Income, Urbanicity Influence Perceptions of Factors that Shape Health.
Income, Urbanicity Influence Perceptions of Factors that Shape Health
A new global study found that highest-earning people view genetics as the most important factor for their health, while lower-income people most value social support. Urban residents prioritize healthcare, while nonurban residents also believe social support plays the largest role in their health.
Robust research shows how determinants such as income and environment influence a person’s physical and mental health, and now a new study led by School of Public Health researchers captures how these demographic factors also shape how people across the globe think about health.
Published in Communications Medicine, a journal in the Nature portfolio, the study spanned eight countries with varying characteristics and found that income level and degree of urban living may help determine what people believe to be most influential to their health.
The global findings show that people with higher incomes tend to emphasize the importance of genetics to their health, while lower-income individuals view social support as a top contributing factor. People in urban areas appear to prioritize healthcare for maintaining optimal health, while people in nonurban areas find the greatest value in social support for their health.
The findings underscore how, regardless of the country, socioeconomic factors play a substantial role in informing people’s perceptions of what matters most for health.
“Our study highlights that social and economic positions significantly shape people’s views of the forces that shape their health,” says study lead and corresponding author Salma Abdalla (SPH’16, ’22), assistant professor of global health and epidemiology and an SPH alum. “Understanding these differing perspectives is essential for designing effective public health messaging that resonates with diverse communities and can lead to population-level interventions that tackle larger determinants of health.”
For the study, Abdalla and colleagues from SPH utilized survey data from 8,753 individuals in Brazil, China, Germany, Egypt, India, Indonesia, Nigeria, and the United States to conduct multiple analyses of the top factors that participants perceived to be most important for their health. The participants selected from a list of 10 determinants: healthcare, education, built environment, employment conditions, income and wealth, childhood conditions, culture, social support, and politics.
Compared to the highest-income individuals, all other income groups—upper-middle income, middle income, lower-middle income, and lowest income—were much less likely to select genetics as the top factor affecting their health. Aside from genetics, people across all income levels (and most countries) tended to have comparable views on the other factors as they relate to their health.
Aside from healthcare, survey participants in urban settings also identified education, the built environment, and income and wealth as important determinants of health in greater proportions than people in nonurban settings, while nonurban residents deemed social support, employment, and childhood conditions, culture, and politics as more impactful to their health.
“The divergence in our results with higher income groups ranking genetics as important to health can perhaps be due to greater access to genetic information and a tendency to attribute success to inherent traits,” Abdalla says. “Conversely, lower-income and rural groups prioritize social support, reflecting its crucial role as a safety net and source of health information in their communities.”
The study’s senior author is Sandro Galea, dean and Robert A. Knox Professor. Coauthors include SPH alums Ethan Assefa (SPH’23), Samuel Rosenberg (SPH’23) research data analyst in the Department of Epidemiology; Mark Hernandez (SPH’21), and Shaffi Fazaludeen Koya (SPH’22).