Redesigning Health Care Practices to Address Childhood Poverty.

PubMed

Fierman, Arthur H; Beck, Andrew F; Chung, Esther K; Tschudy, Megan M; Coker, Tumaini R; Mistry, Kamila B; Siegel, Benjamin; Chamberlain, Lisa J; Conroy, Kathleen; Federico, Steven G; Flanagan, Patricia J; Garg, Arvin; Gitterman, Benjamin A; Grace, Aimee M; Gross, Rachel S; Hole, Michael K; Klass, Perri; Kraft, Colleen; Kuo, Alice; Lewis, Gena; Lobach, Katherine S; Long, Dayna; Ma, Christine T; Messito, Mary; Navsaria, Dipesh; Northrip, Kimberley R; Osman, Cynthia; Sadof, Matthew D; Schickedanz, Adam B; Cox, Joanne

2016-04-01

Child poverty in the United States is widespread and has serious negative effects on the health and well-being of children throughout their life course. Child health providers are considering ways to redesign their practices in order to mitigate the negative effects of poverty on children and support the efforts of families to lift themselves out of poverty. To do so, practices need to adopt effective methods to identify poverty-related social determinants of health and provide effective interventions to address them. Identification of needs can be accomplished with a variety of established screening tools. Interventions may include resource directories, best maintained in collaboration with local/regional public health, community, and/or professional organizations; programs embedded in the practice (eg, Reach Out and Read, Healthy Steps for Young Children, Medical-Legal Partnership, Health Leads); and collaboration with home visiting programs. Changes to health care financing are needed to support the delivery of these enhanced services, and active advocacy by child health providers continues to be important in effecting change. We highlight the ongoing work of the Health Care Delivery Subcommittee of the Academic Pediatric Association Task Force on Child Poverty in defining the ways in which child health care practice can be adapted to improve the approach to addressing child poverty. Copyright © 2016 Academic Pediatric Association. All rights reserved.

The effects of school poverty on adolescents’ sexual health knowledge

PubMed Central

Atkins, Robert; Sulik, Michael J.; Hart, Daniel; Ayres, Cynthia; Read, Nichole

2012-01-01

Using National Longitudinal Study of Adolescent Health data, hierarchical linear modeling was conducted to estimate the association of school poverty concentration to the sexual health knowledge of 6,718 adolescents. Controlling for individual socio-economic status, school poverty had modest negative effects on sexual health knowledge. Although not directly associated with sexual health knowledge, after controlling for demographic characteristics, school poverty interactions showed that sexual health knowledge was associated with higher grade point average (GPA) and age. The combination of low GPA and high-levels of school poverty was especially detrimental for students’ sexual health knowledge. There are differences in the sexual health knowledge of adolescents attending low poverty and high poverty schools that can be attributed to the school environment. PMID:22431188

Poverty, inequality and a political economy of mental health.

PubMed

Burns, J K

2015-04-01

The relationship between poverty and mental health is indisputable. However, to have an influence on the next set of sustainable global development goals, we need to understand the causal relationships between social determinants such as poverty, inequality, lack of education and unemployment; thereby clarifying which aspects of poverty are the key drivers of mental illness. Some of the major challenges identified by Lund (2014) in understanding the poverty-mental health relationship are discussed including: the need for appropriate poverty indicators; extending this research agenda to a broader range of mental health outcomes; the need to engage with theoretical concepts such as Amartya Sen's capability framework; and the need to integrate the concept of income/economic inequality into studies of poverty and mental health. Although income inequality is a powerful driver of poor physical and mental health outcomes, it features rarely in research and discourse on social determinants of mental health. This paper interrogates in detail the relationships between poverty, income inequality and mental health, specifically: the role of income inequality as a mediator of the poverty-mental health relationship; the relative utility of commonly used income inequality metrics; and the likely mechanisms underlying the impact of inequality on mental health, including direct stress due to the setting up of social comparisons as well as the erosion of social capital leading to social fragmentation. Finally, we need to interrogate the upstream political, social and economic causes of inequality itself, since these should also become potential targets in efforts to promote sustainable development goals and improve population (mental) health. In particular, neoliberal (market-oriented) political doctrines lead to both increased income inequality and reduced social cohesion. In conclusion, understanding the relationships between politics, poverty, inequality and mental health

Poverty and health sector inequalities.

PubMed Central

Wagstaff, Adam

2002-01-01

Poverty and ill-health are intertwined. Poor countries tend to have worse health outcomes than better-off countries. Within countries, poor people have worse health outcomes than better-off people. This association reflects causality running in both directions: poverty breeds ill-health, and ill-health keeps poor people poor. The evidence on inequalities in health between the poor and non-poor and on the consequences for impoverishment and income inequality associated with health care expenses is discussed in this article. An outline is given of what is known about the causes of inequalities and about the effectiveness of policies intended to combat them. It is argued that too little is known about the impacts of such policies, notwithstanding a wealth of measurement techniques and considerable evidence on the extent and causes of inequalities. PMID:11953787

Mental health and poverty in the inner city.

PubMed

Anakwenze, Ujunwa; Zuberi, Daniyal

2013-08-01

Rapid urbanization globally threatens to increase the risk to mental health and requires a rethinking of the relationship between urban poverty and mental health. The aim of this article is to reveal the cyclic nature of this relationship: Concentrated urban poverty cultivates mental illness, while the resulting mental illness reinforces poverty. The authors used theories about social disorganization and crime to explore the mechanisms through which the urban environment can contribute to mental health problems. They present some data on crime, substance abuse, and social control to support their claim that mental illness reinforces poverty. The authors argue that, to interrupt this cycle and improve outcomes, social workers and policymakers must work together to implement a comprehensive mental health care system that emphasizes prevention, reaches young people, crosses traditional health care provision boundaries, and involves the entire community to break this cycle and improve the outcomes of those living in urban poverty.

A potential role of anti-poverty programs in health promotion.

PubMed

Silverman, Kenneth; Holtyn, August F; Jarvis, Brantley P

2016-11-01

Poverty is one of the most pervasive risk factors underlying poor health, but is rarely targeted to improve health. Research on the effects of anti-poverty interventions on health has been limited, at least in part because funding for that research has been limited. Anti-poverty programs have been applied on a large scale, frequently by governments, but without systematic development and cumulative programmatic experimental studies. Anti-poverty programs that produce lasting effects on poverty have not been developed. Before evaluating the effect of anti-poverty programs on health, programs must be developed that can reduce poverty consistently. Anti-poverty programs require systematic development and cumulative programmatic scientific evaluation. Research on the therapeutic workplace could provide a model for that research and an adaptation of the therapeutic workplace could serve as a foundation of a comprehensive anti-poverty program. Once effective anti-poverty programs are developed, future research could determine if those programs improve health in addition to increasing income. The potential personal, health and economic benefits of effective anti-poverty programs could be substantial, and could justify the major efforts and expenses that would be required to support systematic research to develop such programs. Copyright © 2016 Elsevier Inc. All rights reserved.

Poverty and transitions in health in later life.

PubMed

Adena, Maja; Myck, Michal

2014-09-01

Using a sample of Europeans aged 50+ from 12 countries in the Survey of Health, Ageing and Retirement in Europe (SHARE), we analyse the role of poor material conditions as a determinant of changes in health over a four- to five-year period. We find that poverty defined with respect to relative income has no effect on changes in health. However, broader measures of poor material conditions, such as subjective poverty or low wealth, significantly increase the probability of transition to poor health among the healthy and reduce the chance of recovery from poor health over the time interval analysed. In addition to this, the subjective measure of poverty has a significant effect on mortality, increasing it by 65% among men and by 68% among those aged 50-64. Material conditions affect health among older people. We suggest that if attempts to reduce poverty in later life and corresponding policy targets are to focus on the relevant measures, they should take into account broader definitions of poverty than those based only on relative incomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

[The effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea].

PubMed

Song, Eun Cheol; Shin, Young Jeon

2010-09-01

The low benefit coverage rate of South Korea's health security system has been continually pointed out. A low benefit coverage rate inevitably causes catastrophic health expenditure, which can be the cause of the transition to poverty and the persistence of poverty. This study was conducted to ascertain the effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea. To determine the degree of social mobility, this study was conducted among the 6311 households that participated in the South Korea Welfare Panel Study in both 2006 and 2008. The effect of catastrophic health expenditure on the transition to poverty and the persistence of poverty in South Korea was assessed via multiple logistic regression analysis. The poverty rate in South Korea was 21.6% in 2006 and 20.0% in 2008. 25.1 - 7.3% of the households are facing catastrophic health expenditure. Catastrophic health expenditure was found to affect the transition to poverty even after adjusting for the characteristics of the household and the head of the household, at the threshold of 28% or above. 25.1% of the households in this study were found to be currently facing catastrophic health expenditure, and it was determined that catastrophic health expenditure is a cause of transition to poverty. This result shows that South Korea's health security system is not an effective social safety net. As such, to prevent catastrophic health expenditure and transition to poverty, the benefit coverage of South Korea's health security system needs to the strengthened.

Histories of poverty and self-rated health trajectories.

PubMed

McDonough, Peggy; Berglund, Pat

2003-06-01

This paper investigates the dynamic relationship between poverty histories and self-rated health trajectories. We are interested in patterns of change in individuals' health over time and the ways in which such patterns are structured by continuity and change in poverty experiences. Data, collected for adults aged 25 and older in 1984 (N = 7,258), are from the 1968-1996 annual waves of Panel Study of Income Dynamics (PSID). Individual growth curves allow us to investigate health trajectories as continuous processes, as well as individual and group heterogeneity in these trajectories. We find that, on average, health deteriorates slowly over time, but there is significant variation in health in 1984 and the rate at which health declines. Histories of poverty partly accounted for the sources of individual differences in self-rated health in 1984, but they were not related to health change over time. Although increasing incomes were better for self-rated health than falling incomes, current economic circumstances did not erase the health effects of earlier poverty experiences.

Poverty and child health in the UK: using evidence for action

PubMed Central

Wickham, Sophie; Anwar, Elspeth; Barr, Ben; Law, Catherine; Taylor-Robinson, David

2016-01-01

There are currently high levels of child poverty in the UK, and for the first time in almost two decades child poverty has started to rise in absolute terms. Child poverty is associated with a wide range of health-damaging impacts, negative educational outcomes and adverse long-term social and psychological outcomes. The poor health associated with child poverty limits children's potential and development, leading to poor health and life chances in adulthood. This article outlines some key definitions with regard to child poverty, reviews the links between child poverty and a range of health, developmental, behavioural and social outcomes for children, describes gaps in the evidence base and provides an overview of current policies relevant to child poverty in the UK. Finally, the article outlines how child health professionals can take action by (1) supporting policies to reduce child poverty, (2) providing services that reduce the health consequences of child poverty and (3) measuring and understanding the problem and assessing the impact of action. PMID:26857824

Integrating Poverty and Gender into Health Programs: A Sourcebook for Health Professionals.

PubMed

Coll-Black, Sarah; Bhushan, Anjana; Fritsch, Kathleen

2007-12-01

Evidence increasingly shows that poverty and gender inequalities are important determinants of health and influence the opportunity for timely and appropriate health care. These findings suggest that health professionals need to have a sound understanding of health inequalities and their causes, as well as of how they can be addressed. However, through surveys to health ministries and educational institutions in 2001, the World Health Organization Regional Office for the Western Pacific found that awareness of, and capacity to respond to, poverty and gender concerns in health was weak. In response, the Regional Office initiated a project to develop materials to support the integration of poverty and gender concerns into health professional education curricula. The multimodule publication, Integrating Poverty and Gender into Health Programmes: A Sourcebook for Health Professionals, supports evidence-based and participatory learning. The experience to date suggests that the publication might be meeting a long-felt need for such a response.

Relationship between poverty and health among adolescents.

PubMed

Abernathy, Thomas J; Webster, Greg; Vermeulen, Marian

2002-01-01

Although the effect of low socioeconomic status on the health of adolescents has been documented, the mechanism by which this occurs is not well understood. Furthermore, improving adolescent health through public health policy typically requires the presence of one or more modifiable risk factors which can be targeted for intervention. In spite of the well-documented negative associations between poverty and health, few modifiable risk factors have been identified. This study used the Evans-Stoddart Model of Health and Well-Being as a framework to examine data on 1,759 adolescents, aged 12 to 19, collected as part of the 1994 National Population Health Survey. Results not only confirm the relationship between income and health, but suggest how the pathway operates through the social environment, lifestyle differences, access to health care, and a reduced sense of self-esteem and self-mastery. Bivariate and multivariate analyses found positive associations between physical activity levels and self-esteem and mastery. We interpret these findings as preliminary evidence that it might be possible to buffer the impact of poverty on health through policies which increase physical activity levels among those living in poverty. Such policies could also include a secondary goal of increasing the activity levels among inactive adolescents who are not living in poverty, as they will derive benefits from this increase, both psychologically and physiologically.

Multidimensional poverty and health: evidence from a nationwide survey in Japan.

PubMed

Oshio, Takashi; Kan, Mari

2014-12-19

It is well known that lower income is associated with poorer health, but poverty has several dimensions other than income. In the current study, we investigated the associations between multidimensional poverty and health variables. Using micro data obtained from a nationwide population survey in Japan (N = 24,905), we focused on four dimensions of poverty (income, education, social protection, and housing conditions) and three health variables (self-rated health (SRH), psychological distress, and current smoking). We examined how health variables were associated with multidimensional poverty measures, based on descriptive and multivariable logistic regression analyses. Unions as composite measures of multiple poverty dimensions were more useful for identifying individuals in poor SRH or psychological distress than a single dimension such as income. In comparison, intersections of poverty dimensions reduced the coverage of individuals considered to be in poverty and tend to be difficult to justify without any explicit policy objective. Meanwhile, education as a unidimensional poverty indicator could be useful for predicting current smoking. Results obtained from the current study confirmed the practical relevance of multidimensional poverty for health.

A Poverty Simulation to Inform Public Health Practice

ERIC Educational Resources Information Center

Strasser, Sheryl; Smith, Megan O.; Pendrick Denney, Danielle; Jackson, Matt C.; Buckmaster, Pam

2013-01-01

Background: Poverty is a pervasive condition linked to a myriad of health conditions and severe health outcomes. Public health professionals are at the forefront of addressing poverty-related issues and require education that enhances their understanding and cultural competence. Purpose: The purpose of this research was to evaluate the impacts of…

Poverty and child health in the UK: using evidence for action.

PubMed

Wickham, Sophie; Anwar, Elspeth; Barr, Ben; Law, Catherine; Taylor-Robinson, David

2016-08-01

There are currently high levels of child poverty in the UK, and for the first time in almost two decades child poverty has started to rise in absolute terms. Child poverty is associated with a wide range of health-damaging impacts, negative educational outcomes and adverse long-term social and psychological outcomes. The poor health associated with child poverty limits children's potential and development, leading to poor health and life chances in adulthood. This article outlines some key definitions with regard to child poverty, reviews the links between child poverty and a range of health, developmental, behavioural and social outcomes for children, describes gaps in the evidence base and provides an overview of current policies relevant to child poverty in the UK. Finally, the article outlines how child health professionals can take action by (1) supporting policies to reduce child poverty, (2) providing services that reduce the health consequences of child poverty and (3) measuring and understanding the problem and assessing the impact of action. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Environment, poverty and health linkages in the Wami River basin: A search for sustainable water resource management

NASA Astrophysics Data System (ADS)

Madulu, Ndalahwa F.

The Wami Rivers basin is an important area due to its diversified use which benefits a multi-diversity of stakeholders. While large scale irrigated sugar production is the main issue of concern upstream, there are other equally important socio-economic activities which include biodiversity and environmental conservation, domestic water supply, livestock water needs, and fishing. A large water supply project has just been completed downstream of the Wami River to provide water for the Chalinze township and surrounding villages. Other important undertakings include irrigated rice farming in Dakawa area, livestock keeping activities, and the establishment of the Sadani National Park (SANAPA) and the Wami-Mbiki Wildlife Management Area (WMA). The Wami River basin forms significant parts of both the Wami-Mbiki WMA and the SANAPA wildlife conservation areas. Regardless of its importance, the basin is increasingly being degraded through deforestation for agricultural expansion, timber, and more important charcoal making. The basin is also being polluted through disposal of excess molasses from the sugar industry, and use of poisonous substances and herbs in fishing. The worsening environmental condition in the basin has become a health threat to both people in the surrounding villages and wildlife. To a large extent, such changes are intensifying poverty levels among the local population. These changes are raising concerns about the long-term environmental sustainability and health implications of the current water use competition and conflicts in the basin. The purpose of this paper is to examine the main water resource use conflicts and how they affect environmental sustainability in the long-run. It also intends to establish linkages between wildlife management, pastoralism, agricultural activities and how such linkages influence poverty alleviation efforts in the basin. An attempt has been made to examine the environmental and health implications of human activities

Targeting reproductive health to reduce poverty.

PubMed

1999-01-01

An article highlighting the comment made by Dr. Joe Kasonde regarding the reduction of poverty by uplifting the reproductive health. Better health services had been the focus of poverty reduction and improvement of economic status especially in the Central and Eastern Europe following the decline in their Gross Domestic Product in 1989. As a result, a drop in maternal nutritional status, increase in maternal morbidity and the number of sexually transmitted diseases (STD)-infected mothers were reported. Socioeconomic progress was proposed to be achieved by targeting the reproductive health of the population. In Central Asian republics, a high incidence of nutrition anemia and deprivation was noted that would most likely bring about economic hardship. Reports reveal a rise in the number of maternal mortality due to the high cost of health services as a result of economic crisis, while other mothers prefer abortion. Statistics showed 95% of maternal mortality between the 1989 and 1996 was caused by unsafe abortion. An increase in the number of persons infected with syphilis and other STDs reported in 1995 was induced by poverty. A strategy was proposed to reverse the economic situation through the promotion of better reproductive health services.

Serious psychological distress and health outcomes for persons with epilepsy in poverty.

PubMed

Elliott, John O; Charyton, Christine; Lu, Bo; Moore, J Layne

2009-06-01

Epidemiology literature demonstrates socioeconomic status as an important variable for outcomes in persons with epilepsy. However, no previous studies have analyzed the association between poverty and epilepsy in the United States. Forty-one percent (246/604) of persons with a history of epilepsy (PWHE) in the 2005 California Health Interview Survey (n=43,020) had an annual income <200% Federal Poverty Level (FPL), adjusted lifetime prevalence rate 0.5% [98.33% CI 0.4-0.7]. Four groups are presented in the analyses: (1) those with a history of epilepsy <200% FPL, (2) those with a history of epilepsy > or =200% FPL, (3) those not reporting a history of epilepsy <200% FPL and (4) those not reporting a history of epilepsy > or =200% FPL. PWHE in poverty reported significantly higher amounts of serious psychological distress, based on the validated Kessler 6 (K6) scale, than both non-epilepsy populations. After adjusting for demographics and other comorbid conditions, logistic regression analyses show PWHE in poverty are significantly more likely to report fair or poor self-rated health status when compared to the PWHE not in poverty and both non-epilepsy populations. PWHE in poverty are also more likely to report > or =14 generally unhealthy days and > or =14 physically unhealthy days in the past 30 days compared to the PWHE not in poverty and both non-epilepsy populations. Psychological well-being needs to be incorporated into any comprehensive treatment strategy for managing epilepsy.

Accounting for trends in health poverty: a decomposition analysis for Britain, 1991-2008.

PubMed

Brzezinski, Michal

2015-03-01

We use data from the British Household Panel Survey to analyse changes in poverty of self-reported health from 1991 to 2008. We use the indices recently introduced by Bennett and Hatzimasoura (Poverty measurement with ordinal data. Institute for International Economic Policy, IIEP-WP-2011-14, 2011), which can be interpreted as ordinal counterparts of the classical Foster et al. (Econometrica 52(3):761-766, 1984) poverty measures. We decompose changes in self-reported health poverty over time into within-group health poverty changes and population shifts between groups. We also provide statistical inference for the Bennett and Hatzimasoura's (Poverty measurement with ordinal data. Institute for International Economic Policy, IIEP-WP-2011-14, 2011) indices. Results suggest that when "fair" self-reported health status is chosen as a health poverty threshold all of the used indices indicate the growth of health poverty in Britain. However, when the health poverty threshold is lower ("poor" self-reported health status) the increase in health poverty incidence was compensated by decreasing average health poverty depth and improving health inequality among those who are poor with respect to health. The subgroup decompositions suggest that the most important factors accounting for the changes in total health poverty in Britain include a rise of both health poverty and population shares of persons cohabiting and couples with no children as well as an increase of the population of retired persons.

Globalization, poverty and women's health: mapping the connections.

PubMed

Sicchia, Suzanne R; Maclean, Heather

2006-01-01

Poverty and other forms of inequity undermine individual and population health and retard development. Although absolute poverty has reportedly declined in recent years, research suggests that relative poverty or the gap between the rich and poor within and between countries has been exacerbated over this same period. There is growing concern about the feminization of poverty, and the impact globalization is having on this important social problem. Gender inequality persists in all regions, and women and girls continue to be over-represented among the world's poor. This suggests that women are not consistently benefitting from the economic, political and social gains globalization can offer. Instead, it appears that poor women and girls, particularly those living in developing countries, are disproportionately burdened by the costs of these swift changes to the detriment of their personal health and well-being. Immediate action is needed to correct these disparities and ensure that globalization supports both national and international commitments to poverty reduction, and the, promotion of women's health and human rights.

[Urbanization, poverty and health in Columbia].

PubMed

Stingl, P

1990-06-01

A rapid process of urbanisation is recognisable all over the world today. Already 80% of the world's big cities are located in underdeveloped countries. 60% of their city inhabitants are slum-dwellers living under more or less miserable conditions in shanty towns. This paper documents the reality of life of a 60,000-inhabitants shanty town population in Columbia as well as the implications on health by poverty-linked social environment. In addition to disastrous conditions of housing and nutrition, chronic individual and collective psychological stress seem to be the most important risk factors for the health of the population. The international linkups between wealth, poverty and poverty-conditioned disease make it necessary that physicians of industrial nations also become aware of the world's disparity and injustice in order to help in overcoming miserable living conditions by thinking in global terms.

Poverty & health: criticality of public financing.

PubMed

Duggal, Ravi

2007-10-01

Countries with universal or near universal access to healthcare have health financing mechanisms which are single-payer systems in which either a single autonomous public agency or a few coordinated agencies pool resources to finance healthcare. This contributes to both equity in healthcare as well as to low levels of poverty in these countries. It is only in countries like India and a number of developing countries, which still rely mostly on out-of-pocket payments, where universal access to healthcare is elusive. In such countries those who have the capacity to buy healthcare from the market most often get healthcare without having to pay for it directly because they are either covered by social insurance or buy private insurance. In contrast, a large majority of the population, who suffers a hand-to-mouth existence, is forced to make direct payments, often with a heavy burden of debt, to access healthcare from the market because public provision is grossly inadequate or non existent. Thus, the absence of adequate public health investment not only results in poor health outcomes but it also leads to escalation of poverty. This article critically reviews the linkages of poverty with healthcare financing using evidence from national surveys and concludes that public financing is critical to good access to healthcare for the poor and its inadequacy is closely associated with poverty levels in the country.

The effects of poverty on children's development and oral health.

PubMed

da Fonseca, Marcio A

2012-01-01

According to the US Census Bureau, the poverty rate for children under 18 years of age increased to 22% in 2010. Poverty leads to adverse health outcomes in children and adolescents such as harmful effects on learning, psychosocial development, physical health, productivity and family life. Because the citizens and residents of a country are its most valuable assets, it is unwise to allow housing instability, food insecurity and hunger to continue to exist at its current levels. Reducing poverty is likely to prevent illnesses, decrease hospitalizations, and lead to lower health care costs. There is also a need for intervention strategies to ensure equitable access to healthy foods across the world. Children who are food insecure are more likely to be in poor health and to have poor nutritional outcomes. Poverty may lead to poor dental health due to malnutrition or incorrect diet and it may also have an effect on the child's behavior in the dental office. An understanding of poverty will lessen the anger, frustration and prejudice that pediatric dentists may feel when working with low-income families. This manuscript presents a concise overview of the effects of poverty in children's lives.

Human development, poverty, health & nutrition situation in India.

PubMed

Antony, G M; Laxmaiah, A

2008-08-01

Human development index (HDI) is extensively used to measure the standard of living of a country. India made a study progress in the HDI value. Extreme poverty is concentrated in rural areas of northern States while income growth has been dynamic in southern States and urban areas. This study was undertaken to assess the trends in HDI, human poverty index (HPI) and incidence of poverty among Indian states, the socio-economic, health, and diet and nutritional indicators which determine the HDI, changes in protein and calorie adequacy status of rural population, and also trends in malnutrition among children in India. The variations in socio-economic, demographic and dietary indicators by grades of HDI were studied. The trends in poverty and nutrition were also studied. Univariate, bivariate and multivariate analysis were done to analyse data. While India's HDI value has improved over a time; our rank did not improve much compared to other developing countries. Human poverty has not reduced considerably as per the HPI values. The undernutrition among preschool children is still a major public health problem in India. The incidence of poverty at different levels of calorie requirement has not reduced in both rural and urban areas. The time trends in nutritional status of pre-school children showed that, even though, there is an improvement in stunting over the years, the trend in wasting and underweight has not improved much. Proper nutrition and health awareness are important to tackle the health hazards of developmental transition. Despite several national nutrition programmes in operation, we could not make a significant dent in the area of health and nutrition. The changing dietary practices of the urban population, especially the middle class, are of concern. Further studies are needed to measure the human development and poverty situation of different sections of the population in India using an index, which includes both income indicators and non income

Ethics and allocation of health resources--the influence of poverty on health.

PubMed

Taipale, V

1999-01-01

Poverty and health are examined from the global and Nordic perspectives. The data from global social policy research, Nordic comparisons and equity in health research provide a basis for the discussion. At the global level the consequences of poverty are growing and the resultant problems posed are becoming increasingly evident. Poverty and sickness are interwoven; poverty aggravates mental problems, a situation regarding which we have seen steady deterioration. Research suggests that social cohesion, the factor that creates social capital and empowerment in societies, is a major factor that promotes health and the economy. Structural measures to combat poverty would require a global social policy: global redistribution, global regulation and global provision. However, the international community is not yet fully prepared for this discussion. At the Nordic level, Finland is a laboratory in which the viability of the welfare state has been tested in the worst recession ever to hit an OECD country. On the whole, it seems that income disparity has not grown during the recession and that services have functioned moderately well despite budget cuts. However, during that period the correlation between unemployment and sickness became apparent, and the challenges to healthcare more evident. We must make headway in untangling these relationships, because the tendency towards greater income disparity is growing in the post-recession boom. At the social welfare and health service level even the Nordic welfare states are not in full command of the means to alleviate poverty and its related health problems. Has the time come to dispel our Nordic arrogance and look at how the present services may in fact be generating inequity?

[Poverty, public transfers and health: An analysis on self-rated health of social benefit recipients in Germany].

PubMed

Pförtner, T-K; Schumann, N

2016-09-01

Prevention and reduction of poverty are key elements of social welfare policy in Germany. This study is the first analysis of self-rated health of individuals that escape poverty by benefiting form public transfers. Analyses are based on the German Socio-economic Panel (GSOEP) of 2010. Self-rated health was based on subjective assessment of general health status. Subjects were directly asked about receipt of public transfers. Income poverty was based on the equalized disposable income and is applied to a threshold of 60% of the median-based average income. We analyzed the association between self-rated health and pre- and post-transfer poverty by means of descriptive analyses and binary logistic regression. After adjusting for age, we found a significantly higher risk of poor self-rated health among those who escaped income poverty due to the receipt of social transfers compared to others (ORWomen: 1.85; 95%-CI: 1.27-2.69; ORMen: 2.57; 95%-CI: 1.63-4.05), in particular to those at risk of post-transfer poverty. These poverty-related inequalities in health were predominantly explained by nationality, occupational status, household type and long-term care within the household. This study provides first evidence that the receipt of public transfers is associated with increased risk of poor health in the light of impending income-poverty. This study adds to the current debate about the social and health implications of public transfers in the relationship between poverty and health. © Georg Thieme Verlag KG Stuttgart · New York.

Relative deprivation, poverty, and subjective health: JAGES cross-sectional study.

PubMed

Saito, Masashige; Kondo, Katsunori; Kondo, Naoki; Abe, Aya; Ojima, Toshiyuki; Suzuki, Kayo

2014-01-01

To evaluate the association between relative deprivation (lacking daily necessities) and subjective health in older Japanese adults, we performed a cross-sectional analysis using data from the Japan Gerontological Evaluation Study (JAGES). The data were obtained from functionally independent residents aged ≥65 years from 24 municipalities in Japan (n = 24,742). Thirteen items in three dimensions were used to evaluate relative deprivation of material conditions. Approximately 28% of older Japanese people indicated that they lacked some daily necessities (non-monetary poverty). A two-level Poisson regression analysis revealed that relative deprivation was associated with poor self-rated health (PR = 1.3-1.5) and depressive symptoms (PR = 1.5-1.8) in both men and women, and these relationships were stronger than those observed in people living in relative poverty (monetary poverty). The interaction effect between relative deprivation and relative poverty was not associated with poor health. As a dimension of the social determinants of health, poverty should be evaluated from a multidimensional approach, capturing not only monetary conditions but also material-based, non-monetary conditions.

Poverty, AIDS and child health: identifying highest-risk children in South Africa.

PubMed

Cluver, Lucie; Boyes, Mark; Orkin, Mark; Sherr, Lorraine

2013-10-11

Identifying children at the highest risk of negative health effects is a prerequisite to effective public health policies in Southern Africa. A central ongoing debate is whether poverty, orphanhood or parental AIDS most reliably indicates child health risks. Attempts to address this key question have been constrained by a lack of data allowing distinction of AIDS-specific parental death or morbidity from other causes of orphanhood and chronic illness. To examine whether household poverty, orphanhood and parental illness (by AIDS or other causes) independently or interactively predict child health, developmental and HIV-infection risks. We interviewed 6 002 children aged 10 - 17 years in 2009 - 2011, using stratified random sampling in six urban and rural sites across three South African provinces. Outcomes were child mental health risks, educational risks and HIV-infection risks. Regression models that controlled for socio-demographic co-factors tested potential impacts and interactions of poverty, AIDS-specific and other orphanhood and parental illness status. Household poverty independently predicted child mental health and educational risks, AIDS orphanhood independently predicted mental health risks and parental AIDS illness independently predicted mental health, educational and HIV-infection risks. Interaction effects of poverty with AIDS orphanhood and parental AIDS illness were found across all outcomes. No effects, or interactions with poverty, were shown by AIDS-unrelated orphanhood or parental illness. The identification of children at highest risk requires recognition and measurement of both poverty and parental AIDS. This study shows negative impacts of poverty and AIDS-specific vulnerabilities distinct from orphanhood and adult illness more generally. Additionally, effects of interaction between family AIDS and poverty suggest that, where these co-exist, children are at highest risk of all.

Providing health care to human beings trapped in the poverty culture.

PubMed

Benson, D S

2000-01-01

The culture of poverty impacts everything patients in this socioeconomic group think and do. If what poor patients say does not sit well with the way we think, that doesn't mean they are wrong. Physicians have to adjust their mental model and think in different cultural terms. The author recently completed his thirtieth year of a career dedicated to providing health care to people living in poverty. He shares seven concepts important in building a mental model that will enable physicians to successfully provide health care to this patient population: (1) Poverty is the number one health problem; (2) we see same diseases as everyone else; (3) patients are trapped in the poverty culture; (4) patients' behavior is often manipulative; (5) compliance is a unique challenge; (6) patients have limited resources; and (7) the ultimate contributors to poverty are unwanted adolescent pregnancy and substance abuse. These concepts can help physicians to be more effective in providing health care to patients living in poverty. They can help them understand what is happening, so that their experience might be fulfilling rather than demoralizing.

Racial/Ethnic Disparities in the Use of Mental Health Services in Poverty Areas

PubMed Central

Chow, Julian Chun-Chung; Jaffee, Kim; Snowden, Lonnie

2003-01-01

Objectives. This study examined racial/ethnic disparities in mental health service access and use at different poverty levels. Methods. We compared demographic and clinical characteristics and service use patterns of Whites, Blacks, Hispanics, and Asians living in low-poverty and high-poverty areas. Logistic regression models were used to assess service use patterns of minority racial/ethnic groups compared with Whites in different poverty areas. Results. Residence in a poverty neighborhood moderates the relationship between race/ethnicity and mental health service access and use. Disparities in using emergency and inpatient services and having coercive referrals were more evident in low-poverty than in high-poverty areas. Conclusions. Neighborhood poverty is a key to understanding racial/ethnic disparities in the use of mental health services. PMID:12721146

Racial/ethnic disparities in the use of mental health services in poverty areas.

PubMed

Chow, Julian Chun-Chung; Jaffee, Kim; Snowden, Lonnie

2003-05-01

This study examined racial/ethnic disparities in mental health service access and use at different poverty levels. We compared demographic and clinical characteristics and service use patterns of Whites, Blacks, Hispanics, and Asians living in low-poverty and high-poverty areas. Logistic regression models were used to assess service use patterns of minority racial/ethnic groups compared with Whites in different poverty areas. Residence in a poverty neighborhood moderates the relationship between race/ethnicity and mental health service access and use. Disparities in using emergency and inpatient services and having coercive referrals were more evident in low-poverty than in high-poverty areas. Neighborhood poverty is a key to understanding racial/ethnic disparities in the use of mental health services.

Fuel poverty and the health of older people: the role of local climate.

PubMed

de Vries, R; Blane, D

2013-09-01

Fuel poverty is a risk factor for ill-health, particularly among older people. We hypothesized that both the risk of fuel poverty and the strength of its detrimental effects on health would be increased in areas of colder and wetter climate. Individual data on respiratory health, hypertension, depressive symptoms and self-rated health were derived from the 2008/09 wave of the English Longitudinal Study of Ageing. Climate data for 89 English counties and unitary authorities were obtained from the UK Met Office. Multilevel regression models (n = 7160) were used to test (i) the association between local climate and fuel poverty risk, and (ii) the association between local climate and the effect of fuel poverty on health (adjusted for age, gender, height, smoking status and household income). Individual risk of fuel poverty varied across counties. However, this variation was not explained by differences in climate. Fuel poverty was significantly related to worse health for two of the outcomes (respiratory health and depressive symptoms). However, there was no significant effect of climate on fuel poverty's association with these outcomes. Although there is regional variation in England in both the risk of fuel poverty and its effects on health, this variation is not explained by differences in rainfall and winter temperatures.

Improving global health - is tourism's role in poverty elimination perpetuating poverty, powerlessness and 'ill-being'?

PubMed

Bauer, Irmgard L

2017-01-01

The spectrum of challenges for public health in a global context is ever expanding. It is difficult for health professionals to keep informed about details of key issues affecting global health determinants such as poverty. Tourism is seen as one strategy to eliminate poverty in developing countries and to improve global health, but the industry struggles with keeping its promise. Apart from often negative impacts on the well-being of local communities, it also turns out not to be as altruistic as it appears at first sight. Discourses largely focus on power and control of the non-poor over the poor despite all the rhetoric to the contrary. Economic aspects still dictate the debate rather than local people's understanding of well-being. Only with a major shift in the approach to local populations, acknowledging the communities' right to self-determination and accepting them as equal partners with access to genuine benefits, will this disturbing imbalance be redressed and allow better health for more people possible. Public health professionals should question claims about the beneficial influence of tourism in poor regions and not lower their vigilance for poverty-related health problems, so that the poor are not overlooked when all other stakeholders are busy with their own agenda.

Relative Deprivation, Poverty, and Subjective Health: JAGES Cross-Sectional Study

PubMed Central

Saito, Masashige; Kondo, Katsunori; Kondo, Naoki; Abe, Aya; Ojima, Toshiyuki; Suzuki, Kayo

2014-01-01

To evaluate the association between relative deprivation (lacking daily necessities) and subjective health in older Japanese adults, we performed a cross-sectional analysis using data from the Japan Gerontological Evaluation Study (JAGES). The data were obtained from functionally independent residents aged ≥65 years from 24 municipalities in Japan (n = 24,742). Thirteen items in three dimensions were used to evaluate relative deprivation of material conditions. Approximately 28% of older Japanese people indicated that they lacked some daily necessities (non-monetary poverty). A two-level Poisson regression analysis revealed that relative deprivation was associated with poor self-rated health (PR = 1.3–1.5) and depressive symptoms (PR = 1.5–1.8) in both men and women, and these relationships were stronger than those observed in people living in relative poverty (monetary poverty). The interaction effect between relative deprivation and relative poverty was not associated with poor health. As a dimension of the social determinants of health, poverty should be evaluated from a multidimensional approach, capturing not only monetary conditions but also material-based, non-monetary conditions. PMID:25350284

Fuel poverty as a major determinant of perceived health: the case of France.

PubMed

Lacroix, E; Chaton, C

2015-05-01

The number of households in fuel poverty is growing. Individuals increasingly struggle to heat their homes, and therefore, a growing number of individuals are exposed to low temperatures, which can affect their health. This study sought to determine the link between a subjective measure of fuel poverty (self-reported feeling cold) and self-reported health. The impact of other particular individual and environmental features on self-reported health were also analysed. Econometric analysis. The study method uses self-reported perception of thermal discomfort (self-reported feeling cold) as a proxy for fuel poverty. The French database of the Healthcare and Insurance survey carried by the Institute for Research and Information on Health Economics (IRDES) was used to estimate a dichotomous probit model. The estimation allows us to infer a negative impact of fuel poverty on self-reported health. Thus, a person in fuel poverty is 2.36 percentage points more likely to report poor or fair health status than a person who is not in fuel poverty. It may be appropriate to reduce the impacts of fuel poverty to provide support for the most vulnerable categories of individuals with respect to the health impacts of fuel poverty and cold homes, e.g., chronic patients who experience difficulty heating their homes. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The Role of Public Health Insurance in Reducing Child Poverty.

PubMed

Wherry, Laura R; Kenney, Genevieve M; Sommers, Benjamin D

2016-04-01

Over the past 30 years, there have been major expansions in public health insurance for low-income children in the United States through Medicaid, the Children's Health Insurance Program (CHIP), and other state-based efforts. In addition, many low-income parents have gained Medicaid coverage since 2014 under the Affordable Care Act. Most of the research to date on health insurance coverage among low-income populations has focused on its effect on health care utilization and health outcomes, with much less attention to the financial protection it offers families. We review a growing body of evidence that public health insurance provides important financial benefits to low-income families. Expansions in public health insurance for low-income children and adults are associated with reduced out of pocket medical spending, increased financial stability, and improved material well-being for families. We also review the potential poverty-reducing effects of public health insurance coverage. When out of pocket medical expenses are taken into account in defining the poverty rate, Medicaid plays a significant role in decreasing poverty for many children and families. In addition, public health insurance programs connect families to other social supports such as food assistance programs that also help reduce poverty. We conclude by reviewing emerging evidence that access to public health insurance in childhood has long-term effects for health and economic outcomes in adulthood. Exposure to Medicaid and CHIP during childhood has been linked to decreased mortality and fewer chronic health conditions, better educational attainment, and less reliance on government support later in life. In sum, the nation's public health insurance programs have many important short- and long-term poverty-reducing benefits for low-income families with children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

[Solidarity in health. Report on the 2017 Poverty and Health Congress].

PubMed

Waldhauer, Julia; Amler, Marion; Böhme, Nicole; Janella, Maren; Pospiech, Stefan; Lampert, Thomas

2017-08-01

The annual congress Armut und Gesundheit (Poverty and Health), which is organized by Gesundheit Berlin-Brandenburg e. V. and takes place at the Technical University of Berlin has become one of the biggest public health events in Germany. It constitutes an exchange platform for sciences, practice, and politics. This year's congress topic was solidarity in health, aiming to emphasize the responsibility that society and its actors have to bear in order to warrant health equity. Overall, 121 activities took place, with more than 500 experts and moderators discussing a wide range of subjects and questions including regional disparities in poverty, ethics in public health, the current situation of homeless and people without insurance, time trends in health inequalities, health and healthcare of refugees and asylum seekers, and the current progress and challenges in connection with the German prevention act.

Poverty, Ethnic Identity, and Health Care.

ERIC Educational Resources Information Center

Bullough, Bonnie; Bullough, Vern L.

This book tries to present the health care problems of the major ethnic minority groups in perspective. Although poverty is probably the most crucial variable in the genesis of these problems, there are still many subtle and not so subtle forms of discrimination operating in the health field. Unfortunately, discrimination in other aspects of…

Poverty and Health: Working with Families.

ERIC Educational Resources Information Center

Blackburn, Clare

This book is concerned with the impact of poverty on health, focusing on families with young children in the United Kingdom. It draws together information from a wide range of disciplines to provide workers in the health and welfare fields with a better understanding of the complex interconnections between living conditions, lifestyles, and health…

Barriers to primary care responsiveness to poverty as a risk factor for health.

PubMed

Bloch, Gary; Rozmovits, Linda; Giambrone, Broden

2011-06-29

Poverty is widely recognized as a major determinant of poor health, and this link has been extensively studied and verified. Despite the strong evidentiary link, little work has been done to determine what primary care health providers can do to address their patients' income as a risk to their health. This qualitative study explores the barriers to primary care responsiveness to poverty as a health issue in a well-resourced jurisdiction with near-universal health care insurance coverage. One to one interviews were conducted with twelve experts on poverty and health in primary care in Ontario, Canada. Participants included family physicians, specialist physicians, nurse practitioners, community workers, advocates, policy experts and researchers. The interviews were analysed for anticipated and emergent themes. This study reveals provider- and patient-centred structural, attitudinal, and knowledge-based barriers to addressing poverty as a risk to health. While many of its findings reinforce previous work in this area, this study's findings point to a number of areas front line primary care providers could target to address their patients' poverty. These include a lack of provider understanding of the lived reality of poverty, leading to a failure to collect adequate data about patients' social circumstances, and to the development of inappropriate care plans. Participants also pointed to prejudicial attitudes among providers, a failure of primary care disciplines to incorporate approaches to poverty as a standard of care, and a lack of knowledge of concrete steps providers can take to address patients' poverty. While this study reinforces, in a well-resourced jurisdiction such as Ontario, the previously reported existence of significant barriers to addressing income as a health issue within primary care, the findings point to the possibility of front line primary care providers taking direct steps to address the health risks posed by poverty. The consistent

Childhood Poverty, Cumulative Risk Exposure, and Mental Health in Emerging Adults

PubMed Central

Evans, Gary W.; Cassells, Rochelle C.

2014-01-01

One out of four American children are born into poverty, but little is known about the long-term, mental health implications of early deprivation. The more time in poverty from birth-age-9, the worse mental health as emerging adults (n = 196, M = 17.30 years, 53% male). These results maintain independently of concurrent, adult income levels for self-reported externalizing symptoms and a standard learned helplessness behavioral protocol, but internalizing symptoms were unaffected by childhood poverty. We then demonstrate that part of the reason why early poverty exposure is harmful to mental health among emerging adults is because of elevated cumulative risk exposure assessed at age 13. The significant, prospective, longitudinal relations between early childhood poverty and externalizing symptoms plus learned helplessness behavior are mediated, in part, by exposure to a confluence of psychosocial (violence, family turmoil, child separation from family) and physical (noise, crowding, substandard housing) risk factors during adolescence. PMID:26609499

Catastrophic out-of-pocket payments for health and poverty nexus: evidence from Senegal.

PubMed

Séne, Ligane Massamba; Cissé, Momath

2015-09-01

Out-of-pocket payments are the primary source through which health expenditure is met in Senegal. However, these payments are financial burdens that lead to impoverishment when they become catastrophic. The purpose of this study is to cast light on the determinants of catastrophic household out-of-pocket health expenditures and to assess their implications on poverty. The 2011 poverty monitoring survey is used in this study. This survey aims to draw poverty profiles and to highlight the socio-economic characteristics of different social groups. In line with the concerns raised by the new Supplemental Poverty Measure, poverty statistics are adjusted to take into account household health expenditures and to estimate their impoverishing effects. To identify the determinants of the magnitude of catastrophic health expenditure, we implement a seemingly unrelated equations system of Tobit regressions to take into account censoring through a conditional mixed-process estimator procedure. We identify major causes of catastrophic expenditures, such as the level of overall health spending, the expensiveness of health goods and services, the characteristics of health facilities, the health stock shocks, the lack of insurance, etc. Results show evidence that catastrophic health expenditures jeopardize household welfare for some people that fall into poverty as a result of negative effects on disposable income and disruption of the material living standards of households. Our findings warrant further policy improvements to minimize the financial risks of out-of-pocket health expenditures and increase the efficiency of health care system for more effective poverty reduction strategies.

Black-white metropolitan segregation and self-rated health: Investigating the role of neighborhood poverty.

PubMed

Do, D Phuong; Frank, Reanne; Iceland, John

2017-08-01

While black-white segregation has been consistently linked to detrimental health outcomes for blacks, whether segregation is necessarily a zero-sum arrangement in which some groups accrue health advantages at the expense of other groups and whether metropolitan segregation impacts the health of racial groups uniformly within the metropolitan area, remains unclear. Using nationally representative data from the 2008-2013 National Health Interview Survey linked to Census data, we investigate whether the association between metropolitan segregation and health is invariant within the metropolitan area or whether it is modified by neighborhood poverty for black and white Americans. In doing so, we assess the extent to which segregation involves direct health tradeoffs between blacks and whites. We conduct race-stratified multinomial and logistic regression models to assess the relationship between 1) segregation and level of neighborhood poverty and 2) segregation, neighborhood poverty, and poor health, respectively. We find that, for blacks, segregation was associated with a higher likelihood of residing in high poverty neighborhoods, net of individual-level socioeconomic characteristics. Segregation was positively associated with poor health for blacks in high poverty neighborhoods, but not for those in lower poverty neighborhoods. Hence, the self-rated health of blacks clearly suffers as a result of black-white segregation - both directly, and indirectly through exposure to high poverty neighborhoods. We do not find consistent evidence for a direct relationship between segregation and poor health for whites. However, we find some suggestive evidence that segregation may indirectly benefit whites through decreasing their exposure to high poverty environments. These findings underscore the critical role of concentrated disadvantage in the complex interconnection between metropolitan segregation and health. Weakening the link between racial segregation and concentrated

[Social politics against poverty and in favor of health in Mexico].

