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.

The joint contribution of neighborhood poverty and social integration to mortality risk in the United States.

PubMed

Marcus, Andrea Fleisch; Echeverria, Sandra E; Holland, Bart K; Abraido-Lanza, Ana F; Passannante, Marian R

2016-04-01

A well-established literature has shown that social integration strongly patterns health, including mortality risk. However, the extent to which living in high-poverty neighborhoods and having few social ties jointly pattern survival in the United States has not been examined. We analyzed data from the Third National Health and Nutrition Examination Survey (1988-1994) linked to mortality follow-up through 2006 and census-based neighborhood poverty. We fit Cox proportional hazards models to estimate associations between social integration and neighborhood poverty on all-cause mortality as independent predictors and in joint-effects models using the relative excess risk due to interaction to test for interaction on an additive scale. In the joint-effects model adjusting for age, gender, race/ ethnicity, and individual-level socioeconomic status, exposure to low social integration alone was associated with increased mortality risk (hazard ratio [HR]: 1.42, 95% confidence interval [CI]: 1.28-1.59) while living in an area of high poverty alone did not have a significant effect (HR: 1.10; 95% CI: 0.95-1.28) when compared with being jointly unexposed. Individuals simultaneously living in neighborhoods characterized by high poverty and having low levels of social integration had an increased risk of mortality (HR: 1.63; 95% CI: 1.35-1.96). However, relative excess risk due to interaction results were not statistically significant. Social integration remains an important determinant of mortality risk in the United States independent of neighborhood poverty. Copyright © 2016 Elsevier Inc. All rights reserved.

Race, Neighborhood Economic Status, Income Inequality and Mortality.

PubMed

Mode, Nicolle A; Evans, Michele K; Zonderman, Alan B

2016-01-01

Mortality rates in the United States vary based on race, individual economic status and neighborhood. Correlations among these variables in most urban areas have limited what conclusions can be drawn from existing research. Our study employs a unique factorial design of race, sex, age and individual poverty status, measuring time to death as an objective measure of health, and including both neighborhood economic status and income inequality for a sample of middle-aged urban-dwelling adults (N = 3675). At enrollment, African American and White participants lived in 46 unique census tracts in Baltimore, Maryland, which varied in neighborhood economic status and degree of income inequality. A Cox regression model for 9-year mortality identified a three-way interaction among sex, race and individual poverty status (p = 0.03), with African American men living below poverty having the highest mortality. Neighborhood economic status, whether measured by a composite index or simply median household income, was negatively associated with overall mortality (p<0.001). Neighborhood income inequality was associated with mortality through an interaction with individual poverty status (p = 0.04). While racial and economic disparities in mortality are well known, this study suggests that several social conditions associated with health may unequally affect African American men in poverty in the United States. Beyond these individual factors are the influences of neighborhood economic status and income inequality, which may be affected by a history of residential segregation. The significant association of neighborhood economic status and income inequality with mortality beyond the synergistic combination of sex, race and individual poverty status suggests the long-term importance of small area influence on overall mortality.

Racial disparities in diabetes mortality in the 50 most populous US cities.

PubMed

Rosenstock, Summer; Whitman, Steve; West, Joseph F; Balkin, Michael

2014-10-01

While studies have consistently shown that in the USA, non-Hispanic Blacks (Blacks) have higher diabetes prevalence, complication and death rates than non-Hispanic Whites (Whites), there are no studies that compare disparities in diabetes mortality across the largest US cities. This study presents and compares Black/White age-adjusted diabetes mortality rate ratios (RRs), calculated using national death files and census data, for the 50 most populous US cities. Relationships between city-level diabetes mortality RRs and 12 ecological variables were explored using bivariate correlation analyses. Multivariate analyses were conducted using negative binomial regression to examine how much of the disparity could be explained by these variables. Blacks had statistically significantly higher mortality rates compared to Whites in 39 of the 41 cities included in analyses, with statistically significant rate ratios ranging from 1.57 (95 % CI: 1.33-1.86) in Baltimore to 3.78 (95 % CI: 2.84-5.02) in Washington, DC. Analyses showed that economic inequality was strongly correlated with the diabetes mortality disparity, driven by differences in White poverty levels. This was followed by segregation. Multivariate analyses showed that adjusting for Black/White poverty alone explained 58.5 % of the disparity. Adjusting for Black/White poverty and segregation explained 72.6 % of the disparity. This study emphasizes the role that inequalities in social and economic determinants, rather than for example poverty on its own, play in Black/White diabetes mortality disparities. It also highlights how the magnitude of the disparity and the factors that influence it can vary greatly across cities, underscoring the importance of using local data to identify context specific barriers and develop effective interventions to eliminate health disparities.

Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults

PubMed Central

Illescas, Alex H.; Hohl, Bernadette C.; Llanos, Adana A. M.

2017-01-01

Background Social isolation is an important determinant of all-cause mortality, with evidence suggesting an association with cancer-specific mortality as well. In this study, we examined the associations between social isolation and neighborhood poverty (independently and jointly) on cancer mortality in a population-based sample of US adults. Methods Using data from the Third National Health and Nutrition Examination Survey (NHANES III; 1988–1994), NHANES III Linked Mortality File (through 2011) and 1990 Census, we estimated the relationship between social isolation and high neighborhood poverty and time-to-cancer death using multivariable-adjusted Cox proportional hazards models. We examined the associations of each factor independently and explored the multiplicative and additive interaction effects on cancer mortality risk and also analyzed these associations by sex. Results Among 16 044 US adults with 17–23 years of follow-up, there were 1133 cancer deaths. Social isolation (HR 1.25, 95% CI: 1.01–1.54) and high neighborhood poverty (HR 1.31, 95% CI: 1.08–1.60) were associated with increased risk of cancer mortality adjusting for age, sex, and race/ethnicity; in sex-specific estimates this increase in risk was evident among females only (HR 1.39, 95% CI: 1.04–1.86). These associations were attenuated upon further adjustment for socioeconomic status. There was no evidence of joint effects of social isolation and high neighborhood poverty on cancer mortality overall or in the sex-stratified models. Conclusions These findings suggest that social isolation and higher neighborhood poverty are independently associated with increased risk of cancer mortality, although there is no evidence to support our a priori hypothesis of a joint effect. PMID:28273125

Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults.

PubMed

Fleisch Marcus, Andrea; Illescas, Alex H; Hohl, Bernadette C; Llanos, Adana A M

2017-01-01

Social isolation is an important determinant of all-cause mortality, with evidence suggesting an association with cancer-specific mortality as well. In this study, we examined the associations between social isolation and neighborhood poverty (independently and jointly) on cancer mortality in a population-based sample of US adults. Using data from the Third National Health and Nutrition Examination Survey (NHANES III; 1988-1994), NHANES III Linked Mortality File (through 2011) and 1990 Census, we estimated the relationship between social isolation and high neighborhood poverty and time-to-cancer death using multivariable-adjusted Cox proportional hazards models. We examined the associations of each factor independently and explored the multiplicative and additive interaction effects on cancer mortality risk and also analyzed these associations by sex. Among 16 044 US adults with 17-23 years of follow-up, there were 1133 cancer deaths. Social isolation (HR 1.25, 95% CI: 1.01-1.54) and high neighborhood poverty (HR 1.31, 95% CI: 1.08-1.60) were associated with increased risk of cancer mortality adjusting for age, sex, and race/ethnicity; in sex-specific estimates this increase in risk was evident among females only (HR 1.39, 95% CI: 1.04-1.86). These associations were attenuated upon further adjustment for socioeconomic status. There was no evidence of joint effects of social isolation and high neighborhood poverty on cancer mortality overall or in the sex-stratified models. These findings suggest that social isolation and higher neighborhood poverty are independently associated with increased risk of cancer mortality, although there is no evidence to support our a priori hypothesis of a joint effect.

Race, Neighborhood Economic Status, Income Inequality and Mortality

PubMed Central

Mode, Nicolle A; Evans, Michele K; Zonderman, Alan B

2016-01-01

Mortality rates in the United States vary based on race, individual economic status and neighborhood. Correlations among these variables in most urban areas have limited what conclusions can be drawn from existing research. Our study employs a unique factorial design of race, sex, age and individual poverty status, measuring time to death as an objective measure of health, and including both neighborhood economic status and income inequality for a sample of middle-aged urban-dwelling adults (N = 3675). At enrollment, African American and White participants lived in 46 unique census tracts in Baltimore, Maryland, which varied in neighborhood economic status and degree of income inequality. A Cox regression model for 9-year mortality identified a three-way interaction among sex, race and individual poverty status (p = 0.03), with African American men living below poverty having the highest mortality. Neighborhood economic status, whether measured by a composite index or simply median household income, was negatively associated with overall mortality (p<0.001). Neighborhood income inequality was associated with mortality through an interaction with individual poverty status (p = 0.04). While racial and economic disparities in mortality are well known, this study suggests that several social conditions associated with health may unequally affect African American men in poverty in the United States. Beyond these individual factors are the influences of neighborhood economic status and income inequality, which may be affected by a history of residential segregation. The significant association of neighborhood economic status and income inequality with mortality beyond the synergistic combination of sex, race and individual poverty status suggests the long-term importance of small area influence on overall mortality. PMID:27171406

Distribution of chronic disease mortality and deterioration in household socioeconomic status in rural Bangladesh: an analysis over a 24-year period

PubMed Central

Khan, Jahangir AM; Trujillo, Antonio J; Ahmed, Sayem; Siddiquee, Ali Tanweer; Alam, Nurul; Mirelman, Andrew J; Koehlmoos, Tracey Perez; Niessen, Louis Wilhelmus; Peters, David H

2015-01-01

Background: Little is known about long-term changes linking chronic diseases and poverty in low-income countries such as Bangladesh. This study examines how chronic disease mortality rates change across socioeconomic groups over time in Bangladesh, and whether such mortality is associated with households falling into poverty. Methods: Age-sex standardized chronic diseases mortality rates were estimated across socioeconomic groups in 1982, 1996 and 2005, using data from the health and demographic surveillance system in Matlab, Bangladesh. Changes in households falling below a poverty threshold after a chronic disease death were estimated between 1982–96 and 1996–2005. Results: Age-sex standardized chronic disease mortality rates rose from 646 per 100 000 population in 1982 to 670 in 2005. Mortality rates were higher in wealthier compared with poorer households in 1982 [Concentration Index = 0.037; 95% confidence interval (CI): 0.002, 0.072], but switched direction in 1996 (Concentration Index = −0.007; 95% CI: −0.023, 0.009), with an even higher concentration in the poor by 2005 (Concentration Index = −0.047; 95% CI: −0.061, −0.033). Between 1982–96 and 1996–2005, the highest chronic disease mortality rates were found among those households that fell below the poverty line. Households that had a chronic disease death in 1982 were 1.33 (95% CI: 1.03, 1.70) times more likely to fall below the poverty line in 1996 compared with households that did not. Conclusions: Chronic disease mortality is a growing proportion of the disease burden in Bangladesh, with poorer households being more affected over time periods, leading to future household poverty. PMID:26467760

Distribution of chronic disease mortality and deterioration in household socioeconomic status in rural Bangladesh: an analysis over a 24-year period.

PubMed

Khan, Jahangir Am; Trujillo, Antonio J; Ahmed, Sayem; Siddiquee, Ali Tanweer; Alam, Nurul; Mirelman, Andrew J; Koehlmoos, Tracey Perez; Niessen, Louis Wilhelmus; Peters, David H

2015-12-01

Little is known about long-term changes linking chronic diseases and poverty in low-income countries such as Bangladesh. This study examines how chronic disease mortality rates change across socioeconomic groups over time in Bangladesh, and whether such mortality is associated with households falling into poverty. Age-sex standardized chronic diseases mortality rates were estimated across socioeconomic groups in 1982, 1996 and 2005, using data from the health and demographic surveillance system in Matlab, Bangladesh. Changes in households falling below a poverty threshold after a chronic disease death were estimated between 1982-96 and 1996-2005. Age-sex standardized chronic disease mortality rates rose from 646 per 100 000 population in 1982 to 670 in 2005. Mortality rates were higher in wealthier compared with poorer households in 1982 [Concentration Index = 0.037; 95% confidence interval (CI): 0.002, 0.072], but switched direction in 1996 (Concentration Index = -0.007; 95% CI: -0.023, 0.009), with an even higher concentration in the poor by 2005 (Concentration Index = -0.047; 95% CI: -0.061, -0.033). Between 1982-96 and 1996-2005, the highest chronic disease mortality rates were found among those households that fell below the poverty line. Households that had a chronic disease death in 1982 were 1.33 (95% CI: 1.03, 1.70) times more likely to fall below the poverty line in 1996 compared with households that did not. Chronic disease mortality is a growing proportion of the disease burden in Bangladesh, with poorer households being more affected over time periods, leading to future household poverty. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Investigating the relationship between neighborhood poverty and mortality risk: A marginal structural modeling approach

PubMed Central

Do, D. Phuong; Wang, Lu; Elliott, Michael R.

