Poor People in Rich Nations: The United States in Comparative Perspective

Most examinations of United States domestic antipoverty policy are inherently parochial, for they are based on the experiences of only our nation in isolation from the others. However, cross-national comparisons can also teach lessons about antipoverty policy. While all nations value low poverty, high levels of economic self-reliance, and equality of opportunity for younger persons, they differ dramatically in the extent to which they reach these goals. Nations also exhibit differences in the extent to which working age adults mix economic self-reliance (earned incomes), family support, and government support to avoid poverty. We begin by reviewing international concepts and measures of poverty. The Luxembourg Income Study (LIS) database contains the information needed to construct comparable poverty measures for more than 30 nations. It allows comparisons of the level and trend of poverty and inequality across several nations, along with considerable detail on the sources of market incomes and public policies that shape these outcomes. We will highlight the different relationships between antipoverty policy and outcomes among several countries, and consider the implications of our analysis for research and for antipoverty policy in the United States. In doing so, we will draw on a growing body of evidence that evaluates antipoverty programs in a cross-national context. Many international bodies have publishes crossnational studies of the incidence of poverty in recent years, including the United Nations Children's Fund, the United Nations Human Development Report, the Organization for Economic Cooperation and Development, and the Luxembourg Income Study. A large subset of these studies is based on LIS data

Excess comorbidity prevalence and cost associated with functional dyspepsia in an employed population

Background: Limited published data exist on the associated comorbid conditions with functional dyspepsia (FD). Aims: This study aimed to assess the prevalence, services, and costs related to comorbid conditions associated with FD and the risk of having FD for each comorbid condition. Methods: A retrospective database analysis was undertaken using payroll data and adjudicated claims from January 1, 2001, through December 31, 2004 among >300,000 employees. Employees with FD were compared to propensity-score-matched employees without FD (controls). Outcome measures included the prevalence, costs, and utilization of health services for comorbid conditions as defined by the Agency for Healthcare Research and Quality (AHRQ) and the odds ratios of having FD from a multivariate model. Results: FD employees (N = 1,669) and a 50:1 matched control cohort (N = 83,450) were compared. Compared to matched controls, FD employees were more likely to have all major diagnostic categories. Moreover, 199/261 of the AHRQ’s specific categories were more common in the FD cohort. Annual medical costs for the FD cohort were greater than for controls in 155/261 (59%) specific categories and significantly greater (P ≤ 0.05) in 76 categories (29%). Similarly, services were greater for 179/261 (69%) specific categories and significantly greater (P ≤ 0.05) in 110 categories (42%). In a multivariate model, esophageal disorders, gastritis and duodenitis, and abdominal pain were the most associated with having FD (odds ratios 3.8, 3.7, and 3.6, respectively). Only hypertension complications and disorders of the teeth and jaw were significantly negatively associated with FD.Conclusion: There is unexplained excess comorbidity associated with FD which may be a major determining factor for excess healthcare services and costs