Social Science & Medicine
Volume 61, Issue 8 , October 2005, Pages 1776-1784

Relating health policy to women's health outcomes

Jennifer P. Wisdoma, , , Michelle Berlinb,  and Jodi A. Lapidusa,

aDepartment of Public Health and Preventive Medicine, Oregon Health &
Science University, 3181 SW Sam Jackson Park Road, CSB 669, Portland, OR
97239-3098, USA
bDepartments of Obstetrics and Gynecology, Medical Informatics and Clinical
Epidemiology and Public Health and Preventive Medicine, Oregon Health &
Science University, 3181 Sam Jackson Park Rd UHN50 Portland, OR 97239-3098,
USA

Available online 21 April 2005.
Abstract
Individuals’ social and economic circumstances, including socioeconomic
status and medical care availability, are central to health outcomes,
particularly for women. These factors are often mediated by governmental
policies. This exploratory study found associations between women's health
outcomes and state-level policies related to women's health. Outcomes were
mortality rates for four leading causes of death for women in the US (heart
disease, stroke, lung cancer, and breast cancer), infant mortality, and a
mental health outcome variable. State policies on key women's health issues
were evaluated on the degree to which they adequately protected women's
health. Our regression models accounted for significant variance in
mortality rates and substantial variance in the mental health outcome.
Policies affecting access to care (Medicaid eligibility and efforts to
expand Medicaid) and community (environmental health tracking and violence
against women) were significantly associated with mortality outcomes. State
health policies should be examined further for their relationship to health
outcomes.

Keywords: Mortality rates; Women's health; Chronic disease; Infant
mortality; State-level health policy, USA
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Time on my side? Life course trajectories of poverty and health

Peggy McDonougha, , , Amanda Sackerb and Richard D. Wigginsc

aDepartment of Public Health Sciences, University of Toronto, Ont., M5S
1A8, Canada
bUniversity College, London
cCity University, London

Available online 26 April 2005.
Abstract
This study examines the relationship between poverty and health in time.
Following the argument that time is significant for shaping the experience
of being poor or not poor and growing evidence of heterogeneity in
long-term patterns of poverty, we investigate whether different kinds of
poverty have distinct consequences for long-term health. Using data from
the 1968–1996 annual waves of the United States Panel Study of Income
Dynamics Data, we estimate a general growth mixture model to assess the
relationship between the longitudinal courses of poverty and health. The
model allows us to first estimate latent poverty classes in the data and
then determine their effects on latent self-rated health. Four types of
long-term poverty patterns characterized as stable nonpoor, exiting
poverty, entering poverty and stable poor were evident in the data. These
different kinds of poverty affected self-rated health trajectories in
distinct ways, but worked in concert with age, education and race to create
gaps in initial health status that were constant over time.

Keywords: Poverty; Self-rated health; Trajectories; Inequalities; USA