PubMed

Hamui-Sutton, Alicia; Irigoyen-Coria, Arnulfo; Gómez-Clavelina, Francisco Javier; Fernández-Ortega, Miguel Angel

2006-01-01

One of the biggest challenges that Mexico faces is to fight against the poverty. The transition of a characteristic welfare model from the government in a closed economy, to an open economy where the functions of the State are limited, has modified the modalities of the social politics against poverty. Six indispensable conditions are identified for poverty's reduction: 1. Economic development with stability in order to generate more and better jobs for poor people. 2. To improve regional economies. 3. To improve home conditions of poor people. 4. To elevate education levels (to encourage an authentic heath education). 5. To diminish catastrophic expenses for health problems. 6. Technical training for all workers. The impact of poverty over health can provide valuable elements to establish effective preventive strategies on health workers.

Resilience to Urban Poverty: Theoretical and Empirical Considerations for Population Health

PubMed Central

Sanders, Anne E.; Lim, Sungwoo; Sohn, Woosung

2008-01-01

Objectives. To better understand the trajectory that propels people from poverty to poor health, we investigated health resilience longitudinally among African American families with incomes below 250% of the federal poverty level. Methods. Health resilience is the capacity to maintain good health in the face of significant adversity. With higher levels of tooth retention as a marker of health resilience, we used a social–epidemiological framework to define capacity for health resilience through a chain of determinants starting in the built environment (housing quality) and community context (social support) to familial influences (religiosity) and individual mental health and health behavior. Results. Odds of retaining 20 or more teeth were 3 times as likely among adults with resilience versus more-vulnerable adults (odds ratio=3.1; 95% confidence interval [CI]=1.3, 7.4). Children of caregivers with resilience had a lower incident rate of noncavitated tooth decay at 18- to 24-month follow-up (incidence risk ratio=0.8; 95% CI=0.7, 0.9) compared with other children. Conclusions. Health resilience to poverty was supported by protective factors in the built and social environments. When poverty itself cannot be eliminated, improving the quality of the built and social environments will foster resilience to its harmful health effects. PMID:18445798

Resilience to urban poverty: theoretical and empirical considerations for population health.

PubMed

Sanders, Anne E; Lim, Sungwoo; Sohn, Woosung

2008-06-01

To better understand the trajectory that propels people from poverty to poor health, we investigated health resilience longitudinally among African American families with incomes below 250% of the federal poverty level. Health resilience is the capacity to maintain good health in the face of significant adversity. With higher levels of tooth retention as a marker of health resilience, we used a social-epidemiological framework to define capacity for health resilience through a chain of determinants starting in the built environment (housing quality) and community context (social support) to familial influences (religiosity) and individual mental health and health behavior. Odds of retaining 20 or more teeth were 3 times as likely among adults with resilience versus more-vulnerable adults (odds ratio=3.1; 95% confidence interval [CI]=1.3, 7.4). Children of caregivers with resilience had a lower incident rate of noncavitated tooth decay at 18- to 24-month follow-up (incidence risk ratio=0.8; 95% CI=0.7, 0.9) compared with other children. Health resilience to poverty was supported by protective factors in the built and social environments. When poverty itself cannot be eliminated, improving the quality of the built and social environments will foster resilience to its harmful health effects.

Poverty dynamics and parental mental health: Determinants of childhood mental health in the UK

PubMed Central

Fitzsimons, Emla; Goodman, Alissa; Kelly, Elaine; Smith, James P

2017-01-01

Using data from the British Millennium Cohort Study (MCS), an ongoing longitudinal study of a cohort of 18,827 children born in the UK in 2000–2001, we investigate important correlates of mental health issues during childhood. MCS respondents were sampled at birth, at age 9 months, and then when they were 3, 5, 7 and 11 years old. Each sweep contains detailed information on the family’s SES, parenting activities, developmental indicators, parental relationship status, and indicators of parental mental health. The Strengths and Difficulties Questionnaire (SDQ) and the related Rutter scale were used to identify behavioral and emotional problems in children. In this paper, childhood problems are separated into four domains: hyperactivity, emotional symptoms, conduct problems, and peer problems. We focus on two aspects of this relationship at ages 5 and 11 – the role of temporary and persistent poverty and the role of temporary and persistent mental health problems of mothers and fathers. At ages 11 and 5, without other controls in the model, persistent and transitory poverty have strong estimated associations with all four domains, with somewhat stronger estimated effects for persistent poverty. After a set of controls are added, we document that both persistent levels of poverty and transitions into poverty are strongly associated with levels of and transitions into childhood mental health problems. Similarly, sustained levels and transitions into mothers’ mental health problems are strongly associated with levels and transitions into children’s mental health problems. This is much less so for fathers. PMID:28056382

Poverty dynamics and parental mental health: Determinants of childhood mental health in the UK.

PubMed

Fitzsimons, Emla; Goodman, Alissa; Kelly, Elaine; Smith, James P

2017-02-01

Using data from the British Millennium Cohort Study (MCS), an ongoing longitudinal study of a cohort of 18,827 children born in the UK in 2000-2001, we investigate important correlates of mental health issues during childhood. MCS respondents were sampled at birth, at age 9 months, and then when they were 3, 5, 7 and 11 years old. Each sweep contains detailed information on the family's SES, parenting activities, developmental indicators, parental relationship status, and indicators of parental mental health. The Strengths and Difficulties Questionnaire (SDQ) and the related Rutter scale were used to identify behavioral and emotional problems in children. In this paper, childhood problems are separated into four domains: hyperactivity, emotional symptoms, conduct problems, and peer problems. We focus on two aspects of this relationship at ages 5 and 11-the role of temporary and persistent poverty and the role of temporary and persistent mental health problems of mothers and fathers. At ages 11 and 5, without other controls in the model, persistent and transitory poverty have strong estimated associations with all four domains, with somewhat stronger estimated effects for persistent poverty. After a set of controls are added, we document that both persistent levels of poverty and transitions into poverty are strongly associated with levels of and transitions into childhood mental health problems. Similarly, sustained levels and transitions into mothers' mental health problems are strongly associated with levels and transitions into children's mental health problems. This is much less so for fathers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Poverty, health and satellite-derived vegetation indices: their inter-spatial relationship in West Africa

PubMed Central

Sedda, Luigi; Tatem, Andrew J.; Morley, David W.; Atkinson, Peter M.; Wardrop, Nicola A.; Pezzulo, Carla; Sorichetta, Alessandro; Kuleszo, Joanna; Rogers, David J.

2015-01-01

Background Previous analyses have shown the individual correlations between poverty, health and satellite-derived vegetation indices such as the normalized difference vegetation index (NDVI). However, generally these analyses did not explore the statistical interconnections between poverty, health outcomes and NDVI. Methods In this research aspatial methods (principal component analysis) and spatial models (variography, factorial kriging and cokriging) were applied to investigate the correlations and spatial relationships between intensity of poverty, health (expressed as child mortality and undernutrition), and NDVI for a large area of West Africa. Results This research showed that the intensity of poverty (and hence child mortality and nutrition) varies inversely with NDVI. From the spatial point-of-view, similarities in the spatial variation of intensity of poverty and NDVI were found. Conclusions These results highlight the utility of satellite-based metrics for poverty models including health and ecological components and, in general for large scale analysis, estimation and optimisation of multidimensional poverty metrics. However, it also stresses the need for further studies on the causes of the association between NDVI, health and poverty. Once these relationships are confirmed and better understood, the presence of this ecological component in poverty metrics has the potential to facilitate the analysis of the impacts of climate change on the rural populations afflicted by poverty and child mortality. PMID:25733559

Deterioration in health: What is the role of unemployment and poverty?

PubMed

Vaalavuo, Maria

2016-06-01

There is powerful evidence on the association between ill health and low income or low socioeconomic position of the individual. In this article we study the deterioration in self-assessed health and its determinants, focusing on unemployment and poverty status of the person. A special focus on worsening health status gives more information on the link between health and socioeconomic characteristics than static analysis of health status. The longitudinal EU Statistics on Income and Living Conditions (EU-SILC) data covering years from 2008 to 2013 for 26 EU Member States is used to follow people for whom we have data for 4 consecutive years. We will use information on the self-rated health status of the person. Logistic regression analysis is employed to study the determinants of transition to worse health status. The results show that unemployment (OR 1.23) and poverty (OR 1.19) before the health transition are significantly associated with worsening health even when controlled for the prior health status of the person. CONCLUSIONS THE RESULTS SUPPORT CAUSAL LINK BETWEEN UNEMPLOYMENT AND POVERTY STATUS AND SUBSEQUENT HEALTH STATUS, WHILE WE CANNOT EXCLUDE THE ROLE OF SELECTION IN THE MECHANISM UNDERSTANDING BETTER THE LINK BETWEEN HEALTH AND UNEMPLOYMENT OR POVERTY IS IMPORTANT FOR BETTER DESIGN OF HEALTH AND SOCIAL POLICIES. © 2016 the Nordic Societies of Public Health.

Global health and local poverty: rich countries' responses to vulnerable populations.

PubMed

Simms, Chris D; Persaud, D David

2009-01-01

Poverty is an important determinant of ill health, mortality and suffering across the globe. This commentary asks what we can learn about poverty by looking at the way rich countries respond to the needs of vulnerable populations both within their own societies and those of low-income countries. Taking advantage of recent efforts to redefine child poverty in a way that is consistent with the World Health Organization's Commission on Social Determinants of Health, three sets of data are reviewed: levels of child well-being within 23 Organization of Economic Community Development countries; the amount of official development assistance these countries disburse to poor countries; and, government social transfers targeted at families as a percentage of GDP. Analysis shows that countries in Northern Europe tend to have lower levels of child poverty, and are the most generous with social transfers and providing development assistance to poor countries; in contrast, the non-European countries like Australia, Canada, Japan, and the United States, and generally, the G7 countries, are the least generous towards the vulnerable at home and abroad and tend to have the highest levels of child poverty. The findings suggest that nations' responses tend to be ideologically based rather than evidence or needs based and that poverty is neither inevitable nor intractable.

Health systems as defences against the consequences of poverty: equity in health as social justice.

PubMed

Mburu, F M

1983-01-01

The main development problems in the Third World are known to be gross socioeconomic inequality, widespread poor health status accompanied by high fertility and infant mortality rates, low life expectancy, mass illiteracy and mass poverty. In most of these countries governments invest a great deal of scarce resources toward the consequences of poverty rather than it causes. The paucity of resources for such social services is exacerbated by continuously increasing demands and needs which have to be satisfied. Unmet needs tend to cause apathy in the population. For purposes of controlling poverty and its consequences, these must be clearly formulated and relevant policies, a commitment to implement such policies, adequate administrative capacity and reasonably adequate resources. In the case of the health services system, the same requirements apply. Above all, the health system has to be directed toward the greatest needs of the population. This must involve policy makers, implementors and the consumer community. This paper argues that health systems cannot be an effective weapon against the consequences of poverty unless the above kinds of policy exist and are implemented.

Financial catastrophe and poverty impacts of out-of-pocket health payments in Turkey.

PubMed

Özgen Narcı, Hacer; Şahin, İsmet; Yıldırım, Hasan Hüseyin

2015-04-01

To determine the prevalence of catastrophic health payments, examine the determinants of catastrophic expenditures, and assess the poverty impact of out-of-pocket (OOP) payments. Data came from the 2004 to 2010 Household Budget Survey. Catastrophic health spending was defined by health payments as percentage of household consumption expenditures and capacity to pay at a set of thresholds. The poverty impact was evaluated by poverty head counts and poverty gaps before and after OOP health payments. The percentage of households that catastrophically spent their consumption expenditure and capacity to pay increased from 2004 to 2010, regardless of the threshold used. Households with a share of more than 40% health spending in both consumption expenditure and capacity to pay accounted for less than 1% across years. However, when a series of potential confounders were taken into account, the study found statistically significantly increased risk for the lowest threshold and decreased risk for the highest threshold in 2010 relative to the base year. Household income, size, education, senior and under 5-year-old members, health insurance, disabled members, payment for inpatient care and settlement were also statistically significant predictors of catastrophic health spending. Overall, poverty head counts were below 1%. Poverty gaps reached a maximum of 0.098%, with an overall increase in 2010 compared to 2004. Catastrophe and poverty increased from 2004 to 2010. However, given that the realization of some recent policies will affect the financial burden of OOP payments on households, the findings of this study need to be replicated.

Childhood poverty and health: cumulative risk exposure and stress dysregulation.

PubMed

Evans, Gary W; Kim, Pilyoung

2007-11-01

A massive literature documents the inverse association between poverty or low socioeconomic status and health, but little is known about the mechanisms underlying this robust relation. We examined longitudinal relations between duration of poverty exposure since birth, cumulative risk exposure, and physiological stress in two hundred seven 13-year-olds. Chronic stress was assessed by basal blood pressure and overnight cortisol levels; stress regulation was assessed by cardiovascular reactivity to a standard acute stressor and recovery after exposure to this stressor. Cumulative risk exposure was measured by multiple physical (e.g., substandard housing) and social (e.g., family turmoil) risk factors. The greater the number of years spent living in poverty, the more elevated was overnight cortisol and the more dysregulated was the cardiovascular response (i.e., muted reactivity). Cardiovascular recovery was not affected by duration of poverty exposure. Unlike the duration of poverty exposure, concurrent poverty (i.e., during adolescence) did not affect these physiological stress outcomes. The effects of childhood poverty on stress dysregulation are largely explained by cumulative risk exposure accompanying childhood poverty.

A health plan to reduce poverty.

PubMed

Weil, Alan

2007-01-01

Noting that the failures of the U.S. health care system are compounding the problems faced by low-income Americans, Alan Weil argues that any strategy to reduce poverty must provide access to health care for all low-income families. Although nearly all children in families with incomes under 200 percent of poverty are eligible for either Medicaid or the State Children's Health Insurance Program (SCHIP), the parents of poor children often lack health insurance. Parents who leave welfare normally get a year of coverage but then lose coverage unless their employer provides it, and many employers of low-wage workers do not offer health insurance. Similarly, parents who take low-paying jobs to avoid welfare usually have no coverage at all. This lack of coverage discourages adults from working and may also affect the health of children because adults without health insurance are less likely to take their children for preventive care. Weil proposes creating a federal earned income health credit (EIHC) and redefining the federal floor of coverage through Medicaid and SCHIP. His aim is to make health insurance affordable for low-income families and to make sure enough options are available that individuals and families can get coverage using a combination of their own, their employer's, and public resources. Weil would expand Medicaid eligibility to include all families whose income falls below the poverty line. The EIHC would be a refundable tax credit that would be available to parents during the year in advance of filing a tax return. The credit, which would be based on taxpayer earnings and family structure, would phase in as earnings increase, reach a plateau, and then phase out farther up the income scale. The credit would be larger for families with dependents. The EIHC would function seamlessly with the employee payroll withholding system. It would be available only to adults who demonstrate that they had health insurance coverage during the year and, for adults

Do race, neglect, and childhood poverty predict physical health in adulthood? A multilevel prospective analysis

PubMed Central

Nikulina, Valentina

2015-01-01

Childhood neglect and poverty often co-occur and both have been linked to poor physical health outcomes. In addition, Blacks have higher rates of childhood poverty and tend to have worse health than Whites. This paper examines the unique and interacting effects of childhood neglect, race, and family and neighborhood poverty on adult physical health outcomes. This prospective cohort design study uses a sample (N = 675) of court-substantiated cases of childhood neglect and matched controls followed into adulthood (Mage = 41). Health indicators (C-Reactive Protein [CRP], hypertension, and pulmonary functioning) were assessed through blood collection and measurements by a registered nurse. Data were analyzed using hierarchical linear models to control for clustering of participants in childhood neighborhoods. Main effects showed that growing up Black predicted CRP and hypertension elevations, despite controlling for neglect and childhood family and neighborhood poverty and their interactions. Multivariate results showed that race and childhood adversities interacted to predict adult health outcomes. Childhood family poverty predicted increased risk for hypertension for Blacks, not Whites. In contrast, among Whites, childhood neglect predicted elevated CRP. Childhood neighborhood poverty interacted with childhood family poverty to predict pulmonary functioning in adulthood. Gender differences in health indicators were also observed. The effects of childhood neglect, childhood poverty, and growing up Black in the United States are manifest in physical health outcomes assessed 30 years later. Implications are discussed. PMID:24189205

A Commentary on "Piercing the Bubble": Should Management Education "Confront" Poverty?

ERIC Educational Resources Information Center

Dart, Raymond

2008-01-01

This commentary contrasts "Piercing the Bubble" by proposing "pull" (rather than "push") strategies as a way for business schools to more meaningfully engage poverty and social exclusion. By reframing poverty issues in such a manner that they connect with core business student interests of career opportunities, current management practices, and…

Poverty, Family Process, and the Mental Health of Immigrant Children in Canada

PubMed Central

Beiser, Morton; Hou, Feng; Hyman, Ilene; Tousignant, Michel

2002-01-01

Objectives. This study examined the differential effects of poverty on the mental health of foreign-born children, Canadian-born children of immigrant parents, and children of nonimmigrant parents. Methods. Secondary analysis of data from a national Canadian study of children between 4 and 11 years of age was conducted. Results. Compared with their receiving-society counterparts, foreign-born children were more than twice as likely to live in poor families, but they had lower levels of emotional and behavioral problems. The effect of poverty on children's mental health among long-term immigrant and receiving-society families was indirect and primarily mediated by single-parent status, ineffective parenting, parental depression, and family dysfunction. In comparison, the mental health effect of poverty among foreign-born children could not be explained by the disadvantages that poor families often suffer. Conclusions. Poverty may represent a transient and inevitable part of the resettlement process for new immigrant families. For long-stay immigrant and receiving-society families, however, poverty probably is not part of an unfolding process; instead, it is the nadir of a cycle of disadvantage. PMID:11818295

Do race, neglect, and childhood poverty predict physical health in adulthood? A multilevel prospective analysis.

PubMed

Nikulina, Valentina; Widom, Cathy Spatz

2014-03-01

Childhood neglect and poverty often co-occur and both have been linked to poor physical health outcomes. In addition, Blacks have higher rates of childhood poverty and tend to have worse health than Whites. This paper examines the unique and interacting effects of childhood neglect, race, and family and neighborhood poverty on adult physical health outcomes. This prospective cohort design study uses a sample (N=675) of court-substantiated cases of childhood neglect and matched controls followed into adulthood (M(age)=41). Health indicators (C-Reactive Protein [CRP], hypertension, and pulmonary functioning) were assessed through blood collection and measurements by a registered nurse. Data were analyzed using hierarchical linear models to control for clustering of participants in childhood neighborhoods. Main effects showed that growing up Black predicted CRP and hypertension elevations, despite controlling for neglect and childhood family and neighborhood poverty and their interactions. Multivariate results showed that race and childhood adversities interacted to predict adult health outcomes. Childhood family poverty predicted increased risk for hypertension for Blacks, not Whites. In contrast, among Whites, childhood neglect predicted elevated CRP. Childhood neighborhood poverty interacted with childhood family poverty to predict pulmonary functioning in adulthood. Gender differences in health indicators were also observed. The effects of childhood neglect, childhood poverty, and growing up Black in the United States are manifest in physical health outcomes assessed 30 years later. Implications are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

[Poverty and Health: The Living Standard Approach as a Supplementary Concept to Measure Relative Poverty. Results from the German Socio-Economic Panel (GSOEP 2011)].

PubMed

Pförtner, T-K

2016-06-01

A common indicator of the measurement of relative poverty is the disposable income of a household. Current research introduces the living standard approach as an alternative concept for describing and measuring relative poverty. This study compares both approaches with regard to subjective health status of the German population, and provides theoretical implications for the utilisation of the income and living standard approach in health research. Analyses are based on the German Socio-Economic Panel (GSOEP) from the year 2011 that includes 12 290 private households and 21106 survey members. Self-rated health was based on a subjective assessment of general health status. Income poverty is based on the equalised disposable income and is applied to a threshold of 60% of the median-based average income. A person will be denoted as deprived (inadequate living standard) if 3 or more out of 11 living standard items are lacking due to financial reasons. To calculate the discriminate power of both poverty indicators, descriptive analyses and stepwise logistic regression models were applied separately for men and women adjusted for age, residence, nationality, educational level, occupational status and marital status. The results of the stepwise regression revealed a stronger poverty-health relationship for the living standard indicator. After adjusting for all control variables and the respective poverty indicator, income poverty was statistically not significantly associated with a poor subjective health status among men (OR Men: 1.33; 95% CI: 1.00-1.77) and women (OR Women: 0.98; 95% CI: 0.78-1.22). In contrast, the association between deprivation and subjective health status was statistically significant for men (OR Men: 2.00; 95% CI: 1.57-2.52) and women (OR Women: 2.11; 95% CI: 1.76-2.64). The results of the present study indicate that the income and standard of living approach measure different dimensions of poverty. In comparison to the income approach, the living

Income or living standard and health in Germany: different ways of measurement of relative poverty with regard to self-rated health.

PubMed

Pfoertner, Timo-Kolja; Andress, Hans-Juergen; Janssen, Christian

2011-08-01

Current study introduces the living standard concept as an alternative approach of measuring poverty and compares its explanatory power to an income-based poverty measure with regard to subjective health status of the German population. Analyses are based on the German Socio-Economic Panel (2001, 2003 and 2005) and refer to binary logistic regressions of poor subjective health status with regard to each poverty condition, their duration and their causal influence from a previous time point. To calculate the discriminate power of both poverty indicators, initially the indicators were considered separately in regression models and subsequently, both were included simultaneously. The analyses reveal a stronger poverty-health relationship for the living standard indicator. An inadequate living standard in 2005, longer spells of an inadequate living standard between 2001, 2003 and 2005 as well as an inadequate living standard at a previous time point is significantly strongly associated with subjective health than income poverty. Our results challenge conventional measurements of the relationship between poverty and health that probably has been underestimated by income measures so far.

Nexus of Poverty, Energy Balance and Health

PubMed Central

Mishra, C. P.

2012-01-01

Since the inception of planning process in India, health planning was an integral component of socio-economic planning. Recommendations of several committees, policy documents and Millennium development goals were instrumental in development of impressive health infrastructure. Several anti-poverty and employment generation programmes were instituted to remove poverty. Spectacular achievements took place in terms of maternal and child health indicators and expectancy of life at birth. However, communicable diseases and undernutrition remain cause of serious concern and non-communicable diseases are imposing unprecedented challenge to planners and policy makers. Estimates of poverty based on different criteria point that it has remained a sustained problem in the country and emphasizes on revisiting anti-poverty programmes, economic policies and social reforms. Poverty affects purchasing power and thereby, food consumption. Energy intake data has inherent limitations. It must be assessed in terms of energy expenditure. Energy balance has been least explored area of research. The studies conducted in three different representative population group of Eastern Uttar Pradesh revealed that 69.63% rural adolescent girls (10-19 years), 79.9% rural reproductive age group females and 62.3% rural geriatric subjects were in negative energy balance. Negative energy balance was significantly less in adolescent girls belonging to high SES (51.37%), having main occupation of family as business (55.3%), and highest per capita income group (57.1%) with respect to their corresponding sub-categories. In case of rural reproductive age groups, this was maximum (93.0%) in SC/ST category and least (65.7%) in upper caste group. In case of geriatric group, higher adjusted Odd's Ratio for negative energy balance for subjects not cared by family members (AOR 23.43, CI 3.93-139.56), not kept money (AOR 5.27, CI 1.58-17.56), belonging to lower and upper middle SES by Udai Pareekh Classification

Multidimensional poverty in rural Mozambique: a new metric for evaluating public health interventions.

PubMed

Victor, Bart; Blevins, Meridith; Green, Ann F; Ndatimana, Elisée; González-Calvo, Lázaro; Fischer, Edward F; Vergara, Alfredo E; Vermund, Sten H; Olupona, Omo; Moon, Troy D

2014-01-01

Poverty is a multidimensional phenomenon and unidimensional measurements have proven inadequate to the challenge of assessing its dynamics. Dynamics between poverty and public health intervention is among the most difficult yet important problems faced in development. We sought to demonstrate how multidimensional poverty measures can be utilized in the evaluation of public health interventions; and to create geospatial maps of poverty deprivation to aid implementers in prioritizing program planning. Survey teams interviewed a representative sample of 3,749 female heads of household in 259 enumeration areas across Zambézia in August-September 2010. We estimated a multidimensional poverty index, which can be disaggregated into context-specific indicators. We produced an MPI comprised of 3 dimensions and 11 weighted indicators selected from the survey. Households were identified as "poor" if were deprived in >33% of indicators. Our MPI is an adjusted headcount, calculated by multiplying the proportion identified as poor (headcount) and the poverty gap (average deprivation). Geospatial visualizations of poverty deprivation were created as a contextual baseline for future evaluation. In our rural (96%) and urban (4%) interviewees, the 33% deprivation cut-off suggested 58.2% of households were poor (29.3% of urban vs. 59.5% of rural). Among the poor, households experienced an average deprivation of 46%; thus the MPI/adjusted headcount is 0.27 ( = 0.58×0.46). Of households where a local language was the primary language, 58.6% were considered poor versus Portuguese-speaking households where 73.5% were considered non-poor. Living standard is the dominant deprivation, followed by health, and then education. Multidimensional poverty measurement can be integrated into program design for public health interventions, and geospatial visualization helps examine the impact of intervention deployment within the context of distinct poverty conditions. Both permit program

Multidimensional Poverty in Rural Mozambique: A New Metric for Evaluating Public Health Interventions

PubMed Central

Victor, Bart; Blevins, Meridith; Green, Ann F.; Ndatimana, Elisée; González-Calvo, Lázaro; Fischer, Edward F.; Vergara, Alfredo E.; Vermund, Sten H.; Olupona, Omo; Moon, Troy D.

2014-01-01

Background Poverty is a multidimensional phenomenon and unidimensional measurements have proven inadequate to the challenge of assessing its dynamics. Dynamics between poverty and public health intervention is among the most difficult yet important problems faced in development. We sought to demonstrate how multidimensional poverty measures can be utilized in the evaluation of public health interventions; and to create geospatial maps of poverty deprivation to aid implementers in prioritizing program planning. Methods Survey teams interviewed a representative sample of 3,749 female heads of household in 259 enumeration areas across Zambézia in August-September 2010. We estimated a multidimensional poverty index, which can be disaggregated into context-specific indicators. We produced an MPI comprised of 3 dimensions and 11 weighted indicators selected from the survey. Households were identified as “poor” if were deprived in >33% of indicators. Our MPI is an adjusted headcount, calculated by multiplying the proportion identified as poor (headcount) and the poverty gap (average deprivation). Geospatial visualizations of poverty deprivation were created as a contextual baseline for future evaluation. Results In our rural (96%) and urban (4%) interviewees, the 33% deprivation cut-off suggested 58.2% of households were poor (29.3% of urban vs. 59.5% of rural). Among the poor, households experienced an average deprivation of 46%; thus the MPI/adjusted headcount is 0.27 ( = 0.58×0.46). Of households where a local language was the primary language, 58.6% were considered poor versus Portuguese-speaking households where 73.5% were considered non-poor. Living standard is the dominant deprivation, followed by health, and then education. Conclusions Multidimensional poverty measurement can be integrated into program design for public health interventions, and geospatial visualization helps examine the impact of intervention deployment within the context of distinct

Health and vulnerability to poverty in Ghana: evidence from the Ghana Living Standards Survey Round 5

PubMed Central

2012-01-01

Background An understanding of the complex relationship between health status and welfare is crucial for critical policy interventions. However, the focus of most policies in developing regions has been on current welfare to the neglect of forward-looking welfare analysis. The absence of adequate research in the area of future poverty or vulnerability to poverty has also contributed to the focus on current welfare. The objectives of this study were to estimate vulnerability to poverty among households in Ghana and examine the relationship between health status and vulnerability to poverty. Method The study used cross section data from the Fifth Round of the Ghana Living Standards Survey (GLSS 5) with a nationally representative sample of 8,687 households from all administrative regions in Ghana. A three-step Feasible Generalized Least Squares (FGLS) estimation procedure was employed to estimate vulnerability to poverty and to model the effect of health status on expected future consumption and variations in future consumption. Vulnerability to poverty estimates were also examined against various household characteristics. Results Using an upper poverty line, the estimates of vulnerability show that about 56% of households in Ghana are vulnerable to poverty in the future and this is higher than the currently observed poverty level of about 29%. Households with ill members were vulnerable to poverty. Moreover, households with poor hygiene conditions were also vulnerable to future poverty. The vulnerability to poverty estimates were, however, sensitive to the poverty line used and varied with household characteristics. Conclusion The results imply that policies directed towards poverty reduction need to take into account the vulnerability of households to future poverty. Also, hygienic conditions and health status of households need not be overlooked in poverty reduction strategies. PMID:22827954

Struggling to Survive: Sexual Assault, Poverty, and Mental Health Outcomes of African American women

PubMed Central

Bryant-Davis, Thema; Ullman, Sarah E.; Tsong, Yuying; Tillman, Shaquita; Smith, Kimberly

2013-01-01

A substantial body of research documents the mental health consequences of sexual assault including, but not limited to, depression, posttraumatic stress disorder (PTSD), substance use, and suicidality. Far less attention has been given to the mental health effects of sexual assault for ethnic minority women or women living in poverty. Given African American women’s increased risk for sexual assault and increased risk for persistent poverty, the current study explores the relationship between income and mental health effects within a sample of 413 African American sexual assault survivors. Hierarchical regression analyses revealed that after controlling for childhood sexual abuse there were positive relationships between poverty and mental health outcomes of depression, PTSD, and illicit drug use. There was no significant relationship between poverty and suicidal ideation. Counseling and research implications are discussed. PMID:20397989

Poverty, health and policy: a historical look at the South African experience.

PubMed

Pick, William; Rispel, Laetitia; Naidoo, Shan

2008-07-01

The resurgence of interest in links between health and development raises interesting questions about the process of research, policy-making, and implementation in the field of health and poverty. To learn about the process in South Africa, we examined three commissions of inquiry relating poverty and health -- in 1929, 1942, and the early 1980s. Power relations of the players were a decisive factor and determined the type and nature of the research conducted.

Poverty and inequality - but of what - as social determinants of health in Africa?

PubMed

Worku, Eshetu B; Woldesenbet, Selamawit A

2015-12-01

Many African economies have achieved substantial economic growth over the past recent years, yet several of the Millennium Development Goals (MDGs) including those concerned with health, remain considerably behind target. This paper examines whether progress towards these goals is being hampered by existing levels of poverty and income inequality. It also considers whether the inequality hypothesis of Wilkinson and Pickett1 applies to population health outcomes in African states. Correlation analysis and scatter plots were used to assess graphically the link between variations in health outcomes, level of poverty and income inequality in different countries. Health status outcomes were measured by using four indicators: infant and under-five (child) mortality rates; maternal mortality ratios; and life expectancy at birth. In each of the 52 African nations, the proportion of the population living below the poverty line is used as an indicator of the level of poverty and Gini coefficient as a measure of income inequality. The study used a comprehensive review of secondary and relevant literature that are pertinent in the subject area. The data datasets obtained online from UNICEF2 and UNDP3 (2009) used to test the research questions. World Health Organization the three broad dimensions to consider when moving towards better population health outcome through Universal Health Coverage and the Social Determinants of Health framework reviewed to establish the poverty and income inequality link in African countries population health outcomes. The study shows that poverty is strongly associated with all health outcome differences in Africa (IMR, cc = 0.63; U5MR, cc = 0.64; MMR, cc = 0.49; life expectancy at birth, cc = -0.67); income inequality with only one of the four indicators (IMR, cc = 0.14; U5MR, cc = 0.07; MMR, cc = 0.22; life expectancy at birth, cc = -0.49), whereas income inequality is associated with one of the four indicators. The study shows that tackling

Childhood Poverty and Its Effect on Health and Well-being: Enhancing Training for Learners Across the Medical Education Continuum.

PubMed

Chamberlain, Lisa J; Hanson, Elizabeth R; Klass, Perri; Schickedanz, Adam; Nakhasi, Ambica; Barnes, Michelle M; Berger, Susan; Boyd, Rhea W; Dreyer, Benard P; Meyer, Dodi; Navsaria, Dipesh; Rao, Sheela; Klein, Melissa

2016-04-01

Childhood poverty is unacceptably common in the US and threatens the health, development, and lifelong well-being of millions of children. Health care providers should be prepared through medical curricula to directly address the health harms of poverty. In this article, authors from The Child Poverty Education Subcommittee (CPES) of the Academic Pediatric Association Task Force on Child Poverty describe the development of the first such child poverty curriculum for teachers and learners across the medical education continuum. Educators, physicians, trainees, and public health professionals from 25 institutions across the United States and Canada were convened over a 2-year period and addressed 3 goals: 1) define the core competencies of child poverty education, 2) delineate the scope and aims of a child poverty curriculum, and 3) create a child poverty curriculum ready to implement in undergraduate and graduate medical education settings. The CPES identified 4 core domains for the curriculum including the epidemiology of child poverty, poverty-related social determinants of health, pathophysiology of the health effects of poverty, and leadership and action to reduce and prevent poverty's health effects. Workgroups, focused on each domain, developed learning goals and objectives, built interactive learning modules to meet them, and created evaluation and faculty development materials to supplement the core curriculum. An editorial team with representatives from each workgroup coordinated activities and are preparing the final curriculum for national implementation. This comprehensive, standardized child poverty curriculum developed by an international group of educators in pediatrics and experts in the health effects of poverty should prepare medical trainees to address child poverty and improve the health of poor children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Concepts of health: women's struggle for wholeness in the midst of poverty.

PubMed

Polakoff, Elizabeth; Gregory, David

2002-12-01

This article describes the findings of a modest qualitative study that deals with the concept of health and involves the women-centered interviewing of six women who live in poverty. The themes uncovered in this study identify the struggle for wholeness in the midst of poverty. The findings validate many of the nursing theorists' definitions of health as wholeness, and challenge care providers to bring an appreciation of this view to their understanding of women's health.

The contribution of veterinary medicine to public health and poverty reduction in developing countries.

PubMed

Muma, John B; Mwacalimba, Kennedy K; Munang'andu, Hetron M; Matope, Gift; Jenkins, Akinbowale; Siamudaala, Victor; Mweene, Aaron S; Marcotty, Tanguy

2014-01-01

Few studies have explicitly examined the linkages between human health, animal disease control and poverty alleviation. This paper reviews the contribution that veterinary medicine can make to poverty alleviation in sub-Saharan Africa. Our analysis attempts to explore aspects of this contribution under five themes: food production; food safety; impact and control of zoonotic infections; promotion of ecotourism; and environmental protection. While these areas of human activity have, more or less, fallen under the influence of the veterinary profession to varying degrees, we attempt to unify this mandate using a 'One Health' narrative, for the purpose of providing clarity on the linkages between the veterinary and other professions, livestock production and poverty alleviation. Future opportunities for improving health and reducing poverty in the context of developing African countries are also discussed. We conclude that veterinary science is uniquely positioned to play a key role in both poverty reduction and the promotion of health, a role that can be enhanced through the reorientation of the profession's goals and the creation of synergies with allied and related professions.

Beyond income poverty: Measuring disadvantage in terms of material hardship and health

PubMed Central

Neckerman, Kathryn M.; Garfinkel, Irwin; Teitler, Julien O.; Waldfogel, Jane; Wimer, Christopher

2016-01-01

The New York City (NYC) Longitudinal Study of Wellbeing, or “Poverty Tracker,” is a survey of about 2,300 New York City residents. Its purpose is to provide a multidimensional and dynamic understanding of economic disadvantage in NYC. Measures of disadvantage were collected at baseline and a 12-month follow-up, and include three types of disadvantage: (1) income poverty, using a measure based on the new Supplemental Poverty Measure; (2) material hardship, including indicators of food insecurity, housing hardship, unmet medical needs, utility cutoffs, and financial insecurity; and (3) adult health problems, which can drain family time and resources. This paper presents initial results for NYC families with children under 18. At baseline, 56% of families with children had one or more type of disadvantage, including 28% with income poverty, 39% with material hardship, and 17% with an adult health problem. Even among nonpoor families, 33% experienced material hardship and 14% reported an adult health problem. Two-thirds of all families faced disadvantage at either baseline or follow-up, with 46% experiencing some kind of disadvantage at both time points. Respondents with a college education were much less likely to face disadvantage. Even after adjusting for educational attainment and family characteristics, the families of black and Hispanic respondents had elevated rates of disadvantage. Considering income poverty alone greatly understates the extent of disadvantage among families with children in New York City. These results suggest that in addition to addressing income poverty, policymakers should give priority to efforts to reduce material hardship and help families cope with chronic physical or mental illness. The need for these resources extends far above the poverty line. PMID:27044702

Health safety nets can break cycles of poverty and disease: a stochastic ecological model.

PubMed

Plucinski, Mateusz M; Ngonghala, Calistus N; Bonds, Matthew H

2011-12-07

The persistence of extreme poverty is increasingly attributed to dynamic interactions between biophysical processes and economics, though there remains a dearth of integrated theoretical frameworks that can inform policy. Here, we present a stochastic model of disease-driven poverty traps. Whereas deterministic models can result in poverty traps that can only be broken by substantial external changes to the initial conditions, in the stochastic model there is always some probability that a population will leave or enter a poverty trap. We show that a 'safety net', defined as an externally enforced minimum level of health or economic conditions, can guarantee ultimate escape from a poverty trap, even if the safety net is set within the basin of attraction of the poverty trap, and even if the safety net is only in the form of a public health measure. Whereas the deterministic model implies that small improvements in initial conditions near the poverty-trap equilibrium are futile, the stochastic model suggests that the impact of changes in the location of the safety net on the rate of development may be strongest near the poverty-trap equilibrium.

Health safety nets can break cycles of poverty and disease: a stochastic ecological model

PubMed Central

Pluciński, Mateusz M.; Ngonghala, Calistus N.; Bonds, Matthew H.

2011-01-01

The persistence of extreme poverty is increasingly attributed to dynamic interactions between biophysical processes and economics, though there remains a dearth of integrated theoretical frameworks that can inform policy. Here, we present a stochastic model of disease-driven poverty traps. Whereas deterministic models can result in poverty traps that can only be broken by substantial external changes to the initial conditions, in the stochastic model there is always some probability that a population will leave or enter a poverty trap. We show that a ‘safety net’, defined as an externally enforced minimum level of health or economic conditions, can guarantee ultimate escape from a poverty trap, even if the safety net is set within the basin of attraction of the poverty trap, and even if the safety net is only in the form of a public health measure. Whereas the deterministic model implies that small improvements in initial conditions near the poverty-trap equilibrium are futile, the stochastic model suggests that the impact of changes in the location of the safety net on the rate of development may be strongest near the poverty-trap equilibrium. PMID:21593026

Health Insecurity and Social Protection: Pathways, Gaps, and Their Implications on Health Outcomes and Poverty

PubMed Central

Gama, Elvis

2016-01-01

Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world’s poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented. PMID:26927589

Beyond Income Poverty: Measuring Disadvantage in Terms of Material Hardship and Health.

PubMed

Neckerman, Kathryn M; Garfinkel, Irwin; Teitler, Julien O; Waldfogel, Jane; Wimer, Christopher

2016-04-01

The New York City (NYC) Longitudinal Study of Wellbeing, or "Poverty Tracker," is a survey of approximately 2300 NYC residents. Its purpose is to provide a multidimensional and dynamic understanding of economic disadvantage in NYC. Measures of disadvantage were collected at baseline and a 12-month follow-up, and include 3 types of disadvantage: 1) income poverty, using a measure on the basis of the new Supplemental Poverty Measure; 2) material hardship, including indicators of food insecurity, housing hardship, unmet medical needs, utility cutoffs, and financial insecurity; and 3) adult health problems, which can drain family time and resources. In this article initial results for NYC families with children younger than the age of 18 years are presented. At baseline, 56% of families with children had 1 or more type of disadvantage, including 28% with income poverty, 39% with material hardship, and 17% with an adult health problem. Even among nonpoor families, 33% experienced material hardship and 14% reported an adult health problem. Two-thirds of all families faced disadvantage at either baseline or follow-up, with 46% experiencing some kind of disadvantage at both time points. Respondents with a college education were much less likely to face disadvantage. Even after adjusting for educational attainment and family characteristics, the families of black and Hispanic respondents had increased rates of disadvantage. Considering income poverty alone the extent of disadvantage among families with children in NYC is greatly understated. These results suggest that in addition to addressing income poverty, policymakers should give priority to efforts to reduce material hardship and help families cope with chronic physical or mental illness. The need for these resources extends far above the poverty line. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Searching for social capital: historical perspectives on health, poverty and culture.

PubMed

Welshman, John

2006-11-01

Social capital has been seen as having a positive effect on health, and the concept of social capital has been viewed as of central importance to debates about healthy, sustainable communities. More generally, behaviour and its relationship with health has become much more central to policy-making, as illustrated in the Choosing Health White Paper (2005), and the concept of social capital has been one influence on the concept of social exclusion. Robert Putnam's arguments, both those expressed in Making Democracy Work (1993) and the revised version seen in Bowling Alone (2000) have been taken up by numerous social scientists and policy-makers. But despite the explicitly historical perspective that Putnam employs in Bowling Alone in particular, the history of social capital remains rather neglected in the available literature. This article is concerned with providing a historical perspective on social capital, especially the ways in which social investigators have viewed the relationships between health, poverty and behaviour. The article puts social capital alongside that of 'underclass' concepts such as the culture of poverty thesis, and examines how the latter has been invented and reinvented in the U.K. and the U.S.A. over the last 120 years. It argues that there are important similarities between the culture of poverty and social capital, but also significant differences, and these have implications for current policy initiatives. One way of analysing concepts like social capital and social exclusion more rigorously is by locating them within this longer-term history of social investigation, in which debates about health, poverty, and culture have been of

County-level poverty is equally associated with unmet health care needs in rural and urban settings.

PubMed

Peterson, Lars E; Litaker, David G

2010-01-01

Regional poverty is associated with reduced access to health care. Whether this relationship is equally strong in both rural and urban settings or is affected by the contextual and individual-level characteristics that distinguish these areas, is unclear. Compare the association between regional poverty with self-reported unmet need, a marker of health care access, by rural/urban setting. Multilevel, cross-sectional analysis of a state-representative sample of 39,953 adults stratified by rural/urban status, linked at the county level to data describing contextual characteristics. Weighted random intercept models examined the independent association of regional poverty with unmet needs, controlling for a range of contextual and individual-level characteristics. The unadjusted association between regional poverty levels and unmet needs was similar in both rural (OR = 1.06 [95% CI, 1.04-1.08]) and urban (OR = 1.03 [1.02-1.05]) settings. Adjusting for other contextual characteristics increased the size of the association in both rural (OR = 1.11 [1.04-1.19]) and urban (OR = 1.11 [1.05-1.18]) settings. Further adjustment for individual characteristics had little additional effect in rural (OR = 1.10 [1.00-1.20]) or urban (OR = 1.11 [1.01-1.22]) settings. To better meet the health care needs of all Americans, health care systems in areas with high regional poverty should acknowledge the relationship between poverty and unmet health care needs. Investments, or other interventions, that reduce regional poverty may be useful strategies for improving health through better access to health care. © 2010 National Rural Health Association.

Social determinants of health: poverty, national infrastructure and investment.

PubMed

Douthit, Nathan T; Alemu, Haimanot Kasahun

2016-06-22

This case presentation of a 19-year-old Ethiopian woman diagnosed with nasopharyngeal carcinoma reveals the barriers the patient has to medical treatment, including poverty and a lack of national infrastructure. The patient lives a life of poverty, and the outcome of her illness is a result of her being unable to overcome barriers to accessing health care due to inability to afford transport, lodging and treatment. In this case, the patient's vulnerability to disease due to her poverty is not overcome because of lack of infrastructure. The infrastructure fails to develop because of inadequate investment and other delays in building. The end result is that the patient is vulnerable to disease. Her disease process impacts her family and their contribution to Ethiopia's development. 2016 BMJ Publishing Group Ltd.

Poverty and psychological health among AIDS-orphaned children in Cape Town, South Africa.

PubMed

Cluver, Lucie; Gardner, Frances; Operario, Don

2009-06-01

This study examined associations between AIDS-orphanhood status, poverty indicators, and psychological problems (depression, anxiety, post-traumatic stress, peer problems, delinquency, conduct problems) among children and adolescents in townships surrounding Cape Town, South Africa. One thousand and twenty-five children and adolescents completed standardized and culturally sensitive cross-sectional surveys. Children orphaned by AIDS had more psychological problems including depression, peer problems, post-traumatic stress, and conduct problems. Specific poverty indicators including food security, access to social welfare grants, employment in the household and access to school were associated with better psychological health. Poverty indicators mediated associations of AIDS-orphanhood with psychological problems. Food security showed the most consistent association with reduced psychological problems. Poverty alleviation measures have the potential to improve psychological health for AIDS-orphaned children in South African townships.

General ecological models for human subsistence, health and poverty.

PubMed

Ngonghala, Calistus N; De Leo, Giulio A; Pascual, Mercedes M; Keenan, Donald C; Dobson, Andrew P; Bonds, Matthew H

2017-08-01

The world's rural poor rely heavily on their immediate natural environment for subsistence and suffer high rates of morbidity and mortality from infectious diseases. We present a general framework for modelling subsistence and health of the rural poor by coupling simple dynamic models of population ecology with those for economic growth. The models show that feedbacks between the biological and economic systems can lead to a state of persistent poverty. Analyses of a wide range of specific systems under alternative assumptions show the existence of three possible regimes corresponding to a globally stable development equilibrium, a globally stable poverty equilibrium and bistability. Bistability consistently emerges as a property of generalized disease-economic systems for about a fifth of the feasible parameter space. The overall proportion of parameters leading to poverty is larger than that resulting in healthy/wealthy development. All the systems are found to be most sensitive to human disease parameters. The framework highlights feedbacks, processes and parameters that are important to measure in studies of rural poverty to identify effective pathways towards sustainable development.

Poverty Matters: The Cost of Child Poverty in America.

ERIC Educational Resources Information Center

Sherman, Arloc

The poverty affecting 14.5 million U.S. children living below the poverty line poses long-term effects, including risks to health, educational achievement, family stability, and employment prospects. This report provides compelling evidence of the substantial costs of poverty among children to our nation's economic well-being, and shows that…

[THE GLOBAL AND ECONOMIC CRISIS. AND HEALTH MANAGEMENT].

PubMed

del Rey Calero, Juan

2014-01-01

The Global and economic crisis and Health Management The Health care process discussed are 4 steps: assessment, planing, intervention and evaluation. The identify association between social factors linked to social vulnerability (socio economic status, unemployed, poverty) and objective health relate quality of life. The poverty rate is 24.2%, unemployed 26.26%, youth unemployed 56.13%.ratio worker/retired 2.29. Debts 100% GDP The health inequality influence on health related quality of life. The Health System efficiency index. according Bloomber rate (2,013) Spain is 5 degrees in the world, points 68.3 on 100, for the life expectancy 82.3 years, the personal cost of health care 2,271€. Health care 10% GDP (public 7%,private 3%), SS protected population 92.4%, retired person cost 9.2% GDP, p. capita GDP 23,737€. Cost of Care: Hospital/specialist 54%, P. Care 15%, Pharmaceutical 19.8%, P. Health 3.1%.