2013-01-01

Extant observational studies generally support the existence of a link between neighborhood context and health. However, estimating the causal impact of neighborhood effects from observational data has proven to be a challenge. Omission of relevant factors may lead to overestimating the effects of neighborhoods on health while inclusion of time-varying confounders that may also be mediators (e.g., income, labor force status) may lead to underestimation. Using longitudinal data from the 1990 to 2007 years of the Panel Study of Income Dynamics, this study investigates the link between neighborhood poverty and overall mortality risk. A marginal structural modeling strategy is employed to appropriately adjust for simultaneous mediating and confounding factors. To address the issue of possible upward bias from the omission of key variables, sensitivity analysis to assess the robustness of results against unobserved confounding is conducted. We examine two continuous measures of neighborhood poverty – single-point and a running average. Both were specified as piece-wise linear splines with a knot at 20 percent. We found no evidence from the traditional naïve strategy that neighborhood context influences mortality risk. In contrast, for both the single-point and running average neighborhood poverty specifications, the marginal structural model estimates indicated a statistically significant increase in mortality risk with increasing neighborhood poverty above the 20 percent threshold. For example, below 20 percent neighborhood poverty, no association was found. However, after the 20 percent poverty threshold is reached, each 10 percentage point increase in running average neighborhood poverty was found to increase the odds for mortality by 89 percent [95% CI = 1.22, 2.91]. Sensitivity analysis indicated that estimates were moderately robust to omitted variable bias. PMID:23849239

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.

Distinguishing the race-specific effects of income inequality and mortality in U.S. metropolitan areas.

PubMed

Nuru-Jeter, Amani M; Williams, T; LaVeist, Thomas A

2014-01-01

In the United States, the association between income inequality and mortality has been fairly consistent. However, few studies have explicitly examined the impact of race. Studies that have either stratified outcomes by race or conducted analyses within race-specific groups suggest that the income inequality/mortality relation may differ for blacks and whites. The factors explaining the association may also differ for the two groups. Multivariate ordinary least squares regression analysis was used to examine associations between study variables. We used three measures of income inequality to examine the association between income inequality and age-adjusted all-cause mortality among blacks and whites separately. We also examined the role of racial residential segregation and concentrated poverty in explaining associations among groups. Metropolitan areas were included if they had a population of at least 100,000 and were at least 10 percent black. There was a positive income inequality/mortality association among blacks and an inverse association among whites. Racial residential segregation completely attenuated the income inequality/mortality relationship for blacks, but was not significant among whites. Concentrated poverty was a significant predictor of mortality rates in both groups but did not confound associations. The implications of these findings and directions for future research are discussed.

Child mortality and poverty in three world regions (the West, Asia and Sub-Saharan Africa) 1988-2010: Evidence of relative intra-regional neglect?

PubMed

Pritchard, Colin; Keen, Steven

2016-12-01

Poverty kills children. This study assesses the relationship between poverty and child mortality rates (CMRs) in 71 societies from three world regions to determine whether some countries, relative to their region, neglect their children. Spearman rank order correlations were calculated to determine any association between the CMR and poverty data, including income inequality and gross national income. A current CMR one standard deviation (SD) above or below the regional average and a percentage change between 1988 and 2010 were used as the measures to assess the progress of nations. There were positive significant correlations between higher CMRs and relative poverty measures in all three regions. In Western countries, the current CMRs in the USA, New Zealand and Canada were 1 SD below the Western mean. The narrowest income inequalities, apart from Japan, were seen in the Scandinavian nations alongside low CMRs. In Asia, the current CMRs in Pakistan, Myanmar and India were the highest in their region and were 1 SD below the regional mean. Alongside South Korea, these nations had the lowest percentage reductions in CMRs. In Sub-Saharan Africa, the current CMRs in Somalia, Burkina Faso, Sierra Leone, Chad, Democratic Republic of Congo and Angola were the highest in their region and were 1 SD below the regional mean. Those concerned with the pursuit of social justice need to alert their societies to the corrosive impact of poverty on child mortality. Progress in reducing CMRs provides an indication of how well nations are meeting the needs of their children. Further country-specific research is required to explain regional differences.

Double jeopardy: interaction effects of marital and poverty status on the risk of mortality.

PubMed

Smith, K R; Waitzman, N J

1994-08-01

The purpose of this paper is to examine the hypothesis that marital and poverty status interact in their effects on mortality risks beyond their main effects. This study examines the epidemiological bases for applying an additive rather than a multiplicative specification when testing for interaction between two discrete risk factors. We specifically predict that risks associated with being nonmarried and with being poor interact to produce mortality risks that are greater than each risk acting independently. The analysis is based on men and women who were ages 25-74 during the 1971-1975 National Health and Nutrition Examination Survey I (NHANES I) and who were traced successfully in the NHANES I Epidemiologic Follow-Up Study in 1982-1984. Overall, being both poor and nonmarried places nonelderly (ages 25-64) men, but not women, at risk of mortality greater than that expected from the main effects. This study shows that for all-cause mortality, marital and poverty status interact for men but less so for women; these findings exist when interaction is assessed with either a multiplicative or an additive standard. This difference is most pronounced for poor, widowed men and (to a lesser degree) poor, divorced men. For violent/accidental deaths among men, the interaction effects are large on the basis of an additive model. Weak main and interaction effects were detected for the elderly (age 65+).

Hispanic and Immigrant Paradoxes in U.S. Breast Cancer Mortality: Impact of Neighborhood Poverty and Hispanic Density.

PubMed

Pruitt, Sandi L; Tiro, Jasmin A; Xuan, Lei; Lee, Simon J Craddock

2016-12-14

To test the Hispanic and Immigrant Paradoxes-i.e., survival advantages despite a worse risk factor profile-and the modifying role of neighborhood context, we examined associations between patient ethnicity, birthplace, neighborhood Hispanic density and neighborhood poverty among 166,254 female breast cancer patients diagnosed 1995-2009 in Texas, U.S. Of all, 79.9% were non-Hispanic White, 15.8% Hispanic U.S.-born, and 4.2% Hispanic foreign-born. We imputed birthplace for the 60.7% of Hispanics missing birthplace data using multiple imputation. Shared frailty Cox proportional hazard models (patients nested within census tracts) adjusted for age, diagnosis year, stage, grade, histology, urban/rural residence, and local mammography capacity. Whites (vs. U.S.-born Hispanics) had increased all-cause and breast cancer mortality. Foreign-born (vs. U.S.-born) Hispanics had increased all-cause and breast cancer mortality. Living in higher Hispanic density neighborhoods was generally associated with increased mortality, although associations differed slightly in magnitude and significance by ethnicity, birthplace, and neighborhood poverty. We found no evidence of an Immigrant Paradox and some evidence of a Hispanic Paradox where protective effects were limited to U.S.-born Hispanics. Contrary to prior studies, foreign birthplace and residence in higher Hispanic density neighborhoods were associated with increased mortality. More research on intersections between ethnicity, birthplace and neighborhood context are needed.

Poverty, hunger, education, and residential status impact survival in HIV.

PubMed

McMahon, James; Wanke, Christine; Terrin, Norma; Skinner, Sally; Knox, Tamsin

2011-10-01

Despite combination antiretroviral therapy (ART), HIV infected people have higher mortality than non-infected. Lower socioeconomic status (SES) predicts higher mortality in many chronic illnesses but data in people with HIV is limited. We evaluated 878 HIV infected individuals followed from 1995 to 2005. Cox proportional hazards for all-cause mortality were estimated for SES measures and other factors. Mixed effects analyses examined how SES impacts factors predicting death. The 200 who died were older, had lower CD4 counts, and higher viral loads (VL). Age, transmission category, education, albumin, CD4 counts, VL, hunger, and poverty predicted death in univariate analyses; age, CD4 counts, albumin, VL, and poverty in the multivariable model. Mixed models showed associations between (1) CD4 counts with education and hunger; (2) albumin with education, homelessness, and poverty; and (3) VL with education and hunger. SES contributes to mortality in HIV infected persons directly and indirectly, and should be a target of health policy in this population.

Poverty and child (0-14 years) mortality in the USA and other Western countries as an indicator of "how well a country meets the needs of its children" (UNICEF).

PubMed

Pritchard, Colin; Williams, Richard

2011-01-01

Children's (0-14 years) mortality rates in the USA and 19 Western countries (WCs) were examined in the context of a nation-specific measure of relative poverty and the Gross Domestic Product Health Expenditure (GDPHE) of countries to compare the effectiveness and efficiency of health care systems "to meet the needs of its children" (UNICEF). World Health Organisation child mortality rates per million were analysed for 1979-1981 and 2003-2005 to determine any significant differences between the USA and the other WCs over these periods. Child mortality rates are correlated with all countries GDPHE and 'relative poverty', defined by 'Income Inequalities', i.e., the gap between top and bottom 20% of incomes. Outputs: The mortality rate of every country fell substantially ranging from falls of 46% in the USA to 78% in Portugal. The highest current mortality rates are: USA, 2436 per million (pm), New Zealand 2105 pm, Portugal 1929 pm, Canada 1877 pm and the UK 1834 pm; the lowest are: Japan 1073 pm and Sweden 1075 pm, Finland 1193 pm and Norway 1200 pm. A total of 16 countries rates fell significantly more than the USA over these periods. Inputs: The USA had the greatest GDPHE and widest Income Inequality gap. There was no significant correlation between GDPHE and mortality but highly significant correlations with children's deaths and income inequalities. The five widest income inequality countries had the six worst rates, the narrowest four had the lowest. Despite major improvements in every WC, based upon financial inputs and child mortality outputs, the USA health care system appears the least efficient and effective in "meeting the needs of its children".

[Association between types of need, human development index, and infant mortality in Mexico, 2008].

PubMed

Medina-Gómez, Oswaldo Sinoe; López-Arellano, Oliva

2011-08-01

The aim of this study was to assess the association between different types of economic and social deprivation and infant mortality rates reported in 2008 in Mexico. We conducted an ecological study analyzing the correlation and relative risk between the human development index and levels of social and economic differences in State and national infant mortality rates. There was a strong correlation between higher human development and lower infant mortality. Low schooling and poor housing and crowding were associated with higher infant mortality. Although infant mortality has declined dramatically in Mexico over the last 28 years, the decrease has not been homogeneous, and there are persistent inequalities that determine mortality rates in relation to different poverty levels. Programs with a multidisciplinary approach are needed to decrease infant mortality rates through comprehensive individual and family development.

Excess black mortality in the United States and in selected black and white high-poverty areas, 1980-2000.

PubMed

Geronimus, Arline T; Bound, John; Colen, Cynthia G

2011-04-01

Black working-aged residents of urban high-poverty areas suffered severe excess mortality in 1980 and 1990. Our goal in this study was to determine whether this trend persisted in 2000. We analyzed death certificate and census data to estimate age-standardized all-cause and cause-specific mortality among 16- to 64-year-old Blacks and Whites nationwide and in selected urban and rural high-poverty areas. Urban men's mortality rate estimates peaked in 1990 and declined between 1990 and 2000 back to or below 1980 levels. Evidence of excess mortality declines among urban or rural women and among rural men was modest, with some increases. Between 1980 and 2000, there was little decline in chronic disease mortality among men and women in most areas, and in some instances there were increases. In 2000, despite improved economic conditions, working-age residents of the study areas still died disproportionately of early onset of chronic disease, suggesting an entrenched burden of disease and unmet health care needs. The lack of consistent improvement in death rates among working-age residents of high-poverty areas since 1980 necessitates reflection and concerted action given that sustainable progress has been elusive for this age group.

The relationship between social stratification and all-cause mortality among children in the United States: 1968-1992.

PubMed

DiLiberti, J H

2000-01-01

US childhood poverty rates have increased for most of the past 2 decades. Although overall mortality among children has apparently fallen during this interval, these aggregate mortality rates may hide a disproportionate burden imposed on the least advantaged. This study assessed the impact of social stratification on long-term US childhood mortality rates and examined the temporal relationship between mortality attributable to social stratification and childhood poverty rates. Using US childhood mortality data obtained from the Compressed Mortality File (National Center for Health Statistics) and a county-level measure of social stratification (residential telephone availability), I evaluated the impact of social stratification on long-term trends (1968-1992) in age-adjusted mortality and compared the resulting attributable proportions to trends in childhood poverty rates. Between 1968 and 1987 the proportion of US childhood deaths attributable to social stratification decreased from.22 to.17. Subsequently, it increased to.24 in 1992, despite continuous declines in overall childhood mortality rates. These proportions correlated strongly with earlier childhood poverty rates, taking into account an apparent 9-year lag. Among black children comparable trends were not observed, although throughout this time period their mortality rates were far higher than among the rest of the population and declined more slowly. Despite declining childhood mortality rates between 1968 and 1992, children living in the least advantaged counties continued to die at higher rates than those living in the most advantaged counties. This differential worsened considerably after 1987, and by 1992 had a substantive impact on US life expectancy at birth, resulting in perhaps the most significant (in terms of years of life lost) reversal in the health of the US public in the 20th century.

