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ETSU study: lower income associated with significantly worse health outcomes in Tennessee

Contributed • Jan 17, 2020 at 6:38 PM

Dr. Kate Beatty, interim director of research for the East Tennessee State University College of Public Health’s Center for Rural Health Research, has authored an article in the Southern Medical Journal.

The article, “Poverty and Health in Tennessee,” examines the effects of poverty on health among the 95 counties of Tennessee.

Beatty is also an assistant professor in the college’s Department of Health Services Management and Policy. Dr. Randy Wykoff, dean, and Olivia Egen, student in the Doctor of Public Health program, are co-authors along with Dr. John Dreyzehner, former commissioner of the Tennessee Department of Health.

“Differences in county-level health outcomes vary dramatically by income level, even when those counties are located within the same state,” Beatty said. “At a time in U.S. history when life expectancy is declining for the first time in decades and the gap between the rich and poor is widening, a better understanding of the relationship between poverty and health is essential to addressing the health challenges faced by the people of Tennessee.”

The researchers ranked all of the counties of Tennessee by five-year median household income, from the wealthiest to the poorest. The counties were divided into quintiles, from wealthiest to poorest, to reflect the general impact of wealth on health.

The study found people living in the wealthiest quintile lived on average two and a half to four years longer and had lower rates of all unhealthy behaviors and health outcomes investigated compared with those in the poorest quintile.

This disparity was even more pronounced when comparing the wealthiest five counties to the poorest five. For every measure of health behavior and health outcome, people living in the wealthiest quintile were healthier than those living in the poorest quintile.

Key findings included women living in the wealthiest quintile lived on average two and a half years longer and men lived four years longer, and both had significantly lower rates of smoking, obesity, and lack of physical activity.

Of the 19 wealthiest counties in Tennessee, eight had lower premature death rates than the national median, whereas all of Tennessee’s 19 poorest counties had premature death rates that were worse than the national median.

This study highlights the fact that lower income is associated with significantly worse health outcomes in Tennessee and reinforces the importance of economic development for improving Tennessee’s overall health statistics, Beatty added.

The Center for Rural Health Research at ETSU was established by Tennessee Governor Bill Lee in July 2019. The goal of the Center is to improve health in rural and nonurban areas.

To learn more, visit www.etsu.edu/cph/center_phpp.

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