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

Fiona Imlach Gunasekara, Kristie Carter and Tony Blakely

Social Science & Medicine, 2011, vol. 72, issue 2, 193-201

Abstract: 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.

Keywords: Income; Health; change; Longitudinal; studies; Systematic; review; Self-rated; health (search for similar items in EconPapers)
Date: 2011
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Citations: View citations in EconPapers (34)

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