Abolishing inequity, a necessity for poverty reduction and the realisation of child mortality targets.

PubMed

Målqvist, Mats

2015-02-01

The first Millennium Development Goal (MDG 1) due in 2015 concerns poverty reduction. It has been claimed to be fulfilled on a global level, but still more than 1 billion people are living in abject poverty. There is a strong link between the economy and child survival, and only a minority of countries will have reached the MDG target for child mortality reduction by 2015. This paper discusses the relationship between poverty and child survival. It argues that a focus on equity is necessary to further reduce child mortality, through poverty reduction in absolute terms and also through targeting interventions for increased child survival to disadvantaged populations. The political will to actually achieve real change for those in greatest need is crucial but not to be taken for granted, and the distribution rather than the generation of wealth needs to be made a priority in the post-MDG era. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Maternal Mortality in Colombia in 2011: A Two Level Ecological Study

PubMed Central

Cárdenas-Cárdenas, Luz Mery; Cotes-Cantillo, Karol; Chaparro-Narváez, Pablo Enrique; Fernández-Niño, Julián Alfredo; Paternina-Caicedo, Angel; Castañeda-Orjuela, Carlos; De la Hoz-Restrepo, Fernando

2015-01-01

Objective Maternal mortality reduction is a Millennium Development Goal. In Colombia, there is a large disparity in the maternal mortality ratio (MMR) between and into departments (states) and also between municipalities. We examined socioeconomics variables at the municipal and departmental levels which could be associated to the municipal maternal mortality in Colombia. Methods A multilevel ecology study was carried out using different national data sources in Colombia. The outcome variable was the MMR at municipal level in 2011 with multidimensional poverty at municipal and department level as the principal independent variables and other measures of the social and economic characteristics at municipal and departmental level were also considered explicative variables (overall fertility municipal rate, percentage of local rural population, health insurance coverage, per capita territorial participation allocated to the health sector, transparency index and Gini coefficient). The association between MMR and socioeconomic contextual conditions at municipal and departmental level was assessed using a multilevel Poisson regression model. Results The MMR in the Colombian municipalities was associated significantly with the multidimensional poverty (relative ratio of MMR: 3.52; CI 95%: 1.09-11.38). This association was stronger in municipalities from departments with the highest poverty (relative ratio of MMR: 7.14; CI 95%: 2.01-25.35). Additionally, the MMR at municipal level was marginally associated with municipally health insurance coverage (relative ratio of MMR: 0.99; CI 95%: 0.98-1.00), and significantly with transparency index at departmental level (relative ratio of MMR: 0.98; CI 95%: 0.97-0.99). Conclusion Poverty and transparency in a contextual level were associated with the increase of the municipal MMR in Colombia. The results of this study are useful evidence for informing the public policies discussion and formulation processes with a differential approach. PMID:25785719

Maternal mortality in Colombia in 2011: a two level ecological study.

PubMed

Cárdenas-Cárdenas, Luz Mery; Cotes-Cantillo, Karol; Chaparro-Narváez, Pablo Enrique; Fernández-Niño, Julián Alfredo; Paternina-Caicedo, Angel; Castañeda-Orjuela, Carlos; De la Hoz-Restrepo, Fernando

2015-01-01

Maternal mortality reduction is a Millennium Development Goal. In Colombia, there is a large disparity in the maternal mortality ratio (MMR) between and into departments (states) and also between municipalities. We examined socioeconomics variables at the municipal and departmental levels which could be associated to the municipal maternal mortality in Colombia. A multilevel ecology study was carried out using different national data sources in Colombia. The outcome variable was the MMR at municipal level in 2011 with multidimensional poverty at municipal and department level as the principal independent variables and other measures of the social and economic characteristics at municipal and departmental level were also considered explicative variables (overall fertility municipal rate, percentage of local rural population, health insurance coverage, per capita territorial participation allocated to the health sector, transparency index and Gini coefficient). The association between MMR and socioeconomic contextual conditions at municipal and departmental level was assessed using a multilevel Poisson regression model. The MMR in the Colombian municipalities was associated significantly with the multidimensional poverty (relative ratio of MMR: 3.52; CI 95%: 1.09-11.38). This association was stronger in municipalities from departments with the highest poverty (relative ratio of MMR: 7.14; CI 95%: 2.01-25.35). Additionally, the MMR at municipal level was marginally associated with municipally health insurance coverage (relative ratio of MMR: 0.99; CI 95%: 0.98-1.00), and significantly with transparency index at departmental level (relative ratio of MMR: 0.98; CI 95%: 0.97-0.99). Poverty and transparency in a contextual level were associated with the increase of the municipal MMR in Colombia. The results of this study are useful evidence for informing the public policies discussion and formulation processes with a differential approach.

[Trend in mortality from external causes in pregnant and postpartum women and its relationship to socioeconomic factors in Colombia, 1998-2010].

PubMed

Salazar, Edwin; Buitrago, Carolina; Molina, Federico; Alzate, Catalina Arango

2015-05-01

Determine the trend in mortality from external causes in pregnant and postpartum women and its relationship to socioeconomic factors. Descriptive study, based on the official registries of deaths reported by the National Statistics Agency, 1998-2010. The trend was analyzed using Poisson regressions. Bivariate correlations and multiple linear regression models were constructed to explore the relationship between mortality and socioeconomic factors: human development index, Gini index, gross domestic product, unsatisfied basic needs, unemployment rate, poverty, extreme poverty, quality of life index, illiteracy rate, and percentage of affiliation to the Social Security System. A total of 2 223 female deaths from external causes were recorded, of which 1 429 occurred during pregnancy and 794 in the postpartum period. The gross mortality rate dropped from 30.7 per 100 000 live births plus fetal deaths in 1998 to 16.7 in 2010. A downward curve with no significant inflection points was shown in the risk of dying from this cause. The multiple linear regression model showed a correlation between mortality and extreme poverty and the illiteracy rate, suggesting that these indicators could explain 89.4% of the change in mortality from external causes in pregnant and postpartum women each year in Colombia. Mortality from external causes in pregnant and postpartum women showed a significant downward trend that may be explained by important socioeconomic changes in the country, including a decrease in extreme poverty and in the illiteracy rate.

Determinants of under-five mortality in rural and urban Kenya.

PubMed

Ettarh, R R; Kimani, J

2012-01-01

The disparity in under-five year-old mortality rates between rural and urban areas in Kenya (also reported in other in sub-Saharan African countries), is a critical national concern. The objective of this study was to investigate the influence of geographical location and maternal factors on the likelihood of mortality among under-five children in rural and urban areas in Kenya. Data from the 2008-2009 Kenya Demographic and Health Survey were used to determine mortality among under-five children (n=16,162) in rural and urban areas in the 5 years preceding the survey. Multivariate analysis was used to compare the influence of key risk factors in rural and urban areas. Overall, the likelihood of death among under-five children in the rural areas was significantly higher than that in the urban areas (p<0.05). Household poverty was a key predictor for mortality in the rural areas, but the influence of breastfeeding was similar in the two areas. The likelihood of under-five mortality was significantly higher in the rural areas of Coast, Nyanza and Western Provinces than in Central Province. The study shows that the determinants of under-five mortality differ in rural and urban areas in Kenya. Innovative and targeted strategies are required to address rural poverty and province-specific sociocultural factors in order to improve child survival in rural Kenya.

Quantifying the individual-level association between income and mortality risk in the United States using the National Longitudinal Mortality Study.

PubMed

Brodish, Paul Henry; Hakes, Jahn K

2016-12-01

Policy makers would benefit from being able to estimate the likely impact of potential interventions to reverse the effects of rapidly rising income inequality on mortality rates. Using multiple cohorts of the National Longitudinal Mortality Study (NLMS), we estimate the absolute income effect on premature mortality in the United States. A multivariate Poisson regression using the natural logarithm of equivilized household income establishes the magnitude of the absolute income effect on mortality. We calculate mortality rates for each income decile of the study sample and mortality rate ratios relative to the decile containing mean income. We then apply the estimated income effect to two kinds of hypothetical interventions that would redistribute income. The first lifts everyone with an equivalized household income at or below the U.S. poverty line (in 2000$) out of poverty, to the income category just above the poverty line. The second shifts each family's equivalized income by, in turn, 10%, 20%, 30%, or 40% toward the mean household income, equivalent to reducing the Gini coefficient by the same percentage in each scenario. We also assess mortality disparities of the hypothetical interventions using ratios of mortality rates of the ninth and second income deciles, and test sensitivity to the assumption of causality of income on mortality by halving the mortality effect per unit of equivalized household income. The estimated absolute income effect would produce a three to four percent reduction in mortality for a 10% reduction in the Gini coefficient. Larger mortality reductions result from larger reductions in the Gini, but with diminishing returns. Inequalities in estimated mortality rates are reduced by a larger percentage than overall estimated mortality rates under the same hypothetical redistributions. Copyright © 2016 Elsevier Ltd. All rights reserved.

On hunger and child mortality in India.

PubMed

Gaiha, Raghav; Kulkarni, Vani S; Pandey, Manoj K; Imai, Katsushi S

2012-01-01

Despite accelerated growth there is pervasive hunger, child undernutrition and mortality in India. Our analysis focuses on their determinants. Raising living standards alone will not reduce hunger and undernutrition. Reduction of rural/urban disparities, income inequality, consumer price stabilization, and mothers’ literacy all have roles of varying importance in different nutrition indicators. Somewhat surprisingly, public distribution system (PDS) do not have a significant effect on any of them. Generally, child undernutrition and mortality rise with poverty. Our analysis confirms that media exposure triggers public action, and helps avert child undernutrition and mortality. Drastic reduction of economic inequality is in fact key to averting child mortality, conditional upon a drastic reordering of social and economic arrangements.

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 poverty should be the immediate concern in Africaas a means of promoting better health for all. There is a question mark over whether the findings of Wilkinson and Pickett1 on the relationship between income inequality and health apply to Africa. The reasons for this question mark are discussed. More research is needed to investigate whether the inequality results found in this study are replicated in other studies of African health.

Widening rural-urban disparities in all-cause mortality and mortality from major causes of death in the USA, 1969-2009.

PubMed

Singh, Gopal K; Siahpush, Mohammad

2014-04-01

This study examined trends in rural-urban disparities in all-cause and cause-specific mortality in the USA between 1969 and 2009. A rural-urban continuum measure was linked to county-level mortality data. Age-adjusted death rates were calculated by sex, race, cause-of-death, area-poverty, and urbanization level for 13 time periods between 1969 and 2009. Cause-of-death decomposition and log-linear and Poisson regression were used to analyze rural-urban differentials. Mortality rates increased with increasing levels of rurality overall and for non-Hispanic whites, blacks, and American Indians/Alaska Natives. Despite the declining mortality trends, mortality risks for both males and females and for blacks and whites have been increasingly higher in non-metropolitan than metropolitan areas, particularly since 1990. In 2005-2009, mortality rates varied from 391.9 per 100,000 population for Asians/Pacific Islanders in rural areas to 1,063.2 for blacks in small-urban towns. Poverty gradients were steeper in rural areas, which maintained higher mortality than urban areas after adjustment for poverty level. Poor blacks in non-metropolitan areas experienced two to three times higher all-cause and premature mortality risks than affluent blacks and whites in metropolitan areas. Disparities widened over time; excess mortality from all causes combined and from several major causes of death in non-metropolitan areas was greater in 2005-2009 than in 1990-1992. Causes of death contributing most to the increasing rural-urban disparity and higher rural mortality include heart disease, unintentional injuries, COPD, lung cancer, stroke, suicide, diabetes, nephritis, pneumonia/influenza, cirrhosis, and Alzheimer's disease. Residents in metropolitan areas experienced larger mortality reductions during the past four decades than non-metropolitan residents, contributing to the widening gap.

United States black:white infant mortality disparities are not inevitable: identification of community resilience independent of socioeconomic status.

PubMed

Fry-Johnson, Yvonne W; Levine, Robert; Rowley, Diane; Agboto, Vincent; Rust, George

2010-01-01

U.S. disparities in Black:White infant mortality are persistent. National trends, however, may obscure local successes. Zero-corrected, negative binomial multivariable modeling was used to predict Black infant mortality (1999-2003) in all U.S. counties with reliable rates. Independent variables included county population size, racial composition, educational attainment, poverty, income and geographic origin. Resilient counties were defined as those whose Black infant mortality rate residual score was < 2.0. Mortality data was accessed from the Compressed Mortality File compiled by the National Center for Health Statistics and found on the CDC WONDER website. Demographic information was obtained from the US Census. The final model included the percentage of Blacks, age 18 to 64 years, speaking little or no English (P < .008), a socioeconomic index comprising educational attainment, poverty, and per capita income (P < .001), and household income in 1990 (P < .001). After accounting for these factors, a stratum comprising Essex and Plymouth Counties, Mass.; Bronx, N.Y.; and Multnomah, Ore. was identified as unusually resilient. Percentage of Black poverty and educational attainment in Black women in the resilient stratum approximated the average for all 330 counties. In 1979, Black infant mortality in the resilient stratum (23.6 per 1000 live births) exceeded Black US infant mortality (22.6). By 2001, Black infant mortality in the resilient stratum (5.6) was below the corresponding value for Whites (5.7). Resilient county neonatal mortality declined both early and late in the observation period, while post-neonatal declines were most marked after 1996. Models for reduction/elimination of racial disparities in US infant mortality, independent from county-level contextual measures of socioeconomic status, may already exist.

