Excerpts from... and abstract below...

Health behaviours and health: evidence that the relationship is not
conditional on income adequacy
Social Science and Medicine Volume: 51, Issue: 12, December 15, 2000,
pp. 1741-1754  Williamson, Deanna L.


To investigate the relationships between health beha-
viours and health by income I conducted a secondary
analysis of data from the first cycle of the National
Population Health Survey (NPHS). The NPHS, which
is carried out by Statistics Canada, provides the most
current data about the health behaviours and health of
Canadians (Statistics Canada, 1995)...

Findings in Table 5 indicate that physical activity
and smoking accounted for almost none of the var-
iance in the number of chronic health conditions for
any of the income adequacy groups (0.1



±1.2%),
beyond the variance that was due to the sociodemo-
graphic control variables (DR2). Also, most of the par-
tial regression coefficients (b ) for physical activity and
smoking were not statistically significant. Moreover,
differences between the partial regression coefficients
(b ) for physical activity and smoking across income
adequacy levels were not statistically significant.


Policy and program implications

For much of the past two decades public
health policies and programs in Canada
have focused, almost solely, on the role
that individual health behaviours
play in health (Labonte, 1994; Pinder, 1994). Scores of
health education programs and social marketing cam-
paigns have inundated Canadians with information
about such topics as the dangers of smoking, the ben-
e®ts of physical activity, and the risks associated with
unprotected sexual activity. Even if health education
and social marketing successfully persuade people to
adopt healthy behaviours, the effectiveness of these
strategies to enhance the health of Canadians is ques-
tionable in light of evidence about the small degree of
influence that health behaviours seemingly have on
health. The need for policy makers and public health
professionals to expand their focus beyond individual
health behaviours is further emphasized by the ever
growing body of research that has demonstrated the
significant role that a broad range of psychosocial fac-
tors and socioeconomic conditions play in the determination
of health (Antonovsky, 1987; Feinstein, 1993;
Kawachi & Kennedy 1997; Kooiker & Christiansen,
1995; Marmot, Ry., Bumpass, Shipley & Marks, 1997;
Mirowsky & Ross, 1989; Roberge, Berthelot & Wolf-
son, 1995; Syme, 1991; Wallerstein, 1992).

Abstract
This study used Canadian data to examine whether the relationships between two
health behaviours (physical
activity and smoking) and two measures of health (self-perceived health status
and number of chronic health
conditions) are conditional on income adequacy. Studies that have investigated
the manner in which socioeconomic
circumstances, such as income adequacy, and health behaviours interact to
influence health are few in number and
characterized by inconsistent findings. In addition, there is a complete absence
 of published Canadian research that
has explored these relationships. I investigated the relationship between health
 behaviours and health by income
adequacy with a secondary analysis of data from the first cycle of the National
Population Health Survey (NPHS),
conducted by Statistics Canada in 1994-95. The sample consisted of 11,941 NPHS
respondents 20±64 years of age
who did not have an illness or disability that prevented them from being
employed. As a whole, findings from a
series of hierarchical multiple regression analyses did not provide adequate
evidence to conclude that the e.ects of
physical activity and smoking on self-perceived health status and chronic health
 conditions are conditional on
income adequacy. Instead, findings showed that the health behaviours each had a
similar degree of influence on the
self-perceived health status and number of chronic health conditions of
respondents at all income adequacy levels.
Moreover, the magnitude of the relationships between the health behaviours and
health measures was very small.
By enhancing knowledge about both the nature and magnitude of the relationships
among Canadians' income
adequacy, health behaviours, and health, this study makes a significant
contribution to the small body of research
that has explored the possibility that the relationship between health
behaviours and health varies by socioeconomic
circumstances. I conclude the paper with a discussion of the implications that
the ®ndings have for public health
policies and programs.  2000 Elsevier Science Ltd. All rights reserved.