Search

Previous attempts to measure material well-being or hardship have not made clear the relationship of individual items to the broader concept of hardship. The current study used the Survey of Income and Program Participation (SIPP), a large-scale U.S. survey with a large number of questions on the material circumstances of households to create a measurement model of hardship that takes this relationship into account. A higher-order model with five-first-order factors: consumer durables, resources available to meet needs, housing conditions, neighborhood problems and crime, and community services, and a single second-order factor "hardship" fit the data well, with the "Housing" and "Neighborhood" first-order factors most strongly related to the higher-order hardship construct. Desppove te our attempts to tie the hardship measures to objective conditions, subjective evaluations were strongly related to most of the factors.

Abstract: Material deprivation has been measured in a variety of ways, such as in terms of income shortfalls or the experience of different types of material hardship. This paper tests the extent to which indicators of hardship are associated with income poverty. Using a U.S. dataset with detailed income and poverty information observed over a few years, we find that timing, duration, and depth of poverty are all associated with material hardships (food insecurity, difficulty meeting basic needs, lack of consumer durables, housing problems, neighborhood problems, and fear of crime). Even very short spells of poverty have a measurable impact on material well-being, although not all types of well-being are affected in equal measures. [Copyright &y& Elsevier]

CONTEXT. Disparities in child health are a major public health concern. However, it is unclear whether these are predominantly the result of low income, race, or other social risk factors that may contribute to their health disadvantage. Although others have examined the effects of the accumulation of risk factors, this methodology has not been applied to child health. OBJECTIVE. We tested 4 social risk factors (poverty, minority race/ethnicity, low parental education, and not living with both biological parents) to assess whether they have cumulative effects on child health and examined whether access to health care reduced health disparities. DESIGN. We analyzed data on 57 553 children <18 years from the 1994 and 1995 National Health Interview Survey Disability Supplement. Of the 4 risk factors, 3 (poverty, low parental education, and single-parent household) were consistently associated with child health. These were summed, generating the Social Disadvantage Index (range: 0-3). RESULTS. A total of 43.6% of children had no social disadvantages, 30.8% had 1, 15.6% had 2, and 10.0% had all 3. Compared with those with no social disadvantages, the odds ratios (ORs) of being in "good, fair, or pour health" (versus "excellent or very good") were 1.95 for 1 risk, 3.22 for 2 risks, and 4.06 for 3 risks. ORs of having a chronic condition increased from 1.25 (1 risk) to 1.60 (2 risks) to 2.11 (3 risks). ORs for activity limitation were 1.51 (1 risk) to 2.14 (2 risks) and 2.88 (3 risks). Controlling for health insurance did not affect these findings. CONCLUSIONS. The accumulation of social disadvantage among children was strongly associated with poorer child health and having insurance did not reduce the observed health disparities. [ABSTRACT FROM AUTHOR]