Major parasitic diseases of poverty in mainland China: perspectives for better control.

PubMed

Wang, Jin-Lei; Li, Ting-Ting; Huang, Si-Yang; Cong, Wei; Zhu, Xing-Quan

2016-08-01

Significant progress has been made in the prevention, control, and elimination of human parasitic diseases in China in the past 60 years. However, parasitic diseases of poverty remain major causes of morbidity and mortality, and inflict enormous economic costs on societies.In this article, we review the prevalence rates, geographical distributions, epidemic characteristics, risk factors, and clinical manifestations of parasitic diseases of poverty listed in the first issue of the journal Infectious Diseases of Poverty on 25 October 2012. We also address the challenges facing control of parasitic diseases of poverty and provide suggestions for better control.

Contextual determinants of neonatal mortality using two analysis methods, Rio Grande do Sul, Brazil.

PubMed

Zanini, Roselaine Ruviaro; Moraes, Anaelena Bragança de; Giugliani, Elsa Regina Justo; Riboldi, João

2011-02-01

To analyze neonatal mortality determinants using multilevel logistic regression and classic hierarchical models. Cohort study including 138,407 live births with birth certificates and 1,134 neonatal deaths recorded in 2003, in the state of Rio Grande do Sul, Southern Brazil. The Information System on Live Births and mortality records were linked for gathering information on individual-level exposures. Sociodemographic data and information on the pregnancy, childbirth care and characteristics of the children at birth were collected. The associated factors were estimated and compared by traditional and multilevel logistic regression analysis. The neonatal mortality rate was 8.19 deaths per 1,000 live births. Low birth weight, 1- and 5-minute Apgar score below eight, congenital malformation, pre-term birth and previous fetal loss were associated with neonatal death in the traditional model. Elective cesarean section had a protective effect. Previous fetal loss did not remain significant in the multilevel model, but the inclusion of a contextual variable (poverty rate) showed that 15% of neonatal mortality variation can be explained by varying poverty rates in the microregions. The use of multilevel models showed a small effect of contextual determinants on the neonatal mortality rate. There was found a positive association with the poverty rate in the general model, and the proportion of households with water supply among preterm newborns.

Missed opportunities: racial and neighborhood socioeconomic disparities in emergency colorectal cancer diagnosis and surgery.

PubMed

Pruitt, Sandi L; Davidson, Nicholas O; Gupta, Samir; Yan, Yan; Schootman, Mario

2014-12-09

Disparities by race and neighborhood socioeconomic status exist for many colorectal cancer (CRC) outcomes, including screening use and mortality. We used population-based data to determine if disparities also exist for emergency CRC diagnosis and surgery. We examined two emergency CRC outcomes using 1992-2005 population-based U.S. SEER-Medicare data. Among CRC patients aged ≥66 years, we examined racial (African American vs. white) and neighborhood poverty disparities in two emergency outcomes defined as: 1) newly diagnosed CRC or 2) CRC surgery associated with: obstruction, perforation, or emergency inpatient admission. Multilevel logistic regression (patients nested in census tracts) analyses adjusted for sociodemographic, tumor, and clinical covariates. Of 83,330 CRC patients, 29.1% were diagnosed emergently. Of 55,046 undergoing surgery, 26.0% had emergency surgery. For both outcomes, race and neighborhood poverty disparities were evident. A significant race by poverty interaction (p < .001) was noted: poverty rate was associated with both outcomes among African Americans, but not whites. Compared to whites in low poverty (<10%) neighborhoods, African Americans in high poverty (≥20%) neighborhoods had increased odds of emergency diagnosis (AOR: 1.50, 95% CI: 1.38-1.63) and surgery (AOR: 1.63, 95% CI: 1.47-1.81). Emergency CRC outcomes are associated with high poverty residence among African Americans in this population-based study, potentially contributing to observed disparities in CRC morbidity and mortality. Targeted efforts to increase CRC screening among African Americans living in high poverty neighborhoods could reduce preventable disparities.

Racial-ethnic differences in all-cause and HIV mortality, Florida, 2000–2011

PubMed Central

Trepka, Mary Jo; Fennie, Kristopher P.; Sheehan, Diana M.; Niyonsenga, Theophile; Lieb, Spencer; Maddox, Lorene M.

2016-01-01

Purpose We compared all-cause and human immunodeficiency virus (HIV) mortality in a population-based, HIV-infected cohort. Methods Using records of people diagnosed with HIV during 2000–2009 from the Florida Enhanced HIV/Acquired Immunodeficiency Syndrome (AIDS) Reporting System, we conducted a proportional hazards analysis for all-cause mortality and a competing risk analysis for HIV mortality through 2011 controlling for individual level factors, neighborhood poverty, and rural/urban status and stratifying by concurrent AIDS status (AIDS within 3 months of HIV diagnosis). Results Of 59,880 HIV-infected people, 32.2% had concurrent AIDS, and 19.3% died. Adjusting for period of diagnosis, age group, sex, country of birth, HIV transmission mode, area level poverty and rural/urban status, non-Hispanic Black (NHB) and Hispanic people had an elevated adjusted hazards ratio (aHR) for HIV mortality relative to non-Hispanic whites (NHB concurrent AIDS: aHR 1.34, 95% CI 1.23–1.47; NHB without concurrent AIDS: aHR 1.41, 95% CI 1.26–1.57; Hispanic concurrent AIDS: aHR 1.18, 95% CI 1.05–1.32; Hispanic without concurrent AIDS: aHR 1.18, 95% CI 1.03–1.36). Conclusions Considering competing causes of death, NHB and Hispanic people had a higher risk of HIV mortality even among those without concurrent AIDS, indicating a need to identify and address barriers to HIV care in these populations. PMID:26948103

Explaining large mortality differences between adjacent counties: a cross-sectional study.

PubMed

Schootman, M; Chien, L; Yun, S; Pruitt, S L

2016-08-02

Extensive geographic variation in adverse health outcomes exists, but global measures ignore differences between adjacent geographic areas, which often have very different mortality rates. We describe a novel application of advanced spatial analysis to 1) examine the extent of differences in mortality rates between adjacent counties, 2) describe differences in risk factors between adjacent counties, and 3) determine if differences in risk factors account for the differences in mortality rates between adjacent counties. We conducted a cross-sectional study in Missouri, USA with 2005-2009 age-adjusted all-cause mortality rate as the outcome and county-level explanatory variables from a 2007 population-based survey. We used a multi-level Gaussian model and a full Bayesian approach to analyze the difference in risk factors relative to the difference in mortality rates between adjacent counties. The average mean difference in the age-adjusted mortality rate between any two adjacent counties was -3.27 (standard deviation = 95.5) per 100,000 population (maximum = 258.80). Six variables were associated with mortality differences: inability to obtain medical care because of cost (β = 2.6), hospital discharge rate (β = 1.03), prevalence of fair/poor health (β = 2.93), and hypertension (β = 4.75) and poverty prevalence (β = 6.08). Examining differences in mortality rates and associated risk factors between adjacent counties provides additional insight for future interventions to reduce geographic disparities.

Comparison of Mortality Disparities in Central Appalachian Coal- and Non-Coal-Mining Counties.

PubMed

Woolley, Shannon M; Meacham, Susan L; Balmert, Lauren C; Talbott, Evelyn O; Buchanich, Jeanine M

2015-06-01

Determine whether select cause of death mortality disparities in four Appalachian regions is associated with coal mining or other factors. We calculated direct age-adjusted mortality rates and associated 95% confidence intervals by sex and study group for each cause of death over 5-year time periods from 1960 to 2009 and compared mean demographic and socioeconomic values between study groups via two-sample t tests. Compared with non-coal-mining areas, we found higher rates of poverty in West Virginia and Virginia (VA) coal counties. All-cause mortality rates for males and females were higher in coal counties across all time periods. Virginia coal counties had statistically significant excesses for many causes of death. We found elevated mortality and poverty rates in coal-mining compared with non-coal-mining areas of West Virginia and VA. Future research should examine these findings in more detail at the individual level.

Estimating life expectancies for US small areas: a regression framework

NASA Astrophysics Data System (ADS)

Congdon, Peter

2014-01-01

Analysis of area mortality variations and estimation of area life tables raise methodological questions relevant to assessing spatial clustering, and socioeconomic inequalities in mortality. Existing small area analyses of US life expectancy variation generally adopt ad hoc amalgamations of counties to alleviate potential instability of mortality rates involved in deriving life tables, and use conventional life table analysis which takes no account of correlated mortality for adjacent areas or ages. The alternative strategy here uses structured random effects methods that recognize correlations between adjacent ages and areas, and allows retention of the original county boundaries. This strategy generalizes to include effects of area category (e.g. poverty status, ethnic mix), allowing estimation of life tables according to area category, and providing additional stabilization of estimated life table functions. This approach is used here to estimate stabilized mortality rates, derive life expectancies in US counties, and assess trends in clustering and in inequality according to county poverty category.

Assessing the burden of medical impoverishment by cause: a systematic breakdown by disease in Ethiopia.

PubMed

Verguet, Stéphane; Memirie, Solomon Tessema; Norheim, Ole Frithjof

2016-10-21

Out-of-pocket (OOP) medical expenses often lead to catastrophic expenditure and impoverishment in low- and middle-income countries. Yet, there has been no systematic examination of which specific diseases and conditions (e.g., tuberculosis, cardiovascular disease) drive medical impoverishment, defined as OOP direct medical costs pushing households into poverty. We used a cost and epidemiological model to propose an assessment of the burden of medical impoverishment in Ethiopia, i.e., the number of households crossing a poverty line due to excessive OOP direct medical expenses. We utilized disease-specific mortality estimates from the Global Burden of Disease study, epidemiological and cost inputs from surveys, and secondary data from the literature to produce a count of poverty cases due to OOP direct medical costs per specific condition. In Ethiopia, in 2013, and among 20 leading causes of mortality, we estimated the burden of impoverishment due to OOP direct medical costs to be of about 350,000 poverty cases. The top three causes of medical impoverishment were diarrhea, lower respiratory infections, and road injury, accounting for 75 % of all poverty cases. We present a preliminary attempt for the estimation of the burden of medical impoverishment by cause for high mortality conditions. In Ethiopia, medical impoverishment was notably associated with illness occurrence and health services utilization. Although currently used estimates are sensitive to health services utilization, a systematic breakdown of impoverishment due to OOP direct medical costs by cause can provide important information for the promotion of financial risk protection and equity, and subsequent design of health policies toward universal health coverage, reduction of direct OOP payments, and poverty alleviation.

ANOTHER "LETHAL TRIAD"-RISK FACTORS FOR VIOLENT INJURY AND LONG-TERM MORTALITY AMONG ADULT VICTIMS OF VIOLENT INJURY.

PubMed

Laytin, Adam D; Shumway, Martha; Boccellari, Alicia; Juillard, Catherine J; Dicker, Rochelle A

2018-05-01

Mental illness, substance abuse, and poverty are risk factors for violent injury, and violent injury is a risk factor for early mortality that can be attenuated through hospital-based violence intervention programs. Most of these programs focus on victims under the age of 30 years. Little is known about risk factors or long-term mortality among older victims of violent injury. To explore the prevalence of risk factors for violent injury among younger (age < 30 years) and older (age 30 ≥ years) victims of violent injury, to determine the long-term mortality rates in these age groups, and to explore the association between risk factors for violent injury and long-term mortality. Adults with violent injuries were enrolled between 2001 and 2004. Demographic and injury data were recorded on enrollment. Ten-year mortality rates were measured. Descriptive analysis and logistic regression were used to compare older and younger subjects. Among 541 subjects, 70% were over age 30. The overall 10-year mortality rate was 15%, and was much higher than in the age-matched general population in both age groups. Risk factors for violent injury including mental illness, substance abuse, and poverty were prevalent, especially among older subjects, and were each independently associated with increased risk of long-term mortality. Mental illness, substance abuse, and poverty constitute a "lethal triad" that is associated with an increased risk of long-term mortality among victims of violent injury, including both younger adults and those over age 30 years. Both groups may benefit from targeted risk-reduction efforts. Emergency department visits offer an invaluable opportunity to engage these vulnerable patients. Copyright © 2018 Elsevier Inc. All rights reserved.

Coming of Age: Ten Years in the Campaign against Infant Mortality. The Southern Regional Project on Infant Mortality 1984-1994.

ERIC Educational Resources Information Center

Southern Governors' Association, Atlanta, GA.

Infant mortality is a complex issue linked to societal problems such as teen pregnancy, poverty, unemployment, illiteracy, and violence. This report chronicles the accomplishments of the Southern Regional Project on Infant Mortality in seeking solutions, sharing strategies, and building coalitions to reduce infant mortality in the south. Phase 1…

Why is poverty unhealthy? Social and physical mediators.

