Individual and household income is generated primarily from paid employment. Income provides individuals and families necessary material resources such as health insurance and medical care, while enabling options for healthy lifestyle choices. Income is defined as money received, especially on a regular basis, for work or through investments. Wealth is economic assets accumulated over time (1).
An individual’s level of income provides the financial resources that determine the daily choices they will make around food, housing, health care, education and saving. Beyond purchasing health insurance or medical care, people don’t often readily connect income to health, but the body of research available shows there are strong relationships between income, health and wealth (1).
Maintaining financial security or a stable income is needed for acquiring the resources and services necessary to maintaining good health and meeting our basic needs. Income also enables a person to live in safer homes and neighborhoods, purchase healthier foods, have more free time for fun or leisure and generally to experience less health-burdensome stress. Lower-income families and individuals have increased likelihoods of living in unsafe homes and neighborhoods, having limited access to healthy foods, employment options and good schools. The links between income and health begin before birth and influence health across the lifespan. A child born in poverty is seven times more likely to be in poor or fair health than a child born into wealth (1).
The potential negative influence that income inequality can play on health is a controversial one, but a review of the available evidence shows that in societies with high levels of income inequality, overall populations are significantly less healthy (2). Adults living in poverty are five times more likely to report being in fair or poor health than adults with family incomes above the poverty level, and are more likely to have higher rates of heart disease, diabetes, stroke and other chronic conditions compared to wealthier adults (3).
Living in poverty has negative health effects for individuals and families for multiple reasons. A significant one is that it often exposes a person to unfavorable living and workplace conditions, stress and environmental hazards, such as indoor and outdoor pollution, which can affect health across an individual’s lifespan (4).
Percent of the population below poverty level, by county, Colorado (2013-2017)
Source: US Census, ACS 5-year estimates (2013-2017), Table: S1701
Health Disparities and Inequities
Income can be seen as a driving force behind the many stark disparities in health status that many people of color experience in the United States. These differences become even more substantial when examined between high- and low-income populations within each racial and ethnic group (3). In 2017, the median net worth for an average Black and Hispanic and Latino household stands at just $11,000 and $14,000 respectively, which is dwarfed by the $134,000 net worth of a median white family. The racial wealth gap in the United States is even more stark when you examine median family wealth by the amounts of durable goods owned, such as cars, electronics and furniture. The average Black and Hispanic and Latino family has $1,700 and $2,000 in wealth compared to a typical white family, which has $116,000 (5). This gap is important to note, since higher-income Black and Hispanic and Latino families have better health than members of their group with less income, and the difference in income is potentially tied more strongly to their health than to their race or ethnicity (3).
Inequities that are present at the beginning of life carry into adulthood and have significant consequences on our health and wellbeing, with at least 50 percent of the variability of lifetime earnings across individuals being determined by attributes that are engrained by age 18 (6). Longitudinal studies that examine the effects of this disadvantage on health over time found that the impact is substantial and cumulative. The Robert Wood Johnson Foundation notes that, “The idea of enacting policies to lift people out of poverty is neither new or revolutionary, what is new, however, is awareness of the health implications of reducing economic disadvantage (1).”
Percent of households that are below poverty, by census tract
In the map below, darker areas represent tracts with a higher percentage of households that are below poverty.
Source: US Census, ACS 5-year estimates (2013-2017), Table: S1701
Implications and Data for Jefferson County
Community Health Needs Assessment Focus Group Findings
Focus group participants had three main concerns centered around income, which are described below.
1. Participants often mentioned food insecurity as a substantial, income-related concern. They frequently cited the high cost of healthy foods, as well as a desire to learn how to buy and prepare healthy foods on a budget. Participants also cited concern about the children in the community in the Free and Reduced Lunch Program and their barriers to accessing healthy foods when school is out. Click here to learn more about food insecurity.
2. Multiple participants cited concerns around healthy aging and aging-in-place for Jefferson County’s older adult population, pointing to the costs of care and support as an income-related issue.
3. Participants in the focus groups held in Spanish reported that access to affordable medical and dental care is a significant financial barrier. Click here to learn more about the cost of healthcare as a barrier to receiving care.
