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Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study
OBJECTIVE: To identify county characteristics associated with high versus low well-being among high-poverty counties. DESIGN: Observational cross-sectional study at the county level to investigate the associations of 29 county characteristics with the odds of a high-poverty county reporting populati...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500307/ https://www.ncbi.nlm.nih.gov/pubmed/32948545 http://dx.doi.org/10.1136/bmjopen-2019-035645 |
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author | Arora, Anita Spatz, Erica S Herrin, Jeph Riley, Carley Roy, Brita Rula, Elizabeth Y Kell, Kenneth Patton Krumholz, Harlan M |
author_facet | Arora, Anita Spatz, Erica S Herrin, Jeph Riley, Carley Roy, Brita Rula, Elizabeth Y Kell, Kenneth Patton Krumholz, Harlan M |
author_sort | Arora, Anita |
collection | PubMed |
description | OBJECTIVE: To identify county characteristics associated with high versus low well-being among high-poverty counties. DESIGN: Observational cross-sectional study at the county level to investigate the associations of 29 county characteristics with the odds of a high-poverty county reporting population well-being in the top quintile versus the bottom quintile of well-being in the USA. County characteristics representing key determinants of health were drawn from the Robert Wood Johnson Foundation County Health Rankings and Roadmaps population health model. SETTING: Counties in the USA that are in the highest quartile of poverty rate. MAIN OUTCOME MEASURE: Gallup-Sharecare Well-being Index, a comprehensive population-level measure of physical, mental and social health. Counties were classified as having a well-being index score in the top or bottom 20% of all counties in the USA. RESULTS: Among 770 high-poverty counties, 72 were categorised as having high well-being and 311 as having low well-being. The high-well-being counties had a mean well-being score of 71.8 with a SD of 2.3, while the low-well-being counties had a mean well-being score of 60.2 with a SD of 2.8. Among the six domains of well-being, basic access, which includes access to housing and healthcare, and life evaluation, which includes life satisfaction and optimism, differed the most between high-being and low-well-being counties. Among 29 county characteristics tested, six were independently and significantly associated with high well-being (p<0.05). These were lower rates of preventable hospital stays, higher supply of primary care physicians, lower prevalence of smoking, lower physical inactivity, higher percentage of some college education and higher percentage of heavy drinkers. CONCLUSIONS: Among 770 high-poverty counties, approximately 9% outperformed expectations, reporting a collective well-being score in the top 20% of all counties in the USA. High-poverty counties reporting high well-being differed from high-poverty counties reporting low well-being in several characteristics. |
format | Online Article Text |
id | pubmed-7500307 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-75003072020-10-05 Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study Arora, Anita Spatz, Erica S Herrin, Jeph Riley, Carley Roy, Brita Rula, Elizabeth Y Kell, Kenneth Patton Krumholz, Harlan M BMJ Open Public Health OBJECTIVE: To identify county characteristics associated with high versus low well-being among high-poverty counties. DESIGN: Observational cross-sectional study at the county level to investigate the associations of 29 county characteristics with the odds of a high-poverty county reporting population well-being in the top quintile versus the bottom quintile of well-being in the USA. County characteristics representing key determinants of health were drawn from the Robert Wood Johnson Foundation County Health Rankings and Roadmaps population health model. SETTING: Counties in the USA that are in the highest quartile of poverty rate. MAIN OUTCOME MEASURE: Gallup-Sharecare Well-being Index, a comprehensive population-level measure of physical, mental and social health. Counties were classified as having a well-being index score in the top or bottom 20% of all counties in the USA. RESULTS: Among 770 high-poverty counties, 72 were categorised as having high well-being and 311 as having low well-being. The high-well-being counties had a mean well-being score of 71.8 with a SD of 2.3, while the low-well-being counties had a mean well-being score of 60.2 with a SD of 2.8. Among the six domains of well-being, basic access, which includes access to housing and healthcare, and life evaluation, which includes life satisfaction and optimism, differed the most between high-being and low-well-being counties. Among 29 county characteristics tested, six were independently and significantly associated with high well-being (p<0.05). These were lower rates of preventable hospital stays, higher supply of primary care physicians, lower prevalence of smoking, lower physical inactivity, higher percentage of some college education and higher percentage of heavy drinkers. CONCLUSIONS: Among 770 high-poverty counties, approximately 9% outperformed expectations, reporting a collective well-being score in the top 20% of all counties in the USA. High-poverty counties reporting high well-being differed from high-poverty counties reporting low well-being in several characteristics. BMJ Publishing Group 2020-09-17 /pmc/articles/PMC7500307/ /pubmed/32948545 http://dx.doi.org/10.1136/bmjopen-2019-035645 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Public Health Arora, Anita Spatz, Erica S Herrin, Jeph Riley, Carley Roy, Brita Rula, Elizabeth Y Kell, Kenneth Patton Krumholz, Harlan M Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study |
title | Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study |
title_full | Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study |
title_fullStr | Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study |
title_full_unstemmed | Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study |
title_short | Identifying characteristics of high-poverty counties in the United States with high well-being: an observational cross-sectional study |
title_sort | identifying characteristics of high-poverty counties in the united states with high well-being: an observational cross-sectional study |
topic | Public Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7500307/ https://www.ncbi.nlm.nih.gov/pubmed/32948545 http://dx.doi.org/10.1136/bmjopen-2019-035645 |
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