PubMed

Cohen, Deborah A; Farley, Thomas A; Mason, Karen

2003-11-01

Socioeconomic status is associated with mortality, yet does not fully explain health disparities. This study analyzed data from the Project on Human Development in Chicago Neighborhoods (PHDCN), in the USA, to identify neighborhood-level factors associated with premature mortality. 1990 US Census data and mortality data from Chicago were merged with data from PHDCN, a study of 8782 residents in 343 Chicago neighborhoods. We performed a multivariate analysis to determine the association between premature mortality and concentrated disadvantage, residential stability, immigrant concentration, "collective efficacy" (a measure of willingness to help out for the common good), and "broken windows" (boarded up stores and homes, litter, and graffiti). Both collective efficacy and broken windows appeared to mediate the effect of concentrated disadvantage on all-cause premature mortality and mortality from cardiovascular disease and homicide, but there was also an interaction between broken windows and collective efficacy. Non-income characteristics associated with poverty should be further investigated. Interventions to determine whether these factors are causally related to health are needed.

Impact of poverty, not seeking medical care, unemployment, inflation, self-reported illness, and health insurance on mortality in Jamaica.

PubMed

Bourne, Paul Andrew

2009-08-01

An extensive review of the literature revealed that no study exists that has examined poverty, not seeking medical care, inflation, self-reported illness, and mortality in Jamaica. The current study will bridge the gap by providing an investigation of poverty; not seeking medical care; illness; health insurance coverage; inflation and mortality in Jamaica. Using two decades (1988-2007), the current study used three sets of secondary data published by the (1) Planning Institute of Jamaica and the Statistical Institute of Jamaica (Jamaica Survey of Living Conditions) (2) the Statistical Institute of Jamaica (Demographic Statistics) and (3) the Bank of Jamaica (Economic Report). Scatter diagrams were used to examine correlations between the particular dependent and independent variables. For the current study, a number of hypotheses were tested to provide explanation morality in Jamaica. The average percent of Jamaicans not seeking medical care over the last 2 decades was 41.9%; and the figure has been steadily declining over the last 5 years. In 1990, the most Jamaicans who did not seek medical care were 61.4% and this fell to 52.3% in 1991; 49.1% in 1992 and 48.2% the proceeding year. Based on the percentages, in the early 1990s (1990-1994), the percent of Jamaicans not seeking medical care was close to 50% and in the latter part of the decade, the figure was in the region of 30% and the low as 31.6% in 1999. In 2006, the percent of Jamaicans not seeking medical care despite being ill was 30% and this increased by 4% the following year. Concomitantly, poverty fell by 3.1 times over the 2 decades to 9.9% in 2007, while inflation increased by 1.9 times, self-reported illness was 15.5% in 2007 with mortality averaging 15,776 year of the 2 decades. There is a significant statistical correlation between not seeking medical-care and prevalence of poverty (r = 0.759, p< 0.05). There is a statistical correlation between not seeking medical care and unemployment; but the association is a non-linear one. The relationship between mortality and unemployment was an unsure one, with there being no clear linear or non-linear correlation. The findings revealed that there is a strong direct association between not seeking medical care and inflation rate (r = 0.752). A strong negative statistical correlation was found between mortality and prevalence of poverty (r=0.717). There is a non-linear statistical association between not seeking medical care and illness/injury. Not seeking medical care is not a good indicator of premature mortality; but that this percentage must be excess of 55%. While this study cannot confirm a clear rate of premature mortality, there are some indications that this occurs beyond a certain level of not seeking care for illness.

Impact of poverty, not seeking medical care, unemployment, inflation, self-reported illness, and health insurance on mortality in Jamaica

PubMed Central

Bourne, Paul Andrew

2009-01-01

Background: An extensive review of the literature revealed that no study exists that has examined poverty, not seeking medical care, inflation, self-reported illness, and mortality in Jamaica. The current study will bridge the gap by providing an investigation of poverty; not seeking medical care; illness; health insurance coverage; inflation and mortality in Jamaica. Materials and Method: Using two decades (1988-2007), the current study used three sets of secondary data published by the (1) Planning Institute of Jamaica and the Statistical Institute of Jamaica (Jamaica Survey of Living Conditions) (2) the Statistical Institute of Jamaica (Demographic Statistics) and (3) the Bank of Jamaica (Economic Report). Scatter diagrams were used to examine correlations between the particular dependent and independent variables. For the current study, a number of hypotheses were tested to provide explanation morality in Jamaica. Results: The average percent of Jamaicans not seeking medical care over the last 2 decades was 41.9%; and the figure has been steadily declining over the last 5 years. In 1990, the most Jamaicans who did not seek medical care were 61.4% and this fell to 52.3% in 1991; 49.1% in 1992 and 48.2% the proceeding year. Based on the percentages, in the early 1990s (1990-1994), the percent of Jamaicans not seeking medical care was close to 50% and in the latter part of the decade, the figure was in the region of 30% and the low as 31.6% in 1999. In 2006, the percent of Jamaicans not seeking medical care despite being ill was 30% and this increased by 4% the following year. Concomitantly, poverty fell by 3.1 times over the 2 decades to 9.9% in 2007, while inflation increased by 1.9 times, self-reported illness was 15.5% in 2007 with mortality averaging 15,776 year of the 2 decades. There is a significant statistical correlation between not seeking medical-care and prevalence of poverty (r = 0.759, p< 0.05). There is a statistical correlation between not seeking medical care and unemployment; but the association is a non-linear one. The relationship between mortality and unemployment was an unsure one, with there being no clear linear or non-linear correlation. The findings revealed that there is a strong direct association between not seeking medical care and inflation rate (r = 0.752). A strong negative statistical correlation was found between mortality and prevalence of poverty (r=0.717). There is a non-linear statistical association between not seeking medical care and illness/injury. Conclusions: Not seeking medical care is not a good indicator of premature mortality; but that this percentage must be excess of 55%. While this study cannot confirm a clear rate of premature mortality, there are some indications that this occurs beyond a certain level of not seeking care for illness. PMID:22666679

Impact of Socioeconomic Status on Timing of Relapse and Overall Survival for Children Treated on Dana-Farber Cancer Institute ALL Consortium Protocols (2000-2010).

PubMed

Bona, Kira; Blonquist, Traci M; Neuberg, Donna S; Silverman, Lewis B; Wolfe, Joanne

2016-06-01

Population-based evidence suggests that lower socioeconomic status (SES) negatively impacts the overall survival (OS) of children with leukemia; however, the relationships between SES and treatment-related mortality, relapse, and timing of relapse remain unclear. We examined OS, event-free survival (EFS) and cumulative incidence (CI) and timing of relapse by community-level poverty for 575 children aged 1-18 years with newly diagnosed acute lymphoblastic leukemia (ALL) treated on consecutive phase III multicenter Dana-Farber Cancer Institute ALL Consortium Protocols between 2000 and 2010. Children were categorized into high- and low-poverty areas for the analysis using aggregate U.S. Census data linked to zip code. Children living in high-poverty areas experienced a 5-year OS of 85% as compared with 92% for those in low-poverty areas (P = 0.02); poverty remained marginally significant (P = 0.07) after adjustment for immunophenotype, age, and white blood cell count. There were no differences detected in EFS or CI relapse by poverty area. However, 92% of the relapses observed in children from high-poverty areas occurred <36 months from complete remission, compared to 48% of those in children from low-poverty areas (P = 0.008). U.S. children with ALL living in high-poverty areas have a higher risk of early relapse when compared with those living in low-poverty areas despite uniform treatment. This may in part explain decreased OS observed in these children. This finding highlights disparities in childhood cancer outcomes by SES despite uniform treatment. Further investigations of the mechanistic pathways underlying this finding are needed. © 2016 Wiley Periodicals, Inc.

A population health approach to reducing observational intensity bias in health risk adjustment: cross sectional analysis of insurance claims.

PubMed

Wennberg, David E; Sharp, Sandra M; Bevan, Gwyn; Skinner, Jonathan S; Gottlieb, Daniel J; Wennberg, John E

2014-04-10

To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Administrative data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Cross sectional analysis. 20% sample of fee for service Medicare beneficiaries residing in one of 306 hospital referral regions in the United States in 2007 (n = 5,153,877). The effect of health risk adjustment on age, sex, and race adjusted mortality and spending rates among hospital referral regions using four indices: the standard Centers for Medicare and Medicaid Services--Hierarchical Condition Categories (HCC) index used by the US Medicare program (calculated from diagnoses listed in Medicare's administrative database); a visit corrected HCC index (to reduce the effects of observational intensity on frequency of diagnoses); a poverty index (based on US census); and a population health index (calculated using data on incidence of hip fractures and strokes, and responses from a population based annual survey of health from the Centers for Disease Control and Prevention). Estimated variation in age, sex, and race adjusted mortality rates across hospital referral regions was reduced using the indices based on population health, poverty, and visit corrected HCC, but increased using the standard HCC index. Most of the residual variation in age, sex, and race adjusted mortality was explained (in terms of weighted R2) by the population health index: R2=0.65. The other indices explained less: R2=0.20 for the visit corrected HCC index; 0.19 for the poverty index, and 0.02 for the standard HCC index. The residual variation in age, sex, race, and price adjusted spending per capita across the 306 hospital referral regions explained by the indices (in terms of weighted R2) were 0.50 for the standard HCC index, 0.21 for the population health index, 0.12 for the poverty index, and 0.07 for the visit corrected HCC index, implying that only a modest amount of the variation in spending can be explained by factors most closely related to mortality. Further, once the HCC index is visit corrected it accounts for almost none of the residual variation in age, sex, and race adjusted spending. Health risk adjustment using either the poverty index or the population health index performed substantially better in terms of explaining actual mortality than the indices that relied on diagnoses from administrative databases; the population health index explained the majority of residual variation in age, sex, and race adjusted mortality. Owing to the influence of observational intensity on diagnoses from administrative databases, the standard HCC index over-adjusts for regional differences in spending. Research to improve health risk adjustment methods should focus on developing measures of risk that do not depend on observation influenced diagnoses recorded in administrative databases.

Urban-rural differences in excess mortality among high-poverty populations: evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health.

PubMed

Geronimus, Arline T; Colen, Cynthia G; Shochet, Tara; Ingber, Lori Barer; James, Sherman A

2006-08-01

Black youth residing in high-poverty areas have dramatically lower probabilities of surviving to age 65 if they are urban than if they are rural. Chronic disease deaths contribute heavily. We begin to probe the reasons using the Harlem Household Survey (HHS) and the Pitt County, North Carolina Study of African American Health (PCS). We compare HHS and PCS respondents on chronic disease rates, health behaviors, social support, employment, indicators of health care access, and health insurance. Chronic disease profiles do not favor Pitt County. Smoking uptake is similar across samples, but PCS respondents are more likely to quit. Indicators of access to health care and private health insurance are more favorable in Pitt County. Findings suggest rural mortality is averted through secondary or tertiary prevention, not primary. Macroeconomic and health system changes of the past 20 years may have left poor urban Blacks as medically underserved as poor rural Blacks.

The Millennium Development Goals: experiences, achievements and what's next

PubMed Central

Lomazzi, Marta; Borisch, Bettina; Laaser, Ulrich

2014-01-01

The Millennium Development Goals (MDGs) are eight international development goals to be achieved by 2015 addressing poverty, hunger, maternal and child mortality, communicable disease, education, gender inequality, environmental damage and the global partnership. Most activities worldwide have focused on maternal and child health and communicable diseases, while less attention has been paid to environmental sustainability and the development of a global partnership. Up to now, several targets have been at least partially achieved: hunger reduction is on track, poverty has been reduced by half, living conditions of 200 million deprived people enhanced, maternal and child mortality as well as communicable diseases diminished and education improved. Nevertheless, some goals will not be met, particularly in the poorest regions, due to different challenges (e.g. the lack of synergies among the goals, the economic crisis, etc.). The post-2015 agenda is now under discussion. The new targets, whatever they will be called, should reflect today's political situation, health and environmental challenges, and an all-inclusive, intersectoral and accountable approach should be adopted. PMID:24560268

The Millennium Development Goals: experiences, achievements and what's next.

PubMed

Lomazzi, Marta; Borisch, Bettina; Laaser, Ulrich

2014-01-01

The Millennium Development Goals (MDGs) are eight international development goals to be achieved by 2015 addressing poverty, hunger, maternal and child mortality, communicable disease, education, gender inequality, environmental damage and the global partnership. Most activities worldwide have focused on maternal and child health and communicable diseases, while less attention has been paid to environmental sustainability and the development of a global partnership. Up to now, several targets have been at least partially achieved: hunger reduction is on track, poverty has been reduced by half, living conditions of 200 million deprived people enhanced, maternal and child mortality as well as communicable diseases diminished and education improved. Nevertheless, some goals will not be met, particularly in the poorest regions, due to different challenges (e.g. the lack of synergies among the goals, the economic crisis, etc.). The post-2015 agenda is now under discussion. The new targets, whatever they will be called, should reflect today's political situation, health and environmental challenges, and an all-inclusive, intersectoral and accountable approach should be adopted.