Health Insecurity and Social Protection: Pathways, Gaps, and Their Implications on Health Outcomes and Poverty.

PubMed

Gama, Elvis

2015-11-27

Health insecurity has emerged as a major concern among health policy-makers particularly in low- and middle-income countries (LMICs). It includes the inability to secure adequate healthcare today and the risk of being unable to do so in the future as well as impoverishing healthcare expenditure. The increasing health insecurity among 150 million of the world's poor has moved social protection in health (SPH) to the top of the agenda among health policy-makers globally. This paper aims to provide a debate on the potential of social protection contribution to addressing health insecurity, poverty, and vulnerability brought by healthcare expenditure in low-income countries, to explore the gaps in current and proposed social protection measures in healthcare and provide suggestions on how social protection intervention aimed at addressing health insecurity, poverty, and vulnerability may be effectively implemented. © 2016 by Kerman University of Medical Sciences.

Can health insurance protect against out-of-pocket and catastrophic expenditures and also support poverty reduction? Evidence from Ghana's National Health Insurance Scheme.

PubMed

Aryeetey, Genevieve Cecilia; Westeneng, Judith; Spaan, Ernst; Jehu-Appiah, Caroline; Agyepong, Irene Akua; Baltussen, Rob

2016-07-22

Ghana since 2004, begun implementation of a National Health Insurance Scheme (NHIS) to minimize financial barriers to health care at point of use of service. Usually health insurance is expected to offer financial protection to households. This study aims to analyze the effect health insurance on household out-of-pocket expenditure (OOPE), catastrophic expenditure (CE) and poverty. We conducted two repeated household surveys in two regions of Ghana in 2009 and 2011. We first analyzed the effect of OOPE on poverty by estimating poverty headcount before and after OOPE were incurred. We also employed probit models and use of instrumental variables to analyze the effect of health insurance on OOPE, CE and poverty. Our findings showed that between 7-18 % of insured households incurred CE as a result of OOPE whereas this was between 29-36 % for uninsured households. In addition, between 3-5 % of both insured and uninsured households fell into poverty due to OOPE. Our regression analyses revealed that health insurance enrolment reduced OOPE by 86 % and protected households against CE and poverty by 3.0 % and 7.5 % respectively. This study provides evidence that high OOPE leads to CE and poverty in Ghana but enrolment into the NHIS reduces OOPE, provides financial protection against CE and reduces poverty. These findings support the pro-poor policy objective of Ghana's National Health Insurance Scheme and holds relevance to other low and middle income countries implementing or aiming to implement insurance schemes.

Mozambique's Debt and the International Monetary Fund's Influence on Poverty, Education, and Health.

PubMed

Beste, Jason; Pfeiffer, James

2016-01-01

For nearly 30 years, Mozambique has been facing austerity measures regulated by the IMF. These austerity measures, grounded in macroeconomic policies, were supposed to lift Mozambique out of poverty, and improve its healthcare and education systems. By taking an in-depth look at the major etiologies of Mozambique's debt and the conditions which forced the country to accept austerity measures-despite their protests-prior to receiving IMF funding, this paper examines how IMF policies over the past 30 years have affected poverty, health, and the education system. The results of these policies have contributed to Mozambique's enduring classification as one of the poorest countries in the world. Aside from economic outcomes, Mozambique also has abysmal health and education systems, with one of the lowest life expectancies in Sub-Saharan Africa. It is time to re-evaluate how the current IMF macroeconomic policies negatively affect, health, education and the socioeconomic status of those who live in abject poverty. As short term macroeconomic policies of PARPA have been ineffective at reducing poverty, promoting education and improving health, the IMF should consider using longer term macroeconomic policies which invest in-rather than limit-public services such as health and education. © The Author(s) 2016.

Religion, Poverty, and Politics: Their Impact on Women's Reproductive Health Outcomes.

PubMed

Kimball, Richard; Wissner, Michael

2015-01-01

This study sought to explore the relationship(s) between U.S. states of selected social determinants of health (SDH) and three women's reproductive health outcomes including abortion, teen births, and infant mortality rates (IMR). The data from multiple population surveys were used to establish on a state-by-state basis, the interactions between selected SDH (religion, voting patterns, child poverty, and GINI) and their policy effects on three women's reproductive health outcomes (abortion, teen births, and IMRs) using publicly available national databases. Child poverty rates and the GINI coefficient were analyzed. Religiosity information was obtained from the Pew Forum's surveys. Voting results were collected from the 2008 congressional and presidential races and were used as proxy measures for conservative- versus liberal-leaning policies and policy makers. Using multiple regression analysis, higher IMRs were associated with higher religiosity scores. Lower abortion rates were associated with voting conservatively and higher income inequality. Higher teen birth rates were associated with higher child poverty rates and voting conservatively. This study shows that selected SDH may have substantial impacts on women's reproductive health outcomes at the state level. Significant inequalities exist between liberal and conservative states that affect women's health outcomes. © 2015 Wiley Periodicals, Inc.

Bisexuality, poverty and mental health: A mixed methods analysis.

PubMed

Ross, Lori E; O'Gorman, Laurel; MacLeod, Melissa A; Bauer, Greta R; MacKay, Jenna; Robinson, Margaret

2016-05-01

Bisexuality is consistently associated with poor mental health outcomes. In population-based data, this is partially explained by income differences between bisexual people and lesbian, gay, and/or heterosexual individuals. However, the interrelationships between bisexuality, poverty, and mental health are poorly understood. In this paper, we examine the relationships between these variables using a mixed methods study of 302 adult bisexuals from Ontario, Canada. Participants were recruited using respondent-driven sampling to complete an internet-based survey including measures of psychological distress and minority stress. A subset of participants completed a semi-structured qualitative interview to contextualize their mental health experiences. Using information regarding household income, number of individuals supported by the income and geographic location, participants were categorized as living below or above the Canadian Low Income Cut Off (LICO). Accounting for the networked nature of the sample, participants living below the LICO had significantly higher mean scores for depression and posttraumatic stress disorder symptoms and reported significantly more perceived discrimination compared to individuals living above the LICO. Grounded theory analysis of the qualitative interviews suggested four pathways through which bisexuality and poverty may intersect to impact mental health: through early life experiences linked to bisexuality or poverty that impacted future financial stability; through effects of bisexual identity on employment and earning potential; through the impact of class and sexual orientation discrimination on access to communities of support; and through lack of access to mental health services that could provide culturally competent care. These mixed methods data help us understand the income disparities associated with bisexual identity in population-based data, and suggest points of intervention to address their impact on bisexual mental

Development of the role of public health nurses in addressing child and family poverty: a framework for action.

PubMed

Cohen, Benita E; Reutter, Linda

2007-10-01

The purpose of this paper is to invite dialogue about how public health nurses could best address child and family poverty. Their current role is reviewed and a framework for expanding this role is presented. The negative health consequences of poverty for children are well-documented worldwide. The high levels of children living in poverty in wealthy industrialized countries such as Canada should be of concern to the health sector. What role(s) can public health nurses play in addressing child and family poverty? A review of scholarly literature from Canada, the United States of America and the United Kingdom was conducted to ascertain support for public health nurses' roles in reducing poverty and its effects. We then reviewed professional standards and competencies for nursing practice in Canada. The data were collected between 2005 and 2006. Numerous nursing scholars have called for public health nurses to address the causes and consequences of poverty through policy advocacy. However, this role was less likely to be identified in professional standards and competencies, and we found little empirical evidence documenting Canadian public health nurses' efforts to engage in this role. Public health nurses' roles in relation to poverty focus primarily on assisting families living in poverty to access appropriate services rather than directing efforts at the policy level. Factors associated with this limited involvement are identified. We suggest that the conceptual framework developed by Blackburn in the United Kingdom offers direction for a more fully developed public health nursing role. Prerequisites to engaging in the strategies articulated in the framework are discussed. Given more organizational support and enhanced knowledge and skills, public health nurses could be playing a greater role in working with others to make child and family poverty history.

Can economic deprivation protect health? Paradoxical multilevel effects of poverty on Hispanic children's wheezing.

PubMed

Collins, Timothy W; Kim, Young-an; Grineski, Sara E; Clark-Reyna, Stephanie

2014-08-06

Prior research suggests that economic deprivation has a generally negative influence on residents' health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA) at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children's current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor's asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children's wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor) Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health.

Assessing the Effects of the New Cooperative Medical Scheme on Alleviating the Health Payment-Induced Poverty in Shaanxi Province, China.

PubMed

Yang, Xiaowei; Gao, Jianmin; Zhou, Zhongliang; Yan, Jue; Lai, Sha; Xu, Yongjian; Chen, Gang

2016-01-01

Disease has become one of the key causes of falling into poverty in rural China. The poor households are even more likely to suffer. The New Cooperative Medical Scheme (NCMS) has been implemented to provide rural residents financial protection against health risks. This study aims to assess the effect of the NCMS on alleviating health payment-induced poverty in the Shaanxi Province of China. The data was drawn from the 5th National Health Service Survey of Shaanxi Province, conducted in 2013. In total, 41,037 individuals covered by NCMS were selected. Poverty headcount ratio (HCR), poverty gap and mean positive poverty gap were used for measuring the incidence, depth and intensity of poverty, respectively. The differences on poverty measures pre- and post- insurance reimbursement indicate the effectiveness of alleviating health payment-induced poverty under NCMS. For the general insured, 5.81% of households fell below the national poverty line owing to the health payment; this HCR dropped to 4.84% after insurance reimbursement. The poverty HCRs for the insured that had hospitalization in the past year dropped from 7.50% to 2.09% after reimbursement. With the NCMS compensation, the poverty gap declined from 42.90 Yuan to 34.49 Yuan (19.60% decreased) for the general insured and from 57.48 Yuan to 10.01 Yuan (82.59% decreased) for the hospital admission insured. The mean positive poverty gap declined 3.56% and 37.40% for two samples, respectively. The NCMS could alleviate the health payment-induced poverty. The effectiveness of alleviating health payment-induced poverty is greater for hospital admission insured than for general insured, mainly because NCMS compensates for serious diseases. Our study suggests that a more comprehensive insurance benefit package design could further improve the effectiveness of poverty alleviation.

Assessing the Effects of the New Cooperative Medical Scheme on Alleviating the Health Payment-Induced Poverty in Shaanxi Province, China

PubMed Central

Gao, Jianmin; Zhou, Zhongliang; Yan, Jue; Lai, Sha; Xu, Yongjian; Chen, Gang

2016-01-01

Background Disease has become one of the key causes of falling into poverty in rural China. The poor households are even more likely to suffer. The New Cooperative Medical Scheme (NCMS) has been implemented to provide rural residents financial protection against health risks. This study aims to assess the effect of the NCMS on alleviating health payment-induced poverty in the Shaanxi Province of China. Methods The data was drawn from the 5th National Health Service Survey of Shaanxi Province, conducted in 2013. In total, 41,037 individuals covered by NCMS were selected. Poverty headcount ratio (HCR), poverty gap and mean positive poverty gap were used for measuring the incidence, depth and intensity of poverty, respectively. The differences on poverty measures pre- and post- insurance reimbursement indicate the effectiveness of alleviating health payment-induced poverty under NCMS. Results For the general insured, 5.81% of households fell below the national poverty line owing to the health payment; this HCR dropped to 4.84% after insurance reimbursement. The poverty HCRs for the insured that had hospitalization in the past year dropped from 7.50% to 2.09% after reimbursement. With the NCMS compensation, the poverty gap declined from 42.90 Yuan to 34.49 Yuan (19.60% decreased) for the general insured and from 57.48 Yuan to 10.01 Yuan (82.59% decreased) for the hospital admission insured. The mean positive poverty gap declined 3.56% and 37.40% for two samples, respectively. Conclusion The NCMS could alleviate the health payment-induced poverty. The effectiveness of alleviating health payment-induced poverty is greater for hospital admission insured than for general insured, mainly because NCMS compensates for serious diseases. Our study suggests that a more comprehensive insurance benefit package design could further improve the effectiveness of poverty alleviation. PMID:27380417

[Poverty and Mental Disorders in the Colombian Population: National Mental Health Survey 2015].

PubMed

Quitian, Hoover; Ruiz-Gaviria, Rafael E; Gómez-Restrepo, Carlos; Rondón, Martin

2016-12-01

Poverty has been associated in some studies with poorer outcomes in mental problems and disorders. A circular relationship has been considered in which poverty fosters the appearance of mental illness and this facilitates greater poverty. There are no studies in Colombia on this subject. To describe the association between mental problems and disorders and poverty according to the Multidimensional Poverty Index (MPI) in Colombia. Using the 2015 National Mental Health Survey, adjusted with the expansion factors for the population. The prevalences of mental problems and disorders obtained through semi-structured interviews employing the instruments SRQ-20, AUDIT C and A, modified PCL, familiar APGAR and CIDI CAPI. The poverty status was determined by the MPI. A total of 13,200 households were interviewed, of which 13.5% were classified as in a poverty condition, 6.3% of the adolescents of poor households reported a life-time prevalence of any mental disorder, and 4.6% in the last 12 months. On the other hand, the prevalences for the same age group not in a poverty condition were 7.2% and 3.3%, respectively. For adults in poverty, the prevalence of life-time mental disorders were 9.2%, with 4.3% in the last year, while those not considered poor showed prevalences of 9.1% and 3.9% for the same time periods. For the population of Colombia, there is a relationship between not being able to access the basic basket of goods and the presence of mental diseases, although there does not seems to be an association between an increase in poverty and the deterioration of mental health. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

The Impact of Relative Poverty on Norwegian Adolescents’ Subjective Health: A Causal Analysis with Propensity Score Matching

PubMed Central

Elstad, Jon Ivar; Pedersen, Axel West

2012-01-01

Studies have revealed that relative poverty is associated with ill health, but the interpretations of this correlation vary. This article asks whether relative poverty among Norwegian adolescents is causally related to poor subjective health, i.e., self-reported somatic and mental symptoms. Data consist of interview responses from a sample of adolescents (N = 510) and their parents, combined with register data on the family’s economic situation. Relatively poor adolescents had significantly worse subjective health than non-poor adolescents. Relatively poor adolescents also experienced many other social disadvantages, such as parental unemployment and parental ill health. Comparisons between the relatively poor and the non-poor adolescents, using propensity score matching, indicated a negative impact of relative poverty on the subjective health among those adolescents who lived in families with relatively few economic resources. The results suggest that there is a causal component in the association between relative poverty and the symptom burden of disadvantaged adolescents. Relative poverty is only one of many determinants of adolescents’ subjective health, but its role should be acknowledged when policies for promoting adolescent health are designed. PMID:23249858

Poverty and health among CDC plantation labourers in Cameroon: Perceptions, challenges and coping strategies.

PubMed

Makoge, Valerie; Vaandrager, Lenneke; Maat, Harro; Koelen, Maria

2017-11-01

Creating better access to good quality healthcare for the poor is a major challenge to development. In this study, we examined inter-linkages between poverty and disease, referred to as poverty-related diseases (PRDs), by investigating how Cameroon Development Corporation (CDC) camp dwellers respond to diseases that adversely affect their health and wellbeing. Living in plantation camps is associated with poverty, overcrowding, poor sanitation and the rapid spread of diseases. In a survey of 237 CDC camp dwellers in Cameroon, we used the health belief model to understand the drivers (perceived threats, benefits and cues for treatment seeking) of reported responses. Using logistic regression analysis, we looked for trends in people's response to malaria. We calculated the odds ratio of factors shown to have an influence on people's health, such as food, water, sanitation challenges and seeking formal healthcare for malaria. Malaria (40.3%), cholera (20.8%) and diarrhoea (17.7%) were the major PRDs perceived by camp dwellers. We found a strong link between what respondents perceived as PRDS and hygiene conditions. Poverty for our respondents was more about living in poor hygiene conditions than lack of money. Respondents perceived health challenges as stemming from their immediate living environment. Moreover, people employed self-medication and other informal health practices to seek healthcare. Interestingly, even though respondents reported using formal healthcare services as a general response to illness (84%), almost 90% stated that, in the case of malaria, they would use informal healthcare services. Our study recommends that efforts to curb the devastating effects of PRDs should have a strong focus on perceptions (i.e. include diseases that people living in conditions of poverty perceive as PRDs) and on hygiene practices, emphasising how they can be improved. By providing insights into the inter-linkages between poverty and disease, our study offers relevant

Piercing the Bubble: How Management Students Can Confront Poverty in Colombia

ERIC Educational Resources Information Center

Rosenbloom, Al; Cortes, Juan Alejandro

2008-01-01

This article describes the current relationship between management education in Colombia and the efforts of the management program at Universidad Pontificia Bolivariana (UPB) in Medellin to reduce local poverty. The article uses the metaphor of "the bubble" to illustrate how social class, family socialization, and the current UPB…

The effects of poverty on the mental, emotional, and behavioral health of children and youth: implications for prevention.

PubMed

Yoshikawa, Hirokazu; Aber, J Lawrence; Beardslee, William R

2012-01-01

This article considers the implications for prevention science of recent advances in research on family poverty and children's mental, emotional, and behavioral health. First, we describe definitions of poverty and the conceptual and empirical challenges to estimating the causal effects of poverty on children's mental, emotional, and behavioral health. Second, we offer a conceptual framework that incorporates selection processes that affect who becomes poor as well as mechanisms through which poverty appears to influence child and youth mental health. Third, we use this conceptual framework to selectively review the growing literatures on the mechanisms through which family poverty influences the mental, emotional, and behavioral health of children. We illustrate how a better understanding of the mechanisms of effect by which poverty impacts children's mental, emotional, and behavioral health is valuable in designing effective preventive interventions for those in poverty. Fourth, we describe strategies to directly reduce poverty and the implications of these strategies for prevention. This article is one of three in a special section (see also Biglan, Flay, Embry, & Sandler, 2012; Muñoz, Beardslee, & Leykin, 2012) representing an elaboration on a theme for prevention science developed by the 2009 report of the National Research Council and Institute of Medicine.

Creating Nurturing Environments: A Science-Based Framework for Promoting Child Health and Development within High-Poverty Neighborhoods

ERIC Educational Resources Information Center

Komro, Kelli A.; Flay, Brian R.; Biglan, Anthony

2011-01-01

Living in poverty and living in areas of concentrated poverty pose multiple risks for child development and for overall health and wellbeing. Poverty is a major risk factor for several mental, emotional, and behavioral disorders, as well as for other developmental challenges and physical health problems. In this paper, the Promise Neighborhoods…

Making a technological choice for disaster management and poverty alleviation in India.

PubMed

Srivastava, Sanjay K

2009-03-01

The right mix of policy, institutional arrangements and use of technology provides the framework for a country's approach to disaster mitigation. Worldwide, there has been a shift away from a strictly 'top-down' approach relying on government alone, to a combination of 'top-down' and 'bottom-up' approaches. The aim is to enhance the indigenous coping mechanisms of vulnerable communities; draw on their cooperative spirit and energy; and empower them through appropriate information and contextual knowledge to mitigate natural disasters. In light of this, the paper examines India's use of space technology in its disaster management efforts. Poverty alleviation and disaster management are almost inseparable in many parts of the country, as vulnerability to natural disasters is closely aligned with poverty. Addressing these issues together requires integrated knowledge systems. The paper examines how knowledge inputs from space technology have strengthened the national resolve to combat natural disasters in conjunction with alleviating rural poverty.

Social Networks, Social Participation, and Health among Youth Living in Extreme Poverty in Rural Malawi

PubMed Central

Rock, Amelia; Barrington, Clare; Abdoulayi, Sara; Tsoka, Maxton; Mvula, Peter; Handa, Sudhanshu

2017-01-01

Extensive research documents that social network characteristics affect health, but knowledge of peer networks of youth in Malawi and sub-Saharan Africa is limited. We examine the networks and social participation of youth living in extreme poverty in rural Malawi, using in-depth interviews with 32 youth and caregivers. We describe youth’s peer networks and assess how gender and the context of extreme poverty influence their networks and participation, and how their networks influence health. In-school youth had larger, more interactive, and more supportive networks than out-of-school youth, and girls described less social participation and more isolation than boys. Youth exchanged social support and influence within their networks that helped cope with poverty-induced stress and sadness, and encouraged protective sexual health practices. However, poverty hampered their involvement in school, religious schools, and community organizations, directly through lack of required material means, and indirectly by reducing time and emotional resources and creating shame and stigma. Poverty alleviation policy holds promise for improving youth’s social wellbeing and mental and physical health by increasing their opportunities to form networks, receive social support, and experience positive influence. PMID:27760393

Social networks, social participation, and health among youth living in extreme poverty in rural Malawi.

PubMed

Rock, Amelia; Barrington, Clare; Abdoulayi, Sara; Tsoka, Maxton; Mvula, Peter; Handa, Sudhanshu

2016-12-01

Extensive research documents that social network characteristics affect health, but knowledge of peer networks of youth in Malawi and sub-Saharan Africa is limited. We examine the networks and social participation of youth living in extreme poverty in rural Malawi, using in-depth interviews with 32 youth and caregivers. We describe youth's peer networks and assess how gender and the context of extreme poverty influence their networks and participation, and how their networks influence health. In-school youth had larger, more interactive, and more supportive networks than out-of-school youth, and girls described less social participation and more isolation than boys. Youth exchanged social support and influence within their networks that helped cope with poverty-induced stress and sadness, and encouraged protective sexual health practices. However, poverty hampered their involvement in school, religious schools, and community organizations, directly by denying them required material means, and indirectly by reducing time and emotional resources and creating shame and stigma. Poverty alleviation policy holds promise for improving youth's social wellbeing and mental and physical health by increasing their opportunities to form networks, receive social support, and experience positive influence. Copyright © 2016 Elsevier Ltd. All rights reserved.

Addressing poverty, education, and gender equality to improve the health of women worldwide.

PubMed

Tyer-Viola, Lynda A; Cesario, Sandra K

2010-01-01

The Millennium Development Goals (MDG) that target alleviating poverty, improving primary education, and fostering gender equity are important as a foundation to promote world health. Achieving these goals will create an environment for healthy lives for women and children. Poverty, education, and gender equality, although undeniably linked, need to be addressed individually. Nurses have the capacity and political will to address MDGs and to contribute to the health and well-being of the world population. © 2010 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Health, Education and Poverty Reduction. OECD Development Centre Policy Brief No. 19

ERIC Educational Resources Information Center

Morrisson, Christian

2002-01-01

It is generally agreed that spending on education and health is key to poverty reduction, but simply allocating more resources to these sectors does not ensure that poverty actually declines. On the basis of four in-depth case studies (on Indonesia, Madagascar, Peru and Tanzania) and three Technical Papers on malnutrition and primary education in…

Creating Nurturing Environments: A Science-Based Framework for Promoting Child Health and Development within High-Poverty Neighborhoods

PubMed Central

Komro, Kelli A.; Flay, Brian R.; Biglan, Anthony

2013-01-01

Living in poverty and living in areas of concentrated poverty pose multiple risks for child development and for overall health and wellbeing. Poverty is a major risk factor for several mental, emotional, and behavioral disorders, as well as for other developmental challenges and physical health problems. In this paper, the Promise Neighborhoods Research Consortium describes a science-based framework for the promotion of child health and development within distressed high-poverty neighborhoods. We lay out a model of child and adolescent developmental outcomes, and integrate knowledge of potent and malleable influences to define a comprehensive intervention framework to bring about a significant increase in the proportion of young people in high-poverty neighborhoods who will develop successfully. Based on a synthesis of research from diverse fields, we designed the Creating Nurturing Environments framework to guide community-wide efforts to improve child outcomes and reduce health and educational inequalities. PMID:21468644

"Without money you're nothing": poverty and health in Mexico from women's perspective.

PubMed

Tezoquipa, Isabel Hernández; Monreal, Luz Arenas; Treviño-Siller, Sandra

2005-01-01

The objective of this qualitative study was to get to know poor Mexican women's experience of poverty in relation to health care. Forty-nine interviews were carried out with poor adult women in Mexico (between 35 and 65 years old). Three central elements were detected in relation to the women's experience of poverty and health care: their socio-economic dependence on their family; the notion of social belonging in their experience with health care rights, reflected in the idea and acceptance that, due to their poverty, they can only be attended at philanthropic institutions; and the existence of survival mechanisms when facing an illness. In recovering the experience of poor women in relation to their health care, we identified that there is a clear idea that, if women had had economic resources, their health problem would have been solved differently. They are also convinced that, due to being poor, they have to content themselves with bad-quality medical care. This conformity finally makes them resign to the fact of either loosing a part of their own body, or even just waiting for death.

Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries.

PubMed

Thomson, Harriet; Snell, Carolyn; Bouzarovski, Stefan

2017-05-31

Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty-which is characterised by an inability to secure adequate levels of energy services in the home-the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings.

Poverty and elimination of urban health disparities: challenge and opportunity.

PubMed

Thomas, Stephen B; Quinn, Sandra Crouse

2008-01-01

The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.

Government health insurance for people below poverty line in India: quasi-experimental evaluation of insurance and health outcomes.

PubMed

Sood, Neeraj; Bendavid, Eran; Mukherji, Arnab; Wagner, Zachary; Nagpal, Somil; Mullen, Patrick

2014-09-11

To evaluate the effects of a government insurance program covering tertiary care for people below the poverty line in Karnataka, India, on out-of-pocket expenditures, hospital use, and mortality. Geographic regression discontinuity study. 572 villages in Karnataka, India. 31,476 households (22,796 below poverty line and 8680 above poverty line) in 300 villages where the scheme was implemented and 28,633 households (21,767 below poverty line and 6866 above poverty line) in 272 neighboring matched villages ineligible for the scheme. A government insurance program (Vajpayee Arogyashree scheme) that provided free tertiary care to households below the poverty line in about half of villages in Karnataka from February 2010 to August 2012. Out-of-pocket expenditures, hospital use, and mortality. Among households below the poverty line, the mortality rate from conditions potentially responsive to services covered by the scheme (mostly cardiac conditions and cancer) was 0.32% in households eligible for the scheme compared with 0.90% among ineligible households just south of the eligibility border (difference of 0.58 percentage points, 95% confidence interval 0.40 to 0.75; P<0.001). We found no difference in mortality rates for households above the poverty line (households above the poverty line were not eligible for the scheme), with a mortality rate from conditions covered by the scheme of 0.56% in eligible villages compared with 0.55% in ineligible villages (difference of 0.01 percentage points, -0.03 to 0.03; P=0.95). Eligible households had significantly reduced out-of-pocket health expenditures for admissions to hospitals with tertiary care facilities likely to be covered by the scheme (64% reduction, 35% to 97%; P<0.001). There was no significant increase in use of covered services, although the point estimate of a 44.2% increase approached significance (-5.1% to 90.5%; P=0.059). Both reductions in out-of-pocket expenditures and potential increases in use might have

Government health insurance for people below poverty line in India: quasi-experimental evaluation of insurance and health outcomes

PubMed Central

Bendavid, Eran; Mukherji, Arnab; Wagner, Zachary; Nagpal, Somil; Mullen, Patrick

2014-01-01

Objectives To evaluate the effects of a government insurance program covering tertiary care for people below the poverty line in Karnataka, India, on out-of-pocket expenditures, hospital use, and mortality. Design Geographic regression discontinuity study. Setting 572 villages in Karnataka, India. Participants 31 476 households (22 796 below poverty line and 8680 above poverty line) in 300 villages where the scheme was implemented and 28 633 households (21 767 below poverty line and 6866 above poverty line) in 272 neighboring matched villages ineligible for the scheme. Intervention A government insurance program (Vajpayee Arogyashree scheme) that provided free tertiary care to households below the poverty line in about half of villages in Karnataka from February 2010 to August 2012. Main outcome measure Out-of-pocket expenditures, hospital use, and mortality. Results Among households below the poverty line, the mortality rate from conditions potentially responsive to services covered by the scheme (mostly cardiac conditions and cancer) was 0.32% in households eligible for the scheme compared with 0.90% among ineligible households just south of the eligibility border (difference of 0.58 percentage points, 95% confidence interval 0.40 to 0.75; P<0.001). We found no difference in mortality rates for households above the poverty line (households above the poverty line were not eligible for the scheme), with a mortality rate from conditions covered by the scheme of 0.56% in eligible villages compared with 0.55% in ineligible villages (difference of 0.01 percentage points, −0.03 to 0.03; P=0.95). Eligible households had significantly reduced out-of-pocket health expenditures for admissions to hospitals with tertiary care facilities likely to be covered by the scheme (64% reduction, 35% to 97%; P<0.001). There was no significant increase in use of covered services, although the point estimate of a 44.2% increase approached significance (−5.1% to 90.5%; P=0.059). Both

Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians.

PubMed

Chung, Esther K; Siegel, Benjamin S; Garg, Arvin; Conroy, Kathleen; Gross, Rachel S; Long, Dayna A; Lewis, Gena; Osman, Cynthia J; Jo Messito, Mary; Wade, Roy; Shonna Yin, H; Cox, Joanne; Fierman, Arthur H

2016-05-01

Approximately 20% of all children in the United States live in poverty, which exists in rural, urban, and suburban areas. Thus, all child health clinicians need to be familiar with the effects of poverty on health and to understand associated, preventable, and modifiable social factors that impact health. Social determinants of health are identifiable root causes of medical problems. For children living in poverty, social determinants of health for which clinicians may play a role include the following: child maltreatment, child care and education, family financial support, physical environment, family social support, intimate partner violence, maternal depression and family mental illness, household substance abuse, firearm exposure, and parental health literacy. Children, particularly those living in poverty, exposed to adverse childhood experiences are susceptible to toxic stress and a variety of child and adult health problems, including developmental delay, asthma and heart disease. Despite the detrimental effects of social determinants on health, few child health clinicians routinely address the unmet social and psychosocial factors impacting children and their families during routine primary care visits. Clinicians need tools to screen for social determinants of health and to be familiar with available local and national resources to address these issues. These guidelines provide an overview of social determinants of health impacting children living in poverty and provide clinicians with practical screening tools and resources. Copyright © 2016 Mosby, Inc. All rights reserved.

The rising prevalence of severe poverty in America: a growing threat to public health.

PubMed

Woolf, Steven H; Johnson, Robert E; Geiger, H Jack

2006-10-01

The U.S. poverty rate has increased since 2000, but the depth of poverty experienced by Americans has been inadequately studied. Of particular concern is whether severe poverty is increasing, a trend that would carry important public health implications. Income-to-poverty (I/P) ratios and income deficits/surpluses were examined for the 1990-2004 period. The severely poor, moderately poor, and near-poor were classified as those with I/P ratios of less than 0.5, 0.5 to 1.0, or 1.0 to 2.0, respectively. Income deficits/surpluses were classified relative to the poverty threshold as Tier I (deficit Dollars 8000 or more), Tier II (deficit or surplus less than Dollars 8000), or Tier III (surplus more than Dollars 8000). Odds ratios for severe poverty and Tier I were also calculated. Severe poverty increased between 2000 and 2004-those with I/P ratios of less than 0.5 grew by 20%, and Tier I grew by 45% to 55%-while the prevalence of higher levels of income diminished. The population in severe poverty was over-represented by children (odds ratio [OR] = 1.69, confidence interval [CI] = 1.63-1.75), African Americans (OR = 2.84, CI = 2.74-2.95), and Hispanics (OR = 1.64, CI = 1.58-1.71). From 2000 to 2004, the prevalence of severe poverty increased sharply while the proportion of Americans in higher income tiers diminished. These trends have broad societal implications. Likely health consequences include a higher prevalence of chronic illnesses, more frequent and severe disease complications, and increased demands and costs for healthcare services. Adverse effects on children warrant special concern. The growth in the number of Americans living in poverty calls for the re-examination of policies enacted in recent years to foster economic progress.

Poverty as a contextual factor affecting sexual health behavior among female sex workers in India.

PubMed

Dasgupta, Satarupa

2013-06-01

A thorough understanding of the environmental and structural factors that precipitate unsafe sexual practices is necessary for HIV/AIDS-prevention research among high-risk population groups like commercial sex workers. I examined how poverty contextualizes sexual health behavior, including condom compliance among commercial female sex workers in a red light district in Calcutta, India. For my research I did an ethnographic study and conducted in-depth interviews of 37 commercial female sex workers. I found that poverty, instead of serving as a catalyst for poor health choices among sex workers, acted as an impetus for pursuing safe sex practices and remaining healthy. The results indicate that sex work, poverty, and health do not always have a paradoxical relationship.

Beyond the feminisation of poverty: gender-aware poverty reduction.

PubMed

Lockwood, M; Baden, S

1995-09-01

There must be an awareness of gender issues in poverty reduction programs. For example, program efforts that direct aid to the promotion of labor intensive employment options disregard women's already overburdened work regime. Public expenditures to benefit the poor, such as primary education or reformed agricultural extension, may be based on the assumption that men and women will benefit equally, yet there is often gender bias in the delivery of services. One recommendation is to target female headed households in budget-constrained anti-poverty programs. One of the few examples of such programs provides urban female household heads in Chile with employment training, housing, health care, child care, and legal aid services. Causes of female headship vary, and a simple correlation with poverty is not always the case. Well-intentioned women-in-development credit programs in Ghana and Bangladesh have been "hijacked" by men. Programs to address gender discrimination only among the poor may overlook other oppressed women. In India gender discrimination is often greatest among women in wealthy households. Programs must offer more than economic resources, they must help women stretch traditional gender boundaries and obtain skills such as literacy or financial management. They must help women organize collectively to protest injustices and achieve institutional reforms.

Health care access and poverty do not explain the higher esophageal cancer mortality in African Americans.

PubMed

Miller, Jordan A G; Rege, Robert V; Ko, Clifford Y; Livingston, Edward H

2004-07-01

Esophageal cancer mortality is increased in African Americans relative to white patients. The reasons for this are unknown but are thought to be related to inadequate access to health care secondary to a higher poverty rate in African American populations. The National Health Interview Survey database for years 1986 to 1994 were combined and linked to the National Death Index. Individuals who died from esophageal carcinoma were assessed in the combined database, thus enabling detailed analysis of their socioeconomic status, race, and health care access. Poverty was 4-fold more frequent in African Americans who died from esophageal carcinoma than whites. Despite poverty, African American patients' access to health care was good and was not statistically related to increased mortality. Although the esophageal carcinoma mortality rate is higher in African Americans than in whites, it is not clearly related to the presence of poverty or to limited health care access. The higher mortality may be related to lifestyle differences, environmental exposure, or difference in disease biology, but it is not related exclusively to socioeconomic factors.

Relationship between oral health in children and poverty related factors.

PubMed

Squassi, Aldo; Mauro, Silvia; Mauro, María José; Sánchez, Gabriel; Bordoni, Noemí

2008-01-01

The aim of this investigation was to analyze the variables related to poverty and its influence on oral health in children living in a suburban area ofBuenos Aires, Argentina. The study population consisted of 1,049 children. 579 children at social risk (Group I) were recruited from five neighborhoods with critical lacks (Katzman, 1989) and divided into 2 subgroups according to age: (A) preschool children and (B) school children. 470 preschool and school children from the same district but living in homes without critical lacks served as controls (Group II). The following variables associated with poverty were analyzed: (a) parents' instructional level, (b) employment conditions, and (c) accessibilty to regular oral health care. Group I comprised children from five neighborhoods categorized according to the incidence rate of each variable. Clinical examinations were performed under similar conditions by three calibrated investigators. DMFS, dmfs, total DMFS + dmfs, DS + ds, Care Index and Loe & Silness plaque index were recorded and analyzed using Students t test, ANOVA and Chi square test (level of significance p < 0.05). Dental indicators were significantly higher in Group I than in Group II. The dental caries indicators increased as the incidence rate of the poverty-related variables rose. The highest number of children with high cariogenic risk was observed in neighborhoods with the highest social risk (c2 = 30.48; p < 0.005). The analyzed poverty-related variables seemed to be associated with factors that play a role in the dental caries development process in school and preschool children living in the Metropolitan area of Buenos Aires.

Can Economic Deprivation Protect Health? Paradoxical Multilevel Effects of Poverty on Hispanic Children’s Wheezing

PubMed Central

Collins, Timothy W.; Kim, Young-an; Grineski, Sara E.; Clark-Reyna, Stephanie

2014-01-01

Prior research suggests that economic deprivation has a generally negative influence on residents’ health. We employ hierarchical logistic regression modeling to test if economic deprivation presents respiratory health risks or benefits to Hispanic children living in the City of El Paso (Texas, USA) at neighborhood- and individual-levels, and whether individual-level health effects of economic deprivation vary based on neighborhood-level economic deprivation. Data come from the US Census Bureau and a population-based survey of El Paso schoolchildren. The dependent variable is children’s current wheezing, an established respiratory morbidity measure, which is appropriate for use with economically-deprived children with an increased likelihood of not receiving a doctor’s asthma diagnosis. Results reveal that economic deprivation (measured based on poverty status) at both neighborhood- and individual-levels is associated with reduced odds of wheezing for Hispanic children. A sensitivity analysis revealed similar significant effects of individual- and neighborhood-level poverty on the odds of doctor-diagnosed asthma. Neighborhood-level poverty did not significantly modify the observed association between individual-level poverty and Hispanic children’s wheezing; however, greater neighborhood poverty tends to be more protective for poor (as opposed to non-poor) Hispanic children. These findings support a novel, multilevel understanding of seemingly paradoxical effects of economic deprivation on Hispanic health. PMID:25101769

Premature retirement due to ill health and income poverty: a cross-sectional study of older workers.

PubMed

Schofield, Deborah J; Callander, Emily J; Shrestha, Rupendra N; Percival, Richard; Kelly, Simon J; Passey, Megan E

2013-05-28

To assess the income-poverty status of Australians who were aged between 45 and 64 years and were out of the labour force due to ill health. A cross-sectional study using a microsimulation model of the 2009 Australian population (Health&WealthMOD). 2009 Australian population. 9198 people aged between 45 and 64 years surveyed for the 2003 Survey of Disability, Ageing and Carers. 50% of the median equivalised income-unit-income poverty line. It was found that individuals who had retired early due to other reasons were significantly less likely to be in income poverty than those retired due to ill health (OR 0.43 95% CI 0.33 to 0.51), and there was no significant difference in the likelihood of being in income poverty between these individuals and those unemployed. Being in the same family as someone who is retired due to illness also significantly increases an individual's chance of being in income poverty. It can be seen that being retired due to illness impacts both the individual and their family.

Roles of prices, poverty, and health in Medicare and private spending in Texas.

PubMed

White, Chapin; Taychakhoonavudh, Suthira; Parikh, Rohan; Franzini, Luisa

2015-05-01

To investigate the roles of prices, poverty, and health in divergences between Medicare and private spending in Texas. Retrospective observational design using 2011 Blue Cross Blue Shield of Texas claims data and publicly available Medicare data. We measured market-level spending per enrollee among the privately insured. Variation in Medicare and private spending per person are decomposed into prices and quantities, and their associations with poverty are measured. Markets are divided into 4 groups and are compared based on the ratio of Medicare to private spending: "high-private," "proportional," "high-Medicare," and "extremely high-Medicare." Among the privately insured, poverty appears to have large spillover effects; it is strongly associated with lower prices, quantities, and spending. Among Medicare beneficiaries, health status is a key driver of spending variation. The 2 markets with extremely high Medicare-to-private spending ratios (Harlingen and McAllen) are predominantly Hispanic communities with markedly higher rates of poverty and lack of insurance and also extremely low physician supply. The markets with relatively high private spending stand out for having good health-system performance and health outcomes, and higher than average hospital prices. Variation in private spending appears to reflect the ability of the local population to pay for healthcare, whereas variation in Medicare is more heavily driven by health status, and presumably, by clinical need. These findings highlight the inadvisability of using Medicare spending as a proxy for systemwide spending, and the need for comprehensive market-level spending data that allow comparisons among populations with different sources of insurance coverage.

Impact of animal health programmes on poverty reduction and sustainable livestock development.

PubMed

Pradere, J P

2017-04-01

Based on data from publications and field observations, this study analyses the interactions between animal health, rural poverty and the performance and environmental impact of livestock farming in low-income countries and middle-income countries. There are strong statistical correlations between the quality of Veterinary Services, livestock productivity and poverty rates. In countries with effective Veterinary Services, livestock growth stems mainly from productivity gains and poverty rates are the lowest. Conversely, these analyses identify no statistical link between the quality of Veterinary Services and increased livestock production volumes. However, where animal diseases are poorly controlled, productivity is low and livestock growth is extensive, based mainly on a steady increase in animal numbers. Extensive growth is less effective than intensive growth in reducing poverty and aggravates the pressure of livestock production on natural resources and the climate.

Improving animal health for poverty alleviation and sustainable livelihoods.

PubMed

Stringer, Andy

2014-11-29

Animals are vital to ensuring food security for individuals, families and communities in countries around the world. In this, the latest article in Veterinary Record's series promoting One Health, Andy Stringer, director of veterinary programmes at the Society for the Protection of Animals Abroad, discusses how improving animal health, particularly of poultry and working equids, has the potential to reduce poverty and promote food security and sustainable livelihoods in low-income countries. British Veterinary Association.

[Social classes and poverty].

PubMed

Benach, Joan; Amable, Marcelo

2004-05-01

Social classes and poverty are two key social determinants fundamental to understand how disease and health inequalities are produced. During the 90's in Spain there has been a notable oscillation in the inequality and poverty levels, with an increase in the middle of the decade when new forms of social exclusion, high levels of unemployment and great difficulties in accessing the labour market, especially for those workers with less resources, emerged. Today society is still characterized by a clear social stratification and the existence of social classes with a predominance of high levels of unemployment and precarious jobs, and where poverty is an endemic social problem much worse than the EU average. To diminish health inequalities and to improve the quality of life will depend very much on the reduction of the poverty levels and the improvement of equal opportunities and quality of employment. To increase understanding of how social class and poverty affect public health, there is a need to improve the quality of both information and research, and furthermore planners and political decision makers must take into account those determinants when undertaking disease prevention and health promotion.

Geographic variation in health care and the affluence-poverty nexus.

PubMed

Cooper, Richard A

2011-01-01

Almost 50 years ago, John F. Kennedy told Yale's graduating class that "what is needed today is a new, difficult but essential confrontation with reality, for the great enemy of truth is very often not the lie-deliberate, contrived and dishonest-but the myth-persistent, persuasive and unrealistic." Today's myth is the belief that 30% of health care spending is due to supplier-induced demand and that this amount could be saved if high-spending regions could more closely resemble low-spending regions. The reality is that, while quality and efficiency remain important goals, the major factors driving geographic differences are related to income inequality. Yet, following the road map of the Dartmouth Atlas, the Affordable Care Act includes penalties for hospitals with excess preventable readmissions (which are mainly of the poor), incentive payments for providers in counties that have the lowest Medicare expenditures (where there tends to be less poverty), incentives for physicians and hospitals that attain new "efficiency standards" (ie, costs similar to the lowest), and a call for the Institute of Medicine to recommend additional incentive strategies based on geographic variation. This scenario iscoupled with a growing bureaucracy, following the blueprint laid out by Brennan and Berwick in the 1990s, but with no tangible measures to increase physician supply. Meaningful health care reform means accepting the reality that poverty and its cultural extensions are the major cause of geographic variation in health care utilization and a major source of escalating health care spending. And it means acknowledging Bertrand Russell's admonition that a high degree of income inequality is not compatible with political democracy, nor is it compatible with health care that this nation can afford. As solutions are sought both within and outside of the health care system, misunderstandings of how and why health care varies geographically cannot be allowed to deter these efforts

Is wealthier always healthier in poor countries? The health implications of income, inequality, poverty, and literacy in India.

PubMed

Rajan, Keertichandra; Kennedy, Jonathan; King, Lawrence

2013-07-01

Standard policy prescriptions for improving public health in less developed countries (LDCs) prioritise raising average income levels over redistributive policies since it is widely accepted that 'wealthier is healthier'. It is argued that income inequality becomes a significant predictor of public health only after the 'epidemiological transition'. This paper tests this theory in India, where rising income levels have not been matched by improvements in public health. We use state-, district-, and individual-level data to investigate the relationship between infant and under-five mortality, and average income, poverty, income inequality, and literacy. Our analysis shows that at both state- and district-level public health is negatively associated with average income and positively associated with poverty. But, at both levels, controlling for poverty and literacy renders average income statistically insignificant. At state-level, only literacy remains a significant and negative predictor. At the less aggregated district-level, both poverty and literacy predict public health but literacy has a stronger effect than poverty. Inequality does not predict public health at state- or district-levels. At the individual-level, however, it is a strong predictor of self-reported ailment, even after we control for district average income, individual income, and individual education. Our analysis suggests that wealthier is indeed healthier in India - but only to the extent that high average incomes reflect low poverty and high literacy. Furthermore, inequality has a strong effect on self-reported health. Standard policy prescriptions, then, need revision: first, alleviating poverty may be more effective than raising average income levels; second, non-income goods like literacy may make an important contribution to public health; and third, policy should be based on a broader understanding of societal well-being and the factors that promote it. Copyright © 2013 Elsevier Ltd. All

[Self-rated health in adults: influence of poverty and income inequality in the area of residence].

PubMed

Caicedo, Beatriz; Berbesi Fernández, Dedsy

2015-01-01

To evaluate the influence of income inequality and poverty in the towns of Bogotá, Colombia, on poor self-rated health among their residents. The study was based on a multipurpose survey applied in Bogotá-Colombia. A hierarchical data structure (individuals=level1, locations=level 2) was used to define a logit-type multilevel logistic model. The dependent variable was self-perceived poor health, and local variables were income inequality and poverty. All analyses were controlled for socio-demographic variables and stratified by sex. The prevalence of self-reported fair or poor health in the study population was 23.2%. Women showed a greater risk of ill health, as well as men and women with a low educational level, older persons, those without work in the last week and persons affiliated to the subsidized health system. The highest levels of poverty in the city increased the risk of poor health. Cross-level interactions showed that young women and men with a low education level were the most affected by income inequality in the locality. In Bogotá, there are geographical differences in the perception of health. Higher rates of poverty and income inequality were associated with an increased risk of self-perceived poor health. Notable findings were the large health inequalities at the individual and local levels. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

Effect of payments for health care on poverty estimates in 11 countries in Asia: an analysis of household survey data.

