Abstract
Background
Poverty remains a significant determinant of childhood health outcomes in the United States. This study examines the relationship between household income and children's health outcomes in the United States, focusing on how income disparities contribute to health inequalities.
Methods
Utilizing a cross-sectional design with data from the 2021–2022 National Survey of Children's Health (NSCH), we analysed the health status of 104 746 children aged 0–17 years and explored chronic disease conditions, including obesity, asthma, anxiety and depression. Three logistic regression models were fitted to evaluate the association between household income, measured by federal poverty level (FPL) and overall health outcome, adjusted for age, biological sex, race, parental education and family structure.
Results
Approximately 92% of participants reported excellent or very good health, with those reporting poorer health more likely to come from lower income households. Children from families earning 0%–99% of the FPL had more than triple the odds of reporting good, fair or poor health compared with those earning ≥ 400% FPL or more (AOR = 3.16, 95% CI: 2.64, 3.78). An inverse dose–response relationship was observed, indicating that as household income increased, the likelihood of reporting adverse health conditions decreased across income groups, with no significant interactions noted between income and biological sex or race.
Conclusion
This cross-sectional study shows that household income predicts children's overall, physical and mental, emotional, developmental or behavioural (MEDB) health outcomes. Using recent national data, we found that income-related disparities were evident across multiple conditions, underscoring the need for interventions that address both healthcare access and broader socio-economic factors. Children from low-income households face higher health risks. Policies that expand preventive care, strengthen family supports and reduce structural inequities are critical to improving child health equity.
Summary
Lower household income is linked to lower overall health and increased risks of conditions like obesity, hearing and vision problems and mental health issues.
Odds of health conditions increase as income decreases, highlighting income as a critical factor in children's health outcomes.
Targeted public health policies are needed to reduce income-related health disparities and improve outcomes for low-income children.
Poverty remains a significant determinant of childhood health outcomes in the United States. This study examines the relationship between household income and children's health outcomes in the United States, focusing on how income disparities contribute to health inequalities.
Methods
Utilizing a cross-sectional design with data from the 2021–2022 National Survey of Children's Health (NSCH), we analysed the health status of 104 746 children aged 0–17 years and explored chronic disease conditions, including obesity, asthma, anxiety and depression. Three logistic regression models were fitted to evaluate the association between household income, measured by federal poverty level (FPL) and overall health outcome, adjusted for age, biological sex, race, parental education and family structure.
Results
Approximately 92% of participants reported excellent or very good health, with those reporting poorer health more likely to come from lower income households. Children from families earning 0%–99% of the FPL had more than triple the odds of reporting good, fair or poor health compared with those earning ≥ 400% FPL or more (AOR = 3.16, 95% CI: 2.64, 3.78). An inverse dose–response relationship was observed, indicating that as household income increased, the likelihood of reporting adverse health conditions decreased across income groups, with no significant interactions noted between income and biological sex or race.
Conclusion
This cross-sectional study shows that household income predicts children's overall, physical and mental, emotional, developmental or behavioural (MEDB) health outcomes. Using recent national data, we found that income-related disparities were evident across multiple conditions, underscoring the need for interventions that address both healthcare access and broader socio-economic factors. Children from low-income households face higher health risks. Policies that expand preventive care, strengthen family supports and reduce structural inequities are critical to improving child health equity.
Summary
Lower household income is linked to lower overall health and increased risks of conditions like obesity, hearing and vision problems and mental health issues.
Odds of health conditions increase as income decreases, highlighting income as a critical factor in children's health outcomes.
Targeted public health policies are needed to reduce income-related health disparities and improve outcomes for low-income children.
| Original language | English |
|---|---|
| Article number | e70179 |
| Pages (from-to) | e70179 |
| Journal | Child: Care, Health and Development |
| Volume | 51 |
| Issue number | 6 |
| DOIs | |
| State | Published - Nov 14 2025 |
Keywords
- federal poverty level
- health disparities
- household income
- overall health status
- public health interventions
