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Change in income and change in self-rated health: Systematic review of studies using repeated measures to control for confounding bias

  • Gunasekara, Fiona Imlach
  • Carter, Kristie
  • Blakely, Tony
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    It is generally assumed that income is strongly and positively associated with health. However, much of the evidence supporting this assumption comes from cross-sectional data or analyses that have not fully accounted for biases from confounding and health selection (the reverse pathway from health to income). This paper reports results of a systematic review of panel and longitudinal studies investigating whether changes in income led to changes in self-rated health (SRH) in adults. A variety of electronic databases were searched, up until January 2010, and thirteen studies were included, using data from five different panel or longitudinal studies. The majority of studies found a small, positive and statistically significant association of income with SRH, which was much reduced after controlling for unmeasured confounders and/or health selection. Residual bias, particularly from measurement error, probably reduced this association to the null. Most studies investigated short-term associations between income and SRH or the effect of temporary (usually one year) income changes or shocks, so did not rule out possibly stronger associations between health and longer-term average income or income lagged over longer time periods. Nevertheless, the true causal short-term relationship between income and health, estimated by longitudinal studies of income change and SRH that control for confounding, may be much smaller than that suggested by previous, mostly cross-sectional, research.

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    File URL: http://www.sciencedirect.com/science/article/B6VBF-51HD71X-1/2/1ede6868ea8dd1bf1d744051e27c86ca
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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 72 (2011)
    Issue (Month): 2 (January)
    Pages: 193-201

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    Handle: RePEc:eee:socmed:v:72:y:2011:i:2:p:193-201
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