PubMed

van Doorslaer, Eddy; O'Donnell, Owen; Rannan-Eliya, Ravi P; Somanathan, Aparnaa; Adhikari, Shiva Raj; Garg, Charu C; Harbianto, Deni; Herrin, Alejandro N; Huq, Mohammed Nazmul; Ibragimova, Shamsia; Karan, Anup; Ng, Chiu Wan; Pande, Badri Raj; Racelis, Rachel; Tao, Sihai; Tin, Keith; Tisayaticom, Kanjana; Trisnantoro, Laksono; Vasavid, Chitpranee; Zhao, Yuxin

2006-10-14

Conventional estimates of poverty do not take account of out-of-pocket payments to finance health care. We aimed to reassess measures of poverty in 11 low-to-middle income countries in Asia by calculating total household resources both with and without out-of-pocket payments for health care. We obtained data on payments for health care from nationally representative surveys, and subtracted these payments from total household resources. We then calculated the number of individuals with less than the internationally accepted threshold of absolute poverty (US1 dollar per head per day) after making health payments. We also assessed the effect of health-care payments on the poverty gap--the amount by which household resources fell short of the 1 dollar poverty line in these countries. Our estimate of the overall prevalence of absolute poverty in these countries was 14% higher than conventional estimates that do not take account of out-of-pocket payments for health care. We calculated that an additional 2.7% of the population under study (78 million people) ended up with less than 1 dollar per day after they had paid for health care. In Bangladesh, China, India, Nepal, and Vietnam, where more than 60% of health-care costs are paid out-of-pocket by households, our estimates of poverty were much higher than conventional figures, ranging from an additional 1.2% of the population in Vietnam to 3.8% in Bangladesh. Out-of-pocket health payments exacerbate poverty. Policies to reduce the number of Asians living on less than 1 dollar per day need to include measures to reduce such payments.

Fostering food security in areas of extreme poverty through Integrated Farm Management: the case of Burundi

NASA Astrophysics Data System (ADS)

Kessler, Aad; van Duivenbooden, Niek; van Beek, Christy

2014-05-01

Extreme poverty in Burundi's rural area and tensions between families with limited access to arable land hinder development towards a more stable and peaceful society. Due to these tensions and a rapid population growth, agricultural land is currently subject to increased degradation and low agricultural productivity. A whole range of other limiting factors contributes to this, such as: poor seed quality, poor nutrient management combined with low soil fertility, inadequate agronomic practices, pests and crop diseases, poorly developed supply chains, health problems, difficult access to credit, and insecurity. Solving one of these problems will not solve the chain that eventually leads to low food production; it will simply move the emphasis to the next constraining factor. An integrated rural development approach is therefore required to break this vicious circle. The project Fanning the Spark, a Public-Private-Partnership between Achmea Foundation, Alterra of Wageningen University and Research Centre, and HealthNet-TPO in Burundi started in September 2013 with an intervention in several rural villages in Gitega. The project's objective is to increase food production at village level, by means of investments in crop production, a family (income) insurance package that protects rural families against the financial consequences of catastrophic events (natural and health) and making micro-credits available. This will enhance farmers' workability and generate income from agricultural activities in order to break the poverty cycle and enhance food security. The insurance package comprises agricultural and health insurances, and will be jointly implemented with the sustainable agriculture component. The latter component focuses on Integrated Farm Management and the use of innovative soil management practices. Farmer-to-farmer training and scaling-up are crucial components, and in the first phase of the project "innovative farmer groups" have a central role in the

Politics, Power, Poverty and Global Health: Systems and Frames.

PubMed

Benatar, Solomon

2016-08-06

Striking disparities in access to healthcare and in health outcomes are major characteristics of health across the globe. This inequitable state of global health and how it could be improved has become a highly popularized field of academic study. In a series of articles in this journal the roles of power and politics in global health have been addressed in considerable detail. Three points are added here to this debate. The first is consideration of how the use of definitions and common terms, for example 'poverty eradication,' can mask full exposure of the extent of rectification required, with consequent failure to understand what poverty eradication should mean, how this could be achieved and that a new definition is called for. Secondly, a criticism is offered of how the term 'global health' is used in a restricted manner to describe activities that focus on an anthropocentric and biomedical conception of health across the world. It is proposed that the discourse on 'global health' should be extended beyond conventional boundaries towards an ecocentric conception of global/planetary health in an increasingly interdependent planet characterised by a multitude of interlinked crises. Finally, it is noted that the paucity of workable strategies towards achieving greater equity in sustainable global health is not so much due to lack of understanding of, or insight into, the invisible dimensions of power, but is rather the outcome of seeking solutions from within belief systems and cognitive biases that cannot offer solutions. Hence the need for a new framing perspective for global health that could reshape our thinking and actions. © 2016 by Kerman University of Medical Sciences.

Deprivation is associated with worse physical and mental health beyond income poverty: a population-based household survey among Chinese adults.

PubMed

Chung, Roger Yat-Nork; Chung, Gary Ka-Ki; Gordon, David; Wong, Samuel Yeung-Shan; Chan, Dicken; Lau, Maggie Ka-Wai; Tang, Vera Mun-Yu; Wong, Hung

2018-05-14

In studying health inequality, poverty as measured by income is frequently used; however, this omits the aspects of non-monetary resources and social barriers to achieving improved living standard. Therefore, our study aimed to examine the associations of individual-level deprivation of material and social necessities with general physical and mental health beyond that of income poverty. A territory-wide two-stage stratified random sample of 2282 community-dwelling Hong Kong adults was surveyed between 2014 and 2015. Income poverty and a Deprivation Index were used as the main independent variables. General health was assessed using the validated 12-item Short-Form Health Survey version 2, from which physical component summary and mental component summary were derived. Our results in multivariable ordinal logistic regressions consistently showed that, after adjusting for income poverty, socio-demographic and lifestyle factors, being deprived was significantly associated with worse physical (OR 1.66; CI 1.25-2.20) and mental health (OR 1.83; CI 1.43-2.35). Being income poor was also significantly associated with worse mental health (OR 1.63; CI 1.28-2.09) but only marginally with physical health (OR 1.34; CI 1.00-1.80) after adjustments. Income does not capture all aspects of poverty that are associated with adverse health outcomes. Deprivation of non-monetary resources has an independent effect on general health above and beyond the effect of income poverty. Policies should move beyond endowment and take into account the multidimensionality of poverty, in order to address the problem of health inequality.

The primary care provider and the patient living in poverty: Applying the Bridges to Health and Healthcare model to NP practice.

PubMed

Wise, Barbara; Dreussi-Smith, Terie

2018-04-01

There is a much recent emphasis on the social determinants of health, and poverty is the most influential of these. It is not enough merely to understand the influence of poverty on health-the primary care provider must understand how to effectively treat patients who live in poverty. This article applies the Bridges to Health and Healthcare model for understanding poverty to primary care practice from an individual provider's perspective. The article walks the reader through the implications of generational poverty for the primary care clinician in a typical office visit from history taking to following up. Most primary care practitioners approach patients from a middle-class perspective. Awareness of the challenges and different perspectives of those in generational poverty can enhance care and outcomes. The individual provider can use the understanding of driving forces, resources, language and cognition, environment, and relationships provided by the Bridges to Health and Healthcare model to benefit patients in generational poverty.

Is wealthier always healthier? The impact of national income level, inequality, and poverty on public health in Latin America.

PubMed

Biggs, Brian; King, Lawrence; Basu, Sanjay; Stuckler, David

2010-07-01

Despite findings indicating that both national income level and income inequality are each determinants of public health, few have studied how national income level, poverty and inequality interact with each other to influence public health outcomes. We analyzed the relationship between gross domestic product (GDP) per capita in purchasing power parity, extreme poverty rates, the gini coefficient for personal income and three common measures of public health: life expectancy, infant mortality rates, and tuberculosis (TB) mortality rates. Introducing poverty and inequality as modifying factors, we then assessed whether the relationship between GDP and health differed during times of increasing, decreasing, and decreasing or constant poverty and inequality. Data were taken from twenty-two Latin American countries from 1960 to 2007 from the December 2008 World Bank World Development Indicators, World Health Organization Global Tuberculosis Database 2008, and the Socio-Economic Database for Latin America and the Caribbean. Consistent with previous studies, we found increases in GDP have a sizable positive impact on population health. However, the strength of the relationship is powerfully influenced by changing levels of poverty and inequality. When poverty was increasing, greater GDP had no significant effect on life expectancy or TB mortality, and only led to a small reduction in infant mortality rates. When inequality was rising, greater GDP had only a modest effect on life expectancy and infant mortality rates, and no effect on TB mortality rates. In sharp contrast, during times of decreasing or constant poverty and inequality, there was a very strong relationship between increasing GDP and higher life expectancy and lower TB and infant mortality rates. Finally, inequality and poverty were found to exert independent, substantial effects on the relationship between national income level and health. Wealthier is indeed healthier, but how much healthier depends on how

Poverty indicators and mental health functioning among adults living with HIV in Delhi, India.

PubMed

Kang, Ezer; Delzell, Darcie A P; McNamara, Paul E; Cuffey, Joel; Cherian, Anil; Matthew, Saira

2016-01-01

Poor mental health functioning among persons living with HIV (PLHIV) has gained considerable attention particularly in low-income countries that disproportionately carry the global HIV/AIDS burden. Fewer studies, however, have examined the relationship between poverty indicators and mental health among PHLIV in India. Based on this cross-sectional study of 196 HIV-seropositive adults who received medical services at Shalom AIDS Project in Delhi, India, structural equation modeling and mediation analysis were employed to estimate the associations between poverty indices (household asset index, food security, unemployment, water treatment, sanitation), HIV-health factors (illness in the past 3 months, co-morbid medical conditions), and psychological distress. In the final model, ownership of fewer household assets was associated with higher levels of food insecurity, which in turn was associated with higher psychological distress. Also, the household asset index, food insecurity, and unemployment had a larger effect on psychological distress than new opportunistic infections. These findings build on increasing evidence that support concerted efforts to design, evaluate, and refine HIV mental health interventions that are mainstreamed with livelihood programming in high poverty regions in India.

Early-Childhood Poverty and Adult Attainment, Behavior, and Health

ERIC Educational Resources Information Center

Duncan, Greg J.; Ziol-Guest, Kathleen M.; Kalil, Ariel

2010-01-01

This article assesses the consequences of poverty between a child's prenatal year and 5th birthday for several adult achievement, health, and behavior outcomes, measured as late as age 37. Using data from the Panel Study of Income Dynamics (1,589) and controlling for economic conditions in middle childhood and adolescence, as well as demographic…

Multidimensional poverty and catastrophic health spending in the mountainous regions of Myanmar, Nepal and India.

PubMed

Mohanty, Sanjay K; Agrawal, Nand Kishor; Mahapatra, Bidhubhusan; Choudhury, Dhrupad; Tuladhar, Sabarnee; Holmgren, E Valdemar

2017-01-18

Economic burden to households due to out-of-pocket expenditure (OOPE) is large in many Asian countries. Though studies suggest increasing household poverty due to high OOPE in developing countries, studies on association of multidimensional poverty and household health spending is limited. This paper tests the hypothesis that the multidimensionally poor are more likely to incur catastrophic health spending cutting across countries. Data from the Poverty and Vulnerability Assessment (PVA) Survey carried out by the International Center for Integrated Mountain Development (ICIMOD) has been used in the analyses. The PVA survey was a comprehensive household survey that covered the mountainous regions of India, Nepal and Myanmar. A total of 2647 households from India, 2310 households in Nepal and 4290 households in Myanmar covered under the PVA survey. Poverty is measured in a multidimensional framework by including the dimensions of education, income and energy, water and sanitation using the Alkire and Foster method. Health shock is measured using the frequency of illness, family sickness and death of any family member in a reference period of one year. Catastrophic health expenditure is defined as 40% above the household's capacity to pay. Results suggest that about three-fifths of the population in Myanmar, two-fifths of the population in Nepal and one-third of the population in India are multidimensionally poor. About 47% of the multidimensionally poor in India had incurred catastrophic health spending compared to 35% of the multidimensionally non-poor and the pattern was similar in both Nepal and Myanmar. The odds of incurring catastrophic health spending was 56% more among the multidimensionally poor than among the multidimensionally non-poor [95% CI: 1.35-1.76]. While health shocks to households are consistently significant predictors of catastrophic health spending cutting across country of residence, the educational attainment of the head of the household is

Politics, Power, Poverty and Global Health: Systems and Frames

PubMed Central

Benatar, Solomon

2016-01-01

Striking disparities in access to healthcare and in health outcomes are major characteristics of health across the globe. This inequitable state of global health and how it could be improved has become a highly popularized field of academic study. In a series of articles in this journal the roles of power and politics in global health have been addressed in considerable detail. Three points are added here to this debate. The first is consideration of how the use of definitions and common terms, for example ‘poverty eradication,’ can mask full exposure of the extent of rectification required, with consequent failure to understand what poverty eradication should mean, how this could be achieved and that a new definition is called for. Secondly, a criticism is offered of how the term ‘global health’ is used in a restricted manner to describe activities that focus on an anthropocentric and biomedical conception of health across the world. It is proposed that the discourse on ‘global health’ should be extended beyond conventional boundaries towards an ecocentric conception of global/planetary health in an increasingly interdependent planet characterised by a multitude of interlinked crises. Finally, it is noted that the paucity of workable strategies towards achieving greater equity in sustainable global health is not so much due to lack of understanding of, or insight into, the invisible dimensions of power, but is rather the outcome of seeking solutions from within belief systems and cognitive biases that cannot offer solutions. Hence the need for a new framing perspective for global health that could reshape our thinking and actions. PMID:27694651

Joining together to combat poverty.

PubMed

Heath, I; Haines, A; Malenica, Z; Oulton, J A; Leopando, Z; Kaseje, D; Addington, W W; Giscard D'Estaing, O; Tumwine, J K; Koivusalo, M; Biscoe, G; Nickson, P; Marusić, M; Vuk Pavlović, S

2000-03-01

The International Poverty and Health Network (IPHN) was created in December 1997 following a series of conferences organized by the World Health Organization, with the aim of integrating health into plans to eradicate poverty. Around 1.3 billion people live on less than US$1 per day. Of the 4.4 billion people in developing countries nearly 60% lack access to sanitation, 30% do not have clean water, 20% have no health care, and 20% do not have enough dietary energy and protein. Even among rich nations there are gross socioeconomic inequalities. Many children are robbed of their physical and mental potential through poverty. Expressed in constant 1963 US dollars, an average Croatian family needed the annual income of US$894 to meet the poverty line in 1960 and US$9,027 in 1995. Accordingly, 9-25% of Croatian households were below the poverty line between 1960 and 1995. The increase in the poverty rate after 1991 was compounded by the war that destroyed almost a third of industrial capacity and infrastructure. Dissipation of the communist economy and inadequate privatization have contributed to the increase in unemployment rate, corruption, and other social ills. IPHN invited Croatian Medical Journal to publish this editorial to help push the issue of poverty up political and medical agendas on a global level. We argue that a factor contributing to the failure of most large-scale programs against poverty to date is the excessive emphasis on material and infrastructure assistance at the expense of spiritual, moral, and intellectual development.

Relate better and judge less: poverty simulation promoting culturally competent care in community health nursing.

PubMed

Yang, Kyeongra; Woomer, Gail Ratliff; Agbemenu, Kafuli; Williams, Lynne

2014-11-01

The study aim was to evaluate the effectiveness of a poverty simulation in increasing understanding of and attitudes toward poverty and resulting in changes in clinical practice among nursing seniors. A poverty simulation was conducted using a diverse group of nursing professors and staff from local community agencies assuming the role of community resource providers. Students were assigned roles as members of low-income families and were required to complete tasks during a simulated month. A debriefing was held after the simulation to explore students' experiences in a simulated poverty environment. Students' understanding of and attitude toward poverty pre- and post-simulation were examined. Changes in the students' clinical experiences following the simulation were summarized into identified categories and themes. The poverty simulation led to a greater empathy for the possible experiences of low income individuals and families, understanding of barriers to health care, change in attitudes towards poverty and to those living in poverty, and changes in the students' nursing practice. Use of poverty simulation is an effective means to teach nursing students about the experience of living in poverty. The simulation experience changed nursing students' clinical practice, with students providing community referrals and initiating inter-professional collaborations. Copyright © 2014 Elsevier Ltd. All rights reserved.

Looking within and beyond the community: lessons learned by researching, theorising and acting to address urban poverty and health.

PubMed

Hodgetts, Darrin; Chamberlain, Kerry; Tankel, Yadena; Groot, Shiloh

2014-01-01

Urban poverty and health inequalities are inextricably intertwined. By working in partnership with service providers and communities to address urban poverty, we can enhance the wellness of people in need. This article reflects on lessons learned from the Family100 project that explores the everyday lives, frustrations and dilemmas faced by 100 families living in poverty in Auckland. Lessons learned support the need to bring the experiences and lived realities of families to the fore in public deliberations about community and societal responses to urban poverty and health inequality.

Supporting the Mental Health of Mothers Raising Children in Poverty

PubMed Central

Beeber, Linda S.; Perreira, Krista M.; Schwartz, Todd

2013-01-01

Poverty increases maternal stress by heightening exposure to negative life events, job loss, chronic strains, poor housing, dangerous neighborhoods, and conflict with partners, culminating in crippling depressive symptoms, the most prevalent mental health threat. Depressive symptoms interfere with the provision of the strong maternal support needed to counter the hardships of poverty, thus placing infants and toddlers at risk for delayed language, social, and emotional development. Initial clinical trials in high-risk mothers have shown promise, and successive tests of interventions will be strengthened if mothers who have mental health risks can be accurately targeted for inclusion. This article reports on a sequential, data-driven process by which high-risk mothers were targeted for intervention in two trials currently in progress to reduce depressive symptoms. An iterative process of using data to identify at-risk mothers and validate the presence of risk factors helped hone the recruitment and design of the intervention trials. This report also offers guidance for further study. PMID:17954677

Income, Poverty, and Health Insurance Coverage in the United States: 2012. Current Population Reports P60-245

ERIC Educational Resources Information Center

DeNavas-Walt, Carmen; Proctor, Bernadette D.; Smith, Jessica C.

2013-01-01

This report presents data on income, poverty, and health insurance coverage in the United States based on information collected in the 2013 and earlier Current Population Survey Annual Social and Economic Supplements (CPS ASEC) conducted by the U.S. Census Bureau. For most groups, the 2012 income, poverty, and health insurance estimates were not…

Poverty and inequity in adolescent health care.

PubMed

Girard, Gustavo A

2009-12-01

Although poverty is not a new phenomenon, currently it has peculiar characteristics: globalization, inequity, new features in education, exclusion, gender inequalities, marginalization of native peoples and migrations, difficulties found by different sectors to have access to technology, and unemployment. These characteristics are seen not only in countries considered to be developing nations, but affect the whole world. The present international financial crisis, this time originating in industrialized countries, represents an aggravating factor, the consequences of which are still difficult to estimate. It has a particular impact on adolescents and young people in terms of health as a whole, mortality rates, violence, nutrition, reproductive health, HIV/AIDS, substance abuse, mental health, and disabilities, all being aggravated by the difficulties of access to ap propriate health services. Social capital is seriously affected, and this entails a strong and deleterious impact not only on present generations but also on future ones. It is a challenge that cannot be ignored.

The impact of the experience of childhood poverty on adult health-risk behaviors in Japan: a mediation analysis.

PubMed

Umeda, Maki; Oshio, Takashi; Fujii, Mayu

2015-12-09

The experience of childhood poverty has a long-lasting, adverse impact on physical health outcomes in adulthood. We examined the mediating effects of adult socioeconomic status (SES) and social support on the association between childhood poverty and adult health-risk behaviors. Cross-sectional data collected from Japanese community residents (N = 3836) were used. A binary indicator of the experience of childhood poverty was constructed by utilizing retrospectively assessed standard of living at age 15 and a set of parental SES variables. The associations of childhood poverty with smoking, lack of exercise, poor dietary habits, and excessive drinking at the time of survey were examined by logistic regression analysis. A mediation analysis was conducted to estimate the magnitudes of the mediating effects of adult SES and social support on these associations. Adult SES and social support together mediated 64.0, 29.4 and 30.6 % of the impacts of the experience of childhood poverty on smoking, lack of exercise, and poor dietary habits, respectively. Educational attainment had the largest mediating effect (58.2 %) on the impact of the experience of childhood poverty on smoking. The results suggest that interventions and policies for supporting children living in poverty should aim to enhance their future SES and provide better social support, as this might improve their overall health.

Community concepts of poverty: an application to premium exemptions in Ghana's National Health Insurance Scheme.

PubMed

Aryeetey, Genevieve C; Jehu-Appiah, Caroline; Kotoh, Agnes M; Spaan, Ernst; Arhinful, Daniel K; Baltussen, Rob; van der Geest, Sjaak; Agyepong, Irene A

2013-03-14

Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana's National Health Insurance Scheme. We employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty. Community defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community. The in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care.

The Effects of Poverty on the Mental, Emotional, and Behavioral Health of Children and Youth: Implications for Prevention

ERIC Educational Resources Information Center

Yoshikawa, Hirokazu; Aber, J. Lawrence; Beardslee, William R.

2012-01-01

This article considers the implications for prevention science of recent advances in research on family poverty and children's mental, emotional, and behavioral health. First, we describe definitions of poverty and the conceptual and empirical challenges to estimating the causal effects of poverty on children's mental, emotional, and behavioral…

Exposure to Childhood Poverty and Mental Health Symptomatology in Adolescence: A Role of Coping Strategies.

PubMed

Kim, Pilyoung; Neuendorf, Cynthia; Bianco, Hannah; Evans, Gary W

2016-12-01

Childhood poverty is associated with stress dysregulation which contributes to psychological illness in later ages. The adverse effects of childhood poverty on stress regulation may be mediated in part by the use of disengaging strategies to cope with stress. However, the relations among childhood poverty, coping strategies and psychopathology throughout childhood to adolescence have not been explored. This prospective, longitudinal study included 185 low- and middle-income adolescents at age 17. Chronic exposure to poverty from birth to early adolescence (age 13) was prospectively associated with increases in the use of disengagement versus engagement coping four years later. Increased use of disengagement coping between the ages of 13 and 17 explained the indirect link between poverty exposure since birth and both externalizing and internalizing symptoms at age 17. The findings provide evidence for a coping pathway underlying the link between prolonged exposure to childhood poverty and mental health sequelae. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Poverty, human development, environmental and health risks: the role of precaution and cautionary policies.

PubMed

Petrini, Carlo

2007-01-01

First of all a definition is given of "poverty" and "precaution". A short, by no means comprehensive, presentation of some especially relevant recent publications on both topics is included, with a view to offering also readers who are not familiar with these issues a broad overview of the specialised literature available. This is followed by a description of the solidarity concept, following various philosophical, cultural and religious trends, analysing their relationship with precaution. An attempt is then made to show how solidarity and precaution could help counteract poverty, the risks for the environment and health, with the ensuing social and health damage. Reasons are outlined which support the adoption of the precaution principle in economics, as well as some arguments which could be put forward to oppose these views. The final remarks are a reply to such criticisms with a view to showing how precaution could be an effective economic tool, as well as a way to tackle those health-related and environmental problems that are also associated with poverty.

In-Work Poverty and Self-Rated Health in a Cohort of Working Germans: A Hybrid Approach for Decomposing Within-Person and Between-Persons Estimates of In-Work Poverty Status.

PubMed

Pförtner, Timo-Kolja; Schmidt-Catran, Alexander W

2017-02-15

In this study, we investigated whether self-rated health (SRH) can be predicted by in-work poverty and how between-persons and within-person differences in the poverty status of people who are working contribute to this relationship. We used a logistic random-effects model designed to test within-person and between-persons differences with data from a nationally representative German sample with 19 waves of data collection (1995-2013) to estimate effects of between-persons and within-person differences in working poverty status on poor SRH. Interactions by age and sex were tested, and models controlled for sociodemographic, socioeconomic, and work-related characteristics. We found significant differences in SRH between individuals with different working poverty status but no evidence that within-person differences in working poverty status are associated with poor SRH. The association between in-work poverty and SRH was significantly stronger for women but did not differ significantly by age. All findings were robust when including sociodemographic, socioeconomic, and working characteristics. In this sample of German adults, we found a polarization of poor SRH between the working nonpoor and the working poor but no causal association of within-person differences in working poverty status with SRH. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

[Single-parent mothers, poverty and mental health: review of the literature].

PubMed

Langlois, J; Fortin, D

1994-01-01

The goal of this article is to discuss an overview of literature published from 1968 to 1993 and dealing with links between single-parenting, poverty and mental health. A total of 56 articles were selected based on the most current data banks. Results show that the population of single-parent mothers is growing and that they are becoming increasingly poor. Of the six mental health variables listed by the author, four (psychological distress, self-esteem, perception of one's own skills and psychological isolation) clearly demonstrate that single-parent mothers are in a less healthy mental state than are mothers in two-parent families. Results also indicate that self-esteem, distress and psychological well-being are affected by economic variables. Results therefore vary according to the variable being measured. Although single-parent mothers experience more psychological discomfort than mothers in two-parent families, they do not seem to experience more serious mental health problems. The authors argue that future research on the subject should take into consideration a certain number of aspects, discussed in the conclusion of this article, which account for links between single-parenting, poverty and mental health.

Women and Poverty in Saskatchewan.

ERIC Educational Resources Information Center

Whyte, Jayne Melville; Thompson, Loraine

A project explored female poverty in Saskatchewan, Canada, and its implications within the framework of Health Canada's Population Health Promotion Model. Data were collected through consultations with 59 women who had experienced poverty, interviews with administrators of agencies and projects that serve poor women, and a literature review.…

Interventions to mitigate the effects of poverty and inequality on mental health.

PubMed

Wahlbeck, Kristian; Cresswell-Smith, Johanna; Haaramo, Peija; Parkkonen, Johannes

2017-05-01

To review psychosocial and policy interventions which mitigate the effects of poverty and inequality on mental health. Systematic reviews, controlled trials and realist evaluations of the last 10 years are reviewed, without age or geographical restrictions. Effective psychosocial interventions on individual and family level, such as parenting support programmes, exist. The evidence for mental health impact of broader community-based interventions, e.g. community outreach workers, or service-based interventions, e.g. social prescribing and debt advice is scarce. Likewise, the availability of evidence for the mental health impact of policy level interventions, such as poverty alleviation or youth guarantee, is quite restricted. The social, economic, and physical environments in which people live shape mental health and many common mental disorders. There are effective early interventions to promote mental health in vulnerable groups, but it is necessary to both initiate and facilitate a cross-sectoral approach, and to form partnerships between different government departments, civic society organisations and other stakeholders. This approach is referred to as Mental Health in All Policies and it can be applied to all public policy levels from local policies to supranational.

Improving population health by reducing poverty: New York's Earned Income Tax Credit.

PubMed

Wicks-Lim, Jeannette; Arno, Peter S

2017-12-01

Despite the established relationship between adverse health outcomes and low socioeconomic status, researchers rarely test the link between health improvements and poverty-alleviating economic policies. New research, however, links individual-level health improvements to the Earned Income Tax Credit (EITC), a broad-based income support policy. We build on these findings by examining whether the EITC has ecological, neighborhood-level health effects. We use a difference-in-difference analysis to measure child health outcomes in 90 low- and middle- income neighborhoods before and after the expansion of New York State and New York City's EITC policy between 1997-2010. Our study takes advantage of the relatively exogenous source of income variation supplied by the EITC-legislative changes to EITC policy parameters. This feature minimizes the endogeneity problem in studying the relationship between income and health. Our estimates link a 15-percentage-point increase in EITC benefit rates to a 0.45 percentage-point reduction in the low birthweight rate. We do not observe any measurable link between EITC benefits and prenatal health or asthma-related pediatric hospitalization. The magnitude of the EITC's impact on low birthweight rates suggests ecological effects, and an additional channel through which anti-poverty measures can serve as public health interventions.

Multidimensional poverty and child survival in India.

PubMed

Mohanty, Sanjay K

2011-01-01

Though the concept of multidimensional poverty has been acknowledged cutting across the disciplines (among economists, public health professionals, development thinkers, social scientists, policy makers and international organizations) and included in the development agenda, its measurement and application are still limited. OBJECTIVES AND METHODOLOGY: Using unit data from the National Family and Health Survey 3, India, this paper measures poverty in multidimensional space and examine the linkages of multidimensional poverty with child survival. The multidimensional poverty is measured in the dimension of knowledge, health and wealth and the child survival is measured with respect to infant mortality and under-five mortality. Descriptive statistics, principal component analyses and the life table methods are used in the analyses. The estimates of multidimensional poverty are robust and the inter-state differentials are large. While infant mortality rate and under-five mortality rate are disproportionately higher among the abject poor compared to the non-poor, there are no significant differences in child survival among educationally, economically and health poor at the national level. State pattern in child survival among the education, economical and health poor are mixed. Use of multidimensional poverty measures help to identify abject poor who are unlikely to come out of poverty trap. The child survival is significantly lower among abject poor compared to moderate poor and non-poor. We urge to popularize the concept of multiple deprivations in research and program so as to reduce poverty and inequality in the population.

Multidimensional Poverty and Child Survival in India

PubMed Central

Mohanty, Sanjay K.

2011-01-01

Background Though the concept of multidimensional poverty has been acknowledged cutting across the disciplines (among economists, public health professionals, development thinkers, social scientists, policy makers and international organizations) and included in the development agenda, its measurement and application are still limited. Objectives and Methodology Using unit data from the National Family and Health Survey 3, India, this paper measures poverty in multidimensional space and examine the linkages of multidimensional poverty with child survival. The multidimensional poverty is measured in the dimension of knowledge, health and wealth and the child survival is measured with respect to infant mortality and under-five mortality. Descriptive statistics, principal component analyses and the life table methods are used in the analyses. Results The estimates of multidimensional poverty are robust and the inter-state differentials are large. While infant mortality rate and under-five mortality rate are disproportionately higher among the abject poor compared to the non-poor, there are no significant differences in child survival among educationally, economically and health poor at the national level. State pattern in child survival among the education, economical and health poor are mixed. Conclusion Use of multidimensional poverty measures help to identify abject poor who are unlikely to come out of poverty trap. The child survival is significantly lower among abject poor compared to moderate poor and non-poor. We urge to popularize the concept of multiple deprivations in research and program so as to reduce poverty and inequality in the population. PMID:22046384

Neighborhoods and Mental Health: Exploring Ethnic Density, Poverty, and Social Cohesion among Asian Americans and Latinos

PubMed Central

Hong, Seunghye; Zhang, Wei; Walton, Emily

2014-01-01

This study examines the associations of neighborhood ethnic density and poverty with social cohesion and self-rated mental health among Asian Americans and Latinos. Path analysis is employed to analyze data from the 2002–2003 National Latino and Asian American Study (NLAAS) and the 2000 U.S. Census (N=2095 Asian Americans living in N=259 neighborhoods; N=2554 Latinos living in N=317 neighborhoods). Findings reveal that neighborhood ethnic density relates to poor mental health in both groups. Social cohesion partially mediates that structural relationship, but is positively related to ethnic density among Latinos and negatively related to ethnic density among Asian Americans. Although higher neighborhood poverty is negatively associated with mental health for both groups, the relationship does not hold in the path models after accounting for social cohesion and covariates. Furthermore, social cohesion fully mediates the association between neighborhood poverty and mental health among Latinos. This study highlights the necessity of reconceptualizing existing theories of social relationships to reflect complex and nuanced mechanisms linking neighborhood structure and mental health for diverse racial and ethnic groups. PMID:24769491

Health, Well-Being and Energy Poverty in Europe: A Comparative Study of 32 European Countries

PubMed Central

Thomson, Harriet; Snell, Carolyn; Bouzarovski, Stefan

2017-01-01

Despite growing pan-European interest in and awareness of the wide-ranging health and well-being impacts of energy poverty—which is characterised by an inability to secure adequate levels of energy services in the home—the knowledge base is largely British-centric and dominated by single-country studies. In response, this paper investigates the relationship between energy poverty, health and well-being across 32 European countries, using 2012 data from the European Quality of Life Survey. We find an uneven concentration of energy poverty, poor health, and poor well-being across Europe, with Eastern and Central Europe worst affected. At the intersection of energy poverty and health, there is a higher incidence of poor health (both physical and mental) amongst the energy poor populations of most countries, compared to non-energy poor households. Interestingly, we find the largest disparities in health and well-being levels between energy poor and non-energy poor households occur within relatively equal societies, such as Sweden and Slovenia. As well as the unique challenges brought about by rapidly changing energy landscapes in these countries, we also suggest the relative deprivation theory and processes of social comparison hold some value in explaining these findings. PMID:28561767

Urban air pollution, poverty, violence and health--Neurological and immunological aspects as mediating factors.

PubMed

Kristiansson, Marianne; Sörman, Karolina; Tekwe, Carmen; Calderón-Garcidueñas, Lilian

2015-07-01

Rapid rural-urban migration has created overcrowded areas characterized by concentrated poverty and increases in indoor and outdoor air pollutants. These "hotspots" constitute an increased risk of violence and disease outbreaks. We hypothesize that the effects of poverty and associated air pollution-related stress on impaired cognitive skills are mediated by inflammatory cytokines. A research framework is proposed, encompassing (i) an epidemiological investigation of associations between poverty, high concentrations of air pollutants, violence and health, (ii) a longitudinal follow-up of working memory capacities and inflammatory markers, and (iii) intervention programs aiming to strengthen employability and decreased exposures to toxic air pollutants. Copyright © 2015 Elsevier Inc. All rights reserved.

A responsive evaluation of mental health treatment in Cambodia: Intentionally addressing poverty to increase cultural responsiveness in therapy.

PubMed

Seponski, Desiree M; Lewis, Denise C; Megginson, Maegan C

2014-01-01

Mental health issues are significant contributors to the global burden of disease with the highest incidence in resource poor countries; 90% of those in need of mental health treatment reside in low resource countries but receive only 10% of the world's resources. Cambodia, the eighth least developed country in the world, serves as one example of the need to address mental health concerns in low-income, resource poor countries. The current study utilises responsive evaluation methodology to explore how poverty-stricken Cambodian clients, therapists and supervisors experience Western models of therapy as culturally responsive to their unique needs. Quantitative and qualitative data were triangulated across multiple stakeholders using numerous methods including a focus group, interviews, surveys, case illustrations and live supervision observation and analysed using constant comparative analysis. Emerging findings suggest that poverty, material needs, therapy location and financial situations greatly impact the daily lives and mental health conditions of Cambodians and hinder clients' therapeutic progress. The local community needs and context of poverty greatly hinder clients' therapeutic progress in therapy treatment and when therapy does not directly address the culture of poverty, clients did not experience therapy as valuable despite some temporary decreases in mental health symptoms.

Health and poverty: past, present and prospects for the future.

PubMed

Najman, J M

1993-01-01

Periodically the results of class comparisons in mortality rates have been reported. These reports have permitted comparisons since the earlier part of this century to the present period. The data thus available enables us to make some tentative predictions about the likely magnitude of class inequalities in mortality in the future. We consequently argue that: the concept of class should be abandoned in favour of a more direct measure of economic inequality which emphasises those living in poverty. despite overall declines in mortality for all socioeconomic groups, in the most recent period there has been an increase in the relative mortality disadvantage in some countries. this increase in mortality disadvantage is paralleled by an increase in the proportion of people, particularly children, living in poverty. Five groups constitute the bulk of those living in poverty and, of these, three (single mothers, the aged and the disabled) are likely to increase in numbers in the future, producing a likely increase in class-related mortality inequalities. Reducing these inequalities will depend upon welfare and education initiatives more than on any changes likely to be produced by the health system.

Poverty, Socio-Economic Position, Social Capital and the Health of Children and Adolescents with Intellectual Disabilities in Britain: A Replication

ERIC Educational Resources Information Center

Emerson, E.; Hatton, C.

2007-01-01

Background: When compared with their nonintellectually disabled peers, people with intellectual disabilities (IDs) have poorer health and are more likely to be exposed to poverty during childhood. Given that exposure to child poverty has been linked to poorer health outcomes, we attempted to estimate the extent to which the health inequalities…

Social Structure and Child Poverty

ERIC Educational Resources Information Center

Ferriss, Abbott L.

2006-01-01

Child poverty, as a critical indicator of the QOL, is intricately related to the social structure of the community. This hypothesis is explored for the 159 counties of Georgia for the year 2000. The influence of demographic, economic, family and health factors upon child poverty are explored through models of total, black and white child poverty.…

County-Level Poverty Is Equally Associated with Unmet Health Care Needs in Rural and Urban Settings

ERIC Educational Resources Information Center

Peterson, Lars E.; Litaker, David G.

2010-01-01

Context: Regional poverty is associated with reduced access to health care. Whether this relationship is equally strong in both rural and urban settings or is affected by the contextual and individual-level characteristics that distinguish these areas, is unclear. Purpose: Compare the association between regional poverty with self-reported unmet…

Community concepts of poverty: an application to premium exemptions in Ghana’s National Health Insurance Scheme

PubMed Central

2013-01-01

Background Poverty is multi dimensional. Beyond the quantitative and tangible issues related to inadequate income it also has equally important social, more intangible and difficult if not impossible to quantify dimensions. In 2009, we explored these social and relativist dimension of poverty in five communities in the South of Ghana with differing socio economic characteristics to inform the development and implementation of policies and programs to identify and target the poor for premium exemptions under Ghana’s National Health Insurance Scheme. Methods We employed participatory wealth ranking (PWR) a qualitative tool for the exploration of community concepts, identification and ranking of households into socioeconomic groups. Key informants within the community ranked households into wealth categories after discussing in detail concepts and indicators of poverty. Results Community defined indicators of poverty covered themes related to type of employment, educational attainment of children, food availability, physical appearance, housing conditions, asset ownership, health seeking behavior, social exclusion and marginalization. The poverty indicators discussed shared commonalities but contrasted in the patterns of ranking per community. Conclusion The in-depth nature of the PWR process precludes it from being used for identification of the poor on a large national scale in a program such as the NHIS. However, PWR can provide valuable qualitative input to enrich discussions, development and implementation of policies, programs and tools for large scale interventions and targeting of the poor for social welfare programs such as premium exemption for health care. PMID:23497484

The effect of a transition into poverty on child and maternal mental health: a longitudinal analysis of the UK Millennium Cohort Study.

PubMed

Wickham, Sophie; Whitehead, Margaret; Taylor-Robinson, David; Barr, Ben

2017-03-01

Whether or not relative measures of income poverty effectively reflect children's life chances has been the focus of policy debates in the UK. Although poverty is associated with poor child and maternal mental health, few studies have assessed the effect of moving into poverty on mental health. To inform policy, we explore the association between transitions into poverty and subsequent mental health among children and their mothers. In this longtitudinal analysis, we used data from the UK Millennium Cohort Study, a large nationally representative cohort of children born in the UK between Sept 1, 2000, and Jan 11, 2002, who participated in five survey waves as they progressed from 9 months of age to 11 years of age. Our analysis included all children and mothers who were free from mental health problems and not in poverty when the children were aged 3 years. We only included singletons (ie, not twins or other multiple pregnancies) and children for whom the mother was the main respondent to the study. The main outcomes were child socioemotional behavioural problems (Strengths and Difficulties Questionnaire) at ages 5 years, 7 years, and 11 years and maternal psychological distress (Kessler 6 scale). Using discrete time-hazard models, we followed up families without mental health problems at baseline and estimated odds ratios for subsequent onset of maternal and child mental health problems associated with first transition into poverty, while adjusting for confounders, including employment transitions. We further assessed whether or not change in maternal mental health explained any effect on child mental health. Of the 6063 families in the UK Millennium Cohort study at 3 years who met our inclusion criteria, 844 (14%) had a new transition into poverty compared with 5219 (86%) who remained out of poverty. After adjustment for confounders, transition into poverty increased the odds of socioemotional behavioural problems in children (odds ratio 1·41 [95% CI 1·02-1·93

Poverty dynamics, poverty thresholds and mortality: An age-stage Markovian model

PubMed Central

Rehkopf, David; Tuljapurkar, Shripad; Horvitz, Carol C.

2018-01-01

Recent studies have examined the risk of poverty throughout the life course, but few have considered how transitioning in and out of poverty shape the dynamic heterogeneity and mortality disparities of a cohort at each age. Here we use state-by-age modeling to capture individual heterogeneity in crossing one of three different poverty thresholds (defined as 1×, 2× or 3× the “official” poverty threshold) at each age. We examine age-specific state structure, the remaining life expectancy, its variance, and cohort simulations for those above and below each threshold. Survival and transitioning probabilities are statistically estimated by regression analyses of data from the Health and Retirement Survey RAND data-set, and the National Longitudinal Survey of Youth. Using the results of these regression analyses, we parameterize discrete state, discrete age matrix models. We found that individuals above all three thresholds have higher annual survival than those in poverty, especially for mid-ages to about age 80. The advantage is greatest when we classify individuals based on 1× the “official” poverty threshold. The greatest discrepancy in average remaining life expectancy and its variance between those above and in poverty occurs at mid-ages for all three thresholds. And fewer individuals are in poverty between ages 40-60 for all three thresholds. Our findings are consistent with results based on other data sets, but also suggest that dynamic heterogeneity in poverty and the transience of the poverty state is associated with income-related mortality disparities (less transience, especially of those above poverty, more disparities). This paper applies the approach of age-by-stage matrix models to human demography and individual poverty dynamics. In so doing we extend the literature on individual poverty dynamics across the life course. PMID:29768416

Pathways into chronic multidimensional poverty amongst older people: a longitudinal study.

PubMed

Callander, Emily J; Schofield, Deborah J

2016-03-07

The use of multidimensional poverty measures is becoming more common for measuring the living standards of older people. However, the pathways into poverty are relatively unknown, nor is it known how this affects the length of time people are in poverty for. Using Waves 1 to 12 of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey, longitudinal analysis was undertaken to identify the order that key forms of disadvantage develop - poor health, low income and insufficient education attainment - amongst Australians aged 65 years and over in multidimensional poverty, and the relationship this has with chronic poverty. Path analysis and linear regression models were used. For all older people with at least a Year 10 level of education attainment earlier mental health was significantly related to later household income (p = 0.001) and wealth (p = 0.017). For all older people with at less than a Year 10 level of education attainment earlier household income was significantly related to later mental health (p = 0.021). When limited to those in multidimensional poverty who were in income poverty and also had poor health, older people generally fell into income poverty first and then developed poor health. The order in which income poverty and poor health were developed had a significant influence on the length of time older people with less than a Year 10 level of education attainment were in multidimensional poverty for. Those who developed poor health first then fell into income poverty spend significantly less time in multidimensional poverty (-4.90, p < .0001) than those who fell into income poverty then developed poor health. Knowing the order that different forms of disadvantage develop, and the influence this has on poverty entrenchment, is of use to policy makers wishing to provide interventions to prevent older people being in long-term multidimensional poverty.

Poverty, development, and women: why should we care?

PubMed

Thompson, Joyce E Beebe

2007-01-01

Healthy, prosperous nations require healthy women and newborns. Young girls and women in resource-poor nations suffer the greatest ill-health consequences from low status, denial of basic human rights, and poverty. Poverty and poor health result in poor economic development. The Millennium Development Goals call for immediate efforts to reduce poverty, improve health, especially of girls and women, and foster development in the world's poorest nations.

Web services for ecosystem services management and poverty alleviation

NASA Astrophysics Data System (ADS)

Buytaert, W.; Baez, S.; Veliz Rosas, C.

2011-12-01

Over the last decades, near real-time environmental observation, technical advances in computer power and cyber-infrastructure, and the development of environmental software algorithms have increased dramatically. The integration of these evolutions is one of the major challenges of the next decade for environmental sciences. Worldwide, many coordinated activities are ongoing to make this integration a reality. However, far less attention is paid to the question of how these developments can benefit environmental services management in a poverty alleviation context. Such projects are typically faced with issues of large predictive uncertainties, limited resources, limited local scientific capacity. At the same time, the complexity of the socio-economic contexts requires a very strong bottom-up oriented and interdisciplinary approach to environmental data collection and processing. Here, we present the results of two projects on integrated environmental monitoring and scenario analysis aimed at poverty alleviation in the Peruvian Andes and Amazon. In the upper Andean highlands, farmers are monitoring the water cycle of headwater catchments to analyse the impact of land-use changes on stream flow and potential consequences for downstream irrigation. In the Amazon, local communities are monitoring the dynamics of turtle populations and their relations with river levels. In both cases, the use of online databases and web processing services enable real-time analysis of the data and scenario analysis. The system provides both physical and social indicators to assess the impact of land-use management options on local socio-economic development.

Neighborhoods and mental health: exploring ethnic density, poverty, and social cohesion among Asian Americans and Latinos.

PubMed

Hong, Seunghye; Zhang, Wei; Walton, Emily

2014-06-01

This study examines the associations of neighborhood ethnic density and poverty with social cohesion and self-rated mental health among Asian Americans and Latinos. Path analysis is employed to analyze data from the 2002-2003 National Latino and Asian American Study (NLAAS) and the 2000 U.S. Census (N = 2095 Asian Americans living in N = 259 neighborhoods; N = 2554 Latinos living in N = 317 neighborhoods). Findings reveal that neighborhood ethnic density relates to poor mental health in both groups. Social cohesion partially mediates that structural relationship, but is positively related to ethnic density among Latinos and negatively related to ethnic density among Asian Americans. Although higher neighborhood poverty is negatively associated with mental health for both groups, the relationship does not hold in the path models after accounting for social cohesion and covariates. Furthermore, social cohesion fully mediates the association between neighborhood poverty and mental health among Latinos. This study highlights the necessity of reconceptualizing existing theories of social relationships to reflect complex and nuanced mechanisms linking neighborhood structure and mental health for diverse racial and ethnic groups. Copyright © 2014 Elsevier Ltd. All rights reserved.

Poverty, wealth, and health care utilization: a geographic assessment.

PubMed

Cooper, Richard A; Cooper, Matthew A; McGinley, Emily L; Fan, Xiaolin; Rosenthal, J Thomas

2012-10-01

Geographic variation has been of interest to both health planners and social epidemiologists. However, while the major focus of interest of planners has been on variation in health care spending, social epidemiologists have focused on health; and while social epidemiologists have observed strong associations between poor health and poverty, planners have concluded that income is not an important determinant of variation in spending. These different conclusions stem, at least in part, from differences in approach. Health planners have generally studied variation among large regions, such as states, counties, or hospital referral regions (HRRs), while epidemiologists have tended to study local areas, such as ZIP codes and census tracts. To better understand the basis for geographic variation in hospital utilization, we drew upon both approaches. Counties and HRRs were disaggregated into their constituent ZIP codes and census tracts and examined the interrelationships between income, disability, and hospital utilization that were examined at both the regional and local levels, using statistical and geomapping tools. Our studies centered on the Milwaukee and Los Angeles HRRs, where per capita health care utilization has been greater than elsewhere in their states. We compared Milwaukee to other HRRs in Wisconsin and Los Angeles to the other populous counties of California and to a region in California of comparable size and diversity, stretching from San Francisco to Sacramento (termed "San-Framento"). When studied at the ZIP code level, we found steep, curvilinear relationships between lower income and both increased hospital utilization and increasing percentages of individuals reporting disabilities. These associations were also evident on geomaps. They were strongest among populations of working-age adults but weaker among seniors, for whom income proved to be a poor proxy for poverty and whose residential locations deviated from the major underlying income

What socio-demographic factors influence poverty and financial health care access among disabled people in Flanders: a cross-sectional study.

