Ohioans.
In 2017, HPIO hosted an educational forum, Linking Health and Wealth: How Economic Vitality Can Lead to Healthier Ohioans, and released a policy brief on the topic, Connections between Income and Health.
This page provides links to resources that were referenced during the forum and in the brief, as well as additional data and information on income and health. If there is a resource you believe would be a useful addition to this page, please e-mail Zach Reat, firstname.lastname@example.org.
This page was last updated on 02/02/2018.
In HPIO’s 2017 Health Value Dashboard, Ohio ranked 29 out of 50 states and the District of Columbia on metrics related to the social and economic environment, including unemployment, poverty, labor force participation and income inequality. Below are links to state and national resources with information about income and related factors.
The agencies and websites listed below are resources for information about income in the U.S. In some cases, data is also available at state and local levels and may be disaggregated by race/ethnicity, gender, age or other factors.
The websites and reports listed below include information about income in Ohio. Some of the resources disaggregate information by race/ethnicity, gender, age and other factors.
Specific offices within the agencies listed below are responsible for developing and administering policies and programs that can impact the incomes of Ohioans.
Researchers have identified three primary ways in which income and health are connected:
The resources below provide an overview of the connections between income and health.
Individual health behaviors reflect personal choice, but research shows that social and environmental factors also have a strong influence on health behaviors.
Income influences access to health care through several factors, including access to high-quality healthcare services and affordable health insurance coverage.
Jobs that pay a living wage, offer flexibility to address life’s challenges and give employees a sense of control over their work promote better mental and physical health.
Health-related absenteeism impacts income by reducing productivity and making it more difficult to pursue advancement opportunities such as education, training or job promotion.
Temporary or permanent disabilities can impact income for working-age adults through job loss, reduction of hours, changing work duties and/or limiting access to opportunities for advancement.
Institutional, structural and interpersonal racism can influence both health and income. For example, residential segregation is shown to increase risk for poor birth outcomes, and discrimination in the workplace contributes to persistent wage and employment disparities experienced by minority groups.
Housing and neighborhood conditions impact health and income in numerous ways, including exposure to dangerous materials such as lead, exposure to violent crime and restricted access to quality education and employment opportunities.
Higher educational attainment is associated with higher income-earning potential and better health. In addition to the health benefits of higher income, higher educational attainment equips people with skills to more effectively navigate the healthcare system, communicate with providers and manage complex and/or chronic conditions.
Long-term exposure to stress can negatively affect health and potentially lead to unhealthy coping mechanisms, such as smoking and excessive drinking.
Policies and programs to increase incomes typically involve taxes, employment training/retraining or other supports such as food assistance or child care assistance. The evidence inventory below was developed for the Ohio Legislative Service Commission and included in the report, A New Approach to Reduce Infant Mortality and Achieve Equity: Policy Recommendations to Improve Housing, Transportation, Education and Employment. This report focused primarily on women of childbearing age, but the evidence inventory below includes policies and programs that impact incomes throughout the life course.
Three evidenced-based programs—tax credits, work supports and employment training and/or workforce development programs—were highlighted in the Connections between Income and Health brief. Information about these programs and how they are implemented in Ohio is provided below.
Tax credits reduce the amount of taxes households are required to pay. Refundable tax credits provide additional income for households that do not owe any income tax. Eligibility for refundable tax credits is typically limited to households with low incomes. An example of a refundable tax credit is the federal Earned Income Tax Credit (EITC).
Most tax credits and deductions are designed to promote economic activity, such as work and home ownership, and there is evidence that they are effective. For example, recent research found that the EITC and Child Tax Credit reduce poverty and encourage work among recipients. Research also shows that increases in the EITC may be related to improvements in health outcomes, including reduced pre-term birth and low birth weight.
Ohio allows tax filers with low incomes to claim a portion of the federal EITC on their state return. In tax year 2016, the Ohio EITC was non-refundable and capped for filers with incomes above $20,000.
Incorporating Economic Policy Into A ‘Health-In-All-Policies’ Agenda (requires access) compares population health outcomes in states to determine if certain economic policies are associated with better health outcomes. The study described in the article found better health outcomes in states with policies that increase the incomes of low-income families, such as higher tax credits, higher minimum wages or the absence of a right-to-work law. The study’s findings are summarized in this blog post.
Government programs for households with very low incomes, including Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Medicaid, Temporary Assistance for Needy Families (TANF) and Supplemental Security Income (SSI), provide cash or in-kind support to households with qualifying incomes. For example, WIC provides vouchers to purchase healthy foods for pregnant women and young children with incomes below 185 percent of the Federal Poverty Level (FPL).
The structure of some programs for people with very low incomes can be a barrier to achieving economic self-sufficiency. Most social safety net programs reduce benefits for recipients as earned income increases. This can create an economic disincentive to accepting a small raise or working more hours because the increase in earned income is at least partially offset by a decrease in benefits. This is referred to as a “benefit cliff.”
The federal government and states fund several programs to connect job seekers with the basic skills, training and supportive services they need to participate in the workforce. The federal Workforce Innovation and Opportunity Act (WIOA), signed into law in 2014, required states to submit a four-year workforce development strategy. Ohio’s Combined State Plan coordinates services for job seekers provided through the funding sources and programs listed below:
Ohio has chosen three additional programs to include in the state’s combined plan including:
The following sources are highlighted in the HPIO publication, Navigating Sources of Evidence: A Guide to Effective Prevention Strategies