{"id":23323,"date":"2023-02-05T04:55:00","date_gmt":"2023-02-04T20:55:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=23323"},"modified":"2023-02-05T10:12:42","modified_gmt":"2023-02-05T02:12:42","slug":"jama%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e7%be%8e%e5%9b%bd%e4%bd%8e%e6%94%b6%e5%85%a5%e5%ae%b6%e5%ba%ad%e5%84%bf%e7%ab%a5%e5%92%8c%e9%9d%92%e5%b0%91%e5%b9%b4%e7%9a%84%e5%ae%b6%e5%ba%ad","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=23323","title":{"rendered":"[JAMA\u53d1\u8868\u8bba\u6587]\uff1a\u7f8e\u56fd\u4f4e\u6536\u5165\u5bb6\u5ead\u513f\u7ae5\u548c\u9752\u5c11\u5e74\u7684\u5bb6\u5ead\u6536\u5165\u4e0e\u7f79\u60a3\u7387\u548c\u75c5\u6b7b\u7387\u7684\u76f8\u5173\u6027"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

December 27, 2022<\/p>\n\n\n\n

Association of Family Income With Morbidity and Mortality Among US Lower-Income Children and Adolescents<\/h1>\n\n\n\n

Victoria\u00a0Udalova,\u00a0Vinayak\u00a0Bhatia,\u00a0Maria\u00a0Polyakova<\/h3>\n\n\n\n

JAMA.\u00a0<\/em>2022;328(24):2422-2430. doi:10.1001\/jama.2022.22778<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Among children and adolescents from lower-income families in the US, is family income associated with health?<\/p>\n\n\n\n

Findings<\/strong>  This cross-sectional study included 795\u202f000 US participants aged 5 to 17 years with family income under 200% of the federal poverty threshold who accessed health care through Medicaid or the Children\u2019s Health Insurance Program. Higher family income was significantly associated with a lower prevalence of diagnosed infections, mental health disorders, injury, asthma, anemia, and substance use disorders and lower 10-year mortality.<\/p>\n\n\n\n

Meaning<\/strong>  Higher family income was associated with lower claims-based measures of morbidity and mortality among children and adolescents in lower-income families in the US.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Family income is known to be associated with children\u2019s health; the association may be particularly pronounced among lower-income children in the US, who tend to have more limited access to health resources than their higher-income peers.<\/p>\n\n\n\n

Objective<\/strong>  To investigate the association of family income with claims-based measures of morbidity and mortality among children and adolescents in lower-income families in the US enrolled in Medicaid or the Children\u2019s Health Insurance Program.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This cross-sectional analysis included 795\u202f000 participants aged 5 to 17 years enrolled in Medicaid (Medicaid Analytic eXtract claims, 2011-2012) living in families with income below 200% of the federal poverty threshold (American Community Survey, 2008-2013). Follow-up ended in December 2021.<\/p>\n\n\n\n

Exposures<\/strong>  Family income relative to the federal poverty threshold.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Record of International Classification of Diseases, Ninth Revision <\/em>codes for an infection, mental health disorder, injury, asthma, anemia, or substance use disorder and death record within 10 years of observation (Social Security Administration death records through 2021).<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Among 795\u202f000 individuals in the sample (all statistics weighted: mean [SD] income-to-poverty ratio, 90% [53%]; mean [SD] age, 10.6 [3.9] years; 56% aged 10 to 17 years), 33% had a diagnosed infection, 13% had a mental health disorder, 6% had an injury, 5% had asthma, 2% had anemia, 1% had a substance use disorder, and 0.6% died between 2011 and 2021, with the mean (SD) age at death of 19.8 (4.2) years. For those aged 5 to 9 years, higher family income was associated with lower adjusted prevalence of all outcomes, except mortality: children in families with an additional 100% income relative to the federal poverty threshold had 2.3 (95% CI, 1.8-2.9) percentage points fewer infections, 1.9 (95% CI, 1.5-2.2) percentage points fewer mental health diagnoses, 0.7 (95% CI, 0.5-0.8) percentage points fewer injuries, 0.3 (95% CI, 0.09-0.5) percentage points less asthma, 0.2 (95% CI, 0.08-0.3) percentage points less anemia, and 0.06 (95% CI, 0.03-0.09) percentage points fewer substance use disorder diagnoses. Except for injury and anemia, the associations were more pronounced among those aged 10 to 17 years than those 5 to 9 years (P<\/em>\u00a0for interaction <.05). For those aged 10 to 17 years, an additional 100% income relative to the federal poverty threshold was associated with a lower 10-year mortality rate by 0.18 (95% CI, 0.12-0.25) percentage points.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  Among children and adolescents in the US aged 5 to 17 years with family income under 200% of the federal poverty threshold who accessed health care through Medicaid or the Children\u2019s Health Insurance Program, higher family income was significantly associated with a lower prevalence of diagnosed infections, mental health disorders, injury, asthma, anemia, and substance use disorders and lower 10-year mortality. Further research is needed to understand whether these associations are causal.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  December 27, 202 […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23323"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=23323"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23323\/revisions"}],"predecessor-version":[{"id":23324,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/23323\/revisions\/23324"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=23323"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=23323"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=23323"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}