PubMed

Adams, Margo; Augustyns, Nele; Janssens, Herman; Vriesacker, Bart; Van Hal, Guido

2014-02-12

Current literature shows that people with a disability have a lower income than people without a disability. Disabled people often experience difficulties with health care access.The objective of this study is to assess the current financial situation and poverty rate amongst disabled people in Flanders. Furthermore we wanted to analyze factors that contribute to the risk of poverty and problems with financial health care access in adult people with a disability in Flanders. An online and paper survey were constructed and made available through two large organizations for people with different types of disability in Flanders. Descriptive statistics and logistic regression analysis were performed. In this convenience sample, 20.9% of the 889 respondents live under the poverty threshold. Important contributing factors to the risk of poverty are having children (OR 3.43, 95% CI 2.10-5.59) and a low level of dependence (OR 16.40, 95% CI 6.21-43.28). 25.2% of the respondents did not access health care because of financial shortcomings. A low level of dependence is one important contributing factor (OR 3.16, 95% CI 1.41-6.98) to limited financial health care access. This research confirms that disability is associated with a higher risk of poverty and impaired financial health care access.

The influence of poverty and social support on the perceived health of children born to minority migrant mothers.

PubMed

Van Hulst, Andraea; Séguin, Louise; Zunzunegui, Maria-Victoria; Vélez, Maria P; Nikiéma, Béatrice

2011-06-01

Poverty and low social support are common among minority migrant families. Little is known about their impact on the health of children of minority migrants to Canada. This study examined the associations between maternal perception of child's health and migration status, and examined the specific role of poverty and low social support in these associations. Data from the first two rounds of the Quebec Longitudinal Study of Child Development (QLSCD) were analysed. The sample included 1990 children at 17 months of age, classified according to their mother's migration status: children of minority migrant mothers (n=165) and Canadian-born mothers (n=1825). Maternal perception of child's health status and social support were measured at 17 months, household income was measured at 5 and 17 months. Multivariable logistic regressions were performed; interactions of migration status with poverty and social support were tested. Poverty and low social support were more common among minority migrant mothers than among Canadian-born mothers. Children of minority migrant mothers who were 'never poor' and reported high levels of social support were perceived in better health (OR 0.42; 95% confidence interval (CI): 0.19-0.91) than children of Canadian-born mothers (reference group). In contrast, children of minority migrant mothers who were 'always poor' and reported low social support were perceived in worse health (OR 6.32; 95% CI: 1.69-23.71) compared to the reference group. In Quebec, economic hardship and lack of social support are common realities among minority migrants with young children. Combined exposure to poverty and low social support is most detrimental to the perceived health of children of minority migrants.

The regulation and adoption of health technologies under Brazil's Unified Health System: barriers to access to medicines for diseases of poverty?

PubMed

Santana, Rafael Santos; Lupatini, Evandro de Oliveira; Leite, Silvana Nair

2017-05-01

The study aimed to examine the regulation and adoption of health technologies for the diseases of poverty in the Brazil's Unified Health System (SUS). An exploratory, descriptive study was conducted between January and May 2016 consisting of the search and analysis of relevant documents on the websites of Brazil's National Health Surveillance Agency, the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), the National Commission for the Adoption of Technologies by the SUS, and Saúde Legis (the Ministry of Health's Legislation System). The 2014 version of the Brazilian National List of Essential Medicines (RENAME, acronym in Portuguese) contained 132 medicines for diseases of poverty. Over one-third of these (49) had only one national producer, while 24 were not registered in the country. The number of medicines contained in the RENAME dedicated to this group of diseases increased by 46% between 2006 and 2014. Despite advances in the regulation and incorporation of technologies by the SUS, given the lack of market interest and neglect of diseases of poverty, the government has a vital role to play in ensuring access to the best available therapies in order to reduce health inequalities. It therefore follows that Brazil needs to improve the regulation of medicines that do not attract market interest.

A Resilience, Health and Well-Being Lens for Education and Poverty

ERIC Educational Resources Information Center

Ebersöhn, Liesel

2017-01-01

In this paper I argue that the health and well-being outcomes of people at different levels of a social hierarchy, as studied by epidemiologists and psychologists has relevance for educational research, especially in unequal societies. When addressing poverty-associated risk, the educational emphasis need not only be on attaining more individual…

Malnutrition and poverty.

PubMed

Peña, Manuel; Bacallao, Jorge

2002-01-01

This paper is an attempt to discuss the problem of malnutrition within the framework of the global need for development and the challenges posed by the trends of neoliberalism and globalization. We argue that there is a two-way link between poverty and health in which nutrition plays an important role both as an active and as a mediating factor. Key concepts are exposed and expanded: (a) Development per se does not ensure better health; (b) unequal distribution of income has an independent effect on health indicators after adjusting for total income; (c) improving health can make an important contribution to reducing poverty; (d ) improving nutrition throughout the whole life course is an indispensable strategy for better health; (e) obesity has to be included amongst the most critical health problems, has different traits, and presents with different challenges in the developing world and in the industrialized countries.

Use of an Online Game to Evaluate Health Professions Students' Attitudes toward People in Poverty.

PubMed

Richey Smith, Carriann E; Ryder, Priscilla; Bilodeau, Ann; Schultz, Michele

2016-10-25

Objective. To determine baseline attitudes of pharmacy, physician assistant studies, and communication science and disorders students toward people in poverty and to examine the effectiveness of using the online poverty simulation game SPENT to affect these attitudes. Methods. Students completed pre/postassessments using the validated Undergraduate Perceptions of Poverty Tracking Survey (UPPTS). Students played the online, open access, SPENT game alone and/or in pairs in a 50-minute class. Results. Significant improvements in scale scores were seen in students after playing SPENT. Quartile results by prescore indicated that students with the lowest attitudes towards patients in poverty improved the most. Results suggested that most students found the experience worthwhile for themselves and/or for their classmates. Conclusions. The results of this study suggest SPENT may improve perspectives of undergraduate pharmacy and other health professions students.

Protocol: realist synthesis of the impact of unemployment insurance policies on poverty and health.

PubMed

Molnar, Agnes; O'Campo, Patricia; Ng, Edwin; Mitchell, Christiane; Muntaner, Carles; Renahy, Emilie; St John, Alexander; Shankardass, Ketan

2015-02-01

Unemployment insurance is an important social protection policy that buffers unemployed workers against poverty and poor health. Most unemployment insurance studies focus on whether increases in unemployment insurance generosity are predictive of poverty and health outcomes. Less work has used theory-driven approaches to understand and explain how and why unemployment insurance works, for whom, and under what circumstances. Given this, we present a realist synthesis protocol that seeks to unpack how contextual influences trigger relevant mechanisms to generate poverty and health outcomes. In this protocol, we conceptualize unemployment insurance as a key social protection policy; provide a supporting rationale on the need for a realist synthesis; and describe our process on identifying context-mechanism-outcome pattern configurations. Six methodological steps are described: initial theory development, search strategy; selection and appraisal of documents; data extraction; analysis and synthesis process; and presentation and dissemination of revised theory. Our forthcoming realist synthesis will be the first to build and test theory on the intended and unintended outcomes of unemployment insurance policies. Anticipated findings will allow policymakers to move beyond 'black box' approaches to consider 'mechanism-based' explanations that explicate the logic on how and why unemployment insurance matters. Copyright © 2014 Elsevier Ltd. All rights reserved.

Relationship of race and poverty to lower extremity function and decline: findings from the Women's Health and Aging Study.

PubMed

Thorpe, Roland James; Kasper, Judith D; Szanton, Sarah L; Frick, Kevin D; Fried, Linda P; Simonsick, Eleanor M

2008-02-01

Race- and poverty-related disparities in physical function are well documented, though little is known about effects of race and poverty on functional decline and the progression of disability. We examined cross-sectional and longitudinal relationships between race, poverty and lower extremity function using data from moderately to severely disabled women in the U.S. Women's Health and Aging Study. Severity of lower extremity functional limitation was determined from scaled responses of reported difficulty walking (1/4) mile, walking across a room, climbing stairs, and stooping, crouching or kneeling. Usual walking speed assessed over 4m was our objective measure of function. Of the 996 women who described themselves as black or white, 284 (29%) were black and 367 (37%) were living at or below 100% of the federal poverty level. Independent of demographic and health-related factors, among white women, the poor exhibited consistently worse lower extremity function than the non-poor; this association, however, was not observed in black women. Among the non-poor, black women had slower walking speeds, and reported more limitation in lower extremity function than their non-poor white counterparts, even after adjusting for demographic variables and health-related characteristics. After 3 years, accounting for baseline function, demographic and health-related factors, race and poverty status were unrelated to functional decline. Thus, while race and poverty status were associated with functional deficits in old age, they do not appear to impact the rate of functional decline or progression of disability over 3 years.

Dimensions of Poverty and Health Outcomes Among People Living with HIV Infection: Limited Resources and Competing Needs.

PubMed

Kalichman, Seth C; Hernandez, Dominica; Kegler, Christopher; Cherry, Chauncey; Kalichman, Moira O; Grebler, Tamar

2015-08-01

HIV infection is concentrated in populations living in poverty. We examined the overlapping and independent effects of multiple poverty indicators on HIV-related health status. Because substance use can create competing survival needs when resources are limited, we also sought to objectively measure expenditures on food relative to alcohol and tobacco products. To achieve these aims, 459 men and 212 women living with HIV infection in Atlanta, GA completed measures of socio-demographic and heath characteristics as well as multiple indicators of poverty including housing stability, transportation, food insecurity, and substance use. Participants were given a $30 grocery gift card for their participation and we collected receipts which were coded for alcohol (beer, wine, liquors) and tobacco purchases. Results showed that participants with unsuppressed HIV replication were significantly more likely to experience multiple indicators of poverty. In addition, one in four participants purchased alcohol or tobacco products with their gift cards, with as much as one-fourth of money spent on these products. A multivariable logistic regression model showed that food insecurity was independently associated with unsuppressed HIV, and purchasing alcohol or tobacco products did not moderate this association. Results confirm previous research to show the primacy of food insecurity in relation to HIV-related health outcomes. Competing survival needs, including addictive substances, should be addressed in programs that aim to alleviate poverty to enhance the health and well-being of people with HIV infection.

What socio-demographic factors influence poverty and financial health care access among disabled people in Flanders: a cross-sectional study

PubMed Central

2014-01-01

Background Current literature shows that people with a disability have a lower income than people without a disability. Disabled people often experience difficulties with health care access. The objective of this study is to assess the current financial situation and poverty rate amongst disabled people in Flanders. Furthermore we wanted to analyze factors that contribute to the risk of poverty and problems with financial health care access in adult people with a disability in Flanders. Methods An online and paper survey were constructed and made available through two large organizations for people with different types of disability in Flanders. Descriptive statistics and logistic regression analysis were performed. Results In this convenience sample, 20.9% of the 889 respondents live under the poverty threshold. Important contributing factors to the risk of poverty are having children (OR 3.43, 95% CI 2.10-5.59) and a low level of dependence (OR 16.40, 95% CI 6.21-43.28). 25.2% of the respondents did not access health care because of financial shortcomings. A low level of dependence is one important contributing factor (OR 3.16, 95% CI 1.41-6.98) to limited financial health care access. Conclusion This research confirms that disability is associated with a higher risk of poverty and impaired financial health care access. PMID:24521283

Urban poverty and utilization of maternal and child health care services in India.

PubMed

Prakash, Ravi; Kumar, Abhishek

2013-07-01

Drawing upon data from the third round of the National Family Health Survey (NFHS-3) conducted in India during 2005-06, this study compares the utilization of selected maternal and child health care services between the urban poor and non-poor in India and across selected Indian states. A wealth index was created, separately for urban areas, using Principal Component Analysis to identify the urban poor. The findings suggest that the indicators of maternal and child health care are worse among the urban poor than in their non-poor counterparts. For instance, the levels of antenatal care, safe delivery and childhood vaccinations are much lower among the urban poor than non-poor, especially in socioeconomically disadvantageous states. Among all the maternal and child health care indicators, the non-poor/poor difference is most pronounced for delivery care in the country and across the states. Other than poverty status, utilization of antenatal services by mothers increases the chances of safe delivery and child immunization at both national and sub-national levels. The poverty status of the household emerged as a significant barrier to utilization of health care services in urban India.

Poverty, health & intellectual property rights with special reference to India.

PubMed

Satyanarayana, K; Srivastava, S

2007-10-01

This paper examines the nexus between poverty and global health with specific focus on IPR protection and attempts to highlight the current global endeavours to overcome barriers to access to medicines for diseases of the poor. The number of very poor people in the world has increased by 10.4 per cent between 1987 and 2001 to 2735 million. India is now home to the largest number of millionaires in the developing countries. But over 800 million Indians who still survive on Rs 20.0 (US$0.5) a day, and rural poverty is on the rise. The link between poverty and health is well established with the underprivileged are more vulnerable to major health risks due to poor nutrition, inadequate access to clean drinking water, sanitation, exposure to indoor smoke, etc. all of which contribute to the huge and growing burden of disease in the poor countries. The global disease burden is not just huge but growing: over 10 million children die of preventable conditions including vaccine-preventable diseases, about 14 million are killed by infectious diseases every year, 90-95 per cent in poor countries. An estimated third of global population has limited or no access to essential medicines. While the number of poor and unhealthy is growing, Government expenditure on health is dwindling. Many of the diseases of the poor require new medicines and none are forthcoming as there is little R&D for these infections. There are several barriers to access to existing and the newly discovered drugs. One major reason is the general lack of interest by the pharma industry to discover new medicines for diseases of the poor due to very limited market in developing countries. In addition, global intellectual property rights (IPR) protection regimes like the Trade Related Intellectual Property Rights (TRIPS) are considered a major obstacle for the poor access to medicines. There have been some global initiatives on the need to improve affordability and accessibility of medicines. Some strategies to

A Prospective Study of the Impact of Current Poverty, History of Poverty, and Exiting Poverty on Accumulation of Disease Damage in Systemic Lupus Erythematosus.

PubMed

Yelin, Edward; Trupin, Laura; Yazdany, Jinoos

2017-08-01

To estimate the effect of current poverty, number of years in poverty, and exiting poverty on disease damage accumulation in systemic lupus erythematosus (SLE). For this study, 783 patients with SLE were followed up from 2003 to 2015 through annual structured interviews. Respondents were categorized in each year by whether they had a household income of ≤125% of the US federal poverty level. Linear and logistic regression analyses were used to assess the impact of poverty in 2009, number of years in poverty between 2003 and 2009, and permanent exits from poverty as of 2009 on the extent of disease damage (according to the Brief Index of Lupus Damage [BILD] score) or accumulation of a clinically meaningful increase in disease damage (defined as a minimum 2-point increase in the BILD damage score) by 2015. After adjustment for sociodemographic features, health care characteristics, and health behaviors, poverty in 2009 was associated with an increased level of accumulated disease damage in 2015 (mean difference in BILD damage score between poor and non-poor 0.62 points, 95% confidence interval [95% CI] 0.25-0.98) and increased odds of a clinically important increase in damage (odds ratio [OR] 1.67, 95% CI 0.98-2.85). Being poor in every year between 2003 and 2009 was associated with greater damage (mean change in BILD score 2.45, 95% CI 1.88-3.01) than being poor for one-half or more of those years (mean change in BILD score 1.45, 95% CI 0.97-1.93), for fewer than one-half of those years (mean change in BILD score 1.49, 95% CI 1.10-1.88), or for none of those years (mean change in BILD score 1.34, 95% CI 1.20-1.49). Those exiting poverty permanently had similar increases in disease damage (mean change in BILD score 1.30, 95% CI 0.90-1.69) as those who were never in poverty (mean change in BILD score 1.36, 95% CI 1.23-1.50) but much less damage than those who remained in poverty (mean change in BILD score 1.98, 95% CI 1.59-2.38). The effects of current poverty

Recalibrating the spirit level: An analysis of the interaction of income inequality and poverty and its effect on health.

PubMed

Rambotti, Simone

2015-08-01

The publication of The Spirit Level (Wilkinson and Pickett, 2009) marked a paramount moment in the analysis of health and inequality, quickly attracting a remarkable degree of attention, both positive and negative, both in academic and in public discourse. Following at least 20 years of research, the book proposes a simple and powerful argument: inequality per se, more specifically income inequality, is harmful to every aspect of social life. In order to confirm this idea, the authors present a series of bivariate, cross-sectional associations showing comparisons across countries and within the United States. Despite the methodological limitations of this approach, the authors advance causal claims concerning the detrimental effects of income inequality. They also rule out poverty as a plausible alternative explanation, without directly measuring it. Meanwhile, over the last decade stratification scholars have demonstrated the nonlinear effect of economic factors, especially income, on health. The results suggest that a relative approach is best for analyzing dynamics at the top of the income distribution, whereas an absolute approach seems most appropriate for studying the bottom of the distribution. Consistent with this perspective, here I reanalyze data from The Spirit Level, adding a measure of poverty, in order to control the effect of inequality and explore its interaction with poverty. The findings show that inequality and poverty-which I contend are two interdependent but nonetheless distinct phenomena-interact across countries, such that the detrimental effects of inequality are present or stronger in countries with high poverty, and absent or weaker in countries with low poverty; poverty replaces inequality as the favored explanation of health and social ills across states. The new evidence suggests that income distributions are characterized by a complex interplay between inequality and poverty, whose interaction deserves further analysis. Copyright �

Cost and results of information systems for health and poverty indicators in the United Republic of Tanzania.

PubMed Central

Rommelmann, Vanessa; Setel, Philip W.; Hemed, Yusuf; Angeles, Gustavo; Mponezya, Hamisi; Whiting, David; Boerma, Ties

2005-01-01

OBJECTIVE: To examine the costs of complementary information generation activities in a resource-constrained setting and compare the costs and outputs of information subsystems that generate the statistics on poverty, health and survival required for monitoring, evaluation and reporting on health programmes in the United Republic of Tanzania. METHODS: Nine systems used by four government agencies or ministries were assessed. Costs were calculated from budgets and expenditure data made available by information system managers. System coverage, quality assurance and information production were reviewed using questionnaires and interviews. Information production was characterized in terms of 38 key sociodemographic indicators required for national programme monitoring. FINDINGS: In 2002-03 approximately US$ 0.53 was spent per Tanzanian citizen on the nine information subsystems that generated information on 37 of the 38 selected indicators. The census and reporting system for routine health service statistics had the largest participating populations and highest total costs. Nationally representative household surveys and demographic surveillance systems (which are not based on nationally representative samples) produced more than half the indicators and used the most rigorous quality assurance. Five systems produced fewer than 13 indicators and had comparatively high costs per participant. CONCLUSION: Policy-makers and programme planners should be aware of the many trade-offs with respect to system costs, coverage, production, representativeness and quality control when making investment choices for monitoring and evaluation. In future, formal cost-effectiveness studies of complementary information systems would help guide investments in the monitoring, evaluation and planning needed to demonstrate the impact of poverty-reduction and health programmes. PMID:16184275

Poverty eradication: a new paradigm.

PubMed

Pethe, V P

1998-08-01

This article offers a new paradigm for eradicating poverty in India. It was assumed incorrectly by Mahatma Gandhi that a good society without mass poverty would follow after independence. India copied Western models of development and developed giant factories, big dams, and megacities. Agriculture did not expand the number of jobs for people. The Western paradigm failed in India because of the false assumption of "trickle down" of income to the masses. The targeted programs to the poor did not directly benefit enough of the poor. Mega-industrialization led to reduced employment and higher skill needs. The model failed mainly because it was a proxy and relied on indirect ways of reaching the poor. The models failed to be adapted to conditions in India. The Swadeshi paradigm is a direct model for addressing mass poverty. Poverty is affected by immediate, intermediate, and ultimate determinants. Poverty begets social and economic problems, such as ignorance, ill health, high fertility, unemployment, and crime. In India and developing countries, mass poverty results from under use of human resources; lack of equal opportunities; and an outdated non-egalitarian social structure, an unjust global economic order, human cruelty, and erosion of ethical values. Indians are squandering their precious resources mimicking Western consumerism. Poverty leads to rapid population growth. People become productive assets with universal literacy, compulsory and free education, health services and sanitation, vocational training, and work ethics. India needs people-oriented policies with less emphasis on capital accumulation.

Child poverty and regional disparities in Turkey.

PubMed

Eryurt, Mehmet Ali; Koç, Ismet

2013-01-01

The United Nations Children's Fund (UNICEF) defines child poverty as the inability of the child to realize their existing potential due to their inability to access resources across different dimensions of life (income, health, nutrition, education, environment, etc.). On the basis of this definition, an attempt has been made in this study to put forth the disadvantaged positions children have in different dimensions of their lives, specifically by taking regional disparities into account. As the data source, the Turkey Demographic and Health Survey 2008 is used, a survey that consists of detailed information about the different dimensions of child poverty. In this study, in order to measure poverty in four different dimensions (education and work, health and nutrition, family environment, and domestic environment), a total of 25 variables were used and descriptive and multivariate analyses were made in order to highlight the regional disparities in child poverty. Principle components analysis conducted through the use of a deficit approach reveals that the variables closely related with education and health and nutrition were the critical dimensions behind child poverty in Turkey. The results of this study indicate that 22.4% of children in Turkey are poor when various dimensions of life are taken into account; the region with the highest child poverty is Central East Anatolia, at 34.9%, while the region with the lowest rate is East Marmara, at 15.6%.

Bibliometric analysis of medicine-related publications on poverty (2005-2015).

PubMed

Sweileh, Waleed M; Al-Jabi, Samah W; Sawalha, Ansam F; AbuTaha, Adham S; Zyoud, Sa'ed H

2016-01-01

Poverty is a global problem. The war against poverty requires not only financial support, but also poverty-related research to pinpoint areas of high need of intervention. In line with international efforts to fight poverty and negative consequences, we carried out this study to give a bibliometric overview of medicine-related literature on poverty. Such a s study is an indicator of the extent of interaction of various international key players on the war against poverty-related health problems. Scopus was used to achieve the objective of this study. The time span set for this study was 2005-2015. Poverty-related articles under the subject area "Medicine" were used to give bibliometric indicators such as annual growth of publications, international collaboration, highly cited articles, active countries, institutions, journals, and authors. The total number of retrieved articles was 1583. The Hirsh-index of retrieved articles was 56. A modest and fluctuating increase was seen over the study period. Visualization map of retrieved articles showed that "HIV", infectious diseases, mental health, India, and Africa were most commonly encountered terms. No significant dominance of any particular author or journal was observed in retrieved articles. The United States of America had the largest share in the number of published articles. The World Health Organization and Centers for Disease Prevention and Control were among top active institutions/organizations. International collaboration was observed in less than one third of publications. Top cited articles focused on three poverty-related health issues, mainly, infectious diseases, malnutrition, and child development/psychology. Most of top articles were published in high impact journals. Data indicated that articles on poverty were published in high influential medical journals indicative of the importance of poverty as a global health problem. However, the number publications and the extent of international

Poverty identification for a pro-poor health insurance scheme in Tanzania: reliability and multi-level stakeholder perceptions.

PubMed

Kuwawenaruwa, August; Baraka, Jitihada; Ramsey, Kate; Manzi, Fatuma; Bellows, Ben; Borghi, Josephine

2015-12-01

Many low income countries have policies to exempt the poor from user charges in public facilities. Reliably identifying the poor is a challenge when implementing such policies. In Tanzania, a scorecard system was established in 2011, within a programme providing free national health insurance fund (NHIF) cards, to identify poor pregnant women and their families, based on eight components. Using a series of reliability tests on a 2012 dataset of 2,621 households in two districts, this study compares household poverty levels using the scorecard, a wealth index, and monthly consumption expenditures. We compared the distributions of the three wealth measures, and the consistency of household poverty classification using cross-tabulations and the Kappa statistic. We measured errors of inclusion and exclusion of the scorecard relative to the other methods. We also gathered perceptions of the scorecard criteria through qualitative interviews with stakeholders at multiple levels of the health system. The distribution of the scorecard was less skewed than other wealth measures and not truncated, but demonstrated clumping. There was a higher level of agreement between the scorecard and the wealth index than consumption expenditure. The scorecard identified a similar number of poor households as the "basic needs" poverty line based on monthly consumption expenditure, with only 45 % errors of inclusion. However, it failed to pick up half of those living below the "basic needs" poverty line as being poor. Stakeholders supported the inclusion of water sources, income, food security and disability measures but had reservations about other items on the scorecard. In choosing poverty identification strategies for programmes seeking to enhance health equity it's necessary to balance between community acceptability, local relevance and the need for such a strategy. It is important to ensure the strategy is efficient and less costly than alternatives in order to effectively reduce

Medical education for equity in health: a participatory action research involving persons living in poverty and healthcare professionals.

PubMed

Hudon, Catherine; Loignon, Christine; Grabovschi, Cristina; Bush, Paula; Lambert, Mireille; Goulet, Émilie; Boyer, Sophie; De Laat, Marianne; Fournier, Nathalie

2016-04-12

Improving the knowledge and competencies of healthcare professionals is crucial to better address the specific needs of persons living in poverty and avoid stigmatization. This study aimed to explore the needs and expectations of persons living in poverty and healthcare professionals in terms of medical training regarding poverty and its effects on health and healthcare. We conducted a participatory action research study using photovoice, a method using photography, together with merging of knowledge and practice, an approach promoting dialogue between different sources of knowledge. Nineteen healthcare professionals and persons from an international community organization against poverty participated in the study. The first phase included 60 meetings and group sessions to identify the perceived barriers between persons living in poverty and healthcare teams. In the second phase, sub-committees deployed action plans in academic teaching units to overcome barriers identified in the first phase. Data were analysed through thematic analysis, using NVivo, in collaboration with five non-academic co-researchers. Four themes in regard to medical training were highlighted: improving medical students' and residents' knowledge on poverty and the living conditions of persons living in poverty; improving their understanding of the reality of those people; improving their relational skills pertaining to communication and interaction with persons living in poverty; improving their awareness and capacity for self-reflection. At the end of the second phase, actions were undertaken such as improving knowledge of the living conditions of persons living in poverty by posting social assistance rates, and tailoring interventions to patients' reality by including sociodemographic information in electronic medical records. Our findings also led to a participatory research project aiming to improve the skills and competency of residents and health professionals in regard to the quality of

76 FR 3637 - Annual Update of the HHS Poverty Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Annual Update of the HHS Poverty... update of the Department of Health and Human Services (HHS) poverty guidelines to account for last... program. For information about poverty figures for immigration forms, the Hill-Burton Uncompensated...

77 FR 4034 - Annual Update of the HHS Poverty Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Annual Update of the HHS Poverty... update of the Department of Health and Human Services (HHS) poverty guidelines to account for last... program. For information about poverty figures for immigration forms, the Hill-Burton Uncompensated...

78 FR 5182 - Annual Update of the HHS Poverty Guidelines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Annual Update of the HHS Poverty... update of the Department of Health and Human Services (HHS) poverty guidelines to account for last... program. For information about poverty figures for immigration forms, the Hill-Burton Uncompensated...

Child Poverty: Definition and Measurement.

PubMed

Short, Kathleen S

2016-04-01

This article provides a discussion of what we mean when we refer to 'child poverty.' Many images come to mind when we discuss child poverty, but when we try to measure and quantify the extent of child poverty, we often use a very narrow concept. In this article a variety of poverty measures that are used in the United States are described and some of the differences between those measures are illustrated. In this article 3 measures are explored in detail: a relative measure of poverty that is used more often in an international context, the official US poverty measure, and a new supplemental poverty measure (SPM). The new measure differs from the other 2 because it takes into account noncash benefits that are provided to poor families. These include nutrition assistance such as food stamps, subsidized housing, and home energy assistance. The SPM also takes account of necessary expenses that families face, such as taxes and expenses related to work and health care. Comparing estimates for 2012, the SPM showed lower poverty rates for children than the other 2 measures. Because noncash benefits help those in extreme poverty, there were also lower percentages of children in extreme poverty with resources below half the SPM threshold. These results suggest that 2 important measures of poverty, the relative measure used in international comparisons, and the official poverty measure, are not able to gauge the effect of government programs on the alleviation of poverty, and the SPM illustrates that noncash benefits do help families meet their basic needs. Published by Elsevier Inc.

A Developing Theology of Poverty and Health Applied to Nursing Education

ERIC Educational Resources Information Center

Cone, Pamela M. H.

2015-01-01

Throughout history, the issue of poverty has been a problem in society. In this article, examination of Hebrew and Greek words related to poverty throughout the Bible revealed descriptions of the various types and causes of poverty. Historical research uncovered writings on poverty by several early Church Fathers and influential Christian scholars…

Cigarette smoking and poverty in China.

PubMed

Liu, Yuanli; Rao, Keqin; Hu, Teh-Wei; Sun, Qi; Mao, Zhenzhong

2006-12-01

Drawing on the 1998 China national health services survey data, this study estimated the poverty impact of two smoking-related expenses: excessive medical spending attributable to smoking and direct spending on cigarettes. The excessive medical spending attributable to smoking is estimated using a regression model of medical expenditure with smoking status (current smoker, former smoker, never smoker) as part of the explanatory variables, controlling for people's demographic and socioeconomic characteristics. The poverty impact is measured by the changes in the poverty head count, after smoking-related expenses are subtracted from income. We found that the excessive medical spending attributable to smoking may have caused the poverty rate to increase by 1.5% for the urban population and by 0.7% for the rural population. To a greater magnitude, the poverty headcount in urban and rural areas increased by 6.4% and 1.9%, respectively, due to the direct household spending on cigarettes. Combined, the excessive medical spending attributable to smoking and consumption spending on cigarettes are estimated to be responsible for impoverishing 30.5 million urban residents and 23.7 million rural residents in China. Smoking related expenses pushed a significant proportion of low-income families into poverty in China. Therefore, reducing the smoking rate appears to be not only a public health strategy, but also a poverty reduction strategy.

Disparities in health, poverty, incarceration, and social justice among racial groups in the United States: a critical review of evidence of close links with neoliberalism.

PubMed

Nkansah-Amankra, Stephen; Agbanu, Samuel Kwami; Miller, Reuben Jonathan

2013-01-01

Problems of poverty, poor health, and incarceration are unevenly distributed among racial and ethnic minorities in the United States. We argue that this is due, in part, to the ascendance of United States-style neoliberalism, a prevailing political and economic doctrine that shapes social policy, including public health and anti-poverty intervention strategies. Public health research most often associates inequalities in health outcomes, poverty, and incarceration with individual and cultural risk factors. Contextual links to structural inequality and the neoliberal doctrine animating state-sanctioned interventions are given less attention. The interrelationships among these are not clear in the extant literature. Less is known about public health and incarceration. Thus, the authors describe the linkages between neoliberalism, public health, and criminal justice outcomes. We suggest that neoliberalism exacerbates racial disparities in health, poverty, and incarceration in the United States. We conclude by calling for a new direction in public health research that advances a pro-poor public health agenda to improve the general well-being of disadvantaged groups.

Global notes: counting the world's poor--how do we define poverty?

PubMed

Vidyasagar, D

2006-06-01

Health professionals are in constant interaction with parents and infants who are victims of poverty and poor socioeconomic status. But an important question remains: do we know how to define poverty? Defining poverty accurately is important as the definition is the basis of policy development. The definition of poverty has changed during the last quarter century. In addition to economic considerations, it is broadened to include other dimensions of life such as literacy, health and longevity. This article attempts to provide national and international definitions of poverty, the magnitude and effects of poverty.

Strategies to combat poverty and their interface with health promotion.

PubMed

dos Santos Oliveira, Simone Helena; Alves Monteiro, Maria Adelane; Vieira Lopes, Maria do Socorro; Silva de Brito, Daniele Mary; Vieira, Neiva Francenely Cunha; Barroso, Maria Grasiela Teixeira; Ximenes, Lorena Barbosa

2007-01-01

The population impoverishment is a social reality whose overcoming is necessary so that we can think about health as a positive concept. This study proposes a reflection on the coping strategies adopted by the Conjunto Palmeira, a Brazilian community in the Northeast, and their interface with health promotion. This community's reality is an example of overcoming social exclusion for different regions of Brazil and other countries. The history of the Conjunto and the collective strategies of empowerment for coping with poverty and search for human development are initially presented. After that, we establish the relationship of those strategies with the action fields for health promotion. Finally, we consider that the mutual responsibility of the community with its health and its relationship with the environment in which they live are means of promoting transformation towards the conquest of a worthy social space.

Overview of migration, poverty and health dynamics in Nairobi City's slum settlements.

PubMed

Zulu, Eliya M; Beguy, Donatien; Ezeh, Alex C; Bocquier, Philippe; Madise, Nyovani J; Cleland, John; Falkingham, Jane

2011-06-01

The Urbanization, Poverty, and Health Dynamics research program was designed to generate and provide the evidence base that would help governments, development partners, and other stakeholders understand how the urban slum context affects health outcomes in order to stimulate policy and action for uplifting the wellbeing of slum residents. The program was nested into the Nairobi Urban Health and Demographic Surveillance System, a uniquely rich longitudinal research platform, set up in Korogocho and Viwandani slum settlements in Nairobi city, Kenya. Findings provide rich insights on the context in which slum dwellers live and how poverty and migration status interacts with health issues over the life course. Contrary to popular opinions and beliefs that see slums as homogenous residential entities, the findings paint a picture of a highly dynamic and heterogeneous setting. While slum populations are highly mobile, about half of the population comprises relatively well doing long-term dwellers who have lived in slum settlements for over 10 years. The poor health outcomes that slum residents exhibit at all stages of the life course are rooted in three key characteristics of slum settlements: poor environmental conditions and infrastructure; limited access to services due to lack of income to pay for treatment and preventive services; and reliance on poor quality and mostly informal and unregulated health services that are not well suited to meeting the unique realities and health needs of slum dwellers. Consequently, policies and programs aimed at improving the wellbeing of slum dwellers should address comprehensively the underlying structural, economic, behavioral, and service-oriented barriers to good health and productive lives among slum residents.

Surveying the hidden attitudes of hospital nurses' towards poverty.

PubMed

Wittenauer, James; Ludwick, Ruth; Baughman, Kristin; Fishbein, Rebecca

2015-08-01

To explore the attitudes held by registered nurses about persons living in poverty. As a profession, nursing has strong commitment to advocating for the socioeconomically disadvantaged. The links among poverty and health disparities are well established and research demonstrates that attitudes of providers can influence how those in poverty use health services. Although nurses are the largest sector of healthcare providers globally, little research has been published on their attitudes towards patients they care for who live in poverty. Cross-sectional survey. Used a convenience sample of 117 registered nurses who completed the Attitudes Towards Poverty Short Form that contained three subscales. Regression analysis was used to examine the associations between the nurses' age, education, and years of experience, political views and financial security with their total score and subscale scores. Nurses were more likely to agree with stigmatising statements than statements that attributed poverty to personal deficiency or structural factors. In the multivariate analysis, years of experience were associated with more positive attitudes towards those living in poverty. Nurses with the most experience had less stigmatising beliefs about poverty and were more likely to endorse structural explanations. Those with a baccalaureate education were also more likely to endorse structural explanations for poverty. Gaining knowledge about attitudes towards and the factors influencing those attitudes, for example, education, are important in helping combat the disparities associated with poverty. Nurses have a duty to evaluate their individual attitudes and biases towards those living in poverty and how those attitudes and biases may influence daily practice. Assessing nurses' attitudes towards poverty may aid in better means of empowering nurses to seek solutions that will improve health conditions for those living in poverty. © 2015 John Wiley & Sons Ltd.

Poverty Reduction Begins with Children.

ERIC Educational Resources Information Center

United Nations Children's Fund, New York, NY.

This report describes how children bear the brunt of poverty and explains why they are central to poverty reduction in developing nations. The report also illustrates UNICEF's support for the process of improving access to, and quality of, health care, education, water and sanitation, and child protection. It describes how the participation of the…

Waging War on Poverty: Poverty Trends Using a Historical Supplemental Poverty Measure

PubMed Central

Fox, Liana E.; Wimer, Christopher; Garfinkel, Irwin; Kaushal, Neeraj; Waldfogel, Jane

2015-01-01

Using data from the Consumer Expenditure Survey and the March Current Population Survey, we provide poverty estimates for 1967 to 2012 based on a historical Supplemental Poverty Measure (SPM). During this period, poverty, as officially measured, has stagnated. However, the official poverty measure (OPM) does not account for the effect of near-cash transfers on the financial resources available to families, an important omission since such transfers have become an increasingly important part of government anti-poverty policy. Applying the historical SPM, which does count such transfers, we find that trends in poverty have been more favorable than the OPM suggests and that government policies have played an important and growing role in reducing poverty—a role that is not evident when the OPM is used to assess poverty. We also find that government programs have played a particularly important role in alleviating child poverty and deep poverty, especially during economic downturns. PMID:26347369

The role of poverty in explaining health variations in 7-year-old children from different family structures: findings from the UK Millennium Cohort Study.

PubMed

Pearce, Anna; Lewis, Hannah; Law, Catherine

2013-02-01

Despite rises in reconstituted and lone-parent families, relatively little is known about how the health of children in different family types varies, and the extent to which any differences might be explained by poverty. The authors examined this using cross-sectional data on 13 681 seven-year-olds from the Millennium Cohort Study. The authors estimated RRs and 95% CIs for having poor physical (general health, long-standing illness, injury, overweight, asthma, fits) and mental health (using strengths and difficulties scores) according to family structure using Poisson regression. The authors adjusted for confounders (aRR) and then investigated the role of poverty as a mediator by entering a poverty score (based on income, receipt of benefits, subjective poverty and material deprivation) into the main model. Children living in reconstituted and lone-parent families were at a slight increased risk of poor health compared with those living with two natural parents. Adjusting for poverty tended to remove the elevated risk of poor physical health in children living in lone-parent and reconstituted families. However, for the mental health outcomes, poverty tended to remove the elevated risk for lone parents but not for reconstituted families. For example, the aRR for borderline-abnormal total difficulties fell from 1.45 (1.22 to 1.72) to 1.34 (1.13 to 1.59) in children living in reconstituted families and from 1.29 (1.14 to 1.45) to 1.05 (0.92 to 1.19) in those living with lone parents. Poor physical and mental health was slightly more prevalent in children living in lone-parent or reconstituted families. Poverty reduction may help to reduce these differences, especially for children living with lone parents; however, alternative mechanisms should be also explored, particularly for children living in reconstituted families.

Ontario's Poverty Reduction Strategy: A Critical Discourse Analysis.

PubMed

Benbow, Sarah; Gorlick, Carolyne; Forchuk, Cheryl; Ward-Griffin, Catherine; Berman, Helene

2016-01-01

This article overviews the second phase of a two-phase study which examined experiences of health and social exclusion among mothers experiencing homelessness in Ontario, Canada. A critical discourse analysis was employed to analyze the policy document, Realizing Our Potential: Ontario's Poverty Reduction Strategy, 2014-2019. In nursing, analysis of policy is an emerging form of scholarship, one that draws attention to the macro levels influencing health and health promotion, such as the social determinants of health, and the policies that impact them. The clear neo-liberal underpinnings, within the strategy, with a focus on productivity and labor market participation leave little room for an understanding of poverty reduction from a human rights perspective. Further, gender-neutrality rendered the poverty experienced by women, and mothers, invisible. Notably, there were a lack of deadlines, target dates, and thorough action and evaluation plans. Such absence troubles whether poverty reduction is truly a priority for the government, and society as a whole.

Differential Effects of Social Networks on Mammography Use by Poverty Status.

PubMed

Yeo, Younsook

2016-01-01

This study examines whether social networks have differential effects on mammography use depending on poverty status. Data were analyzed on US women (40+), employing logistic regression and simple slope analyses for a post hoc probing of moderating effects. Among women not in poverty, living with a spouse/partner and attending church, regardless of frequency, were positively associated with mammography use; family size was negatively associated. Among women living in poverty, mammography showed a positive association only with weekly church attendance. Mammography was negatively associated with health-related social interactions occurring through the Internet. Post hoc probing showed significant moderating effects of poverty on the relationship between online health-related interactions and mammography use. To make the Internet a meaningful health empowerment tool for women in poverty, future research should identify how health-related interactions that occur online affect women in poverty's psychological and behavioral reactions that will contribute to our understanding of why they are discouraged from having mammograms. The mechanisms behind the differential effects of church attendance and poverty status on mammography also need further clarification.

Collaborative youth mental health service users, immigration, poverty, and family environment.

PubMed

Nadeau, Lucie; Lecompte, Vanessa; Johnson-Lafleur, Janique; Pontbriand, Annie; Rousseau, Cécile

2018-05-01

This article examines the association between immigration, poverty and family environment, and the emotional and behavioral problems reported by youth and their family receiving mental health (MH) services within a collaborative care model in a multiethnic neighborhood. Participants in this study were 140 parent-child dyads that are part of an ongoing longitudinal project looking at the association between individual, familial, social and organizational factors, and outcomes of youth receiving MH services in local health and social service organizations in the Montreal area. Measures included in this study were collected at the initial phase of the longitudinal project (Time 0). Parents completed a sociodemographic questionnaire and the Family Environment Scale (FES), and both parents and children completed the Strength and Difficulties questionnaire (SDQ). Results suggest that the family environment, especially family conflicts, has a significant role in the MH problems of children seeking help in collaborative MH services. In this specific population, results also show a trend, but not a statistically significant association, between poverty or immigration and emotional and behavioral problems. They suggest as well that boys show more MH problems, although this could be a contamination effect (parents' perspective). The results support the importance of interventions that not only target the child symptomatology but also address family dynamics, especially conflicts. Collaborative care models may be particularly well suited to allow for a coherent consideration of family environmental factors in youth mental health and to support primary care settings in addressing these issues.

Poverty, health infrastructure and the nutrition of Peruvian children.

PubMed

Valdivia, Martín

2004-12-01

This paper offers empirical evidence on the impact of the expansion in health infrastructure of the 1990s upon child nutrition in Peru, as measured by the height for age z-score. Using a pooled sample of three rounds of the Peruvian DHS, I have controlled for biases in the allocation of public investments by using a district fixed effects model. The econometric analysis shows a positive effect of the expansion of the last decade in urban areas, but not in rural areas. Furthermore, the effect for urban children is highly non-linear and has a pro-poor bias, in the sense that the estimated effect is larger for children of less educated mothers. These findings support the idea that reducing distance and waiting time barriers is necessary to improve child health and nutrition in developing countries, but that we need more explicitly inclusive policies to improve the health of the rural poor, especially indigenous groups, that are caught in this type of poverty trap.

The GP's perception of poverty: a qualitative study.

PubMed

Willems, Sara J; Swinnen, Wilfried; De Maeseneer, Jan M

2005-04-01

Health differences between people from lower and higher social classes increase. The accessibility of the health care system is one of the multiple and complex causes. The Physician's perceptions, beliefs and attitudes towards the patient are in this context important determinants. To explore the general practitioners' definition of poverty and their perception of the deprived patients' attitude towards health and health care, to get insight into the ways general practitioners deal with the problem of poverty and to present the proposals general practitioners make to improve health care for the deprived. The study involved qualitative methodology using 21 semi-structured interviews. The interviews were recorded and transcribed verbatim. The transcripts were coded using Framework Analysis techniques. Interviews were undertaken with general practitioners in primary care, working in a deprived area in the city of Ghent. In the definition of poverty, three concepts can be identified: socioeconomic aspects, psychological and individual characteristics, and socio-cultural concepts. General practitioners adopt different types of approaches to deal with deprived patients in practice: adaptation of the doctor-patient communication, lowering of the financial threshold, referral to specialists and other health care professionals. Including the issue of poverty and poverty in the curriculum of the medical students and in the in-service training for practicing doctors could have a positive impact on their attitude towards this patient group. Further research is needed into the barriers in the accessibility of the health care system for the deprived, exploring qualitatively and quantitatively the experiences and the living conditions of deprived patients and the perceptions of health care providers.

Ninez y Pobreza (Childhood and Poverty).

ERIC Educational Resources Information Center

Didonet, Vital

1992-01-01

Reviews data on child poverty worldwide, providing statistics on 20 poverty-related problems. Examines effects of economic factors (i.e., unemployment, wage stagnation, inflation, and internal migration) and political policies (i.e., military spending over health and education) on child well-being, arguing that families and children themselves…

Poverty, Education and Health in Indonesia: Who Benefits from Public Spending? Working Paper.

ERIC Educational Resources Information Center

Lanjouw, Peter; Pradhan, Menno; Saadah, Fadia; Sayed, Haneen; Sparrow, Robert

This paper focuses on two important dimensions of Indonesia's development record: education and health. The paper investigates the extent to which the poor benefit from public and private provisioning of these services. Multiple rounds of annual household surveys document a reversal in the rate of decline in poverty and a slowdown in improvements…

Beyond the cross-sectional: neighborhood poverty histories and preterm birth.

PubMed

Margerison-Zilko, Claire; Cubbin, Catherine; Jun, Jina; Marchi, Kristen; Fingar, Kathryn; Braveman, Paula

2015-06-01

We examined associations between longitudinal neighborhood poverty trajectories and preterm birth (PTB). Using data from the Neighborhood Change Database (1970-2000) and the American Community Survey (2005-2009), we categorized longitudinal trajectories of poverty for California neighborhoods (i.e., census tracts). Birth data included 23 291 singleton California births from the Maternal and Infant Health Assessment (2003-2009). We estimated associations (adjusted for individual-level covariates) between PTB and longitudinal poverty trajectories and compared these to associations using traditional, cross-sectional measures of poverty. Compared to neighborhoods with long-term low poverty, those with long-term high poverty and those that experienced increasing poverty early in the study period had 41% and 37% increased odds of PTB (95% confidence interval [CI] = 1.18, 1.69 and 1.09, 1.72, respectively). High (compared with low) cross-sectional neighborhood poverty was not associated with PTB (odds ratio = 1.08; 95% CI = 0.91, 1.28). Neighborhood poverty histories may contribute to an understanding of perinatal health and should be considered in future research.

Poverty and Internalizing Symptoms: The Indirect Effect of Middle Childhood Poverty on Internalizing Symptoms via an Emotional Response Inhibition Pathway.