Housing, income inequality and child injury mortality in Europe: a cross-sectional study.

PubMed

Sengoelge, M; Hasselberg, M; Ormandy, D; Laflamme, L

2014-03-01

Child poverty rates are compared throughout Europe to monitor how countries are caring for their children. Child poverty reduction measures need to consider the importance of safe living environments for all children. In this study we investigate how European country-level economic disparity and housing conditions relate to one another, and whether they differentially correlate with child injury mortality. We used an ecological, cross-sectional study design of 26 European countries of which 20 high-income and 6 upper-middle-income. Compositional characteristics of the home and its surroundings were extracted from the 2006 European Union Income Social Inclusion and Living Conditions Database (n = 203,000). Mortality data of children aged 1-14 years were derived from the World Health Organization Mortality Database. The main outcome measure was age standardized cause-specific injury mortality rates analysed by income inequality and housing and neighbourhood conditions. Nine measures of housing and neighbourhood conditions highly differentiating European households at country level were clustered into three dimensions, labelled respectively housing, neighbourhood and economic household strain. Income inequality significantly and positively correlated with housing strain (r = 0.62, P = 0.001) and household economic strain (r = 0.42, P = 0.009) but not significantly with neighbourhood strain (r = 0.34, P = 0.087). Child injury mortality rates correlated strongly with both country-level income inequality and housing strain, with very small age-specific differences. In the European context housing, neighbourhood and household economic strains worsened with increasing levels of income inequality. Child injury mortality rates are strongly and positively associated with both income inequality and housing strain, suggesting that housing material conditions could play a role in the association between income inequality and child health. © 2013 John Wiley & Sons Ltd.

(Dis)respect and black mortality.

PubMed

Kennedy, B P; Kawachi, I; Lochner, K; Jones, C; Prothrow-Stith, D

1997-01-01

A growing number of studies have documented the deleterious health consequences of the experience of racial discrimination in African Americans. The present study examined the association of racial prejudice--measured at a collective level--to black and white mortality across the United States. Cross-sectional ecologic study, based on data from 39 states. Collective disrespect was measured by weighted responses to a question on a national survey, which asked: "On the average blacks have worse jobs, income, and housing than white people. Do you think the differences are: (A) Mainly due to discrimination? (yes/no); (b) Because most blacks have less in-born ability to learn? (yes/no); (c) Because most blacks don't have the chance for education that it takes to rise out of poverty? (yes/no); and (d) Because most blacks just don't have the motivation or will power to pull themselves up out of poverty? (yes/no)." For each state, we calculated the percentage of respondents who answered in the affirmative to the above statements. Age-standardized total and cause-specific mortality rates in 1990 were obtained for each state. Both measures of collective disrespect were strongly correlated with black mortality (r = 0.53 to 0.56), as well as with white mortality (r = 0.48 to 0.54). A 1 percent increase in the prevalence of those who believed that blacks lacked innate ability was associated with an increase in age-adjusted black mortality rate of 359.8 per 100,000 (95% confidence interval: 187.5 to 532.1 deaths per 100,000). These data suggest that racism, measured as an ecologic characteristic, is associated with higher mortality in both blacks and whites.

Do family policy regimes matter for children's well-being?

PubMed

Engster, Daniel; Stensöta, Helena Olofsdotter

2011-01-01

Researchers have studied the impact of different welfare state regimes, and particularly family policy regimes, on gender equality. Very little research has been conducted, however, on the association between different family policy regimes and children's well-being. This article explores how the different family policy regimes of twenty OECD countries relate to children's well-being in the areas of child poverty, child mortality, and educational attainment and achievement. We focus specifically on three family policies: family cash and tax benefits, paid parenting leaves, and public child care support. Using panel data for the years 1995, 2000, and 2005, we test the association between these policies and child well-being while holding constant for a number of structural and policy variables. Our analysis shows that the dual-earner regimes, combining high levels of support for paid parenting leaves and public child care, are strongly associated with low levels of child poverty and child mortality. We find little long-term effect of family policies on educational achievement, but a significant positive correlation between high family policy support and higher educational attainment. We conclude that family policies have a significant impact on improving children's well-being, and that dual-earner regimes represent the best practice for promoting children's health and development.

Modelling determinants of child mortality and poverty in the Comoros.

PubMed

Lachaud, Jean-Pierre

2004-03-01

Based on the Demographic and Health Survey of the Comoros of 1996, the analysis of the determinants of child mortality reaches three conclusions. Firstly, differentiated analytical options generate partially convergent results and provide different dimensions of child mortality. Secondly, the study shows that the low standard of living of households in terms of assets is associated with high child mortality. Thirdly, the determinants of infant and infanto-juvenile mortality are relatively comparable. On the one hand, some common factors to both analytical options affect negatively child health: (i) geographical location in rural zones and/or on the islands of Anjouan and Mohéli; (ii) the low standard of living of households in terms of assets; (iii) some community elements, in particular morbidity, the insufficiency of vaccination and the absence of childbirth assisted by qualified persons. On the other hand, characteristics of mothers and births have an impact on infant and infanto-juvenile survival.

A population health approach to reducing observational intensity bias in health risk adjustment: cross sectional analysis of insurance claims

PubMed Central

Sharp, Sandra M; Bevan, Gwyn; Skinner, Jonathan S; Gottlieb, Daniel J

2014-01-01

Objective To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Setting Administrative data from the US Medicare program for services provided in 2007 among 306 US hospital referral regions. Design Cross sectional analysis. Participants 20% sample of fee for service Medicare beneficiaries residing in one of 306 hospital referral regions in the United States in 2007 (n=5 153 877). Main outcome measures The effect of health risk adjustment on age, sex, and race adjusted mortality and spending rates among hospital referral regions using four indices: the standard Centers for Medicare and Medicaid Services—Hierarchical Condition Categories (HCC) index used by the US Medicare program (calculated from diagnoses listed in Medicare’s administrative database); a visit corrected HCC index (to reduce the effects of observational intensity on frequency of diagnoses); a poverty index (based on US census); and a population health index (calculated using data on incidence of hip fractures and strokes, and responses from a population based annual survey of health from the Centers for Disease Control and Prevention). Results Estimated variation in age, sex, and race adjusted mortality rates across hospital referral regions was reduced using the indices based on population health, poverty, and visit corrected HCC, but increased using the standard HCC index. Most of the residual variation in age, sex, and race adjusted mortality was explained (in terms of weighted R2) by the population health index: R2=0.65. The other indices explained less: R2=0.20 for the visit corrected HCC index; 0.19 for the poverty index, and 0.02 for the standard HCC index. The residual variation in age, sex, race, and price adjusted spending per capita across the 306 hospital referral regions explained by the indices (in terms of weighted R2) were 0.50 for the standard HCC index, 0.21 for the population health index, 0.12 for the poverty index, and 0.07 for the visit corrected HCC index, implying that only a modest amount of the variation in spending can be explained by factors most closely related to mortality. Further, once the HCC index is visit corrected it accounts for almost none of the residual variation in age, sex, and race adjusted spending. Conclusion Health risk adjustment using either the poverty index or the population health index performed substantially better in terms of explaining actual mortality than the indices that relied on diagnoses from administrative databases; the population health index explained the majority of residual variation in age, sex, and race adjusted mortality. Owing to the influence of observational intensity on diagnoses from administrative databases, the standard HCC index over-adjusts for regional differences in spending. Research to improve health risk adjustment methods should focus on developing measures of risk that do not depend on observation influenced diagnoses recorded in administrative databases. PMID:24721838

Identification of racial disparities in breast cancer mortality: does scale matter?

PubMed

Tian, Nancy; Goovaerts, Pierre; Zhan, F Benjamin; Wilson, Jeff G

2010-07-05

This paper investigates the impact of geographic scale (census tract, zip code, and county) on the detection of disparities in breast cancer mortality among three ethnic groups in Texas (period 1995-2005). Racial disparities were quantified using both relative (RR) and absolute (RD) statistics that account for the population size and correct for unreliable rates typically observed for minority groups and smaller geographic units. Results were then correlated with socio-economic status measured by the percentage of habitants living below the poverty level. African-American and Hispanic women generally experience higher mortality than White non-Hispanics, and these differences are especially significant in the southeast metropolitan areas and southwest border of Texas. The proportion and location of significant racial disparities however changed depending on the type of statistic (RR versus RD) and the geographic level. The largest proportion of significant results was observed for the RD statistic and census tract data. Geographic regions with significant racial disparities for African-Americans and Hispanics frequently had a poverty rate above 10.00%. This study investigates both relative and absolute racial disparities in breast cancer mortality between White non-Hispanic and African-American/Hispanic women at the census tract, zip code and county levels. Analysis at the census tract level generally led to a larger proportion of geographical units experiencing significantly higher mortality rates for minority groups, although results varied depending on the use of the relative versus absolute statistics. Additional research is needed before general conclusions can be formulated regarding the choice of optimal geographic regions for the detection of racial disparities.

Identification of racial disparities in breast cancer mortality: does scale matter?

PubMed Central

2010-01-01

Background This paper investigates the impact of geographic scale (census tract, zip code, and county) on the detection of disparities in breast cancer mortality among three ethnic groups in Texas (period 1995-2005). Racial disparities were quantified using both relative (RR) and absolute (RD) statistics that account for the population size and correct for unreliable rates typically observed for minority groups and smaller geographic units. Results were then correlated with socio-economic status measured by the percentage of habitants living below the poverty level. Results African-American and Hispanic women generally experience higher mortality than White non-Hispanics, and these differences are especially significant in the southeast metropolitan areas and southwest border of Texas. The proportion and location of significant racial disparities however changed depending on the type of statistic (RR versus RD) and the geographic level. The largest proportion of significant results was observed for the RD statistic and census tract data. Geographic regions with significant racial disparities for African-Americans and Hispanics frequently had a poverty rate above 10.00%. Conclusions This study investigates both relative and absolute racial disparities in breast cancer mortality between White non-Hispanic and African-American/Hispanic women at the census tract, zip code and county levels. Analysis at the census tract level generally led to a larger proportion of geographical units experiencing significantly higher mortality rates for minority groups, although results varied depending on the use of the relative versus absolute statistics. Additional research is needed before general conclusions can be formulated regarding the choice of optimal geographic regions for the detection of racial disparities. PMID:20602784

Striving against adversity: the dynamics of migration, health and poverty in rural South Africa.

PubMed

Collinson, Mark A

2010-06-03

This article is a review of the PhD thesis of Mark Collinson, titled, 'Striving against adversity: the dynamics of migration, health and poverty in rural South Africa'. The findings show that in rural South Africa, temporary migration has a major impact on household well-being and health. Remittances from migrants make a significant difference to socioeconomic status (SES) in households left behind by the migrant. For the poorest households the key factors improving SES are government grants and female temporary migration, while for the less poor it is male temporary migration and local employment. Migration is associated with HIV but not in straightforward ways. Migrants that return more frequently may be less exposed to outside partners and therefore less implicated in the HIV epidemic. There are links between migration and mortality patterns, including a higher risk of dying for returnee migrants compared with permanent residents. A mother's migration impacts significantly on child survival for South African and former refugee parents, but there is an additional mortality risk for children of Mozambican former refugees. It is recommended that national censuses and surveys account for temporary migration when collecting information on household membership, because different migration types have different outcomes. Without discriminating between different migration types, the implications for sending and receiving communities will remain lost to policy-makers.

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, a risk factor overlooked: a cross-sectional cohort study comparing poverty rate and cardiovascular disease outcomes in the state of Florida.

PubMed

Al-Turk, Bashar; Harris, Ciel; Nelson, Grant; Smotherman, Carmen; Palacio, Carlos; House, Jeff

2018-03-01

The purpose of this study is to examine the relationship between poverty rate and heart disease in our state. A cross-sectional data analysis was performed using figures provided by the Center for Disease Control's Interactive Atlas of Heart Disease and Stroke Tables. Spearman's correlations and simple regressions were used to determine if there was a relationship between poverty and cardiovascular hospitalization rate and cardiovascular death rate. There was a positive monotonic correlation between poverty rate and cardiovascular hospitalization rate (Rho=0.384, P=0.001). There was a positive monotonic correlation between poverty rate and cardiovascular death rate (Rho=0.646, P<0.0001). County poverty rate had a statistically significant positive relationship with cardiovascular hospitalization and cardiovascular mortality in the state of Florida. © American Federation for Medical Research (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Childhood poverty and adult psychological well-being

PubMed Central

Evans, Gary W.

2016-01-01

Childhood disadvantage has repeatedly been linked to adult physical morbidity and mortality. We show in a prospective, longitudinal design that childhood poverty predicts multimethodological indices of adult (24 y of age) psychological well-being while holding constant similar childhood outcomes assessed at age 9. Adults from low-income families manifest more allostatic load, an index of chronic physiological stress, higher levels of externalizing symptoms (e.g., aggression) but not internalizing symptoms (e.g., depression), and more helplessness behaviors. In addition, childhood poverty predicts deficits in adult short-term spatial memory. PMID:27956615

Racial and Ethnic Infant Mortality Gaps and the Role of Socio-Economic Status

PubMed Central

Elder, Todd E.; Goddeeris, John H.; Haider, Steven J.

