O’Campo P, Urquia M. Aligning method with theory: a comparison of two approaches to modeling the social determinants of health. Maternal and Child Health Journal. 2012; 16 (9): 1870-8.
Issue: Health equity researchers generally study the links between having a low income and a single health problem like diabetes. But a low income doesn’t simply lead to one disease or another. It has an overall negative effect on physical and mental health and leads to multiple, concurrent health problems.
What we did: We looked at health survey data from more than 6,000 Canadian women who had recently given birth. We looked at their experience of these health problems: adverse birth outcomes, postpartum depression, serious abuse, hospitalization during pregnancy and frequent stressful life events. Typically, researchers would look at how income impacted each one of these conditions, separately. In this study, we looked at income and the chance of having multiple health problems (3-5 problems) at the same time.
What we found: Lower income was directly related to having multiple health problems. New mothers with very low incomes were nearly 20 times more likely to face multiple health problems than new mothers with high incomes.
Implications for policy: This study suggests that if new mothers did not have to live on low household incomes, they could see substantial increases to their health and the health of their babies. We found that if all new mothers had household incomes of at least $50,000 a year, the occurrence of multiple health problems around pregnancy could be reduced by 60%.
Implications for research: By focusing on single diseases, researchers can inadvertently obscure the fact that low income poses pervasive, generalized harm to health and leads to multiple health problems. Researchers should adopt alternative research models that reflect the overall health impacts of socio-economic inequality.
Contact: Patricia O’Campo (O’CampoP@smh.ca)