PubMed

Capistrano, Christian G; Bianco, Hannah; Kim, Pilyoung

2016-01-01

Childhood poverty is a pervasive problem that can alter mental health outcomes. Children from impoverished circumstances are more likely than their middle-income counterparts to develop internalizing problems such as depression and anxiety. To date, however, the emotional-cognitive control processes that link childhood poverty and internalizing symptoms remain largely unexplored. Using the Emotion Go/NoGo paradigm, we examined the association between poverty and emotional response inhibition in middle childhood. We further examined the role of emotional response inhibition in the link between middle childhood poverty and internalizing symptoms. Lower income was associated with emotional response inhibition difficulties (indexed by greater false alarm rates in the context of task irrelevant angry and sad faces). Furthermore, emotional response inhibition deficits in the context of angry and sad distracters were further associated with child-report internalizing problems. The results of the current study demonstrate the significance of understanding the emotional-cognitive control vulnerabilities of children raised in poverty and their association with mental health outcomes.

Independent and combined influence of homeownership, occupation, education, income, and community poverty on physical health in persons with arthritis.

PubMed

Callahan, Leigh F; Martin, Kathryn Remmes; Shreffler, Jack; Kumar, Deepak; Schoster, Britta; Kaufman, Jay S; Schwartz, Todd A

2011-05-01

To examine the independent and combined influence of individual- and community-level socioeconomic status (SES) measures on physical health status outcomes in people with self-reported arthritis. From 2004-2005, 968 participants completed a telephone survey assessing health status, chronic conditions, community characteristics, and sociodemographic variables. Individual-level SES measures used included homeownership, occupation (professional or not), educational attainment (less than high school, high school degree, and more than high school), and income (<$15,000, $15,000-$45,000, and >$45,000). Community poverty (2000 US Census block group percentage of individuals living below the poverty line [low, medium, and high]) was used as a community-level SES measure. Outcomes were physical functioning (Medical Outcomes Study Short Form 12 version 2 physical component summary [PCS]), functional disability (Health Assessment Questionnaire [HAQ]), and the Centers for Disease Control and Prevention (CDC) Health-Related Quality of Life (HRQOL) Healthy Days physical and limited activity days, and were analyzed via multivariable regressions. When entered separately, all individual-level SES variables were significantly (P < 0.01) associated with poorer PCS, HAQ, and CDC HRQOL scores. A higher magnitude of effect was seen for household income, specifically <$15,000 per year in final models with all 4 individual SES measures and community poverty. The magnitude of effect for education is reduced and marginally significant for the PCS and number of physically unhealthy days. No effects were seen for occupation, homeownership, and community poverty. Findings confirm that after adjusting for important covariates, lower individual- and community-level SES measures are associated with poorer physical health outcomes, while household income is the strongest predictor (as measured by both significance and effect) of poorer health status in final models. Studies not having participant

Where You Live Matters: Localising Environmental Impacts on Health, Nutrition and Poverty in Cambodia Using Small Area Estimation Techniques

NASA Astrophysics Data System (ADS)

Nilsen, K.; van Soesbergen, A.; Matthews, Z.

2016-12-01

Socioeconomic development depends on local environments. However, the scientific evidence quantifying the impact of environmental factors on health, nutrition and poverty at subnational levels is limited. This is because socioeconomic indicators are derived from sample surveys representative only at aggregate levels compared to environmental variables mostly available in high-resolution grids. Cambodia was selected because of its commitment to development in the context of a rapidly deteriorating environment. Having made considerable progress since 2005, access to health services is limited, a quarter of the population is still poor and 40% rural children are malnourished. Cambodia is also facing considerable environmental challenges including high deforestation rates, land degradation and natural hazards. Addressing existing gaps in the knowledge of environmental impacts on health and livelihoods, this study applies small area estimation (SAE) to quantify health, nutritional and poverty outcomes in the context of local environments. SAE produces reliable subnational estimates of socioeconomic outcomes available only from sample surveys by combining them with information from auxiliary sources (census). A model is used to explain common trades across areas and a random effect structure is applied to explain the observed extra heterogeneity. SAE models predicting health, nutrition and poverty outcomes excluding and including contextual environmental variables on natural hazards vulnerability, forest cover, climate, and agricultural production are compared. Results are mapped at regional and district levels to spatially assess the impacts of environmental variation on the outcomes. Inter and intra-regional inequalities are also estimated to examine the efficacy of health/socioeconomic policy targeting based on geographic location. Preliminary results suggest that localised environmental factors have considerable impacts on the indicators estimated and should

Poverty, global health, and infectious disease: lessons from Haiti and Rwanda.

PubMed

Alsan, Marcella M; Westerhaus, Michael; Herce, Michael; Nakashima, Koji; Farmer, Paul E

2011-09-01

Poverty and infectious diseases interact in complex ways. Casting destitution as intractable, or epidemics that afflict the poor as accidental, erroneously exonerates us from responsibility for caring for those most in need. Adequately addressing communicable diseases requires a biosocial appreciation of the structural forces that shape disease patterns. Most health interventions in resource-poor settings could garner support based on cost/benefit ratios with appropriately lengthy time horizons to capture the return on health investments and an adequate accounting of externalities; however, such a calculus masks the suffering of inaction and risks eroding the most powerful incentive to act: redressing inequality. Copyright © 2011 Elsevier Inc. All rights reserved.

Five Evils: Multidimensional Poverty and Race in America

ERIC Educational Resources Information Center

Reeves, Richard; Rodrigue, Edward; Kneebone, Elizabeth

2016-01-01

Poverty is about a lack of money, but it's not only about that. As a lived experience, poverty is also characterized by ill health, insecurity, discomfort, isolation, and more. To put it another way: Poverty is multidimensional, and its dimensions often cluster together to intensify the negative effects of being poor. In this first of a two-part…

Adolescent Coping with Poverty-Related Stress

ERIC Educational Resources Information Center

Wadsworth, Martha E.; Wolff, Brian; Santiago, Catherine DeCarlo; Moran, Erica G.

2008-01-01

Adolescents living in poverty face numerous stressors that are toxic for their mental health and well-being. There are effective strategies for coping with poverty-related stress that have been shown to reduce psychological symptoms in the face of this stress. However, stress itself weakens an adolescent's ability to use these cognitively…

Paying attention to gender and poverty in health research: content and process issues.

PubMed Central

Ostlin, Piroska; Sen, Gita; George, Asha

2004-01-01

Despite the magnitude of the problem of health inequity within and between countries, little systematic research has been done on the social causes of ill-health. Health researchers have overwhelmingly focused on biomedical research at the level of individuals. Investigations into the health of groups and the determinants of health inequities that lie outside the control of the individual have received a much smaller share of research resources. Ignoring factors such as socioeconomic class, race and gender leads to biases in both the content and process of research. We use two such factors--poverty and gender--to illustrate how this occurs. There is a systematic imbalance in medical journals: research into diseases that predominate in the poorest regions of the world is less likely to be published. In addition, the slow recognition of women's health problems, misdirected and partial approaches to understanding women's and men's health, and the dearth of information on how gender interacts with other social determinants continue to limit the content of health research. In the research community these imbalances in content are linked to biases against researchers from poorer regions and women. Researchers from high-income countries benefit from better funding and infrastructure. Their publications dominate journals and citations, and these researchers also dominate advisory boards. The way to move forward is to correct biases against poverty and gender in research content and processes and provide increased funding and better career incentives to support equity-linked research. Journals need to address equity concerns in their published content and in the publishing process. Efforts to broaden access to research information need to be well resourced, publicized and expanded. PMID:15643794

75 FR 3734 - 2009 HHS Poverty Guidelines Extended Until March 1, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-22

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary 2009 HHS Poverty Guidelines... 2009 Department of Health and Human Services (HHS) poverty guidelines will remain in effect until updated 2010 poverty guidelines are published, which shall not take place before March 1, 2010. DATES...

Social welfare matters: a realist review of when, how, and why unemployment insurance impacts poverty and health.

PubMed

O'Campo, Patricia; Molnar, Agnes; Ng, Edwin; Renahy, Emilie; Mitchell, Christiane; Shankardass, Ketan; St John, Alexander; Bambra, Clare; Muntaner, Carles

2015-05-01

The recent global recession and concurrent rise in job loss makes unemployment insurance (UI) increasingly important to smooth patterns of consumption and keep households from experiencing extreme material poverty. In this paper, we undertake a realist review to produce a critical understanding of how and why UI policies impact on poverty and health in different welfare state contexts between 2000 and 2013. We relied on literature and expert interviews to generate an initial theory and set of propositions about how UI might alleviate poverty and mental distress. We then systematically located and synthesized peer-review studies to glean supportive or contradictory evidence for our initial propositions. Poverty and psychological distress, among unemployed and even the employed, are impacted by generosity of UI in terms of eligibility, duration and wage replacement levels. Though unemployment benefits are not intended to compensate fully for a loss of earnings, generous UI programs can moderate harmful consequences of unemployment. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Disparities in diabetes: the nexus of race, poverty, and place.

PubMed

Gaskin, Darrell J; Thorpe, Roland J; McGinty, Emma E; Bower, Kelly; Rohde, Charles; Young, J Hunter; LaVeist, Thomas A; Dubay, Lisa

2014-11-01

We sought to determine the role of neighborhood poverty and racial composition on race disparities in diabetes prevalence. We used data from the 1999-2004 National Health and Nutrition Examination Survey and 2000 US Census to estimate the impact of individual race and poverty and neighborhood racial composition and poverty concentration on the odds of having diabetes. We found a race-poverty-place gradient for diabetes prevalence for Blacks and poor Whites. The odds of having diabetes were higher for Blacks than for Whites. Individual poverty increased the odds of having diabetes for both Whites and Blacks. Living in a poor neighborhood increased the odds of having diabetes for Blacks and poor Whites. To address race disparities in diabetes, policymakers should address problems created by concentrated poverty (e.g., lack of access to reasonably priced fruits and vegetables, recreational facilities, and health care services; high crime rates; and greater exposures to environmental toxins). Housing and development policies in urban areas should avoid creating high-poverty neighborhoods.

Poverty, food security and universal access to sexual and reproductive health services: a call for cross-movement advocacy against neoliberal globalisation.

PubMed

Sundari Ravindran, T K

2014-05-01

Universal access to sexual and reproductive health services is one of the goals of the International Conference on Population and Development of 1994. The Millennium Development Goals were intended above all to end poverty. Universal access to health and health services are among the goals being considered for the post-2015 agenda, replacing or augmenting the MDGs. Yet we are not only far from reaching any of these goals but also appear to have lost our way somewhere along the line. Poverty and lack of food security have, through their multiple linkages to health and access to health care, deterred progress towards universal access to health services, including for sexual and reproductive health needs. A more insidious influence is neoliberal globalisation. This paper describes neoliberal globalisation and the economic policies it has engendered, the ways in which it influences poverty and food security, and the often unequal impact it has had on women as compared to men. It explores the effects of neoliberal economic policies on health, health systems, and universal access to health care services, and the implications for access to sexual and reproductive health. To be an advocate for universal access to health and health care is to become an advocate against neoliberal globalisation. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Beyond the Cross-Sectional: Neighborhood Poverty Histories and Preterm Birth

PubMed Central

Margerison-Zilko, Claire; Jun, Jina; Marchi, Kristen; Fingar, Kathryn; Braveman, Paula

2015-01-01

Objectives. We examined associations between longitudinal neighborhood poverty trajectories and preterm birth (PTB). Methods. Using data from the Neighborhood Change Database (1970–2000) and the American Community Survey (2005–2009), we categorized longitudinal trajectories of poverty for California neighborhoods (i.e., census tracts). Birth data included 23 291 singleton California births from the Maternal and Infant Health Assessment (2003–2009). We estimated associations (adjusted for individual-level covariates) between PTB and longitudinal poverty trajectories and compared these to associations using traditional, cross-sectional measures of poverty. Results. Compared to neighborhoods with long-term low poverty, those with long-term high poverty and those that experienced increasing poverty early in the study period had 41% and 37% increased odds of PTB (95% confidence interval [CI] = 1.18, 1.69 and 1.09, 1.72, respectively). High (compared with low) cross-sectional neighborhood poverty was not associated with PTB (odds ratio = 1.08; 95% CI = 0.91, 1.28). Conclusions. Neighborhood poverty histories may contribute to an understanding of perinatal health and should be considered in future research. PMID:25880941

Health-Seeking Behaviour towards Poverty-Related Disease (PRDs): A Qualitative Study of People Living in Camps and on Campuses in Cameroon.

PubMed

Makoge, Valerie; Maat, Harro; Vaandrager, Lenneke; Koelen, Maria

2017-01-01

Poverty-Related Diseases (PRDs) emphasize poverty as a 'breeding-ground' for a range of diseases. The study presented here starts from the premise that poverty is a general condition that can limit people's capacity to prevent, mitigate or treat diseases. Using an interpretation of health seeking behaviour (HSB), inspired by the salutogenic approach, we investigated how people deal with PRDs, their ability and strategies put in place to cope. We collected HSB data from two groups of respondents in Cameroon: labourers of the Cameroon Development Corporation (CDC) living in settlements called camps and students of the state universities of Buea and Yaoundé living in settlements we refer to as campuses. By selecting these groups, the study offers a unique view of how different people cope with similar health challenges. We carried out semi-structured interviews with 21 camp dwellers and 21 students in a cross-sectional study. Our findings revealed 1) respondents use multiple resources to cope with PRDs. 2) Respondents' perceptions of diseases and connection with poverty closely ties to general hygienic conditions of their living environment. 3) Utilisation of health facilities is not strongly dependent on financial resources. 4) Volatile health facilities are a major challenge and reason for people to revert to other health resources. The study brings out the need for organisations (governmental and non-governmental) to strengthen people's capacities to cope with health situations through better health and housing policies geared at incorporating practices currently used by the people and supporting pro-hygienic initiatives.

Health-Seeking Behaviour towards Poverty-Related Disease (PRDs): A Qualitative Study of People Living in Camps and on Campuses in Cameroon

PubMed Central

Maat, Harro; Vaandrager, Lenneke; Koelen, Maria

2017-01-01

Poverty-Related Diseases (PRDs) emphasize poverty as a ‘breeding-ground’ for a range of diseases. The study presented here starts from the premise that poverty is a general condition that can limit people’s capacity to prevent, mitigate or treat diseases. Using an interpretation of health seeking behaviour (HSB), inspired by the salutogenic approach, we investigated how people deal with PRDs, their ability and strategies put in place to cope. We collected HSB data from two groups of respondents in Cameroon: labourers of the Cameroon Development Corporation (CDC) living in settlements called camps and students of the state universities of Buea and Yaoundé living in settlements we refer to as campuses. By selecting these groups, the study offers a unique view of how different people cope with similar health challenges. We carried out semi-structured interviews with 21 camp dwellers and 21 students in a cross-sectional study. Our findings revealed 1) respondents use multiple resources to cope with PRDs. 2) Respondents’ perceptions of diseases and connection with poverty closely ties to general hygienic conditions of their living environment. 3) Utilisation of health facilities is not strongly dependent on financial resources. 4) Volatile health facilities are a major challenge and reason for people to revert to other health resources. The study brings out the need for organisations (governmental and non-governmental) to strengthen people’s capacities to cope with health situations through better health and housing policies geared at incorporating practices currently used by the people and supporting pro-hygienic initiatives. PMID:28052068

Addressing Child Poverty: How Does the United States Compare With Other Nations?

PubMed

Smeeding, Timothy; Thévenot, Céline

2016-04-01

Poverty during childhood raises a number of policy challenges. The earliest years are critical in terms of future cognitive and emotional development and early health outcomes, and have long-lasting consequences on future health. In this article child poverty in the United States is compared with a set of other developed countries. To the surprise of few, results show that child poverty is high in the United States. But why is poverty so much higher in the United States than in other rich nations? Among child poverty drivers, household composition and parent's labor market participation matter a great deal. But these are not insurmountable problems. Many of these disadvantages can be overcome by appropriate public policies. For example, single mothers have a very high probability of poverty in the United States, but this is not the case in other countries where the provision of work support increases mothers' labor earnings and together with strong public cash support effectively reduces child poverty. In this article we focus on the role and design of public expenditure to understand the functioning of the different national systems and highlight ways for improvements to reduce child poverty in the United States. We compare relative child poverty in the United States with poverty in a set of selected countries. The takeaway is that the United States underinvests in its children and their families and in so doing this leads to high child poverty and poor health and educational outcomes. If a nation like the United States wants to decrease poverty and improve health and life chances for poor children, it must support parental employment and incomes, and invest in children's futures as do other similar nations with less child poverty. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Effects of poverty and lack of insurance on perceptions of racial and ethnic bias in health care.

PubMed

Stepanikova, Irena; Cook, Karen S

2008-06-01

To investigate whether poverty and lack of insurance are associated with perceived racial and ethnic bias in health care. 2001 Survey on Disparities in Quality of Health Care, a nationally representative telephone survey. We use data on black, Hispanic, and white adults who have a regular physician (N=4,556). We estimate multivariate logistic regression models to examine the effects of poverty and lack of health insurance on perceived racial and ethnic bias in health care for all respondents and by racial, ethnic, and language groups. Controlling for sociodemographic and other factors, uninsured blacks and Hispanics interviewed in English are more likely to report racial and ethnic bias in health care compared with their privately insured counterparts. Poor whites are more likely to report racial and ethnic bias in health care compared with other whites. Good physician-patient communication is negatively associated with perceived racial and ethnic bias. Compared with their more socioeconomically advantaged counterparts, poor whites, uninsured blacks, and some uninsured Hispanics are more likely to perceive that racial and ethnic bias operates in the health care they receive. Providing health insurance for the uninsured may help reduce this perceived bias among some minority groups.

Using a community-based definition of poverty for targeting poor households for premium subsidies in the context of a community health insurance in Burkina Faso.

PubMed

Savadogo, Germain; Souarès, Aurelia; Sié, Ali; Parmar, Divya; Bibeau, Gilles; Sauerborn, Rainer

2015-02-06

One of the biggest challenges in subsidizing premiums of poor households for community health insurance is the identification and selection of these households. Generally, poverty assessments in developing countries are based on monetary terms. The household is regarded as poor if its income or consumption is lower than a predefined poverty cut-off. These measures fail to recognize the multi-dimensional character of poverty, ignoring community members' perception and understanding of poverty, leaving them voiceless and powerless in the identification process. Realizing this, the steering committee of Nouna's health insurance devised a method to involve community members to better define 'perceived' poverty, using this as a key element for the poor selection. The community-identified poor were then used to effectively target premium subsidies for the insurance scheme. The study was conducted in the Nouna's Health District located in northwest Burkina Faso. Participants in each village were selected to take part in focus-group discussions (FGD) organized in 41 villages and 7 sectors of Nouna's town to discuss criteria and perceptions of poverty. The discussions were audio recorded, transcribed and analyzed in French using the software NVivo 9. From the FGD on poverty and the subjective definitions and perceptions of the community members, we found that poverty was mainly seen as scarcity of basic needs, vulnerability, deprivation of capacities, powerlessness, voicelessness, indecent living conditions, and absence of social capital and community networks for support in times of need. Criteria and poverty groups as described by community members can be used to identify poor who can then be targeted for subsidies. Policies targeting the poorest require the establishment of effective selection strategies. These policies are well-conditioned by proper identification of the poor people. Community perceptions and criteria of poverty are grounded in reality, to better

Reconsidering the effects of poverty and social support on health: a 5-year longitudinal test of the stress-buffering hypothesis.

PubMed

Moskowitz, David; Vittinghoff, Eric; Schmidt, Laura

2013-02-01

Prior research in the general population has found that social support can buffer the adverse effects of stressors on health. However, both stressors and social support may be qualitatively different for those living in urban poverty. We examined the effects of social support and poverty-specific stressors on self-rated health. We used data from the Welfare Client Longitudinal Survey (WCLS), a 5-year longitudinal study of 718 public aid recipients. We measured received social support and "net social support," defined as the difference between support received and that given to others. We used restricted cubic splines to model the stress-buffering effects of social support on self-rated health as a function of stressful life events and neighborhood disorder. Increased exposure to stressors was associated with poorer self-rated health. Evidence of stress buffering was confined to those with the heaviest exposure to stressors, and its effects decreased across increasing levels of social support. Analyses using net social support had generally more modest effects than those using received social support. Social support does not buffer the effects of stressors on health uniformly for individuals living in conditions of urban poverty. Researchers and policymakers should be cautious in overestimating the beneficial effects that social support may have on health for marginalized populations.

Cross-temporal and cross-national poverty and mortality rates among developed countries.

PubMed

Fritzell, Johan; Kangas, Olli; Bacchus Hertzman, Jennie; Blomgren, Jenni; Hiilamo, Heikki

2013-01-01

A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes.

Cross-Temporal and Cross-National Poverty and Mortality Rates among Developed Countries

PubMed Central

Fritzell, Johan; Kangas, Olli; Bacchus Hertzman, Jennie; Blomgren, Jenni; Hiilamo, Heikki

2013-01-01

A prime objective of welfare state activities is to take action to enhance population health and to decrease mortality risks. For several centuries, poverty has been seen as a key social risk factor in these respects. Consequently, the fight against poverty has historically been at the forefront of public health and social policy. The relationship between relative poverty rates and population health indicators is less self-evident, notwithstanding the obvious similarity to the debated topic of the relationship between population health and income inequality. In this study we undertake a comparative analysis of the relationship between relative poverty and mortality across 26 countries over time, with pooled cross-sectional time series analysis. We utilize data from the Luxembourg Income Study to construct age-specific poverty rates across countries and time covering the period from around 1980 to 2005, merged with data on age- and gender-specific mortality data from the Human Mortality Database. Our results suggest not only an impact of relative poverty but also clear differences by welfare regime that partly goes beyond the well-known differences in poverty rates between welfare regimes. PMID:23840235

The Bangladesh paradox: exceptional health achievement despite economic poverty.

PubMed

Chowdhury, A Mushtaque R; Bhuiya, Abbas; Chowdhury, Mahbub Elahi; Rasheed, Sabrina; Hussain, Zakir; Chen, Lincoln C

2013-11-23

Bangladesh, the eighth most populous country in the world with about 153 million people, has recently been applauded as an exceptional health performer. In the first paper in this Series, we present evidence to show that Bangladesh has achieved substantial health advances, but the country's success cannot be captured simplistically because health in Bangladesh has the paradox of steep and sustained reductions in birth rate and mortality alongside continued burdens of morbidity. Exceptional performance might be attributed to a pluralistic health system that has many stakeholders pursuing women-centred, gender-equity-oriented, highly focused health programmes in family planning, immunisation, oral rehydration therapy, maternal and child health, tuberculosis, vitamin A supplementation, and other activities, through the work of widely deployed community health workers reaching all households. Government and non-governmental organisations have pioneered many innovations that have been scaled up nationally. However, these remarkable achievements in equity and coverage are counterbalanced by the persistence of child and maternal malnutrition and the low use of maternity-related services. The Bangladesh paradox shows the net outcome of successful direct health action in both positive and negative social determinants of health--ie, positives such as women's empowerment, widespread education, and mitigation of the effect of natural disasters; and negatives such as low gross domestic product, pervasive poverty, and the persistence of income inequality. Bangladesh offers lessons such as how gender equity can improve health outcomes, how health innovations can be scaled up, and how direct health interventions can partly overcome socioeconomic constraints. Copyright © 2013 Elsevier Ltd. All rights reserved.

Poverty, Trauma, and Infant Mental Health

ERIC Educational Resources Information Center

Lieberman, Alicia F.; Osofsky, Joy D.

2009-01-01

Young children growing up in poverty face chronic risk factors, including abuse and neglect, severe maternal depression, parental substance abuse, harsh parenting, and family and community violence as well as greater exposure to physical risks, including substandard housing, lack of access to resources, and environmental toxins. The authors offer…

The measurement of poverty in psychiatric epidemiology in LMICs: critical review and recommendations.

PubMed

Cooper, Sara; Lund, Crick; Kakuma, Ritsuko

2012-09-01

Studies exploring the relationship between poverty and mental health in low and middle income countries (LMICs) have produced somewhat conflicting results. This has partly been attributed to poorly operationalized and oversimplified poverty measures. This paper has two aims: (1) to review how socio-economic outcomes in psychiatric epidemiology in LMICs are measured; (2) based on this review, to provide a set of generic recommendations for measuring poverty in psychiatric epidemiology in LMIC. This is relevant for mental health researchers, and for practitioners and policy makers who use mental health research findings. This review was part of a broader systematic review examining the association between poverty and mental illness. An analytic framework was developed to examine the definition and measurement of poverty in these studies. The majority of studies provided no definition for the concept of poverty being used, and very few measured poverty through standardized or validated methods. Many poverty indicators were broken down into extremely open-ended and vague categories, with no details on how the parameters were defined or derived, and no documentation of the time period and unit of analysis for which the poverty variable was measured. This review revealed that using poverty as an indicator in mental health research in LMIC is still in its infancy, with much room for improvement. The implications of poor measurement of poverty in psychiatric epidemiology are discussed. The recommendations provided will hopefully help researchers in psychiatric epidemiology use the concept of poverty in a much more critical, systematic and appropriate manner.

Multidimensional Poverty in China: Findings Based on the CHNS

ERIC Educational Resources Information Center

Yu, Jiantuo

2013-01-01

This paper estimates multidimensional poverty in China by applying the Alkire-Foster methodology to the China Health and Nutrition Survey 2000-2009 data. Five dimensions are included: income, living standard, education, health and social security. Results suggest that rapid economic growth has resulted not only in a reduction in income poverty but…

Child poverty and changes in child poverty.

PubMed

Chen, Wen-Hao; Corak, Miles

2008-08-01

This article offers a cross-country overview of child poverty, changes in child poverty, and the impact of public policy in North America and Europe. Levels and changes in child poverty rates in 12 Organisation for Economic Co-operation and Development (OECD) countries during the 1990s are documented using data from the Luxembourg Income Study project, and a decomposition analysis is used to uncover the relative role of demographic factors, labor markets, and income transfers from the state in determining the magnitude and direction of the changes. Child poverty rates fell noticeably in only three countries and rose in three others. In no country were demographic factors a force for higher child poverty rates, but these factors were also limited in their ability to cushion children from adverse shocks originating in the labor market or the government sector. Increases in the labor market engagement of mothers consistently lowered child poverty rates, while decreases in the employment rates and earnings of fathers were a force for higher rates. Finally, there is no single road to lower child poverty rates. Reforms to income transfers intended to increase labor supply may or may not end up lowering the child poverty rate.

Infant feeding, poverty and human development

PubMed Central

Beasley, Annette; Amir, Lisa H

2007-01-01

The relationship between poverty and human development touches on a central aim of the International Breastfeeding Journal's editorial policy which is to support and protect the health and wellbeing of all infants through the promotion of breastfeeding. It is proposed that exclusive breastfeeding for 6 months, followed by continued breastfeeding to 12 months, could prevent 1,301,000 deaths or 13% of all child deaths under 5 years in a hypothetical year. Although there is a conventional wisdom that poverty 'protects' breastfeeding in developing countries, poverty actually threatens breastfeeding, both directly and indirectly. In the light of increasingly aggressive marketing behaviour of the infant formula manufacturers and the need to protect the breastfeeding rights of working women, urgent action is required to ensure the principles and aim of the International Code of Breastmilk Substitutes, and subsequent relevant resolutions of the World Health Assembly, are implemented. If global disparities in infant health and development are to be significantly reduced, gender inequities associated with reduced access to education and inadequate nutrition for girls need to be addressed. Improving women's physical and mental health will lead to better developmental outcomes for their children. PMID:17953747

Empirical evidence of child poverty and deprivation in Nigeria.

PubMed

Ogwumike, Fidelis O; Ozughalu, Uche M

2018-03-01

Development economists and policy makers have in recent times focused attention on child poverty as a crucial aspect of poverty. The importance of the analysis of child poverty partly lies in the fact that children are the most vulnerable group in every society. This study used two poverty lines and the Foster-Greer-Thorbecke index to analyze extreme and overall child poverty headcount, depth and severity in Nigeria. The study also used the headcount ratio to analyze the extent of child deprivation in education, health, nutrition, child protection, water and sanitation. The study was based on the 2010 Harmonized Nigeria Living Standard Survey (HNLSS) and the 2011 Multiple Indicator Cluster Survey (MICS), obtained from the National Bureau of Statistics (NBS), Abuja, Nigeria. The study revealed that 23.22% of children in Nigeria were in extreme child poverty while 70.31% of children in the country were in overall child poverty. The study further showed that there was pronounced child deprivation in education, health, nutrition, child protection, water and sanitation. Both child poverty and child deprivation were more pronounced in the rural sector than in the urban sector and in Northern Nigeria than in Southern Nigeria. Therefore, the Nigerian government should take adequate steps to eradicate child poverty and obliterate all forms of child deprivation in Nigeria - particularly deprivation in basic needs. In taking such steps, more attention should be focused on rural areas and Northern Nigeria. Copyright © 2017 Elsevier Ltd. All rights reserved.

Child Poverty and Changes in Child Poverty

PubMed Central

CHEN, WEN-HAO; CORAK, MILES

2008-01-01

This article offers a cross-country overview of child poverty, changes in child poverty, and the impact of public policy in North America and Europe. Levels and changes in child poverty rates in 12 Organisation for Economic Co-operation and Development (OECD) countries during the 1990s are documented using data from the Luxembourg Income Study project, and a decomposition analysis is used to uncover the relative role of demographic factors, labor markets, and income transfers from the state in determining the magnitude and direction of the changes. Child poverty rates fell noticeably in only three countries and rose in three others. In no country were demographic factors a force for higher child poverty rates, but these factors were also limited in their ability to cushion children from adverse shocks originating in the labor market or the government sector. Increases in the labor market engagement of mothers consistently lowered child poverty rates, while decreases in the employment rates and earnings of fathers were a force for higher rates. Finally, there is no single road to lower child poverty rates. Reforms to income transfers intended to increase labor supply may or may not end up lowering the child poverty rate. PMID:18939660

IWRM and poverty reduction in Malawi: A socio-economic analysis

NASA Astrophysics Data System (ADS)

Mulwafu, Wapulumuka O.; Msosa, Hendrina K.

Like most other countries in the SADC region, Malawi has swiftly endorsed the United Nations Millennium Development Goals. In the water sector, these principles are reflected in the National Water Policy (2004) and in the Malawi Poverty Reduction Strategy Paper (PRSP) (2002) which emphasize three key aspects. First, the articulation of a vision and policy objectives that address development and management of water for productive purposes, conservation and poverty reduction. Second, the recognition of international and regional conventions and agreements on water resources to which Malawi is a signatory, thereby promoting global partnership for development. Third, the provision of mechanisms for monitoring, assessment and development related to watershed management, conservation and the mitigation of floods and droughts. Both the Malawi Poverty Reduction Strategy Paper and the National Water Policy seek to reduce poverty by increasing access to water for domestic and productive purposes. In particular, the MPRSP will focus on constructing and rehabilitating water facilities, extend water supply capacity, promote community-based management and improve water resources conservation and management. In this paper, we examine the challenges of implementing these goals against the background of various institutional reforms in the water sector. We argue that although Malawi has come up with very clear strategies and guidelines for promoting MDGs, a combination of human and financial resources, bedevil the successful implementation of these ideas. In addition, the strategies do not articulate water as a medium for poverty alleviation in a holistic manner. The paper further demonstrates ways in which the promotion of IWRM can facilitate in reducing poverty.

Poverty and Children with Intellectual Disabilities in the World's Richer Countries

ERIC Educational Resources Information Center

Emerson, Eric

2004-01-01

The experience of poverty has a pervasive impact on the health (including mental health) of children and their parent(s), on family functioning and on the life course of children. The aim of this paper is to consider the relevance of poverty to our understanding of the health (and mental health) of children with intellectual disabilities in the…

Associations Between Socioeconomic Status and Allostatic Load: Effects of Neighborhood Poverty and Tests of Mediating Pathways

PubMed Central

Mentz, Graciela; Lachance, Laurie; Johnson, Jonetta; Gaines, Causandra; Israel, Barbara A.

2012-01-01

Objectives. We examined relationships between neighborhood poverty and allostatic load in a low- to moderate-income multiracial urban community. We tested the hypothesis that neighborhood poverty is associated with allostatic load, controlling for household poverty. We also examined the hypotheses that this association was mediated by psychosocial stress and health-related behaviors. Methods. We conducted multilevel analyses using cross-sectional data from a probability sample survey in Detroit, Michigan (n = 919) and the 2000 US Census. The outcome measure was allostatic load. Independent variables included neighborhood and household poverty, psychosocial stress, and health-related behaviors. Covariates included neighborhood and individual demographic characteristics. Results. Neighborhood poverty was positively associated with allostatic load (P < .05), independent of household poverty and controlling for potential confounders. Relationships between neighborhood poverty were mediated by self-reported neighborhood environment stress but not by health-related behaviors. Conclusions. Neighborhood poverty is associated with wear and tear on physiological systems, and this relationship is mediated through psychosocial stress. These relationships are evident after accounting for household poverty levels. Efforts to promote health equity should focus on neighborhood poverty, associated stressful environmental conditions, and household poverty. PMID:22873478

Associations between socioeconomic status and allostatic load: effects of neighborhood poverty and tests of mediating pathways.

PubMed

Schulz, Amy J; Mentz, Graciela; Lachance, Laurie; Johnson, Jonetta; Gaines, Causandra; Israel, Barbara A

2012-09-01

We examined relationships between neighborhood poverty and allostatic load in a low- to moderate-income multiracial urban community. We tested the hypothesis that neighborhood poverty is associated with allostatic load, controlling for household poverty. We also examined the hypotheses that this association was mediated by psychosocial stress and health-related behaviors. We conducted multilevel analyses using cross-sectional data from a probability sample survey in Detroit, Michigan (n = 919) and the 2000 US Census. The outcome measure was allostatic load. Independent variables included neighborhood and household poverty, psychosocial stress, and health-related behaviors. Covariates included neighborhood and individual demographic characteristics. Neighborhood poverty was positively associated with allostatic load (P < .05), independent of household poverty and controlling for potential confounders. Relationships between neighborhood poverty were mediated by self-reported neighborhood environment stress but not by health-related behaviors. Neighborhood poverty is associated with wear and tear on physiological systems, and this relationship is mediated through psychosocial stress. These relationships are evident after accounting for household poverty levels. Efforts to promote health equity should focus on neighborhood poverty, associated stressful environmental conditions, and household poverty.

Young child poverty in the United States: Analyzing trends in poverty and the role of anti-poverty programs using the Supplemental Poverty Measure.

PubMed

Pac, Jessica; Nam, JaeHyun; Waldfogel, Jane; Wimer, Christopher

2017-03-01

Between 1968 and 2013, the poverty rate of young children age 0 to 5 years fell by nearly one third, in large part because of the role played by anti-poverty programs. However, young children in the U.S. still face a much higher rate of poverty than do older children in the U.S. They also continue to have a much higher poverty rate than do young children in other developed countries around the world. In this paper, we provide a detailed analysis of trends in poverty and the role of anti-poverty programs in addressing poverty among young children, using an improved measure of poverty, the Supplemental Poverty Measure. We examine changes over time and the current status, both for young children overall and for key subgroups (by child age, and by child race/ethnicity). Our findings can be summarized in three key points. First, poverty among all young children age 0-5 years has fallen since the beginning of our time series; but absent the safety net, today's poverty rate among young children would be identical to or higher than it was in 1968. Second, the safety net plays an increasing role in reducing the poverty of young children, especially among Black non-Hispanic children, whose poverty rate would otherwise be 20.8 percentage points higher in 2013. Third, the composition of support has changed from virtually all cash transfers in 1968, to about one third each of cash, credit and in-kind transfers today.

Young child poverty in the United States: Analyzing trends in poverty and the role of anti-poverty programs using the Supplemental Poverty Measure

PubMed Central

Pac, Jessica; Nam, JaeHyun; Waldfogel, Jane; Wimer, Christopher

2017-01-01

Between 1968 and 2013, the poverty rate of young children age 0 to 5 years fell by nearly one third, in large part because of the role played by anti-poverty programs. However, young children in the U.S. still face a much higher rate of poverty than do older children in the U.S. They also continue to have a much higher poverty rate than do young children in other developed countries around the world. In this paper, we provide a detailed analysis of trends in poverty and the role of anti-poverty programs in addressing poverty among young children, using an improved measure of poverty, the Supplemental Poverty Measure. We examine changes over time and the current status, both for young children overall and for key subgroups (by child age, and by child race/ethnicity). Our findings can be summarized in three key points. First, poverty among all young children age 0–5 years has fallen since the beginning of our time series; but absent the safety net, today’s poverty rate among young children would be identical to or higher than it was in 1968. Second, the safety net plays an increasing role in reducing the poverty of young children, especially among Black non-Hispanic children, whose poverty rate would otherwise be 20.8 percentage points higher in 2013. Third, the composition of support has changed from virtually all cash transfers in 1968, to about one third each of cash, credit and in-kind transfers today. PMID:28659652

The mechanisms mediating the effects of poverty on children's intellectual development.

PubMed

Guo, G; Harris, K M

2000-11-01

Although adverse consequences of poverty for children are documented widely, little is understood about the mechanisms through which the effects of poverty disadvantage young children. In this analysis we investigate multiple mechanisms through which poverty affects a child's intellectual development. Using data from the NLSY and structural equation models, we have constructed five latent factors (cognitive stimulation, parenting style, physical environment, child's ill health at birth, and ill health in childhood) and have allowed these factors, along with child care, to mediate the effects of poverty and other exogenous variables. We produce two main findings. First, the influence of family poverty on children's intellectual development is mediated completely by the intervening mechanisms measured by our latent factors. Second, our analysis points to cognitive stimulation in the home, and (to a lesser extent) to parenting style, physical environment of the home, and poor child health at birth, as mediating factors that are affected by lack of income and that influence children's intellectual development.

Trachoma and Relative Poverty: A Case-Control Study.

PubMed

Habtamu, Esmael; Wondie, Tariku; Aweke, Sintayehu; Tadesse, Zerihun; Zerihun, Mulat; Zewdie, Zebideru; Callahan, Kelly; Emerson, Paul M; Kuper, Hannah; Bailey, Robin L; Mabey, David C W; Rajak, Saul N; Polack, Sarah; Weiss, Helen A; Burton, Matthew J

2015-11-01

Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited. Two hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a) A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b) Self-rated wealth, and (c) Peer-rated wealth. Activity participation data were collected using a modified 'Stylised Activity List' developed for the World Bank's Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06-3.78; p<0.0001), self-rated wealth (OR, 4.41, 95%CI, 2.75-7.07; p<0.0001) and peer-rated wealth (OR, 8.22, 95% CI, 4.59-14.72; p<0.0001). Cases had less access to latrines (57% v 76.5%, p = <0.0001) and higher person-to-room density (4.0 v 3.31; P = 0.0204) than the controls. Compared to controls, cases were significantly less likely to participate in economically productive activities regardless of visual impairment and other health problems, more likely to report difficulty in performing activities and more likely to receive assistance in performing productive activities. This study demonstrated a strong association between trachomatous trichiasis and relative poverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements might lead to a virtuous cycle of improving health and wealth. Trachoma is a

Poverty nutrition linkages.

PubMed

Ramachandran, Prema

2007-10-01

At the time of independence majority of Indians were poor. In spite of spending over 80 per cent of their income on food, they could not get adequate food. Living in areas of poor environmental sanitation they had high morbidity due to infections; nutrition toll due to infections was high because of poor access to health care. As a result, majority of Indians especially children were undernourished. The country initiated programmes to improve economic growth, reduce poverty, improve household food security and nutritional status of its citizens, especially women and children. India defined poverty on the basis of calorie requirement and focused its attention on providing subsidized food and essential services to people below poverty line. After a period of slow but steady economic growth, the last decade witnessed acceleration of economic growth. India is now one of the fastest growing economies in the world with gross domestic product (GDP) growth over 8 per cent. There has been a steady but slow decline in poverty; but last decade's rapid economic growth did not translate in to rapid decline in poverty. In 1970s, country became self sufficient in food production; adequate buffer stocks have been built up. Poor had access to subsidized food through the public distribution system. As a result, famines have been eliminated, though pockets of food scarcity still existed. Over the years there has been a decline in household expenditure on food due to availability of food grains at low cost but energy intake has declined except among for the poor. In spite of unaltered/declining energy intake there has been some reduction in undernutrition and increase in overnutrition in adults. This is most probably due to reduction in physical activity. Under the Integrated Child Development Services (ICDS) programme food supplements are being provided to children, pregnant and lactating women in the entire country. In spite of these, low birth weight rates are still over 30 per

Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the U.S.A.

PubMed

Walker, Elizabeth Reisinger; Druss, Benjamin G

2017-07-01

The health of individuals in the U.S.A. is increasingly being defined by complexity and multimorbidity. We examined the patterns of co-occurrence of mental illness, substance abuse/dependence, and chronic medical conditions and the cumulative burden of these conditions and living in poverty on self-rated health. We conducted a secondary data analysis using publically-available data from the National Survey on Drug Use and Health (NSDUH), which is an annual nationally-representative survey. Pooled data from the 2010-2012 NSDUH surveys included 115,921 adults 18 years of age or older. The majority of adults (52.2%) had at least one type of condition (mental illness, substance abuse/dependence, or chronic medical conditions), with substantial overlap across the conditions. 1.2%, or 2.2 million people, reported all three conditions. Generally, as the number of conditions increased, the odds of reporting worse health also increased. The likelihood of reporting fair/poor health was greatest for people who reported AMI, chronic medical conditions, and poverty (AOR = 9.41; 95% CI: 7.53-11.76), followed by all three conditions and poverty (AOR = 9.32; 95% CI: 6.67-13.02). For each combination of conditions, the addition of poverty increased the likelihood of reporting fair/poor health. Traditional conceptualizations of multimorbidity should be expanded to take into account the complexities of co-occurrence between mental illnesses, chronic medical conditions, and socioeconomic factors.

Health care access, concentrated poverty, and pediatric asthma hospital care use in California's San Joaquin Valley: A multilevel approach.

PubMed

Alcala, Emanuel; Cisneros, Ricardo; Capitman, John A

2017-12-20

California's San Joaquin Valley is a region with a history of poverty, low health care access, and high rates of pediatric asthma. It is important to understand the potential barriers to care that challenge vulnerable populations. The objective was to describe pediatric asthma-related utilization patterns in the emergency department (ED) and hospital by insurance coverage as well as to identify contributing individual-level indicators (age, sex, race/ethnicity, and insurance coverage) and neighborhood-level indicators of health care access. This was a retrospective study based on secondary data from California hospital and ED records 2007-2012. Children who used services for asthma-related conditions, were aged 0-14 years, Hispanic or non-Hispanic white, and resided in the San Joaquin Valley were included in the analysis. Poisson multilevel modeling was used to control for individual- and neighborhood-level factors. The effect of insurance coverage on asthma ED visits and hospitalizations was modified by the neighborhood-level percentage of concentrated poverty (RR = 1.01, 95% CI = 1.01-1.02; RR = 1.03, 95% CI = 1.02-1.04, respectively). The effect of insurance coverage on asthma hospitalizations was completely explained by the neighborhood-level percentage of concentrated poverty. Observed effects of insurance coverage on hospital care use were significantly modified by neighborhood-level measures of health care access and concentrated poverty. This suggests not only an overall greater risk for poor children on Medi-Cal, but also a greater vulnerability or response to neighborhood social factors such as socioeconomic status, community cohesiveness, crime, and racial/ethnic segregation.

Poverty and common mental disorders in developing countries.

PubMed

Patel, Vikram; Kleinman, Arthur

2003-01-01

A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment.

Poverty and common mental disorders in developing countries.

PubMed Central

Patel, Vikram; Kleinman, Arthur

2003-01-01

A review of English-language journals published since 1990 and three global mental health reports identified 11 community studies on the association between poverty and common mental disorders in six low- and middle-income countries. Most studies showed an association between indicators of poverty and the risk of mental disorders, the most consistent association being with low levels of education. A review of articles exploring the mechanism of the relationship suggested weak evidence to support a specific association with income levels. Factors such as the experience of insecurity and hopelessness, rapid social change and the risks of violence and physical ill-health may explain the greater vulnerability of the poor to common mental disorders. The direct and indirect costs of mental ill-health worsen the economic condition, setting up a vicious cycle of poverty and mental disorder. Common mental disorders need to be placed alongside other diseases associated with poverty by policy-makers and donors. Programmes such as investment in education and provision of microcredit may have unanticipated benefits in reducing the risk of mental disorders. Secondary prevention must focus on strengthening the ability of primary care services to provide effective treatment. PMID:14576893

Childhood poverty and recruitment of adult emotion regulatory neurocircuitry

PubMed Central

Ma, Sean T.; Okada, Go; Shaun Ho, S.; Swain, James E.; Evans, Gary W.

2015-01-01

One in five American children grows up in poverty. Childhood poverty has far-reaching adverse impacts on cognitive, social and emotional development. Altered development of neurocircuits, subserving emotion regulation, is one possible pathway for childhood poverty’s ill effects. Children exposed to poverty were followed into young adulthood and then studied using functional brain imaging with an implicit emotion regulation task focused. Implicit emotion regulation involved attention shifting and appraisal components. Early poverty reduced left dorsolateral prefrontal cortex recruitment in the context of emotional regulation. Furthermore, this emotion regulation associated brain activation mediated the effects of poverty on adult task performance. Moreover, childhood poverty also predicted enhanced insula and reduced hippocampal activation, following exposure to acute stress. These results demonstrate that childhood poverty can alter adult emotion regulation neurocircuitry, revealing specific brain mechanisms that may underlie long-term effects of social inequalities on health. The role of poverty-related emotion regulatory neurocircuitry appears to be particularly salient during stressful conditions. PMID:25939653

Disparities in Diabetes: The Nexus of Race, Poverty, and Place

PubMed Central

Thorpe, Roland J.; McGinty, Emma E.; Bower, Kelly; Rohde, Charles; Young, J. Hunter; LaVeist, Thomas A.; Dubay, Lisa

2014-01-01

Objectives. We sought to determine the role of neighborhood poverty and racial composition on race disparities in diabetes prevalence. Methods. We used data from the 1999–2004 National Health and Nutrition Examination Survey and 2000 US Census to estimate the impact of individual race and poverty and neighborhood racial composition and poverty concentration on the odds of having diabetes. Results. We found a race–poverty–place gradient for diabetes prevalence for Blacks and poor Whites. The odds of having diabetes were higher for Blacks than for Whites. Individual poverty increased the odds of having diabetes for both Whites and Blacks. Living in a poor neighborhood increased the odds of having diabetes for Blacks and poor Whites. Conclusions. To address race disparities in diabetes, policymakers should address problems created by concentrated poverty (e.g., lack of access to reasonably priced fruits and vegetables, recreational facilities, and health care services; high crime rates; and greater exposures to environmental toxins). Housing and development policies in urban areas should avoid creating high-poverty neighborhoods. PMID:24228660

The poverty-reducing effect of Medicaid.

