How does it affect your health?
With the ever-widening gap between the rich and poor in our country, there has been increasing focus on how poverty impacts the lives of the individuals living it. There is no question that it significantly affects many aspects of a person’s life, such as access to education, proper housing and nutritious food. The concerning fact is the impact all of these play on a person’s health and how it can transcend generations. How prevalent is poverty in the United States? How does it impact individuals? What can we do to fix it?
The United States ranks second to last in developed countries when it comes to childhood poverty. This is why the widening income inequality is a major cause for concern. Poverty and poor health are intricately link, but the relationship between them is a complicated one. It is deeply rooted in political, social and economic injustices. Poverty is a cause and consequence of poor health. In order to better understand the relationship, we need to look at a few things more closely. One of those things is knowing the difference between wealth and income. Wealth is the total value of assets (and debts) a person has; whereas, income is the flow of money they have coming in. If we use these definitions, the inequality between the wealthy and poor is even more apparent. Low income and wealth levels are linked to lower life expectancy and higher rates of heart disease, diabetes, and other chronic illnesses. They are also associated with increased infant mortality and higher rates of childhood conditions. Poverty cannot be defined just by a person’s wealth/income level, but also by their lack of access to healthcare services, safe water, adequate nutrition and education. Poor people are unable to participate in decisions that are critical to their day-to-day lives because policies are made without their input. So, they literally don’t have a say in what happens to them. In addition, poor people are exposed to multiple risks that wealthier people aren’t and they are less prepared to cope with them.
One of these risks is the environment in which they live. Many poor people live in areas that are close to sources of pollution. Poverty forces people to live in these situations without decent shelter, clean water or adequate sanitation and this makes them sick. Besides the toxic environmental hazards, often these neighborhoods are dangerous due to high crime levels. Unfortunately, their home life isn’t the only source of hazards. Many poor people are working multiple jobs to support their family and these jobs are in places that have greater risk for causing illness and disability. The reason they work in these conditions is because they are often less educated and more likely to be illiterate; therefore, unable to find employment in a safer setting.
Poverty prevents people from buying healthy food because they don’t have access to healthy options locally nor the ability to travel to where there are healthy options. Poor people live in food deserts where there is no fresh produce available, but there are plenty of fast food restaurants. This type of food is cheap, but high in empty calories and contain large amounts of fat. This is why obesity has increased among poor people even though they are hungry. Often times, they have to make incredibly hard choices, like making sure their children get fed rather than taking care of their own health. Sadly, the harsh effects of poverty start before a baby is even born due to poor maternal health during pregnancy and continues to pile up as the child grows into an adult. Malnutrition plays a significant role in a child’s immune system developing properly so it can fight off diseases that are otherwise preventable and curable. Malnutrition also interferes with a child’s cognitive development. Poor child health and hunger lead to poor school performance and this leads to an inability to find good work as an adult and support the next generation. Also, a good portion of children living in poverty have mothers with some symptoms of depression and mothers who are depressed interact with their children differently, which affects the child emotionally. If a person hasn’t had proper oral care as a child or adolescent, they are more likely to lose teeth and this can make it really challenging to get a job as an adult. All of these things is why the downward spiral of poverty continues from generation to generation.
Children who are born in poverty are more likely to experience an adverse childhood experience (ACE) than other children. ACEs are events that cause stress or trauma to the child, such as abuse/neglect, death of a parent, witnessing substance abuse in their home and neighborhood violence. Children who are exposed to these types of events are more likely to be obese, diabetic, depressed and suicidal while have an increased chance of developing heart disease, cancer, stroke, COPD and other chronic health conditions. These children are also likely to have bad habits, like smoking, alcoholism, drug use, poor work habits and lack of physical activity. So, children in poor families often never catch up when it comes to their health. This has led to a large discrepancy between life expectancy between wealthy and poor people in the United States. It is currently estimated to be somewhere between 10 – 15 years. This number gets even worse when you break it down by race.
Poor people cannot afford to purchase things that are essential to having good health, like sufficient quantity of nutritious foods and preventive healthcare services. Many are unable to have money readily available to pay for healthcare services they need today, let alone afford to save money to have on hand for future healthcare costs. This means that lower income families have less access to primary and preventive healthcare services and only use healthcare services when they are sick, which is more expensive. Since poor people are more likely to be sick due to a wide variety of factors, they spend a greater portion of their income on healthcare services than wealthier people. So, lower income families have to pay out-of-pocket for what higher income families have access to through subsides that are provided by their employers. This is the reason the cost of healthcare as whole is rising.
