Why Even Healthy Low-Income People Have Greater Health Risks Than Higher-Income People

by Peter J. Cunningham

The health of people with low incomes often suffers because they can’t afford adequate housing, food, or child care. Such living conditions, and the stress they cause, can lead to higher rates of  tobacco and alcohol use and increase the risk of health problems developing or worsening over time.

In addition, partly because they are more likely to be unable to afford care, people with low-incomes use fewer preventive care services. As a result, there are fewer opportunities for practitioners to assess and educate these patients about their health risks. Even when low-income people do see health care providers, the social needs like poor housing that may affect their health and complicate treatment are rarely addressed. If health plans and providers can better meet the needs of these patients, such improvement might spur higher quality improvements throughout the system.

To examine the impact of income on health, we analyzed data from the 2014–16 National Health Interview Survey conducted by the Centers for Disease Control and Prevention. We found that even relatively healthy lower-income people — those who earn 200% or less of the federal poverty level (FPL), or about $24,000 or less a year, and have fewer than three chronic conditions and no functional limitations — have higher health risks, greater social needs, and worse access to care than relatively healthy moderate-income (200%–400% FPL) and higher-income (>400% FPL) people.

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