PubMed

Sommers, Benjamin D; Oellerich, Donald

2013-09-01

Medicaid provides health insurance for 54 million Americans. Using the Census Bureau's Supplemental Poverty Measure (which subtracts out-of-pocket medical expenses from family resources), we estimated the impact of eliminating Medicaid. In our counterfactual, Medicaid beneficiaries would become uninsured or gain other insurance. Counterfactual medical expenditures were drawn stochastically from propensity-score-matched individuals without Medicaid. While this method captures the importance of risk protection, it likely underestimates Medicaid's impact due to unobserved differences between Medicaid and non-Medicaid individuals. Nonetheless, we find that Medicaid reduces out-of-pocket medical spending from $871 to $376 per beneficiary, and decreases poverty rates by 1.0% among children, 2.2% among disabled adults, and 0.7% among elderly individuals. When factoring in institutionalized populations, an additional 500,000 people were kept out of poverty. Overall, Medicaid kept at least 2.6 million-and as many as 3.4 million-out of poverty in 2010, making it the U.S.'s third largest anti-poverty program. Published by Elsevier B.V.

The limits of poverty reduction in support of climate change adaptation

NASA Astrophysics Data System (ADS)

Nelson, Donald R.; Lemos, Maria Carmen; Eakin, Hallie; Lo, Yun-Jia

2016-09-01

The relationship between poverty and climate change vulnerability is complex and though not commensurate, the distinctions between the two are often blurred. There is widespread recognition of the need to better understand poverty-vulnerability dynamics in order to improve risk management and poverty reduction investments. This is challenging due to the latent nature of adaptive capacities, frequent lack of baseline data, and the need for high-resolution studies. Here we respond to these challenges by analyzing household-level data in Northeast Brazil to compare drought events 14 years apart. In the period between droughts, the government implemented an aggressive anti-poverty program that includes financial and human capital investments. Poverty declined significantly, but the expected reduction in vulnerability did not occur, in part because the households were not investing in risk management strategies. Our findings complement other research that shows that households make rational decisions that may not correspond with policymaker expectations. We emphasize the need for complementary investments to help channel increased household wealth into risk reduction, and to ensure that the public sector itself continues to prioritize the public functions of risk management, especially in areas where the social cost of climatic risk is high.

Trends in Child Poverty Using an Improved Measure of Poverty.

PubMed

Wimer, Christopher; Nam, JaeHyun; Waldfogel, Jane; Fox, Liana

2016-04-01

The official measure of poverty has been used to assess trends in children's poverty rates for many decades. But because of flaws in official poverty statistics, these basic trends have the potential to be misleading. We use an augmented Current Population Survey data set that calculates an improved measure of poverty to reexamine child poverty rates between 1967 and 2012. This measure, the Anchored Supplemental Poverty Measure, is based partially on the US Census Bureau and Bureau of Labor Statistics' new Supplemental Poverty Measure. We focus on 3 age groups of children, those aged 0 to 5, 6 to 11, and 12 to 17 years. Young children have the highest poverty rates, both historically and today. However, among all age groups, long-term poverty trends have been more favorable than official statistics would suggest. This is entirely due to the effect of counting resources from government policies and programs, which have reduced poverty rates substantially for children of all ages. However, despite this progress, considerable disparities in the risk of poverty continue to exist by education level and family structure. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Childhood poverty and recruitment of adult emotion regulatory neurocircuitry.

PubMed

Liberzon, Israel; Ma, Sean T; Okada, Go; Ho, S Shaun; Swain, James E; Evans, Gary W

2015-11-01

One in five American children grows up in poverty. Childhood poverty has far-reaching adverse impacts on cognitive, social and emotional development. Altered development of neurocircuits, subserving emotion regulation, is one possible pathway for childhood poverty's ill effects. Children exposed to poverty were followed into young adulthood and then studied using functional brain imaging with an implicit emotion regulation task focused. Implicit emotion regulation involved attention shifting and appraisal components. Early poverty reduced left dorsolateral prefrontal cortex recruitment in the context of emotional regulation. Furthermore, this emotion regulation associated brain activation mediated the effects of poverty on adult task performance. Moreover, childhood poverty also predicted enhanced insula and reduced hippocampal activation, following exposure to acute stress. These results demonstrate that childhood poverty can alter adult emotion regulation neurocircuitry, revealing specific brain mechanisms that may underlie long-term effects of social inequalities on health. The role of poverty-related emotion regulatory neurocircuitry appears to be particularly salient during stressful conditions. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

The Relationship between Counselors' Multicultural Counseling Competence and Poverty Beliefs

ERIC Educational Resources Information Center

Clark, Madeline Elizabeth

2016-01-01

The relationship between increased levels of poverty and decreased levels of psychological wellbeing and overall wellness is well documented. Although poverty clearly impacts mental health and wellness, little research in counseling has been conducted exploring the poverty attitudes of counselors. This study explored the relationship between…

Race, ethnicity, concentrated poverty, and low birth weight disparities.

PubMed

Sims, Mario; Sims, Tammy L; Bruce, Marino A

2008-07-01

This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in neighborhoods with 40% or more poverty in metropolitan areas. The results showed that the relationship between concentrated poverty and LBW varied by race and ethnicity. Concentrated poverty was significant for Latinos, even when controlling for maternal health and MSA-level factors. By contrast, maternal health characteristics, such as pre-term birth, teen birth and tobacco use, explained much of the variance in African-American and White LBW These findings extend the discussion about race, class, and health disparities to include Latinos and shows how the relationship between SEP and LBW can vary within an ethnic group.

Race, Ethnicity, Concentrated Poverty, and Low Birth Weight Disparities

PubMed Central

Sims, Mario; Sims, Tammy L.; Bruce, Marino A.

2016-01-01

This study examines the extent to which the relationship between area socioeconomic position (SEP) and low birth weight (LBW) varies by race and ethnicity. A cross-sectional, secondary data analysis was performed with 1992-1994 Vital Statistics and 1990 U.S. Census data for selected metropolitan areas. Low birth weight (< 2500 grams) rates were calculated for non-Hispanic Black, Latino, and non-Hispanic White live singleton births. Concentrated poverty was defined as poor persons living in neighborhoods with 40% or more poverty in metropolitan areas. The results showed that the relationship between concentrated poverty and LBW varied by race and ethnicity. Concentrated poverty was significant for Latinos, even when controlling for maternal health and MSA-level factors. By contrast, maternal health characteristics, such as pre-term birth, teen birth and tobacco use, explained much of the variance in African-American and White LBW. These findings extend the discussion about race, class, and health disparities to include Latinos and shows how the relationship between SEP and LBW can vary within an ethnic group. PMID:18807774

Implications of the global financial crisis for the response to diseases of poverty within overall health sector development: the case of tuberculosis.

PubMed

Maher, Dermot

2010-01-01

The global financial crisis poses a threat to global health, and may exacerbate diseases of poverty, e.g. HIV, malaria and tuberculosis. Exploring the implications of the global financial crisis for the health sector response to tuberculosis is useful to illustrate the practical problems and propose possible solutions. The response to tuberculosis is considered in the context of health sector development. Problems and solutions are considered in five key areas: financing, prioritization, government regulation, integration and decentralization. Securing health gains in global tuberculosis control depends on protecting expenditure by governments of countries badly affected by tuberculosis and by donors, taking measures to increase efficiencies, prioritizing health expenditures and strengthening government regulation. Lessons learned will be valuable for stakeholders involved in the health sector response to tuberculosis and other diseases of poverty.

Policy Analysis of Poverty Alleviation in Semarang City Using Spatial and Sectoral Approach

NASA Astrophysics Data System (ADS)

Muktiali, M.

2018-02-01

Poverty is a multidimensional problem. Therefore, poverty reduction policy is not only related to the increase of income, but also various other dimensions such as improvement of education, health, quality of life, access to electricity, access to sanitation and water supply. Semarang City Government in 2012 initiated a policy of poverty reduction synergy program called “Gerdu Kempling”. Gerdu Kempling is an integrated policy which gives priority to addressing poverty in each village and sub-district in Semarang based on aspects of health, economy, education, infrastructure, and environment. Based on the results of Budget Allocation Analysis and Analysis of Geographic Information Systems (Poverty Mapping), it can be concluded that the program and budget allocation for poverty alleviation in Semarang City are not synchronized either spatially or sectorally.

Urban poverty and infant mortality rate disparities.

PubMed

Sims, Mario; Sims, Tammy L; Bruce, Marino A

2007-04-01

This study examined whether the relationship between high poverty and infant mortality rates (IMRs) varied across race- and ethnic-specific populations in large urban areas. Data were drawn from 1990 Census and 1992-1994 Vital Statistics for selected U.S. metropolitan areas. High-poverty areas were defined as neighborhoods in which > or = 40% of the families had incomes below the federal poverty threshold. Bivariate models showed that high poverty was a significant predictor of IMR for each group; however, multivariate analyses demonstrate that maternal health and regional factors explained most of the variance in the group-specific models of IMR. Additional analysis revealed that high poverty was significantly associated with minority-white IMR disparities, and country of origin is an important consideration for ethnic birth outcomes. Findings from this study provide a glimpse into the complexity associated with infant mortality in metropolitan areas because they suggest that the factors associated with infant mortality in urban areas vary by race and ethnicity.

Mediators and Adverse Effects of Child Poverty in the United States.

PubMed

Pascoe, John M; Wood, David L; Duffee, James H; Kuo, Alice

2016-04-01

The link between poverty and children's health is well recognized. Even temporary poverty may have an adverse effect on children's health, and data consistently support the observation that poverty in childhood continues to have a negative effect on health into adulthood. In addition to childhood morbidity being related to child poverty, epidemiologic studies have documented a mortality gradient for children aged 1 to 15 years (and adults), with poor children experiencing a higher mortality rate than children from higher-income families. The global great recession is only now very slowly abating for millions of America's children and their families. At this difficult time in the history of our nation's families and immediately after the 50th anniversary year of President Lyndon Johnson's War on Poverty, it is particularly germane for the American Academy of Pediatrics, which is "dedicated to the health of all children," to publish a research-supported technical report that examines the mediators associated with the long-recognized adverse effects of child poverty on children and their families. This technical report draws on research from a number of disciplines, including physiology, sociology, psychology, economics, and epidemiology, to describe the present state of knowledge regarding poverty's negative impact on children's health and development. Children inherit not only their parents' genes but also the family ecology and its social milieu. Thus, parenting skills, housing, neighborhood, schools, and other factors (eg, medical care) all have complex relations to each other and influence how each child's genetic canvas is expressed. Accompanying this technical report is a policy statement that describes specific actions that pediatricians and other child advocates can take to attenuate the negative effects of the mediators identified in this technical report and improve the well-being of our nation's children and their families. Copyright © 2016 by the

Investigating the poverty-obesity paradox in Europe.

PubMed

Salmasi, Luca; Celidoni, Martina

2017-08-01

This paper investigates the effect of income- and wealth-based poverty on the probability of being obese for the elderly in Europe by analysing data drawn from the Survey of Health, Ageing and Retirement (SHARE) and the English Longitudinal Study of Ageing (ELSA). We use early-life economic conditions and regional circumstances as instruments for poverty later in life to account for endogeneity issues. After controlling for a large set of covariates at the individual, household, regional and country level, the results show that poverty significantly increases the probability of being obese and the Body Mass Index (BMI), for men and women. The results show that, accounting for endogeneity with a bivariate probit model, poor individuals are from 10 to 20% points more likely to be obese than non-poor individuals. The effect on BMI ranges from 0.295 points (2.39 kg) to 0.395 points (2.75 kg). These results are robust to a series of checks and suggest that anti-poverty interventions might have positive side effects in terms of reducing food-related health inequalities. Copyright © 2017 Elsevier B.V. All rights reserved.

The impact of poverty on self-efficacy: an Australian longitudinal study.

PubMed

Callander, E J; Schofield, D J

2016-06-01

People with strong feelings of 'self-efficacy', i.e. how much a person feels they have control over their life, perform better in the workplace. However, little is known about negative influences on feelings of self-efficacy. In view of the increasing number of people whose income places them below the poverty line despite being in employment, poverty may negatively influence feelings of self-efficacy and hence workplace productivity. To assess whether falling into poverty lowers self-efficacy. Longitudinal analysis of waves 7 to 11 of the nationally representative Household, Income and Labour Dynamics in Australia (HILDA) survey, using linear regression models. Those who fell into multidimensional poverty (income poverty plus poor health or insufficient level of education attainment) had significantly lower self-efficacy scores (up to 18% lower (95% CI -31% to -1%, P < 0.05)) than those never in poverty, after accounting for initial self-efficacy score and other confounding factors. Income uniquely accounted for 3% of the variance in self-efficacy scores, physical health for 10%, mental health for 78% and education for 1%. Given the known links between self-efficacy and workplace productivity, workers who are below the poverty line may be at risk of poor productivity due to the experience of poverty. In addition to the poor outcomes from the employer's perceptive, this may also lead to a negative spiral for the employee. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Poverty, environment, and health: the role of environmental epidemiology and environmental epidemiologists.

PubMed

O'Neill, Marie S; McMichael, Anthony J; Schwartz, Joel; Wartenberg, Daniel

2007-11-01

International attention is focusing increasingly on environmental concerns, from global warming and extreme weather to persistent chemical pollutants that affect our food supplies, health and well-being. These environmental exposures disproportionately affect the poor and those residing in developing countries, and may partly explain the persistent social gradients in health that exist within and between nations. We support recent calls for environmental epidemiologists to play a more active role in furthering the global agenda for sustainability, environmental health and equity. We further suggest that the discipline of environmental epidemiology, as well as relevant funding agencies, broaden their focus to include rigorous research on the upstream, larger-scale societal factors that contribute to inequitable patterns of exposure and health outcomes. By widening the scope of our vision and increasing the strength and breadth of the evidence base about how poverty and environment together affect health, we can better participate in efforts to promote social justice and responsible use and protection of the environment, and thus reduce health inequities. That is both a primary mode and rationale for achieving sustainability.

Have agricultural economists neglected poverty issues?

PubMed

Thiesenhusen, W C

1991-01-01

bringing employment to rural areas. 5 ways are suggested for treating rural poverty in situ: increasing productivity of those with land, group peasants with land in settlements or agrarian reforms, increase health and skill levels, increase employment options, and direct government spending to the rural poor. Egalitarianism with rapid economic growth is assured to reduce poverty. A new way is the introduction of grass roots efforts of nongovernmental organizations (NGOs) which can mobilize and maximize economic activity. Examples are given of NGO Programs of merit.

Trachoma and Relative Poverty: A Case-Control Study

PubMed Central

Habtamu, Esmael; Wondie, Tariku; Aweke, Sintayehu; Tadesse, Zerihun; Zerihun, Mulat; Zewdie, Zebideru; Callahan, Kelly; Emerson, Paul M.; Kuper, Hannah; Bailey, Robin L.; Mabey, David C. W.; Rajak, Saul N.; Polack, Sarah; Weiss, Helen A.; Burton, Matthew J.

2015-01-01

Background Trachoma is widely considered a disease of poverty. Although there are many epidemiological studies linking trachoma to factors normally associated with poverty, formal quantitative data linking trachoma to household economic poverty within endemic communities is very limited. Methodology/Principal Findings Two hundred people with trachomatous trichiasis were recruited through community-based screening in Amhara Region, Ethiopia. These were individually matched by age and gender to 200 controls without trichiasis, selected randomly from the same sub-village as the case. Household economic poverty was measured through (a) A broad set of asset-based wealth indicators and relative household economic poverty determined by principal component analysis (PCA, (b) Self-rated wealth, and (c) Peer-rated wealth. Activity participation data were collected using a modified ‘Stylised Activity List’ developed for the World Bank’s Living Standards Measurement Survey. Trichiasis cases were more likely to belong to poorer households by all measures: asset-based analysis (OR = 2.79; 95%CI: 2.06–3.78; p<0.0001), self-rated wealth (OR, 4.41, 95%CI, 2.75–7.07; p<0.0001) and peer-rated wealth (OR, 8.22, 95% CI, 4.59–14.72; p<0.0001). Cases had less access to latrines (57% v 76.5%, p = <0.0001) and higher person-to-room density (4.0 v 3.31; P = 0.0204) than the controls. Compared to controls, cases were significantly less likely to participate in economically productive activities regardless of visual impairment and other health problems, more likely to report difficulty in performing activities and more likely to receive assistance in performing productive activities. Conclusions/Significance This study demonstrated a strong association between trachomatous trichiasis and relative poverty, suggesting a bidirectional causative relationship possibly may exist between poverty and trachoma. Implementation of the full SAFE strategy in the context of general improvements

Edentulism in high poverty rural counties.

PubMed

Mitchell, Jordan; Bennett, Kevin; Brock-Martin, Amy

2013-01-01

To examine the differences in oral health status among residents of high-poverty counties, as compared to residents of other rural or urban counties, specifically on the prevalence of edentulism. We used the 2005 Behavioral Risk Factor Surveillance System (BRFSS) and the 2006 Area Resource File (ARF). All analyses were conducted with SAS and SAS-callable SUDAAN, in order to account for weighting and the complex sample design. Characteristics significantly related to edentulism include: geographic location, gender, race, age, health status, employment, insurance, not having a usual source of care, education, marital status, presence of chronic disease, having an English interview, not deferring care due to cost, income, and dentist saturation within the county. Significant associations between high-poverty rural and other rural counties and edentulism were found, and other socioeconomic and health status indicators remain strong predictors of edentulism. © 2012 National Rural Health Association.

Pathways from neighborhood poverty to depression among older adults

PubMed Central

Joshi, Spruha; Mooney, Stephen J.; Rundle, Andrew G.; Quinn, James W.; Beard, John R.; Cerdá, Magdalena

2017-01-01

The pathways through which neighborhood poverty can affect resident depression are still unknown. We investigated mechanisms through which neighborhood poverty may influence depression among older adults. Participants were drawn from the New York City Neighborhood and Mental Health in the Elderly Study II, a 3-wave study of adults aged 65–75 (n=3,497) at baseline. Neighborhood poverty and homicide were associated with depressive symptoms at follow-up waves (RR:1.20, 95%CI: 1.05, 1.36; RR: 1.09, 95%CI: 1.02, 1.17, respectively). Homicide accounted for 30% of the effect of neighborhood poverty on depressive symptoms. Neighborhood exposure to violence may be a key mechanism through which neighborhood poverty influences depression among older adults. PMID:28049071

Poverty and Serious Mental Illness: Toward Action on a Seemingly Intractable Problem.

PubMed

Sylvestre, John; Notten, Geranda; Kerman, Nick; Polillo, Alexia; Czechowki, Konrad

2018-03-01

This paper examines the issue of poverty among people with serious mental illness (SMI), positioning it as a key issue to be confronted by community mental health systems and practitioners. The paper reviews three perspectives on poverty, considering how each sheds light on poverty among people with SMI, and their implications for action: (a) monetary resources, (b) basic needs, and (c) capabilities. The paper argues that community mental health programs and systems are currently unable to address poverty as they are overly focused on individual-level interventions that, on their own, cannot raise people out of poverty. The paper calls for a social justice value, informed by the concept of citizenship, as a necessary complement to the recovery concept that has informed community mental health practice for almost 25 years. Finally, the paper argues that community psychologists, with their concepts, methods, and values, are well positioned to contribute to this important issue. However, it also contends that addressing poverty requires collaboration from community psychologists with researchers and practitioners from other fields and domains of expertise to begin to make progress. © Society for Community Research and Action 2017.

75 FR 45628 - Delayed Update of the HHS Poverty Guidelines for the Remainder of 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of the Secretary Delayed Update of the HHS Poverty...: This notice provides a delayed update of the Department of Health and Human Services (HHS) poverty guidelines for the remainder of 2010, and until the 2011 poverty guidelines are published, which is expected...

The effect of income question design in health surveys on family income, poverty and eligibility estimates.

PubMed

Davern, Michael; Rodin, Holly; Beebe, Timothy J; Call, Kathleen Thiede

2005-10-01

To compare systematic differences between an "omnibus" income measure that asks for total family income amounts with a central survey item and an aggregated income measure that sums specific amounts of income obtained from multiple income sources from everyone within a family. The 2001 Current Population Survey-Demographic Supplement (CPS-DS). Data were collected from 78,000 households from February through April 2001. First, we compare the omnibus family income to the aggregated family income amounts for each family. Second, we use the various aggregated family income sources to predict whether there is a mismatch between the omnibus and aggregated family income amounts. Finally, we assign a new aggregated amount of income that is restricted to be within the range of the omnibus amount to observe differences in poverty rates. Data were extracted from University of Michigan's ICPSR website. There is a great deal of variation between the omnibus family income measure and the aggregated family income measure, with the omnibus amount generally being lower than the aggregated. As a result, the percent of people estimated to be in poverty is higher using the omnibus income item. Health surveys generally rely on an omnibus income measure and analysts should be aware that the income estimates derived from it are limited with respect to poverty determination, and the related concept of eligibility estimation. Analysts of health surveys should also consider matching respondents or multiple imputation to improve the usability of the data.

Enhancing nursing students' understanding of poverty through simulation.

PubMed

Patterson, Nena; Hulton, Linda J

2012-01-01

The purposes of this study were (a) to describe the implementation of a poverty simulation, (b) to evaluate its use on nursing students' attitudes about poverty, and (c) to offer lessons learned. Using a mixed-method design, a convenience sample of senior undergraduate nursing students (n = 43) from a public university in a mid-Atlantic state participated in a poverty simulation experience. Students assumed the roles of real-life families and were given limited amounts of resources to survive in a simulated community. This simulation took place during a community health practicum clinical day. The short form of Attitudes about Poverty and Poor Populations Scale (APPPS) was adapted for this evaluation. This 21-item scale includes factors of personal deficiency, stigma, and structural perspective, which measures a range of diverse attitudes toward poverty and poor people. The results of this evaluation demonstrated that nursing students viewed the poverty simulation as an effective teaching strategy and actively participated. In particular, nursing students' scores on the factor of stigma of poverty demonstrated statistically significant changes. With proper planning, organization, and reflection, a poverty simulation experience can be a positive impetus for lifelong learning and civic engagement. © 2011 Wiley Periodicals, Inc.

Catastrophic healthcare expenditure and poverty related to out-of-pocket payments for healthcare in Bangladesh-an estimation of financial risk protection of universal health coverage.

PubMed

Khan, Jahangir A M; Ahmed, Sayem; Evans, Timothy G

2017-10-01

The Sustainable Development Goals target to achieve Universal Health Coverage (UHC), including financial risk protection (FRP) among other dimensions. There are four indicators of FRP, namely incidence of catastrophic health expenditure (CHE), mean positive catastrophic overshoot, incidence of impoverishment and increase in the depth of poverty occur for high out-of-pocket (OOP) healthcare spending. OOP spending is the major payment strategy for healthcare in most low-and-middle-income countries, such as Bangladesh. Large and unpredictable health payments can expose households to substantial financial risk and, at their most extreme, can result in poverty. The aim of this study was to estimate the impact of OOP spending on CHE and poverty, i.e. status of FRP for UHC in Bangladesh. A nationally representative Household Income and Expenditure Survey 2010 was used to determine household consumption expenditure and health-related spending in the last 30 days. Mean CHE headcount and its concentration indices (CI) were calculated. The propensity of facing CHE for households was predicted by demographic and socioeconomic characteristics. The poverty headcount was estimated using 'total household consumption expenditure' and such expenditure without OOP payments for health in comparison with the poverty-line measured by cost of basic need. In absolute values, a pro-rich distribution of OOP payment for healthcare was found in urban and rural Bangladesh. At the 10%-threshold level, in total 14.2% of households faced CHE with 1.9% overshoot. 16.5% of the poorest and 9.2% of the richest households faced CHE. An overall pro-poor distribution was found for CHE (CI = -0.064) in both urban and rural households, while the former had higher CHE incidences. The poverty headcount increased by 3.5% (5.1 million individuals) due to OOP payments. Reliance on OOP payments for healthcare in Bangladesh should be reduced for poverty alleviation in urban and rural Bangladesh in order to

Women Left Behind? Poverty and Headship in Africa.

PubMed

Milazzo, Annamaria; van de Walle, Dominique

2017-06-01

Two stylized facts about poverty in Africa motivate this article: female-headed households tend to be poorer, and poverty has been falling in the aggregate since the 1990s. These facts raise two questions. First, how have female-headed households fared? Second, what role have they played in Africa's impressive recent aggregate growth and poverty reduction? Using data covering the entire region, we reexamine the current prevalence and characteristics of female-headed households and ask whether their prevalence has been rising, what factors have been associated with such changes since the mid-1990s, and whether poverty has fallen equiproportionately for male- and female-headed households. Lower female headship is associated with higher gross domestic product. However, other subtle transformations occurring across Africa-changes in marriage behavior, family formation, health, and education-are positively related to female headship, resulting in a growing share of female-headed households. This shift has been happening alongside declining aggregate poverty incidence. However, rather than being left behind, female-headed households have generally seen faster poverty reduction. As a whole, this group has contributed substantially to the reduction in poverty despite their smaller share in the population.

A multidimensional approach to measure poverty in rural Bangladesh.

PubMed

Bhuiya, Abbas; Mahmood, Shehrin Shaila; Rana, A K M Masud; Wahed, Tania; Ahmed, Syed Masud; Chowdhury, A Mushtaque R

2007-06-01

Poverty is increasingly being understood as a multidimensional phenomenon. Other than income-consumption, which has been extensively studied in the past, health, education, shelter, and social involvement are among the most important dimensions of poverty. The present study attempts to develop a simple tool to measure poverty in its multidimensionality where it views poverty as an inadequate fulfillment of basic needs, such as food, clothing, shelter, health, education, and social involvement. The scale score ranges between 72 and 24 and is constructed in such a way that the score increases with increasing level of poverty. Using various techniques, the study evaluates the poverty-measurement tool and provides evidence for its reliability and validity by administering it in various areas of rural Bangladesh. The reliability coefficients, such as test-retest coefficient (0.85) and Cronbach's alpha (0.80) of the tool, were satisfactorily high. Based on the socioeconomic status defined by the participatory rural appraisal (PRA) exercise, the level of poverty identified by the scale was 33% in Chakaria, 26% in Matlab, and 32% in other rural areas of the country. The validity of these results was tested against some traditional methods of identifying the poor, and the association of the scores with that of the traditional indicators, such as ownership of land and occupation, asset index (r=0.72), and the wealth ranking obtained from the PRA exercise, was consistent. A statistically significant inverse relationship of the poverty scores with the socioeconomic status was observed in all cases. The scale also allowed the absolute level of poverty to be measured, and in the present study, the highest percentage of absolute poor was found in terms of health (44.2% in Chakaria, 36.4% in Matlab, and 39.1% in other rural areas), followed by social exclusion (35.7% in Chakaria, 28.5% in Matlab, and 22.3% in other rural areas), clothing (6.2% in Chakaria, 8.3% in Matlab, and 20

A Multidimensional Approach to Measure Poverty in Rural Bangladesh

PubMed Central

Bhuiya, Abbas; Shaila Mahmood, Shehrin; Rana, A.K.M. Masud; Wahed, Tania; Ahmed, Syed Masud; Chowdhury, A. Mushtaque R.

2007-01-01

Poverty is increasingly being understood as a multidimensional phenomenon. Other than income-consumption, which has been extensively studied in the past, health, education, shelter, and social involvement are among the most important dimensions of poverty. The present study attempts to develop a simple tool to measure poverty in its multidimensionality where it views poverty as an inadequate fulfillment of basic needs, such as food, clothing, shelter, health, education, and social involvement. The scale score ranges between 72 and 24 and is constructed in such a way that the score increases with increasing level of poverty. Using various techniques, the study evaluates the poverty-measurement tool and provides evidence for its reliability and validity by administering it in various areas of rural Bangladesh. The reliability coefficients, such as test-retest coefficient (0.85) and Cronbach's alpha (0.80) of the tool, were satisfactorily high. Based on the socioeconomic status defined by the participatory rural appraisal (PRA) exercise, the level of poverty identified by the scale was 33% in Chakaria, 26% in Matlab, and 32% in other rural areas of the country. The validity of these results was tested against some traditional methods of identifying the poor, and the association of the scores with that of the traditional indicators, such as ownership of land and occupation, asset index (r=0.72), and the wealth ranking obtained from the PRA exercise, was consistent. A statistically significant inverse relationship of the poverty scores with the socioeconomic status was observed in all cases. The scale also allowed the absolute level of poverty to be measured, and in the present study, the highest percentage of absolute poor was found in terms of health (44.2% in Chakaria, 36.4% in Matlab, and 39.1% in other rural areas), followed by social exclusion (35.7% in Chakaria, 28.5% in Matlab, and 22.3% in other rural areas), clothing (6.2% in Chakaria, 8.3% in Matlab, and 20

Child Poverty and the Promise of Human Capacity: Childhood as a Foundation for Healthy Aging.

PubMed

Wise, Paul H

2016-04-01

The effect of child poverty and related early life experiences on adult health outcomes and patterns of aging has become a central focus of child health research and advocacy. In this article a critical review of this proliferating literature and its relevance to child health programs and policy are presented. This literature review focused on evidence of the influence of child poverty on the major contributors to adult morbidity and mortality in the United States, the mechanisms by which these associations operate, and the implications for reforming child health programs and policies. Strong and varied evidence base documents the effect of child poverty and related early life experiences and exposures on the major threats to adult health and healthy aging. Studies using a variety of methodologies, including longitudinal and cross-sectional strategies, have reported significant findings regarding cardiovascular disorders, obesity and diabetes, certain cancers, mental health conditions, osteoporosis and fractures, and possibly dementia. These relationships can operate through alterations in fetal and infant development, stress reactivity and inflammation, the development of adverse health behaviors, the conveyance of child chronic illness into adulthood, and inadequate access to effective interventions in childhood. Although the reviewed studies document meaningful relationships between child poverty and adult outcomes, they also reveal that poverty, experiences, and behaviors in adulthood make important contributions to adult health and aging. There is strong evidence that poverty in childhood contributes significantly to adult health. Changes in the content, financing, and advocacy of current child health programs will be required to address the childhood influences on adult health and disease. Policy reforms that reduce child poverty and mitigate its developmental effects must be integrated into broader initiatives and advocacy that also attend to the health and

Poverty reduction by improving health and social services in Vietnam.

PubMed

Gien, Lan; Taylor, Sharon; Barter, Ken; Tiep, Nguyen; Mai, Bui X; Lan, Nguyen T

2007-12-01

This article describes the development and implementation of a five-year plan for the reduction of poverty and the enhancement of human development through improving public health and social services in rural Vietnam. This plan was achieved by training the trainers and building capacity for the social workers. The project was a collaborative effort between the Schools of Nursing and Social Work at Memorial University, Newfoundland and Labrador, Canada and the University of Labor and Social Affairs, Hanoi, Vietnam. The collaboration was also committed to improving the quality of social work education and training in Vietnam. All the project's objectives were achieved beyond original expectations. The actual outcomes are sustainable and in addition gender equality has been a cross-cutting theme.

[Gaps in effective coverage by socioeconomic status and poverty condition].

PubMed

Gutiérrez, Juan Pablo

2013-01-01

To analyze, in the context of increased health protection in Mexico, the gaps by socioeconomic status and poverty condition on effective coverage of selected preventive interventions. Data from the National Health & Nutrition Survey 2012 and 2006, using previously defined indicators of effective coverage and stratifying them by socioeconomic (SE) status and multidimensional poverty condition. For vaccination interventions, immunological equity has been maintained in Mexico. For indicators related to preventive interventions provided at the clinical setting, effective coverage is lower among those in the lowest SE quintile and among people living in multidimensional poverty. Comparing 2006 and 2012, there is no evidence on gap reduction. While health protection has significantly increased in Mexico, thus reducing SE gaps, those gaps are still important in magnitude for effective coverage of preventive interventions.

Pathways from neighborhood poverty to depression among older adults.

PubMed

Joshi, Spruha; Mooney, Stephen J; Rundle, Andrew G; Quinn, James W; Beard, John R; Cerdá, Magdalena

2017-01-01

The pathways through which neighborhood poverty can affect resident depression are still unknown. We investigated mechanisms through which neighborhood poverty may influence depression among older adults. Participants were drawn from the New York City Neighborhood and Mental Health in the Elderly Study II, a 3-wave study of adults aged 65-75 (n=3,497) at baseline. Neighborhood poverty and homicide were associated with depressive symptoms at follow-up waves (RR:1.20, 95%CI: 1.05, 1.36; RR: 1.09, 95%CI: 1.02, 1.17, respectively). Homicide accounted for 30% of the effect of neighborhood poverty on depressive symptoms. Neighborhood exposure to violence may be a key mechanism through which neighborhood poverty influences depression among older adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

Community Poverty and Child Abuse Fatalities in the United States.

PubMed

Farrell, Caitlin A; Fleegler, Eric W; Monuteaux, Michael C; Wilson, Celeste R; Christian, Cindy W; Lee, Lois K

2017-05-01

Child maltreatment remains a problem in the United States, and individual poverty is a recognized risk factor for abuse. Children in impoverished communities are at risk for negative health outcomes, but the relationship of community poverty to child abuse fatalities is not known. Our objective was to evaluate the association between county poverty concentration and rates of fatal child abuse. This was a retrospective, cross-sectional analysis of child abuse fatalities in US children 0 to 4 years of age from 1999 to 2014 by using the Centers for Disease Control and Prevention Compressed Mortality Files. Population and poverty statistics were obtained from US Census data. National child abuse fatality rates were calculated for each category of community poverty concentration. Multivariate negative binomial regression modeling assessed the relationship between county poverty concentration and child abuse fatalities. From 1999 to 2014, 11 149 children 0 to 4 years old died of child abuse; 45% (5053) were <1 year old, 56% (6283) were boys, and 58% (6480) were white. The overall rate of fatal child abuse was 3.5 per 100 000 children 0 to 4 years old. In the multivariate model, counties with the highest poverty concentration had >3 times the rate of child abuse fatalities compared with counties with the lowest poverty concentration (adjusted incidence rate ratio, 3.03; 95% confidence interval, 2.4-3.79). Higher county poverty concentration is associated with increased rates of child abuse fatalities. This finding should inform public health officials in targeting high-risk areas for interventions and resources. Copyright © 2017 by the American Academy of Pediatrics.

Examining effects of food insecurity and food choices on health outcomes in households in poverty.

PubMed

Lombe, Margaret; Nebbitt, Von Eugene; Sinha, Aakanksha; Reynolds, Andrew

2016-07-01

Evidence documenting effects of food assistance programs, household food insecurity, and nutrition knowledge on health outcomes is building. Using data from a sub-sample of adults who are 185% of the poverty line from the 2007-2008 National Health and Nutrition Examination Survey (N = 2,171), we examine whether household food insecurity, food stamp take-up, and use of informal food supports are associated with health risk among low-income households. Findings indicate that while nutrition knowledge provides protection against health risk in food secure households, the health benefits of nutrition knowledge were not evident in food insecure households. We discuss these findings in light of current policy and practice interventions that recognize the importance of providing healthy, affordable food options for food insecure households.

Targeting Parenting in Early Childhood: A Public Health Approach to Improve Outcomes for Children Living in Poverty.

PubMed

Morris, Amanda Sheffield; Robinson, Lara R; Hays-Grudo, Jennifer; Claussen, Angelika H; Hartwig, Sophie A; Treat, Amy E

2017-03-01

In this article, the authors posit that programs promoting nurturing parent-child relationships influence outcomes of parents and young children living in poverty through two primary mechanisms: (a) strengthening parents' social support and (b) increasing positive parent-child interactions. The authors discuss evidence for these mechanisms as catalysts for change and provide examples from selected parenting programs that support the influence of nurturing relationships on child and parenting outcomes. The article focuses on prevention programs targeted at children and families living in poverty and closes with a discussion of the potential for widespread implementation and scalability for public health impact. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

'More health for the money': an analytical framework for access to health care through microfinance and savings groups.

PubMed

Saha, Somen

2014-10-01

The main contributors to inequities in health relates to widespread poverty. Health cannot be achieved without addressing the social determinants of health, and the answer does not lie in the health sector alone. One of the potential pathways to address vulnerabilities linked to poverty, social exclusion, and empowerment of women is aligning health programmes with empowerment interventions linked to access to capital through microfinance and self-help groups. This paper presents a framework to analyse combined health and financial interventions through microfinance programmes in reducing barriers to access health care. If properly designed and ethically managed such integrated programmes can provide more health for the money spent on health care.

Poverty and private health expenditures in Italian households during the recent crisis.

PubMed

Sarti, Simone; Terraneo, Marco; Tognetti Bordogna, Mara

2017-03-01

The global financial crisis that began in 2008 had an overall effect on the health behaviours of Italian households. Aggregate private health expenditures have decreased while the citizens have increasingly been asked to share health costs. The reduction of households' health expenditure could have serious consequences for health, especially if it concerns the most vulnerable people. The aim of this paper is to analyse the relation between poverty and household health expenditure, considering regional and social group variations. The data used stem from the "Family Expenditure Survey" collected by the Italian Statistical Institute (ISTAT) from 1997 to 2013. Results of multivariate analysis controlling for potential socio-demographic confounders show that the propensity to spend for poor families is decreased in the last years compared to not poor households. Meanwhile, among the households who spend, the average expenditure in euro seems to have been more stable over time. This is an alarming signal for the health of the most vulnerable households. These conditions could result in a gradual deterioration of health in poor families, which is likely to increase the burden on health systems in future. Hence, at this moment public intervention does not seem able to alleviate this situation. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Poverty and severe psychiatric disorder in the U.S.: evidence from the Medical Expenditure Panel Survey.

PubMed

Vick, Brandon; Jones, Kristine; Mitra, Sophie

2012-06-01

Previous studies have shown that persons with severe psychiatric disorders are more likely to be poor and face disparities in education and employment outcomes. Poverty rates, the standard measure of poverty, give no information on how far below the poverty line this group falls. This paper compares the poverty rate, poverty depth (distance from the poverty line) and poverty severity (inequality of incomes below the poverty line) of households with and without a working-age member with severe psychiatric disorder in the United States using data from the 2007 Medical Expenditure Panel Survey (MEPS). First, we perform multivariate analysis of the association between severe disorder and poverty depth using MEPS data. Second, we calculate poverty rates, depth, and severity for the subgroup of households having a member with disorder and compare to the subgroup of households without such a member. In multivariate regressions, the presence of a household member with severe psychiatric disorder predicts a 52-percentage point increase in poverty depth and 3.10 times the odds of being poor. Poverty rate, depth, and severity are significantly greater for households of persons with disorder. Mean total incomes are lower for households of persons with severe disorder compared to other households while mean health expenditures are similar. Severe psychiatric disorder is associated with greater depth of poverty and likelihood of being poor. We identify groups who are the most disadvantaged according to severity of income poverty among households with severe psychiatric disorder. These include households whose head has no high school education, who has been without work for the entire year, and who is black or Hispanic. While these characteristics are related to poverty for the overall sample, they correlate to heightened poverty severity when combined with severe disorder. Families face less severity than single persons but poverty rate, depth, and severity increase for both

Understanding the Lives and Challenges of Women in Poverty after TANF.

PubMed

Hildebrandt, Eugenie

2016-08-01

Welfare Reform has caused a dramatic change in the lives and health of single mothers living in poverty. This qualitative study explored the health and socioeconomic lives of 22 community-dwelling women in poverty in the years after they were terminated from the current work-based welfare program intended to move women from welfare to work and independence. The instruments were a semistructured interview guide, the HANES General Well-Being Schedule, and a demographic data form. Data were analyzed using multistage narrative analysis and descriptive statistics. These primary source data showed participants had multiple barriers that precede or follow poverty. Their voices of how they survive are a rich source of data to assist providers and policy makers in devising evidence-based solutions for reducing poverty in America. © The Author(s) 2016.

Marital Biography, Social Security Receipt, and Poverty.

PubMed

Lin, I-Fen; Brown, Susan L; Hammersmith, Anna M

2017-01-01

Increasingly, older adults are unmarried, which could mean a larger share is at risk of economic disadvantage. Using data from the 2010 Health and Retirement Study, we chart the diverse range of marital biographies, capturing marital sequences and timing, of adults who are age eligible for Social Security and examine three indicators of economic well-being: Social Security receipt, Social Security benefit levels, and poverty status. Partnereds are disproportionately likely to receive Social Security and they enjoy relatively high Social Security benefits and very low poverty levels. Among singles, economic well-being varies by marital biography and gender. Gray divorced and never-married women face considerable economic insecurity. Their Social Security benefits are relatively low, and their poverty rates are quite high (over 25%), indicating Social Security alone is not sufficient to prevent these women from falling into poverty. By comparison, gray widoweds are the most advantaged singles.

Marital Biography, Social Security Receipt, and Poverty

PubMed Central

Lin, I-Fen; Brown, Susan L.; Hammersmith, Anna M.

2017-01-01

Increasingly, older adults are unmarried, which could mean a larger share is at risk of economic disadvantage. Using data from the 2010 Health and Retirement Study, we chart the diverse range of marital biographies, capturing marital sequences and timing, of adults who are age eligible for Social Security and examine three indicators of economic well-being: Social Security receipt, Social Security benefit levels, and poverty status. Partnereds are disproportionately likely to receive Social Security and they enjoy relatively high Social Security benefits and very low poverty levels. Among singles, economic well-being varies by marital biography and gender. Gray divorced and never-married women face considerable economic insecurity. Their Social Security benefits are relatively low, and their poverty rates are quite high (over 25%), indicating Social Security alone is not sufficient to prevent these women from falling into poverty. By comparison, gray widoweds are the most advantaged singles. PMID:28181867

Poverty rates in Venezuela: getting the numbers right.

PubMed

Weisbrot, Mark; Sandoval, Luis; Rosnick, David

2006-01-01

This article looks at household and individual poverty rates in Venezuela over the past seven years. For more than a year, the statement that poverty in Venezuela has increased under the government of President Hugo Chávez has appeared in scores of major newspapers, on major television and radio programs, and even in publications devoted to foreign policy. There are no data to support such statements, and in fact the available data show a decline in poverty for both individuals and households over the seven-year period: the percentage of people in poverty declined from 50 percent in the first quarter of 1999 to 43.7 percent in 2005. Further, there is no evidence to suggest any change in the methodology for measuring poverty during this period, as has been alleged in a number of reports. The article also examines briefly the impact of significant changes in non-cash benefits such as free health care, which are not taken into account in the measured poverty rate, on poor people in Venezuela. Finally, the authors look at how the mistakes in reporting on Venezuela's poverty rate were made; an appendix gives examples of mistakes in major media and foreign policy publications.

Locating Economic Risks for Adolescent Mental and Behavioral Health: Poverty and Affluence in Families, Neighborhoods, and Schools

ERIC Educational Resources Information Center

Coley, Rebekah Levine; Sims, Jacqueline; Dearing, Eric; Spielvogel, Bryn

2018-01-01

Research has identified risks of both poverty and affluence for adolescents. This study sought to clarify associations between income and youth mental and behavioral health by delineating economic risks derived from family, neighborhood, and school contexts within a nationally representative sample of high school students (N = 13,179, average age…

Poverty trap formed by the ecology of infectious diseases

PubMed Central

Bonds, Matthew H.; Keenan, Donald C.; Rohani, Pejman; Sachs, Jeffrey D.

2010-01-01

While most of the world has enjoyed exponential economic growth, more than one-sixth of the world is today roughly as poor as their ancestors were many generations ago. Widely accepted general explanations for the persistence of such poverty have been elusive and are needed by the international development community. Building on a well-established model of human infectious diseases, we show how formally integrating simple economic and disease ecology models can naturally give rise to poverty traps, where initial economic and epidemiological conditions determine the long-term trajectory of the health and economic development of a society. This poverty trap may therefore be broken by improving health conditions of the population. More generally, we demonstrate that simple human ecological models can help explain broad patterns of modern economic organization. PMID:20007179

Optimal multi-dimensional poverty lines: The state of poverty in Iraq

NASA Astrophysics Data System (ADS)

Ameen, Jamal R. M.

2017-09-01

Poverty estimation based on calories intake is unrealistic. The established concept of multidimensional poverty has methodological weaknesses in the treatment of different dimensions and there is disagreement in methods of combining them into a single poverty line. This paper introduces a methodology to estimate optimal multidimensional poverty lines and uses the Iraqi household socio-economic survey data of 2012 to demonstrate the idea. The optimal poverty line for Iraq is found to be 170.5 Thousand Iraqi Dinars (TID).

Waste management, informal recycling, environmental pollution and public health.