In addition, poor people lack information on appropriate health practices, particularly in matters related to activities that would promote good health and when they should use healthcare services. When given prescriptions and medical advice, poor patients might not adhere to them because they can’t pay for the medication, they didn’t understand the directions or felt that the doctor didn’t listen to what their concerns were. This lack of knowledge is why poor children often miss out on routine vaccinations. Also, why people living in poverty are more likely to smoke because they aren’t aware of the dangers and are constantly stressed. When we are stressed, it is harder for us to self-regulate destructive behaviors. The continual stress that they have contributes to overproduction of cortisol (stress hormone) and since that level never really comes down, they are at an increased risk for cardiovascular issues. Also, the elevated stress levels lead to biological changes that can affect over an individual’s health over the long-term. These changes can be become ingrained in your body. This greatly influences maternal health, which affects child health. Women need high-quality prenatal care and good nutrition during pregnancy, but this is extremely challenging to do when you are living in poverty. Also, poor people don’t have the luxury of time to exercise to improve their health because they often are working multiple jobs and have to spend time getting back and forth to these jobs. All these factors contribute to the development of chronic diseases. Chronic disease accounts for about 70% of deaths in our country and disproportionately affect minority communities because they are more likely to be poverty stricken. These diseases used to appear in middle age, but this is no more. People in their 20s, teens and younger are starting to have these chronic conditions because of the diet and lifestyle that is associated with poverty. Considerable loss of income is associated with these conditions. All of this alters economic productivity. It becomes slowed when people are ill or caring for family members that are ill and comes to a screeching halt when people die from these conditions. It is essential that interventions to improve the health of the poor need to account for these stark variances that can occur across different geographic regions of our country.
We need to reduce poverty, improve the availability of nutritious food and make sure people have access to safe water, sanitation and housing. Also, we need to strengthen our national health system in order to do a better job of helping the people who need it the most. The government needs to play a role in this process and the Affordable Care Act is helping because women are able to get earlier access to prenatal care and more services are offered to low-income mothers for the first few months of the child’s life. This allows time to educate parents on how to care for their children, which has been shown to have better health outcomes for those children. We know that improving maternal and child health is one of the most effective ways we could start to make an impact on the health of poor people. Unfortunately, even with government programs, one out of five children are living in poverty. This number would go to one out of three if these programs were not available. We need to find ways to expand and enhance these programs to improve these numbers even further. In Canada, they are trying a program called “mincome,” which is where everyone is guaranteed a minimum income. So far, it has been shown to decrease hospitalization rates and mental health diagnoses. While it definitely sounds different, it allows people to work and contribute to society while being guaranteed a certain standard of living. By doing this, it seems to promote an overall healthier lifestyle.
The key to any change is educating individuals about the importance of good health and when they should be using healthcare services. Education is one of the most powerful tools we have to fight poverty and its effects. Healthcare professionals need to shift the focus of healthcare from just treating the disease to why did the disease occur in the first place and what can be done to rectify this. Doctors can be an important component in helping connecting families with resources that they need. Another thing to keep in mind the cost of healthcare and how this will impact an individual’s ability to be able to follow care instructions. In addition, the cost at the point of service needs to be reduced by lowering user fees and making sure affordable, comprehensive health insurance is available for all individuals. We also should be focusing on reducing the total amount of healthcare services that are used by increasing efficiency, such as not ordering unnecessary tests or the most expensive medications when there is a cheaper alternative that is just as effective. We need to ensure better accessibility to healthcare services by eliminating inequalities, which can be done by locating services in the places that need them and promoting programs that are specific to area needs. We need to implement high-quality early childhood programs that encourage, educate and support parents because this leads to increased educational achievement, higher incomes and better health for their children. All of these changes could be made more quickly and effectively if the private sector was engaged in partnerships with the public sector. Besides healthcare itself, we need to address the living situations of poor people. When people have a safe home, it allows for numerous things. Usually, their health improves dramatically because they have proper ventilation and sanitation. They are sheltered from environmental hazards and feel secure from theft and other concerns. Also, children who live in safe home have higher school attendance and completion rates. Children are better able to develop into responsible adults because they experience security and see their own parents taking care of the home. When people have a safe home, they feel secure, love, support, pride, dignity, hopefulness for their future well-being and can envision success for their children.
Poverty and health will forever be tied together. Poverty increases the chances of poor health and poor health traps individuals in poverty. In order to fix one, we must address the other. Now is the time to step up and make changes to our healthcare system and programs that help individuals who are poverty stricken. If we don’t, the health of our country, as a whole, is going to continue to deteriorate. We own it to ourselves, and each other, to not allow this to happen. A country can only be as great as each person living it. If a good portion of our people are living in poverty with poor health, what does that say about our country?