This study presents a dynamic approach to collecting income information. We conducted a cross- sectional survey of 2,022 residents of historically underserved Appalachian Kentucky, an ideal location due to pervasive low income and our ability to control for potential confounders such as race/ethnicity and residential heterogeneity. In unadjusted analyses, nearly half of the sample indicated they struggled to meet their needs; 43% said they made just enough to get by; and 10% indicated they had more than they needed to live well. Adjusting for socio- demographic characteristics, proportionately more of those with lower self- rated health and a higher number of morbidities reported struggling to make ends meet. Less than 1% refused to respond to the question on self- perceived income sufficiency, compared with 20% who refused to report income levels. We conclude that self- perceived income sufficiency is a useful question to assess resources, both theoretically and practically, in an underserved population.

Original languageEnglish
Pages (from-to)812-828
Number of pages17
JournalJournal of Health Care for the Poor and Underserved
Issue number2
StatePublished - May 2017

Bibliographical note

Publisher Copyright:
© Meharry Medical College.


  • Assessment
  • Health inequity population
  • Income
  • Income adequacy
  • Self- perceived income sufficiency
  • Selfrated health

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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