PubMed

Yang, Hong; Ma, Mingguo; Thompson, Julian R; Flower, Roger J

2018-03-01

With rapid population growth, especially in low-income and middle-income countries, the generation of waste is increasing at an unprecedented rate. For example, annual global waste arising from waste electrical and electronic equipment alone will have increased from 33.8 to 49.8 million tonnes between 2010 and 2018. Despite incineration and other waste treatment techniques, landfill still dominates waste disposal in low-income and middle-income countries. There is usually insufficient funding for adequate waste management in these countries and uptake of more advanced waste treatment technologies is poor. Without proper management, many landfills represent serious hazards as typified by the landslide in Shenzhen, China on 20 December 2015. In addition to formal waste recycling systems, approximately 15million people around the world are involved in informal waste recycling, mainly for plastics, metals, glass and paper. This review examines emerging public health challenges, in particular within low-income and middle-income countries, associated with the informal sector. While informal recyclers contribute to waste recycling and reuse, the relatively primitive techniques they employ, combined with improper management of secondary pollutants, exacerbate environmental pollution of air, soil and water. Even worse, insufficient occupational health measures expose informal waste workers to a range of pollutants, injuries, respiratory and dermatological problems, infections and other serious health issues that contribute to low life expectancy. Integration of the informal sector with its formal counterparts could improve waste management while addressing these serious health and livelihood issues. Progress in this direction has already been made notably in several Latin American countries where integrating the informal and formal sectors has had a positive influence on both waste management and poverty alleviation. © Article author(s) (or their employer(s) unless

Subjective Poverty and Its Relation to Objective Poverty Concepts in Hungary

ERIC Educational Resources Information Center

Nandori, Eszter Siposne

2011-01-01

The paper analyzes subjective poverty in Hungary and compares it to the objective poverty concepts. Subjective poverty is defined by examining who people consider to be poor. Based on the Easterlin paradox, the initial hypothesis states that subjective and absolute poverty concepts are highly correlated. Taking into account that Hungary is a…

Poverty among Foster Children: Estimates Using the Supplemental Poverty Measure

PubMed Central

Pac, Jessica; Waldfogel, Jane; Wimer, Christopher

2017-01-01

We use data from the Current Population Survey and the new Supplemental Poverty Measure (SPM) to provide estimates for poverty among foster children over the period 1992 to 2013. These are the first large-scale national estimates for foster children who are not included in official poverty statistics. Holding child and family demographics constant, foster children have a lower risk of poverty than other children. Analyzing income in detail suggests that foster care payments likely play an important role in reducing the risk of poverty in this group. In contrast, we find that children living with grandparents have a higher risk of poverty than other children, even after taking demographics into account. Our estimates suggest that this excess risk is likely linked to their lower likelihood of receiving foster care or other income supports. PMID:28659651

The relationship between childhood poverty, military service, and later life depression among men: Evidence from the Health and Retirement Study

PubMed Central

Bareis, Natalie; Mezuk, Briana

2017-01-01

Background Childhood poverty has been associated with depression in adulthood, but whether this relationship extends to later life major depression (MD) or is modified by military service is unclear. Methods Data come from the Health and Retirement Study (HRS) 2010 wave, a longitudinal, nationally representative study of older adults. Men with data on military service and childhood poverty were included (N = 6330). Childhood poverty was assessed by four indicators (i.e., parental unemployment, residential instability) experienced before age 16. Military service was categorized as veteran versus civilian, and during draft versus all-volunteer (after 1973) eras. Past year MD was defined by the Composite International Diagnostic Inventory. Results Four in ten men ever served, with 13.7% in the all-volunteer military. Approximately 12% of civilians, 8% draft era and 24% all-volunteer era veterans had MD. Childhood poverty was associated with higher odds of MD (Odds Ratio (OR): 2.38, 95% Confidence Interval (CI): 1.32–4.32) and higher odds of military service (OR: 2.58, 95% CI: 1.58–4.21). Military service was marginally associated with MD (OR: 1.28, 95% CI: 0.98–1.68) and did not moderate the association between childhood poverty and MD. Limitations Self-report data is subject to recall bias. The HRS did not assess childhood physical and emotional abuse, or military combat exposure. Conclusions Men raised in poverty had greater odds of draft and all-volunteer military service. Early-life experiences, independent of military service, appear associated with greater odds of MD. Assessing childhood poverty in service members may identify risk for depression in later life. PMID:27455351

The relationship between childhood poverty, military service, and later life depression among men: Evidence from the Health and Retirement Study.

PubMed

Bareis, Natalie; Mezuk, Briana

2016-12-01

Childhood poverty has been associated with depression in adulthood, but whether this relationship extends to later life major depression (MD) or is modified by military service is unclear. Data come from the Health and Retirement Study (HRS) 2010 wave, a longitudinal, nationally representative study of older adults. Men with data on military service and childhood poverty were included (N=6330). Childhood poverty was assessed by four indicators (i.e., parental unemployment, residential instability) experienced before age 16. Military service was categorized as veteran versus civilian, and during draft versus all-volunteer (after 1973) eras. Past year MD was defined by the Composite International Diagnostic Inventory. Four in ten men ever served, with 13.7% in the all-volunteer military. Approximately 12% of civilians, 8% draft era and 24% all-volunteer era veterans had MD. Childhood poverty was associated with higher odds of MD (Odds Ratio (OR): 2.38, 95% Confidence Interval (CI): 1.32-4.32) and higher odds of military service (OR: 2.58, 95% CI: 1.58-4.21). Military service was marginally associated with MD (OR: 1.28, 95% CI: 0.98-1.68) and did not moderate the association between childhood poverty and MD. Self-report data is subject to recall bias. The HRS did not assess childhood physical and emotional abuse, or military combat exposure. Men raised in poverty had greater odds of draft and all-volunteer military service. Early-life experiences, independent of military service, appear associated with greater odds of MD. Assessing childhood poverty in service members may identify risk for depression in later life. Copyright © 2016 Elsevier B.V. All rights reserved.

Connecting the Dots Between Health, Poverty and Place in Accra, Ghana

PubMed Central

Weeks, John R.; Getis, Arthur; Stow, Douglas A.; Hill, Allan G.; Rain, David; Engstrom, Ryan; Stoler, Justin; Lippitt, Christopher; Jankowska, Marta; Lopez-Carr, Anna Carla; Coulter, Lloyd; Ofiesh, Caetlin

2013-01-01

West Africa has a rapidly growing population, an increasing fraction of which lives in urban informal settlements characterized by inadequate infrastructure and relatively high health risks. Little is known, however, about the spatial or health characteristics of cities in this region or about the spatial inequalities in health within them. In this article we show how we have been creating a data-rich field laboratory in Accra, Ghana, to connect the dots between health, poverty, and place in a large city in West Africa. Our overarching goal is to test the hypothesis that satellite imagery, in combination with census and limited survey data, such as that found in demographic and health surveys (DHSs), can provide clues to the spatial distribution of health inequalities in cities where fewer data exist than those we have collected for Accra. To this end, we have created the first digital boundary file of the city, obtained high spatial resolution satellite imagery for two dates, collected data from a longitudinal panel of 3,200 women spatially distributed throughout Accra, and obtained microlevel data from the census. We have also acquired water, sewerage, and elevation layers and then coupled all of these data with extensive field research on the neighborhood structure of Accra. We show that the proportional abundance of vegetation in a neighborhood serves as a key indicator of local levels of health and well-being and that local perceptions of health risk are not always consistent with objective measures. PMID:24532846

Poverty Measurement in the U.S., Europe, and Developing Countries

ERIC Educational Resources Information Center

Couch, Kenneth A.; Pirog, Maureen A.

2010-01-01

In December of 2009, many within the American community of analysts, policymakers, and program managers are looking expectantly at the possibility of change in the basic measure used to gauge poverty in the United States. A broad consensus has emerged that the current official measure of poverty in the United States is deeply flawed, in the income…

CHILDREN AND POVERTY.

ERIC Educational Resources Information Center

WITMER, HELEN L.

THREE MAJOR QUESTIONS ARE RAISED--(1) WHAT IS MEANT BY POVERTY AND TO WHAT EXTENT DOES THE OVERALL AMOUNT OF POVERTY DEPEND ON THE SORT OF MEASURING ROD USED. (2) HOW MANY AND WHAT PROPORTION OF THE NATION'S CHILDREN ARE GROWING UP IN POVERTY. AND (3) WHERE, GEOGRAPHICALLY AND SOCIALLY, ARE THESE CHILDREN OF THE POOR TO BE FOUND. POVERTY IS…

Spatial variations in US poverty: beyond metropolitan and non-metropolitan.

PubMed

Wang, Man; Kleit, Rachel Garshick; Cover, Jane; Fowler, Christopher S

2012-01-01

Because poverty in rural and urban areas of the US often has different causes, correlates and solutions, effective anti-poverty policies depend on a thorough understanding of the ruralness or urbanness of specific places. This paper compares several widely used classification schemes and the varying magnitudes of poverty that they reveal in the US. The commonly used ‘metropolitan/non-metropolitan’ distinction obscures important socioeconomic differences among metropolitan areas, making our understanding of the geography of poverty imprecise. Given the number and concentration of poor people living in mixed-rural and rural counties in metropolitan regions, researchers and policy-makers need to pay more nuanced attention to the opportunities and constraints such individuals face. A cross-classification of the Office of Management and Budget’s metro system with a nuanced RUDC scheme is the most effective for revealing the geographical complexities of poverty within metropolitan areas.

Cold homes, fuel poverty and energy efficiency improvements: A longitudinal focus group approach.

PubMed

Grey, Charlotte N B; Schmieder-Gaite, Tina; Jiang, Shiyu; Nascimento, Christina; Poortinga, Wouter

2017-08-01

Cold homes and fuel poverty have been identified as factors in health and social inequalities that could be alleviated through energy efficiency interventions. Research on fuel poverty and the health impacts of affordable warmth initiatives have to date primarily been conducted using quantitative and statistical methods, limiting the way how fuel poverty is understood. This study took a longitudinal focus group approach that allowed exploration of lived experiences of fuel poverty before and after an energy efficiency intervention. Focus group discussions were held with residents from three low-income communities before (n = 28) and after (n = 22) they received energy efficiency measures funded through a government-led scheme. The results show that improving the energy efficiency of homes at risk of fuel poverty has a profound impact on wellbeing and quality of life, financial stress, thermal comfort, social interactions and indoor space use. However, the process of receiving the intervention was experienced by some as stressful. There is a need for better community engagement and communication to improve the benefits delivered by fuel poverty programmes, as well as further qualitative exploration to better understand the wider impacts of fuel poverty and policy-led intervention schemes.

Cold homes, fuel poverty and energy efficiency improvements: A longitudinal focus group approach

PubMed Central

Grey, Charlotte N. B.; Schmieder-Gaite, Tina; Jiang, Shiyu; Nascimento, Christina

2017-01-01

Cold homes and fuel poverty have been identified as factors in health and social inequalities that could be alleviated through energy efficiency interventions. Research on fuel poverty and the health impacts of affordable warmth initiatives have to date primarily been conducted using quantitative and statistical methods, limiting the way how fuel poverty is understood. This study took a longitudinal focus group approach that allowed exploration of lived experiences of fuel poverty before and after an energy efficiency intervention. Focus group discussions were held with residents from three low-income communities before (n = 28) and after (n = 22) they received energy efficiency measures funded through a government-led scheme. The results show that improving the energy efficiency of homes at risk of fuel poverty has a profound impact on wellbeing and quality of life, financial stress, thermal comfort, social interactions and indoor space use. However, the process of receiving the intervention was experienced by some as stressful. There is a need for better community engagement and communication to improve the benefits delivered by fuel poverty programmes, as well as further qualitative exploration to better understand the wider impacts of fuel poverty and policy-led intervention schemes. PMID:28890663

Poverty-related diseases (PRDs): unravelling complexities in disease responses in Cameroon.

PubMed

Makoge, Valerie; Maat, Harro; Vaandrager, Lenneke; Koelen, Maria

2017-01-01

In Cameroon, poverty-related diseases (PRDs) are a major public health concern. Research and policies addressing PRDs are based on a particular understanding of the interaction between poverty and disease, usually an association between poverty indicators and health indicators for a specific country or region. Such indicators are useful but fail to explain the nature of the linkages between poverty and disease or poverty and health. This paper presents results of a study among university students, unravelling how they perceive diseases, the linkages with poverty, their responses to diseases and the motivations behind reported responses. Based on the health belief model, this cross-sectional study was carried out among 272 students at the universities of Buea and Yaoundé in Cameroon. Data were collected using questionnaires containing items matching the research objectives. The questionnaires were self-completed. Malaria was considered as the most common disease perceived and also a major PRD. Contrary to official rankings of HIV/AIDS and TB, cholera and diarrhoea were considered as other major PRDs. Also, typhoid fever was perceived to be more common and a PRD than HIV/AIDS and TB combined. The most prominently attributed cause for disease was (lack of) hygiene. In response, students deployed formal and/or informal healthcare strategies, depending on factors like available money, perceived severity of the disease and disease type. Discrepancies were observed in respondents' response to diseases generally and to malaria in particular. Even though, overall, respondents pre-dominantly reported a formal healthcare response toward diseases in general, for malaria, informal responses dominated. There was an overall strong awareness and (pro)activity among students for dealing with diseases. Although the high use of informal facilities and medication for malaria may well be a reason why eradication is problematic, this seems to be a deliberate strategy linked to an

Evaluation of performance and impacts of maternal and child health hospital services using Data Envelopment Analysis in Guangxi Zhuang Autonomous Region, China: a comparison study among poverty and non-poverty county level hospitals.

PubMed

Wang, Xuan; Luo, Hongye; Qin, Xianjin; Feng, Jun; Gao, Hongda; Feng, Qiming

2016-08-23

As the core of the county-level Maternal and Child Health Hospitals (MCHH) in rural areas of China, the service efficiency affects the fairness and availability of healthcare services. This study aims to identify the determinants of hospital efficiency and explore how to improve the performance of MCHH in terms of productivity and efficiency. Data was collected from a sample of 32 county-level MCHHs of Guangxi in 2014. Firstly, we specified and measured the indicators of the inputs and outputs which represent hospital resources expended and its profiles respectively. Then we estimated the efficiency scores using Data Envelopment Analysis (DEA) for each hospital. Efficiency scores were decomposed into technical, scale and congestion components, and the potential output increases and/or input reductions were also estimated in this model, which would make relatively inefficient hospitals more efficient. In the second stage, the estimated efficiency scores are regressed against hospital external and internal environment factors using a Tobit model. We used DEAP (V2.1) and R for data analysis. The average scores of technical efficiency, net technical efficiency (managerial efficiency) and scale efficiency of the hospitals were 0.875, 0.922 and 0.945, respectively. Half of the hospitals were efficient, and 9.4 % and 40.6 % were weakly efficient and inefficient, respectively. Among the low-productiveness hospitals, 61.1 % came from poor counties (Poor counties in this article are in the list of key poverty-stricken counties at the national level, published by The State Council Leading Group Office of Poverty Alleviation and Development, 2012). The total input indicated that redundant medical resources in poverty areas were significantly higher than those in non-poverty areas. The Tobit regression model showed that the technical efficiency was proportional to the total annual incomes, the number of discharge patients, and the number of outpatient and emergency visits

‘More health for the money’: an analytical framework for access to health care through microfinance and savings groups

PubMed Central

Saha, Somen

2014-01-01

The main contributors to inequities in health relates to widespread poverty. Health cannot be achieved without addressing the social determinants of health, and the answer does not lie in the health sector alone. One of the potential pathways to address vulnerabilities linked to poverty, social exclusion, and empowerment of women is aligning health programmes with empowerment interventions linked to access to capital through microfinance and self-help groups. This paper presents a framework to analyse combined health and financial interventions through microfinance programmes in reducing barriers to access health care. If properly designed and ethically managed such integrated programmes can provide more health for the money spent on health care. PMID:25364028

The link between infertility and poverty: evidence from Bangladesh.

PubMed

Nahar, Papreen

2012-03-01

The link between high fertility and poverty is well established. However, this paper shows how infertility may also generate poverty among childless families in Bangladesh. An ethnographic study was conducted, involving various qualitative research methods that revealed economic consequences to be one of the crucial sequelae of childlessness in Bangladesh. This paper details how the poverty/fertility relationship is dependent on social and institutional characteristics, including patriarchal values, education, urban-rural location and health services. Empirical data show that childlessness generates poverty in various ways, including the deprivation of children's earnings, decline in women's mobility, demoralisation of men to earn an income, marriage devaluation by the husband, disbursements for treatment and denial of microcredit (very small loans to those in poverty, which support them to become self-employed to generate income). The current study shows that the infertility/poverty relationship is mostly contingent upon class and gender. It is therefore the rural poor childless women who are most badly affected economically in Bangladesh rather than the urban middle class childless women. In other words, this study reveal that along with gender, class plays a dominant role in terms of the economic consequences of childlessness in Bangladesh. It sheds light on a different and unusual aspect of poverty and aims to contribute to the gender discussion of livelihood and poverty.

The link between poverty, environment and development. The political challenge of localizing Agenda 21.

PubMed

Wichmann, R

1995-11-01

This article discusses the links between poverty, development, the environment, and implementing Agenda 21. The poor in large cities experience greater health risks and threats from environmental hazards. The poor also face inadequate housing, poor sanitation, polluted drinking water, and lack of other basic services. Many poor live in marginalized areas more susceptible to environmental degradation. During 1990-2030, population size may reach 9.7 billion, or 3.7 billion more than today. 90% may be urban residents. Already a large proportion of urban population live in a decaying urban environment with health and life threatening conditions. At least 250 million do not have easy access to safe piped water. 400 million lack proper sanitation. The liberalization of the global economy is fueling urbanization. The cycle of poverty and environmental decline requires rapid economic growth and closing of the infrastructure gaps. Policy initiatives of Agenda 21 occur at the local urban level. At this level, policies directly affect people. The future success of Agenda 21 will depend on local initiatives. Management approaches may need to change in order to achieve sustainable development. The poor will be more vocal and heard from in the future. Critical areas of management include waste management, pollution control, traffic, transportation, energy, economic development, and job creation. Society must be able to participate in setting priorities. About 1500 local authorities are involved in Agenda 21 planning initiatives. Curitiba, Brazil, is an example of how cities can solve community problems.

Using Simulation to Teach About Poverty in Nursing Education: A Review of Available Tools.

PubMed

Reid, Carol A; Evanson, Tracy A

2016-01-01

Poverty is one of the most significant social determinants of health, and as such, it is imperative that nurses have an understanding of the impact that living in poverty has upon one's life and health. A lack of such understanding will impede nurses from providing care that is patient centered, treats all patients fairly, and advocates for social justice. It is essential that nursing educators assure that poverty-related content and effective teaching strategies are used in nursing curricula in order to help students develop this understanding. Several poverty-simulation tools are available and may be able to assist with development of accurate knowledge, skills, and attitudes. Unfortunately, little evidence exists to evaluate most poverty simulation tools. This article will provide an introduction to several poverty-related simulation tools, discuss any related research that evaluates their effectiveness, and make recommendations for integration of such simulation tools into nursing curricula. Copyright © 2016 Elsevier Inc. All rights reserved.

Explaining the impact of poverty on old-age frailty in Europe: material, psychosocial and behavioural factors.

PubMed

Stolz, Erwin; Mayerl, Hannes; Waxenegger, Anja; Freidl, Wolfgang

2017-12-01

Previous research found poverty to be associated with adverse health outcomes among older adults but the factors that translate low economic resources into poor physical health are not well understood. The goal of this analysis was to assess the impact of material, psychosocial, and behavioural factors as well as education in explaining the poverty-health link. In total, 28 360 observations from 11 390 community-dwelling respondents (65+) in the Survey of Health, Ageing and Retirement in Europe (2004-13, 10 countries) were analysed. Multilevel growth curve models were used to assess the impact of combined income and asset poverty risk on old-age frailty (frailty index) and associated pathway variables. In total, 61.8% of the variation of poverty risk on frailty level was explained by direct and indirect effects. Results stress the role of material and particularly psychosocial factors such as perceived control and social isolation, whereas the role of health behaviour was negligible. We suggest to strengthen social policy and public health efforts in order to fight poverty and its deleterious health effects from early age on as well as to broaden the scope of interventions with regard to psychosocial factors. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Mapping poverty using mobile phone and satellite data

PubMed Central

Pezzulo, Carla; Bjelland, Johannes; Iqbal, Asif M.; Hadiuzzaman, Khandakar N.; Lu, Xin; Wetter, Erik; Tatem, Andrew J.

2017-01-01

Poverty is one of the most important determinants of adverse health outcomes globally, a major cause of societal instability and one of the largest causes of lost human potential. Traditional approaches to measuring and targeting poverty rely heavily on census data, which in most low- and middle-income countries (LMICs) are unavailable or out-of-date. Alternate measures are needed to complement and update estimates between censuses. This study demonstrates how public and private data sources that are commonly available for LMICs can be used to provide novel insight into the spatial distribution of poverty. We evaluate the relative value of modelling three traditional poverty measures using aggregate data from mobile operators and widely available geospatial data. Taken together, models combining these data sources provide the best predictive power (highest r2 = 0.78) and lowest error, but generally models employing mobile data only yield comparable results, offering the potential to measure poverty more frequently and at finer granularity. Stratifying models into urban and rural areas highlights the advantage of using mobile data in urban areas and different data in different contexts. The findings indicate the possibility to estimate and continually monitor poverty rates at high spatial resolution in countries with limited capacity to support traditional methods of data collection. PMID:28148765

Mapping poverty using mobile phone and satellite data.

PubMed

Steele, Jessica E; Sundsøy, Pål Roe; Pezzulo, Carla; Alegana, Victor A; Bird, Tomas J; Blumenstock, Joshua; Bjelland, Johannes; Engø-Monsen, Kenth; de Montjoye, Yves-Alexandre; Iqbal, Asif M; Hadiuzzaman, Khandakar N; Lu, Xin; Wetter, Erik; Tatem, Andrew J; Bengtsson, Linus

2017-02-01

Poverty is one of the most important determinants of adverse health outcomes globally, a major cause of societal instability and one of the largest causes of lost human potential. Traditional approaches to measuring and targeting poverty rely heavily on census data, which in most low- and middle-income countries (LMICs) are unavailable or out-of-date. Alternate measures are needed to complement and update estimates between censuses. This study demonstrates how public and private data sources that are commonly available for LMICs can be used to provide novel insight into the spatial distribution of poverty. We evaluate the relative value of modelling three traditional poverty measures using aggregate data from mobile operators and widely available geospatial data. Taken together, models combining these data sources provide the best predictive power (highest r 2 = 0.78) and lowest error, but generally models employing mobile data only yield comparable results, offering the potential to measure poverty more frequently and at finer granularity. Stratifying models into urban and rural areas highlights the advantage of using mobile data in urban areas and different data in different contexts. The findings indicate the possibility to estimate and continually monitor poverty rates at high spatial resolution in countries with limited capacity to support traditional methods of data collection. © 2017 The Authors.

Overcoming Persistent Poverty--and Sinking into It. Income Trends in Persistent-Poverty and Other High-Poverty Rural Counties, 1989-94.

ERIC Educational Resources Information Center

Nord, Mark

In 1989, 31.6 percent of the rural poor lived in persistent-poverty counties (those with poverty rates exceeding 20 percent for every decennial census year since 1960), and an additional 12.6 percent lived in "new" high-poverty counties. While this represents less than half the rural poor, high and persistent poverty is of particular…

Evaluating the unintended health consequences of poverty alleviation strategies: or what is the relevance of Mohammed Yunus to public health?

PubMed

Mohindra, K S; Haddad, Slim

2008-01-01

Public health researchers are increasingly shifting their attention away from merely documenting those factors that determine health--a solid evidence base on health determinants now exists--to improving our understanding of how various interventions influence population health. This paper argues for greater investigations of the potential unintended health benefits associated with participation in a poverty alleviation strategy (PAS) in low-income countries. We focus on microcredit, a PAS that has been spreading across the developing world. Microcredit aims to address the "credit gap" between the poor and the better off by offering an alternative for the poor to acquire loans: small groups are formed and loans are allocated to members based on group solidarity instead of formal collateral. We argue that microcredit corresponds with activities that will help build up health capital (e.g., greater access to resources) and describe the main pathways from microcredit participation to health. We advocate that microcredit and other potential pro-health PAS be included among the range of interventions considered by public health researchers in improving the health of the poor.

Institutions and poverty.

PubMed

Tebaldi, Edinaldo; Mohan, Ramesh

2010-01-01

This study utilises eight alternative measures of institutions and the instrumental variable method to examine the impacts of institutions on poverty. The estimates show that an economy with a robust system to control corruption, an effective government, and a stable political system will create the conditions to promote economic growth, minimise income distribution conflicts, and reduce poverty. Corruption, ineffective governments, and political instability will not only hurt income levels through market inefficiencies, but also escalate poverty incidence via increased income inequality. The results also imply that the quality of the regulatory system, rule of law, voice and accountability, and expropriation risk are inversely related to poverty but their effect on poverty is via average income rather than income distribution.

A School-Level Proxy Measure for Individual-Level Poverty Using School-Level Eligibility for Free and Reduced-Price Meals.

PubMed

Day, Sophia E; Hinterland, Kinjia; Myers, Christa; Gupta, Leena; Harris, Tiffany G; Konty, Kevin J

2016-03-01

Socioeconomic status (SES) impacts health outcomes. The Youth Risk Behavior Survey (YRBS), like many school-based data sources, lacks individual-level poverty information. We propose using school-level percentages of student eligibility for free/reduced-price meals (%FRPM) as a proxy for individual-level poverty. Using the New York City (NYC) 2009 YRBS, we created school-level poverty quartiles to append to individual YRBS records by ranking schools by %FRPM. We compared this with 2 other school-level poverty measures using students' home and school neighborhood-level poverty and measured the association of these 3 school-level proxies with individual's household income. Last, we evaluated health outcomes by race/ethnicity and poverty to demonstrate the importance of accounting for poverty. The school-level measure that used %FRPM had the strongest association with household income. When the school-level individual poverty proxy was included in illustrative analyses using YRBS data, patterns by poverty within race/ethnicity emerged that were not seen when looking at race/ethnicity alone. Using a poverty measure to analyze school-based data will provide a better understanding of the impact of SES on health outcomes. Based on our evaluation, when individual-level information is not available, we propose using school-level %FRPM, which are publicly available throughout the United States. © 2016, American School Health Association.

Dietary Habits, Poverty, and Chronic Kidney Disease in an Urban Population

PubMed Central

Crews, Deidra C.; Kuczmarski, Marie Fanelli; III, Edgar R. Miller; Zonderman, Alan B.; Evans, Michele K.; Powe, Neil R.

2014-01-01

Background Poverty is associated with chronic kidney disease (CKD) in the US and worldwide. Poor dietary habits may contribute to this disparity. Study Design Cross-sectional study. Setting & Participants 2,058 community-dwelling adults aged 30-64 years residing in Baltimore City, Maryland. Predictors Adherence to the Dietary Approaches to Stop Hypertension (DASH) diet. DASH scoring based on 9 target nutrients (total fat, saturated fat, protein, fiber, cholesterol, calcium, magnesium, sodium, and potassium); adherence defined as score ≥4.5 out of maximum possible score of 9. Poverty (self-reported household income <125% of 2004 Department of Health and Human Services guideline) and non-poverty (≥125% of guideline). Outcomes & Measurements CKD defined as estimated glomerular filtration rate <60mL/min/1.73m2 (CKD-EPI). Multivariable logistic regression used to calculate adjusted odds ratios (AORs) for relation of DASH score tertile and CKD, stratified by poverty status. Results Among 2,058 participants (mean age 48 years; 57% black; 44% male; 42% with poverty), median DASH score was low, 1.5 (IQR, 1-2.5). Only 5.4% were adherent. Poverty, male sex, black race, and smoking were more prevalent among the lower DASH score tertiles, while higher education and regular health care were more prevalent among the highest DASH score tertile (P<0.05 for all). Fiber, calcium, magnesium and potassium intake were lower, and cholesterol higher, among the poverty as compared to non-poverty group (P<0.05 for all), with no difference in sodium intake. A total of 5.6% of the poverty and 3.8% of the non-poverty group had CKD (P=0.05). The lowest DASH tertile (compared to the highest) was associated with more CKD among the poverty [AOR 3.15, 95% Confidence Interval (CI) 1.51-6.56], but not among the non-poverty group (AOR 0.73, 95% CI 0.37-1.43). P interaction 0.001. Conclusions Poor dietary habits are strongly associated with CKD among the urban poor and may represent a target for

Escaping from poverty trap: a choice between government transfer payments and public services.

PubMed

Chen, Sixia; Li, Jianjun; Lu, Shengfeng; Xiong, Bo

2017-01-01

Anti-poverty has always been an important issue to be settled. What policies should be selected to help individuals escaping from the poverty trap: by directly offering transfer payments or indirectly providing public services? This paper is among the first to explore the effects of public anti-poverty programs system in China. We Using unbalanced panel data of China Health and Nutrition Survey (CHNS) from 1989 to 2009, we demonstrate how the individual poverty status is determined through a four-staged simultaneous model. We choose the 3SLS (Three Staged Linear Squared) methodology to do the estimation. GTPs (Government Transfer Payments) don't have positive effects on poverty reductions. The results demonstrate that GTPs increasing by 10% makes private transfer payments decrease by 3.9%. Meanwhile, GTPs increasing by 10% makes the household income decreased by 27.1%. However, public services (such as medical insurance, health services, hygiene protection etc.) have significantly positive impacts on poverty reduction. Public services share a part of living cost of the poor, and are conducive for people to gain higher household income. GTPs given by governments are not effective in reducing the poverty, as a result of "crowd-out effect" and "inductive effect". However, public services are suggested to be adopted by governments to help the poor out of the poverty trap.

Transient poverty, poverty dynamics, and vulnerability to poverty: An empirical analysis using a balanced panel from rural China.

PubMed

Ward, Patrick S

2016-02-01

China's economic reforms starting in the late 1970s have resulted in rapid economic growth, with annual growth in gross domestic product averaging greater than 10 percent per year for more than thirty years. Accompanying this rapid growth in national accounts have been rapid and widespread reductions in poverty. With these reductions in poverty, however, there has often been observed an increase in income inequality, both between as well as within rural and urban sectors. This rising income gap challenges the notion that economic reforms in China have been as successful as the poverty statistics would suggest. In this paper, we suggest that an alternative view would be to consider the effects of these reforms on changing the chronic nature of poverty and reducing household vulnerability to poverty. Using a balanced panel from rural China from 1991 through 2006, we find that most poverty among our sample has shifted from being chronic in nature to being transient, with households either shifting into a state of being non-poor moving in and out of poverty. Among our sample, vulnerability to poverty has been declining over time, but the declines are not uniform over time or space. We decompose household vulnerability status into two proximate causes: low expected income and high income variability, finding vulnerability increasingly due to income variability. Additionally, we demonstrate that vulnerable households have very different characteristics than non-vulnerable households.

Transient poverty, poverty dynamics, and vulnerability to poverty: An empirical analysis using a balanced panel from rural China

PubMed Central

Ward, Patrick S.

2015-01-01

China’s economic reforms starting in the late 1970s have resulted in rapid economic growth, with annual growth in gross domestic product averaging greater than 10 percent per year for more than thirty years. Accompanying this rapid growth in national accounts have been rapid and widespread reductions in poverty. With these reductions in poverty, however, there has often been observed an increase in income inequality, both between as well as within rural and urban sectors. This rising income gap challenges the notion that economic reforms in China have been as successful as the poverty statistics would suggest. In this paper, we suggest that an alternative view would be to consider the effects of these reforms on changing the chronic nature of poverty and reducing household vulnerability to poverty. Using a balanced panel from rural China from 1991 through 2006, we find that most poverty among our sample has shifted from being chronic in nature to being transient, with households either shifting into a state of being non-poor moving in and out of poverty. Among our sample, vulnerability to poverty has been declining over time, but the declines are not uniform over time or space. We decompose household vulnerability status into two proximate causes: low expected income and high income variability, finding vulnerability increasingly due to income variability. Additionally, we demonstrate that vulnerable households have very different characteristics than non-vulnerable households. PMID:26855470

Factors that Affect Poverty Areas in North Sumatera Using Discriminant Analysis

NASA Astrophysics Data System (ADS)

Nasution, D. H.; Bangun, P.; Sitepu, H. R.

2018-04-01

In Indonesia, especially North Sumatera, the problem of poverty is one of the fundamental problems that become the focus of government both central and local government. Although the poverty rate decreased but the fact is there are many people who are poor. Poverty happens covers several aspects such as education, health, demographics, and also structural and cultural. This research will discuss about several factors such as population density, Unemployment Rate, GDP per capita ADHK, ADHB GDP per capita, economic growth and life expectancy that affect poverty in Indonesia. To determine the factors that most influence and differentiate the level of poverty of the Regency/City North Sumatra used discriminant analysis method. Discriminant analysis is one multivariate analysis technique are used to classify the data into a group based on the dependent variable and independent variable. Using discriminant analysis, it is evident that the factor affecting poverty is Unemployment Rate.

Poor livestock keepers: ecosystem–poverty–health interactions

PubMed Central

Lindahl, Johanna; Wanyoike, Francis; Bett, Bernard; Randolph, Tom; Rich, Karl M.

2017-01-01

Humans have never been healthier, wealthier or more numerous. Yet, present success may be at the cost of future prosperity and in some places, especially in sub-Saharan Africa, poverty persists. Livestock keepers, especially pastoralists, are over-represented among the poor. Poverty has been mainly attributed to a lack of access, whether to goods, education or enabling institutions. More recent insights suggest ecosystems may influence poverty and the self-reinforcing mechanisms that constitute poverty traps in more subtle ways. The plausibility of zoonoses as poverty traps is strengthened by landmark studies on disease burden in recent years. While in theory, endemic zoonoses are best controlled in the animal host, in practice, communities are often left to manage disease themselves, with the focus on treatment rather than prevention. We illustrate this with results from a survey on health costs in a pastoral ecosystem. Epidemic zoonoses are more likely to elicit official responses, but these can have unintended consequences that deepen poverty traps. In this context, a systems understanding of disease control can lead to more effective and pro-poor disease management. We illustrate this with an example of how a system dynamics model can help optimize responses to Rift Valley fever outbreaks in Kenya by giving decision makers real-time access to the costs of the delay in vaccinating. In conclusion, a broader, more ecological understanding of poverty and of the appropriate responses to the diseases of poverty can contribute to improved livelihoods for livestock keepers in Africa. This article is part of the themed issue ‘One Health for a changing world: zoonoses, ecosystems and human well-being’. PMID:28584174

Health Care Access and Utilization Among Adults Aged 18-64, by Poverty Level: United States, 2013-2015.

PubMed

Martinez, Michael E; Ward, Brian W

2016-10-01

Data from the National Health Interview Survey, 2013-2015 •From 2013 through 2015, the percentage of adults aged 18-64 who were uninsured at the time of interview decreased for poor (40.0% to 26.2%), near-poor (37.8% to 23.9%), and not-poor (11.7% to 7.7%) adults. •The percentage of adults aged 18-64 who had a usual place to go for medical care increased for poor (66.9% to 73.6%) and near-poor (71.1% to 75.9%) adults. •The percentage of adults aged 18-64 who had seen or talked to a health professional in the past 12 months increased for poor (73.2% to 75.8%) and near-poor (71.9% to 75.9%) adults. •The percentage of adults aged 18-64 who did not obtain needed medical care due to cost at some time during the past 12 months decreased for poor (16.8% to 12.4%), near-poor (14.6% to 11.0%), and not-poor (4.9% to 3.8%) adults. In 2014, U.S. adults could purchase a private health insurance plan through the Health Insurance Marketplace or state-based exchanges established as part of the Affordable Care Act (ACA). Additionally, under ACA some states opted to expand Medicaid coverage to low-income adults. Individuals living in or near poverty may have benefited disproportionately from these changes given their lower rates of health insurance coverage (1). Data from the 2013-2015 National Health Interview Survey (NHIS) are used to describe recent changes in health insurance coverage and selected measures of health care access and utilization for adults aged 18-64 by family poverty level. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

The health, poverty, and financial consequences of a cigarette price increase among 500 million male smokers in 13 middle income countries: compartmental model study

PubMed Central

2018-01-01

Abstract Objective To examine the impact of a 50% increase in market prices of cigarettes on health, poverty, and financial protection. Design Compartmental model study. Setting 13 middle income countries, totalling two billion men. Participants 500 million male smokers. Main outcome measures Life years gained, averted treatment costs, number of men avoiding catastrophic healthcare expenditures and poverty, and additional tax revenue by income group. Results A 50% increase in cigarette prices would lead to about 450 million years of life gained across the 13 countries from smoking cessation, with half of these in China. Across all countries, men in the bottom income group (poorest 20% of the population) would gain 6.7 times more life years than men in the top income group (richest 20% of the population; 155 v 23 million). The average life years gained from cessation for each smoker in the bottom income group was 5.1 times that of the top group (1.46 v 0.23 years). Of the $157bn (£113bn; €127bn) in averted treatment costs, the bottom income group would avert 4.6 times more costs than the top income group ($46bn v $10bn). About 15.5 million men would avoid catastrophic health expenditures in a subset of seven countries without universal health coverage. As result, 8.8 million men, half of them in the bottom income group, would avoid falling below the World Bank definition of extreme poverty. These 8.8 million men constitute 2.4% of people living in extreme poverty in these countries. In contrast, the top income group would pay twice as much as the bottom income group of the $122bn additional tax collected. Overall, the bottom income group would get 31% of the life years saved and 29% each of the averted disease costs and averted catastrophic health expenditures, while paying only 10% of the additional taxes. Conclusions Higher prices of cigarettes provide more health and financial gains to the poorest 20% than to the richest 20% of the population. Higher excise

Neighborhood-Level Poverty at Menarche and Prepregnancy Obesity in African-American Women

PubMed Central

Peters, Rosalind M.; Burmeister, Charlotte; Bielak, Lawrence F.; Johnson, Dayna A.

2016-01-01

Introduction. Menarche is a critical time point in a woman's reproductive system development; exposures at menarche may influence maternal health. Living in a poorer neighborhood is associated with adult obesity; however, little is known if neighborhood factors at menarche are associated with prepregnancy obesity. Methods. We examined the association of neighborhood-level poverty at menarche with prepregnancy body mass index category in 144 pregnant African-American women. Address at menarche was geocoded to census tract (closest to year of menarche); neighborhood-level poverty was defined as the proportion of residents living under the federal poverty level. Cumulative logistic regression was used to examine the association of neighborhood-level poverty at menarche, in quartiles, with categorical prepregnancy BMI. Results. Before pregnancy, 59 (41%) women were obese. Compared to women in the lowest neighborhood-level poverty quartile, women in the highest quartile had 2.9 [1.2, 6.9] times higher odds of prepregnancy obesity; this was slightly attenuated after adjusting for age, marital status, education, and parity (odds ratio: 2.3 [0.9, 6.3]). Conclusions. Living in a higher poverty neighborhood at menarche is associated with prepregnancy obesity in African-American women. Future studies are needed to better understand the role of exposures in menarche on health in pregnancy. PMID:27418977

Neighborhood-Level Poverty at Menarche and Prepregnancy Obesity in African-American Women.

PubMed

Cassidy-Bushrow, Andrea E; Peters, Rosalind M; Burmeister, Charlotte; Bielak, Lawrence F; Johnson, Dayna A

2016-01-01

Introduction. Menarche is a critical time point in a woman's reproductive system development; exposures at menarche may influence maternal health. Living in a poorer neighborhood is associated with adult obesity; however, little is known if neighborhood factors at menarche are associated with prepregnancy obesity. Methods. We examined the association of neighborhood-level poverty at menarche with prepregnancy body mass index category in 144 pregnant African-American women. Address at menarche was geocoded to census tract (closest to year of menarche); neighborhood-level poverty was defined as the proportion of residents living under the federal poverty level. Cumulative logistic regression was used to examine the association of neighborhood-level poverty at menarche, in quartiles, with categorical prepregnancy BMI. Results. Before pregnancy, 59 (41%) women were obese. Compared to women in the lowest neighborhood-level poverty quartile, women in the highest quartile had 2.9 [1.2, 6.9] times higher odds of prepregnancy obesity; this was slightly attenuated after adjusting for age, marital status, education, and parity (odds ratio: 2.3 [0.9, 6.3]). Conclusions. Living in a higher poverty neighborhood at menarche is associated with prepregnancy obesity in African-American women. Future studies are needed to better understand the role of exposures in menarche on health in pregnancy.

Poverty, Inequality, and Discrimination as Sources of Depression among U.S. Women.

ERIC Educational Resources Information Center

Belle, Deborah; Doucet, Joanne

2003-01-01

Poverty, inequality, and discrimination endanger women's well-being. Poverty is a consistent predictor of depression in women. Economic inequalities relate to reduced life expectancy and various negative physical health consequences. Discrimination maintains inequalities, lessens economic security, and exposes women to unmerited contempt.…

Blood pressure among rural Montenegrin children in relation to poverty and gender.

PubMed

Martinovic, Milica; Belojevic, Goran; Evans, Gary W; Asanin, Bogdan; Lausevic, Dragan; Kovacevic, Natasa Duborija; Samardzic, Mira; Jaksic, Marina; Pantovic, Snezana

2014-06-01

Health inequalities may begin during childhood. The aim of this study was to investigate the main effect of poverty and its interactive effect with gender on children's blood pressure. The study was performed in two elementary schools from a rural region near Podgorica, the capital of Montenegro. A questionnaire including questions on family monthly income, children's physical activity and the consumption of junk food was self-administered by parents of 434 children (223 boys and 211 girls) aged 6-13 years. Children's poverty level was assessed using the recommendations from the National Study on Poverty in Montenegro. Children's body weight and height were measured and body mass index-for-gender-and-age percentile was calculated. An oscillometric monitor was used for measurement of children's resting blood pressure in school. A two-factorial analysis of variance with body mass index percentile, physical activity and junk food as covariates showed an interaction of gender and poverty on children's blood pressure, pointing to synergy between poverty and female gender, with statistical significance for raised diastolic pressure (F = 5.462; P = 0.021). Neither physical activity nor the consumption of junk food explained the interactive effect of poverty and gender on blood pressure. We show that poverty is linked to elevated blood pressure for girls but not boys, and this effect is statistically significant for diastolic pressure. The results are discussed in the light of gender differences in stress and coping that are endemic to poverty. © The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Adolescents and Poverty

ERIC Educational Resources Information Center

Wight, Vanessa R.

2011-01-01

More youth live in poverty and poor youth comprise a larger share of the youth population than was the case a decade ago. This article first provides a descriptive analysis of children in poverty; examining the incidence of poverty among children by selected demographic, socioeconomic, and geographic characteristics with a particular focus on…

Using Asset Poverty Measures to Understand Poverty Dynamics, Poverty Traps and Farmer Behavior in Sub-Saharan Africa: A Focus on Rural Ethiopia

ERIC Educational Resources Information Center

Liverpool, Lenis Saweda

2009-01-01

Effective poverty reduction programs require careful measurement of poverty status. Commonly used consumption or income-based classifications of poverty aggregate together households that are persistently poor with those who are only in poverty due to passing conditions. They also classify as non-poor households that are at risk of falling into…

Enhancing Schools’ Capacity to Support Children in Poverty: An Ecological Model of School-Based Mental Health Services

PubMed Central

Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.; Glisson, Charles

2013-01-01

School based mental health services for children in poverty can capitalize on schools’ inherent capacity to support development and bridge home and neighborhood ecologies. We propose an ecological model informed by public health and organizational theories to refocus school based services in poor communities on the core function of schools to promote learning. We describe how coalescing mental health resources around school goals includes a focus on universal programming, mobilizing indigenous school and community resources, and supporting core teaching technologies. We suggest an iterative research–practice approach to program adaptation and implementation as a means toward advancing science and developing healthy children. PMID:18581225

Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Group).

PubMed

Kim, Jae Kyoung; Jeong, Ina; Lee, Ji Yeon; Kim, Jung Hyun; Han, Ah Yeon; Kim, So Yeon; Joh, Joon Sung

2018-03-07

The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

Income inequality, poverty, and population health: evidence from recent data for the United States.

PubMed

Ram, Rati

2005-12-01

In this study, state-level US data for the years 2000 and 1990 are used to provide additional evidence on the roles of income inequality and poverty in population health. Five main points are noted. First, contrary to the suggestion made in several recent studies, the income inequality parameter is observed to be quite robust and carries statistical significance in mortality equations estimated from several observation sets and a fairly wide variety of specificational choices. Second, the evidence does not indicate that significance of income inequality is lost when education variables are included. Third, similarly, the income inequality parameter shows significance when a race variable is added, and also when both race and urbanization terms are entered. Fourth, while poverty is seen to have some mortality-increasing consequence, the role of income inequality appears stronger. Fifth, income inequality retains statistical significance when a quadratic income term is added and also if the log-log version of a fairly inclusive model is estimated. I therefore suggest that the recent skepticism articulated by several scholars in regard to the robustness of the income inequality parameters in mortality equations estimated from the US data should be reconsidered.

Poverty in Education

ERIC Educational Resources Information Center

Greever, Sadie

2014-01-01

The purpose of this literature review is to provide a comprehensive summary of the topic of poverty and its effects upon student behavior and academic performance. Presented in this chapter of the review of the related literature will be: (a) description of poverty and the role of education, (b) effects of poverty on student behavior, (c) effects…

A longitudinal study on the impact of income change and poverty on smoking cessation.

PubMed

Young-Hoon, Kit-Ngan

2012-01-01

Research on the association between income and smoking cessation has examined income as a static phenomenon, either cross-sectionally or as a predictor variable in longitudinal studies. This study recognizes income as a dynamic entity and examines the relationship between a change in income and subsequent smoking behaviour. Longitudinal data from the National Population Health Survey (1994/5 to 2008/9) were used to examine the impact of (1) change in income and (2) change in poverty status, on the probability of being a former or current smoker among a sample of Canadians identified as having ever smoked. Covariates include socio-demographic characteristics, number of cigarettes smoked per day, and smoking in the home. Smoking behaviour was not associated with a change in household income but was associated with a change in household income that moved an individual across the poverty threshold. Canadians whose income increased to above the poverty threshold were less likely to continue smoking than someone who remained in poverty (OR = 0.72, 95% CI: 0.62-0.84). Those who remained out of poverty were also less likely to continue smoking than someone who remained in poverty (OR = 0.66, 95% CI: 0.57-0.75). There was no significant difference between those who remained in poverty and those whose income decreased to below the poverty level. This study strengthens the link between smoking and poverty and supports strategies that address income as a socio-economic determinant of health. Policies that increase household incomes above the poverty line may lead to improvements in smoking cessation rates.

The global distribution of risk factors by poverty level.

PubMed Central

Blakely, Tony; Hales, Simon; Kieft, Charlotte; Wilson, Nick; Woodward, Alistair

2005-01-01

OBJECTIVE: To estimate the individual-level association of income poverty with being underweight, using tobacco, drinking alcohol, having access only to unsafe water and sanitation, being exposed to indoor air pollution and being obese. METHODS: Using survey data for as many countries as possible, we estimated the relative risk association between income or assets and risk factors at the individual level within 11 medium- and low-income subregions of WHO. WHO and The World Bank data on the prevalence of risk factors and income poverty (defined as living on < US$ 1.00 per day, US$ 1-2.00 per day and > US$ 2.00 per day) were analysed to impute the association between poverty and risk factors for each subregion. The possible effect of poverty reduction on the prevalence of risk factors was estimated using population-attributable risk percentages. FINDINGS: There were strong associations between poverty and malnutrition among children, having access only to unsafe water and sanitation, and being exposed to indoor air pollution within each subregion (relative risks were twofold to threefold greater for those living on < US$ 1.00 per day compared with those living on > US$ 2.00 per day). Associations between poverty and obesity, tobacco use and alcohol use varied across subregions. If everyone living on < US$ 2.00 per day had the risk factor profile of those living on > US$ 2.00 per day, 51% of exposures to unimproved water and sanitation could be avoided as could 37% of malnutrition among children and 38% of exposure to indoor air pollution. The more realistic, but still challenging, Millennium Development Goal of halving the number of people living on < US$ 1.00 per day would achieve much smaller reductions. CONCLUSION: To achieve large gains in global health requires both poverty eradication and public health action. The methods used in this study may be useful for monitoring pro-equity progress towards Millennium Development Goals. PMID:15744404