The percent of the population living below poverty in Jefferson County is lower than Colorado and the United States, as shown in the chart above, and has remained fairly stable over time. However, when looking at demographics in Jefferson County, you can see that females, Blacks, Hispanics, and those 18 to 34 years of age have higher rates of poverty than their counterparts (shown in the chart below).
Community Health Needs Assessment Key Informant Findings
Income was a recurring theme across key informant interviews, with many saying that it’s the families which earn less than $50,000 per year that struggle the most to survive. These families have multiple needs competing for a limited amount of money. These needs are described below.
1. Attaining affordable housing is difficult. Many families are coping with near homelessness stay in motels along Colfax corridor. This is directly linked with the rising cost of living, which is displacing many families to more affordable parts of the region, like Aurora.
Additionally, there are stark disparities in housing quality and stability between wealthy and low-income families. One informant working in the human services sector felt that better data collection efforts were needed to “hotspot” the areas of the community with the highest need based on socioeconomic status. Click here to learn more about housing.
2. Food insecurity is a problem. In addition to the higher cost of healthy foods, some areas simply lack grocery stores or other retailers offering nutritious foods.,. Click here to learn more about food insecurity.
3. For some, obtaining affordable health and dental care for themselves and their children is difficult or impossible.
4. Childcare is expensive.
5. Transportation is an issue for many people. It can be difficult to access private transportation, and public transit can be inefficient and unreliable.
Many informants were also concerned about older adults on fixed incomes who struggle to make ends meet They were especially worried about those in the mountain communities who are more isolated and further away from healthcare providers and other resources.
Median household income, by census tract
The map below shows the median household income, by census tract, where the darker tracts indicate higher median family incomes.
Source: US Census, ACS 5-year estimates (2013-2017), Table: B19013
The living wage required to support a family in Jefferson County (2016), updated with the new 2018 minimum wage requirements.
Expenses included in the calculation of the living wage chart above:
Food, Child care, Medical, Housing, Transportation, and other necessities (apparel and services, housekeeping supplies, personal care products and services, reading, and miscellaneous).
For a full break-down by each family type in Jefferson, visit: http://livingwage.mit.edu/counties/08059
* The methodology differs slightly for part-time workers: http://livingwage.mit.edu/resources/MIT-Part-Time-Documentation.pdf
Community Resources within Jefferson County
1. Robert Wood Johnson Foundation. (2011, April). Income, Wealth, and Health [Issue brief]. Retrieved from: https://www.rwjf.org/content/dam/farm/reports/issue_briefs/2011/rwjf70448
2. Wilkinson, R., and Pickett, K. (2006). Income inequality and population health: A review and explanation of the evidence. Social Science Medicine. 62 (7):1768-84. https://www.ncbi.nlm.nih.gov/pubmed/16226363
3. Woolf, S., Aron, L., Dubay, L., Simon, S., Zimmerman, E., Luk, K. Urban Institute. (2015, April). How are income and wealth linked to health and longevity? [Issue Brief]. Retrieved from: https://www.urban.org/sites/default/files/publication/49116/2000178-How-are-Income-and-Wealth-Linked-to-Health-and-Longevity.pdf
4. Institute for Research on Poverty. (2018). Poor and in poor health [Fact Sheet]. Retrieved from: https://www.irp.wisc.edu/publications/factsheets/pdfs/PoorInPoorHealth.pdf
5. Asante-Muhammad, D., Collins, C., Hoxie, J., Nieves, E. Institute of Policy Studies.(2017, September). The Road to Zero Wealth: How the Racial Wealth Divide is Hallowing Out America’s Middle Class. Retrieved from: https://prosperitynow.org/files/PDFs/road_to_zero_wealth.pdf
6. Heckman, J., Mosso, S. (2014). The Economics of Human Development and Social Mobility. Annual Review of Economics, 6, 689-733. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4204337/
US Census, ACS: American Community Survey - American Factfinder (Table: S1701): https://www.census.gov
Living Wage Calculator, Amy Glasmeier (2016), http://livingwage.mit.edu/
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Published on July 17, 2018
Updated on June 28, 2019