2016-01-01

We assess the extent to which differences in socio-economic status are associated with racial and ethnic gaps in a fundamental measure of population health: the rate at which infants die. Using micro-level Vital Statistics data from 2000 to 2004, we examine mortality gaps of infants born to white, black, Mexican, Puerto Rican, Asian, and Native American mothers. We find that between-group mortality gaps are strongly and consistently (except for Mexican infants) associated with maternal marital status, education, and age, and that these same characteristics are powerful predictors of income and poverty for new mothers in U.S. Census data. Despite these similarities, we document a fundamental difference in the mortality gap for the three high mortality groups: whereas the black-white and Puerto Rican-white mortality gaps mainly occur at low birth weights, the Native American-white gap occurs almost exclusively at higher birth weights. We further examine the one group whose IMR is anomalous compared to the other groups: infants of Mexican mothers die at relatively low rates given their socio-economic disadvantage. We find that this anomaly is driven by lower infant mortality among foreign-born mothers, a pattern found within many racial/ethnic groups. Overall, we conclude that the infant mortality gaps for our six racial/ethnic groups exhibit many commonalities, and these commonalities suggest a prominent role for socio-economic differences. PMID:27695196

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.

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 American Academy of Pediatrics.

Explanations for high levels of infant mortality in Pakistan--a dissenting view.

PubMed

Zaidi, A

1989-01-01

The author critiques a paper by Zeba A. Sathar concerning the relationship between poverty and the infant mortality rate in Pakistan. The focus is on the socioeconomic determinants of fertility decline and policy implications. A reply by Sathar is included (pp. 258-9).

America's Infant-Mortality Puzzle.

ERIC Educational Resources Information Center

Eberstadt, Nicholas

1991-01-01

Conventional explanations attributing the high infant mortality rate in United States to the prevalence of poverty and lack of adequate health care do not tell the whole story. Contributions of parental behavior, lifestyles, and public health care availability versus utilization must be examined in determining public policies to address the…

Does gender inequity increase men's mortality risk in the United States? A multilevel analysis of data from the National Longitudinal Mortality Study.

PubMed

Kavanagh, Shane A; Shelley, Julia M; Stevenson, Christopher

2017-12-01

A number of theoretical approaches suggest that gender inequity may give rise to health risks for men. This study undertook a multilevel analysis to ascertain if state-level measures of gender inequity are predictors of men's mortality in the United States. Data for the analysis were taken primarily from the National Longitudinal Mortality Study, which is based on a random sample of the non-institutionalised population. The full data set included 174,703 individuals nested within 50 states and had a six-year follow-up for mortality. Gender inequity was measured by nine variables: higher education, reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and per capita gross domestic product. The results of logistic multilevel modelling showed a number of measures of state-level gender inequity were significantly associated with men's mortality. In all of these cases greater gender inequity was associated with an increased mortality risk. In fully adjusted models for all-age adult men the elected office (OR 1.05 95% CI 1.01-1.09), business ownership (OR 1.04 95% CI 1.01-1.08), earnings (OR 1.04 95% CI 1.01-1.08) and relative poverty (OR 1.07 95% CI 1.03-1.10) measures all showed statistically significant effects for each 1 standard deviation increase in the gender inequity z -score. Similar effects were seen for working-age men. In older men (65+ years) only the earnings and relative poverty measures were statistically significant. This study provides evidence that gender inequity may increase men's health risks. The effect sizes while small are large enough across the range of gender inequity identified to have important population health implications.

On the Importance of Age-Adjustment Methods in Ecological Studies of Social Determinants of Mortality

PubMed Central

Milyo, Jeffrey; Mellor, Jennifer M

2003-01-01

Objective To illustrate the potential sensitivity of ecological associations between mortality and certain socioeconomic factors to different methods of age-adjustment. Data Sources Secondary analysis employing state-level data from several publicly available sources. Crude and age-adjusted mortality rates for 1990 are obtained from the U.S. Centers for Disease Control. The Gini coefficient for family income and percent of persons below the federal poverty line are from the U.S. Bureau of Labor Statistics. Putnam's (2000) Social Capital Index was downloaded from ; the Social Mistrust Index was calculated from responses to the General Social Survey, following the method described in Kawachi et al. (1997). All other covariates are obtained from the U.S. Census Bureau. Study Design We use least squares regression to estimate the effect of several state-level socioeconomic factors on mortality rates. We examine whether these statistical associations are sensitive to the use of alternative methods of accounting for the different age composition of state populations. Following several previous studies, we present results for the case when only mortality rates are age-adjusted. We contrast these results with those obtained from regressions of crude mortality on age variables. Principal Findings Different age-adjustment methods can cause a change in the sign or statistical significance of the association between mortality and various socioeconomic factors. When age variables are included as regressors, we find no significant association between mortality and either income inequality, minority racial concentration, or social capital. Conclusions Ecological associations between certain socioeconomic factors and mortality may be extremely sensitive to different age-adjustment methods. PMID:14727797

Measures of Local Segregation for Monitoring Health Inequities by Local Health Departments.

PubMed

Krieger, Nancy; Waterman, Pamela D; Batra, Neelesh; Murphy, Johnna S; Dooley, Daniel P; Shah, Snehal N

2017-06-01

To assess the use of local measures of segregation for monitoring health inequities by local health departments. We analyzed preterm birth and premature mortality (death before the age of 65 years) rates for Boston, Massachusetts, for 2010 to 2012, using the Index of Concentration at the Extremes (ICE) and the poverty rate at both the census tract and neighborhood level. For premature mortality at the census tract level, the rate ratios comparing the worst-off and best-off terciles were 1.58 (95% confidence interval [CI] = 1.36, 1.83) for the ICE for income, 1.66 (95% CI = 1.43, 1.93) for the ICE for race/ethnicity, and 1.63 (95% CI = 1.40, 1.90) for the ICE combining income and race/ethnicity, as compared with 1.47 (95% CI = 1.27, 1.71) for the poverty measure. Results for the ICE and poverty measures were more similar for preterm births than for premature mortality. The ICE, a measure of social spatial polarization, may be useful for analyzing health inequities at the local level. Public Health Implications. Local health departments in US cities can meaningfully use the ICE to monitor health inequities associated with racialized economic segregation.

Population growth, poverty and health.

PubMed

Kibirige, J S

1997-07-01

One of the most popular explanations for the many problems that face Africa is population growth. Africa's population has doubled since 1960. Africa has the highest fertility rate in the world and the rate of population growth is higher than in any other region. At the same time, Africa faces a social and economic situation that is viewed by many as alarming. Among the problems that devastate Africa is that of persistent poor health. Africa has lower life expectancy, higher mortality rates and is affected by more disease and illness conditions than any other region. Focusing on sub-Saharan Africa, this paper examines the relationship between population growth, poverty and poor health. While most analyses have focused on population growth as an original cause of poverty and underdevelopment, this paper argues that while both population growth and poor health play a significant role in exacerbating the problem of poverty, they are themselves primary consequences of poverty rather than its cause.

Geographic Access to Cancer Care and Mortality Among Adolescents.

PubMed

Tai, Eric; Hallisey, Elaine; Peipins, Lucy A; Flanagan, Barry; Lunsford, Natasha Buchanan; Wilt, Grete; Graham, Shannon

2018-02-01

Adolescents with cancer have had less improvement in survival than other populations in the United States. This may be due, in part, to adolescents not receiving treatment at Children's Oncology Group (COG) institutions, which have been shown to increase survival for some cancers. The objective of this ecologic study was to examine geographic distance to COG institutions and adolescent cancer mortality. We calculated cancer mortality among adolescents and sociodemographic and healthcare access factors in four geographic zones at selected distances surrounding COG facilities: Zone A (area within 10 miles of any COG institution), Zones B and C (concentric rings with distances from a COG institution of >10-25 miles and >25-50 miles, respectively), and Zone D (area outside of 50 miles). The adolescent cancer death rate was highest in Zone A at 3.21 deaths/100,000, followed by Zone B at 3.05 deaths/100,000, Zone C at 2.94 deaths/100,000, and Zone D at 2.88 deaths/100,000. The United States-wide death rate for whites without Hispanic ethnicity, blacks without Hispanic ethnicity, and persons with Hispanic ethnicity was 2.96 deaths/100,000, 3.10 deaths/100,000, and 3.26 deaths/100,000, respectively. Zone A had high levels of poverty (15%), no health insurance coverage (16%), and no vehicle access (16%). Geographic access to COG institutions, as measured by distance alone, played no evident role in death rate differences across zones. Among adolescents, socioeconomic factors, such as poverty and health insurance coverage, may have a greater impact on cancer mortality than geographic distance to COG institution.

The inter- and intra- generational transmission of family poverty and hardship (adversity): A prospective 30 year study

PubMed Central

Bor, William; Ahmadabadi, Zohre; Williams, Gail M.; Alati, Rosa; Mamun, Abdullah A.; Scott, James G.; Clavarino, Alexandra M.

2018-01-01

Background Children exposed to family poverty have been found to have higher morbidity and mortality rates, poorer mental health and cognitive outcomes and reduced life chances across a wide range of life domains. There is, however, very little known about the extent to which poverty is experienced by children over their early life course, particularly in community samples. This study tracks changes in family poverty and the main factors that predict family poverty (adverse life experiences) over a 30-year period since the birth of the study child. Methods Data are from a prospective, longitudinal, birth cohort study conducted in Brisbane, Australia. Consecutive families were recruited at the mothers’ first obstetrical visit at one of two major obstetrical hospitals in Brisbane. Data are available for 2087 families with complete data at the 30-year follow-up. Poverty was measured using family income at each time point (adjusted for inflation). Findings Poverty affects about 20% of families at any time point. It is common for families to move in and out of poverty, as their circumstances are affected by such adversities as unemployment and marital breakdown. Over the period of the study about half the families in the study experienced poverty on at least one occasion. Only a very small minority of families experienced persistent poverty over the 30-year duration of the study. Logistic regressions with time lag show that family poverty predicts subsequent adversities and adverse events predict subsequent poverty. Conclusions Experiences of poverty and adversity are common and may vary greatly over the child’s early life course. In assessing the health consequences of poverty, it is important to distinguish the timing and chronicity of early life course experiences of poverty and adversity. PMID:29360828

The inter- and intra- generational transmission of family poverty and hardship (adversity): A prospective 30 year study.

PubMed

Najman, Jake M; Bor, William; Ahmadabadi, Zohre; Williams, Gail M; Alati, Rosa; Mamun, Abdullah A; Scott, James G; Clavarino, Alexandra M

2018-01-01

Children exposed to family poverty have been found to have higher morbidity and mortality rates, poorer mental health and cognitive outcomes and reduced life chances across a wide range of life domains. There is, however, very little known about the extent to which poverty is experienced by children over their early life course, particularly in community samples. This study tracks changes in family poverty and the main factors that predict family poverty (adverse life experiences) over a 30-year period since the birth of the study child. Data are from a prospective, longitudinal, birth cohort study conducted in Brisbane, Australia. Consecutive families were recruited at the mothers' first obstetrical visit at one of two major obstetrical hospitals in Brisbane. Data are available for 2087 families with complete data at the 30-year follow-up. Poverty was measured using family income at each time point (adjusted for inflation). Poverty affects about 20% of families at any time point. It is common for families to move in and out of poverty, as their circumstances are affected by such adversities as unemployment and marital breakdown. Over the period of the study about half the families in the study experienced poverty on at least one occasion. Only a very small minority of families experienced persistent poverty over the 30-year duration of the study. Logistic regressions with time lag show that family poverty predicts subsequent adversities and adverse events predict subsequent poverty. Experiences of poverty and adversity are common and may vary greatly over the child's early life course. In assessing the health consequences of poverty, it is important to distinguish the timing and chronicity of early life course experiences of poverty and adversity.

Association of Selected Risk Factors with Variation in Child and Adolescent Firearm Mortality by State

ERIC Educational Resources Information Center

Murnan, Judy; Dake, Joseph A.; Price, James H.

2004-01-01

This study examined relationships between variation in child and adolescent firearm mortality by state and the following variables: childhood poverty rate, percent single parent families, percent population that is African American, percent population that is Hispanic. percent students carrying a gun, percent students carrying a weapon, percent…

Countdown to 2015: will the Millennium Development Goal for child survival be met?

PubMed Central

Lawn, Joy E; Costello, Anthony; Mwansambo, Charles; Osrin, David

2007-01-01

The Millennium Development Goals (MDGs), ratified by most nations in 2000, set specific targets for poverty reduction, eradication of hunger, education, gender equality, health and environmental sustainability. MDG 4 aims to reduce child mortality with a target of reducing under‐five mortality rates by two thirds over the period 1990–2015. Over the last year, Live Aid, Make Poverty History, the G8 summits and prominent entertainers have directed unprecedented attention towards development and health. Africa particularly has been in the spotlight. Reports are published and commitments are made, but is there real progress? Are poor people being reached with essential health care? Who will hold leaders to account: celebrities, activists or health professionals? PMID:17515627

Personality traits and illicit substances: the moderating role of poverty.

PubMed

Sutin, Angelina R; Evans, Michele K; Zonderman, Alan B

2013-08-01

Illicit substances increase risk of morbidity and mortality and have significant consequences for society. Personality traits are associated with drug use; we test whether these associations vary by socioeconomic status. Participants (N=412) from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study completed the Revised NEO Personality Inventory and self-reported use of opiates and cocaine. 50% of participants were living below 125% of the federal poverty line. Mean-level personality differences across never, former, and current opiate/cocaine users were compared. Logistic regressions compared never versus current users and interactions between personality traits and poverty status tested whether these associations varied by socioeconomic status. High Neuroticism and low Agreeableness increased risk of drug use. The association between low Conscientiousness and drug use was moderated by poverty, such that low Conscientiousness was a stronger risk factor for illicit substance use among those with relatively higher SES. For every standard deviation decrease in Conscientiousness, there was a greater than 2-fold increase in risk of illicit substance use (OR=2.15, 95% CI=1.45-3.17). Conscientiousness was unrelated to drug use among participants living below 125% of the federal poverty line. Under favorable economic conditions, the tendency to be organized, disciplined, and deliberate is protective against drug use. These tendencies, however, matter less when financial resources are scarce. In contrast, those prone to emotional distress and antagonism are at greater risk for current drug use, regardless of their economic situation. Published by Elsevier Ireland Ltd.

Chronic cardiovascular disease mortality in mountaintop mining areas of central Appalachian states.

PubMed

Esch, Laura; Hendryx, Michael

2011-01-01

To determine if chronic cardiovascular disease (CVD) mortality rates are higher among residents of mountaintop mining (MTM) areas compared to mining and nonmining areas, and to examine the association between greater levels of MTM surface mining and CVD mortality. Age-adjusted chronic CVD mortality rates from 1999 to 2006 for counties in 4 Appalachian states where MTM occurs (N = 404) were linked with county coal mining data. Three groups of counties were compared: MTM, coal mining but not MTM, and nonmining. Covariates included smoking rate, rural-urban status, percent male population, primary care physician supply, obesity rate, diabetes rate, poverty rate, race/ethnicity rates, high school and college education rates, and Appalachian county. Linear regression analyses examined the association of mortality rates with mining in MTM areas and non-MTM areas and the association of mortality with quantity of surface coal mined in MTM areas. Prior to covariate adjustment, chronic CVD mortality rates were significantly higher in both mining areas compared to nonmining areas and significantly highest in MTM areas. After adjustment, mortality rates in MTM areas remained significantly higher and increased as a function of greater levels of surface mining. Higher obesity and poverty rates and lower college education rates also significantly predicted CVD mortality overall and in rural counties. MTM activity is significantly associated with elevated chronic CVD mortality rates. Future research is necessary to examine the socioeconomic and environmental impacts of MTM on health to reduce health disparities in rural coal mining areas. © 2011 National Rural Health Association.

Strategies to reduce infant mortality rate in India.

PubMed

Ghai, O P

1985-01-01

As a systems approach is needed to develop strategies to reduce the infant mortality rate (IMR), it is appropriate to analyze the present situation in India, reasons for low IMR in some Indian states vis-a-vis others, the status in some neighboring countries, and the cost effectiveness of various available technological interventions and their organizational constraints. A 1981 survey revealed 1) a low IMR for the state of Kerala, one which was comparable with Western nations, despite the fact that nearly half of the population in Kerala lived below the poverty line; 2) a very high IMR for the state of Uttar Pradesh, even though the number of people living below the poverty line was not significantly by different from the state of Kerala; and a moderate IMR reduction in the state of Punjab, even though only 15% of the population was below the poverty line. Favorable factors for low IMR appear to be a high female literacy rate, good medical and educational facilities close to the place of residence, and an excellent transportation and communication system. To significantly reduce IMR in a short period of time, it is necessary to adopt certain immediate measures. Nearly 55% of infant deaths occur in the 1st month of life, and these generally are not amenable to general measures and technological interventions. The problem is difficult, but a solution can be found by reaching a broad consensus among professionals and administrators. The major recommendations of a seminar on the Strategies for Reducing infant Mortality in India, held during January 1984, were: provide antenatal care to 100% of pregnant women; work for early registration of pregnancy and identification of high risk pregnancies; immunize 100% of pregnant women with tetanus toxoid; make available intrapartum care for all pregnant women; delineate anticipated job requirements, duties, and functions of village level health workers; make presterilized packaged delivery kits available to all female health workers; and implement secondary level perinatal care.

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.

"Population and poverty: major barriers to food accessibility" -- a panel discussion on civil society and people's participation.

PubMed

1996-01-01

This paper summarizes conference statements on poverty and food policies that were made by parliamentary members from Malaysia, the Philippines, and India. These presentations were made after the main panel discussion on barriers to food accessibility. In Malaysia the government adopted a National Agricultural Policy in 1984. This policy encouraged increased productivity, effective use of resources, agricultural credit and incentives, and integrated pest management. Strong support was given to the food processing industry. Poverty was the main reason for food inaccessibility. Through government efforts, poverty was reduced from 16.5% in 1990 to 8.9% in 1995. The Filipino member reported that government efforts had focused on national campaigns to combat hunger and to encourage community participation. The government was forced to implement a national Plan of Action for Food Security due to increased population, environmental degradation, closing land frontiers, and the global economy. The Plan encouraged increases in productivity, price and supply stabilization, maintenance of stocks, and rice subsidies for the poor. Gender concerns were being incorporated into development programs. The Indian member linked food insecurity to world resource problems. He stated that food problems included imbalances between supply and demand, but more importantly inequalities in access to food and differences in nutritional content of food. Populations in developing countries spent a larger proportion of income on food of lesser quality and variety that contributed to nutritional deficiencies, particularly among women and children. Food insecurity was part of the cycle of poverty, hunger, low productivity, and high mortality. Poverty was the primary cause and a major consequence of hunger and chronic food insecurity. Although India increased food productivity, food insecurity remained. Multidisciplinary approaches are needed.

The role of spatially-derived access-to-care characteristics in melanoma prevention and control in Los Angeles county.

PubMed

Escobedo, Loraine A; Crew, Ashley; Eginli, Ariana; Peng, David; Cousineau, Michael R; Cockburn, Myles

2017-05-01

Among 10,068 incident cases of invasive melanoma, we examined the effects of patient characteristics and access-to-care on the risk of advanced melanoma. Access-to-care was defined in terms of census tract-level sociodemographics, health insurance, cost of dermatological services and appointment wait-times, clinic density and travel distance. Public health insurance and education level were the strongest predictors of advanced melanomas but were modified by race/ethnicity and poverty: Hispanic whites and high-poverty neighborhoods were worse off than non-Hispanic whites and low-poverty neighborhoods. Targeting high-risk, underserved Hispanics and high-poverty neighborhoods (easily identified from existing data) for early melanoma detection may be a cost-efficient strategy to reduce melanoma mortality. Copyright © 2017 Elsevier Ltd. All rights reserved.

The relationship between area poverty rate and site-specific cancer incidence in the United States.

PubMed

Boscoe, Francis P; Johnson, Christopher J; Sherman, Recinda L; Stinchcomb, David G; Lin, Ge; Henry, Kevin A

2014-07-15

The relationship between socioeconomic status and cancer incidence in the United States has not traditionally been a focus of population-based cancer surveillance systems. Nearly 3 million tumors diagnosed between 2005 and 2009 from 16 states plus Los Angeles were assigned into 1 of 4 groupings based on the poverty rate of the residential census tract at time of diagnosis. The sex-specific risk ratio of the highest-to-lowest poverty category was measured using Poisson regression, adjusting for age and race, for 39 cancer sites. For all sites combined, there was a negligible association between cancer incidence and poverty; however, 32 of 39 cancer sites showed a significant association with poverty (14 positively associated and 18 negatively associated). Nineteen of these sites had monotonic increases or decreases in risk across all 4 poverty categories. The sites most strongly associated with higher poverty were Kaposi sarcoma, larynx, cervix, penis, and liver; those most strongly associated with lower poverty were melanoma, thyroid, other nonepithelial skin, and testis. Sites associated with higher poverty had lower incidence and higher mortality than those associated with lower poverty. These findings demonstrate the importance and relevance of including a measure of socioeconomic status in national cancer surveillance. Cancer 2014;120:2191-2198. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. © 2014 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society.

Linking high parity and maternal and child mortality: what is the impact of lower health services coverage among higher order births?

PubMed

Sonneveldt, Emily; DeCormier Plosky, Willyanne; Stover, John

2013-01-01

A number of data sets show that high parity births are associated with higher child mortality than low parity births. The reasons for this relationship are not clear. In this paper we investigate whether high parity is associated with lower coverage of key health interventions that might lead to increased mortality. We used DHS data from 10 high fertility countries to examine the relationship between parity and coverage for 8 child health intervention and 9 maternal health interventions. We also used the LiST model to estimate the effect on maternal and child mortality of the lower coverage associated with high parity births. Our results show a significant relationship between coverage of maternal and child health services and birth order, even when controlling for poverty. The association between coverage and parity for maternal health interventions was more consistently significant across countries all countries, while for child health interventions there were fewer overall significant relationships and more variation both between and within countries. The differences in coverage between children of parity 3 and those of parity 6 are large enough to account for a 12% difference in the under-five mortality rate and a 22% difference in maternal mortality ratio in the countries studied. This study shows that coverage of key health interventions is lower for high parity children and the pattern is consistent across countries. This could be a partial explanation for the higher mortality rates associated with high parity. Actions to address this gap could help reduce the higher mortality experienced by high parity birth.

Maintaining rigor in research: flaws in a recent study and a reanalysis of the relationship between state abortion laws and maternal mortality in Mexico.

PubMed

Darney, Blair G; Saavedra-Avendano, Biani; Lozano, Rafael

2017-01-01

A recent publication [Koch E, Chireau M, Pliego F, Stanford J, Haddad S, Calhoun B, Aracena P, Bravo M, Gatica S, Thorp J. Abortion legislation, maternal healthcare, fertility, female literacy, sanitation, violence against women and maternal deaths: a natural experiment in 32 Mexican states. BMJ Open 2015;5(2):e006013] claimed that Mexican states with more restrictive abortion laws had lower levels of maternal mortality. Our objectives are to replicate the analysis, reanalyze the data and offer a critique of the key flaws of the Koch study. We used corrected maternal mortality data (2006-2013), live births, and state-level indicators of poverty. We replicate the published analysis. We then reclassified state-level exposure to abortion on demand based on actual availability of abortion (Mexico City versus the other 31 states) and test the association of abortion access and the maternal mortality ratio (MMR) using descriptives over time, pooled chi-square tests and regression models. We included 256 state-year observations. We did not find significant differences in MMR between Mexico City (MMR=49.1) and the 31 states (MMR=44.6; p=.44). Using Koch's classification of states, we replicated published differences of higher MMR where abortion is more available. We found a significant, negative association between MMR and availability of abortion in the same multivariable models as Koch, but using our state classification (beta=-22.49, 95% CI=-38.9; -5.99). State-level poverty remains highly correlated with MMR. Koch makes errors in methodology and interpretation, making false causal claims about abortion law and MMR. MMR is falling most rapidly in Mexico City, but our main study limitation is an inability to draw causal inference about abortion law or access and maternal mortality. We need rigorous evidence about the health impacts of increasing access to safe abortion worldwide. Transparency and integrity in research is crucial, as well as perhaps even more in politically contested topics such as abortion. Rigorous evidence about the health impacts of increasing access to safe abortion worldwide is needed. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

How Effective Are Public Health Education Programs, Unfettered Farm Markets and Single Sex Schools?

ERIC Educational Resources Information Center

Fox, Jonathan Franklin

2010-01-01

My dissertation examines the effectiveness of three policy choices in meeting socio-economic goals. The first analyzes the impact of public health education and poverty relief on child mortality in the early twentieth century, when infant and child mortality rates in the United States were startlingly high. During the 1920s, the rates dropped…

Economic Stress, Quality of Life, and Mortality for the Oldest-Old in China

ERIC Educational Resources Information Center

Yeung, W. Jean; Xu, Zhenhua

2012-01-01

China's oldest old population is estimated to quadruple by 2050. Yet, poverty rate for the oldest old has been the highest among all age groups in China. This paper investigates the relationship between economic stress, quality of life, and mortality among the oldest-old in China. Both objective economic hardships and perceived economic strain are…

Socioeconomic disparities in colorectal cancer mortality in the United States, 1990-2007.

PubMed

Enewold, Lindsey; Horner, Marie-Josèphe; Shriver, Craig D; Zhu, Kangmin

2014-08-01

United States colorectal cancer mortality rates have declined; however, disparities by socioeconomic status and race/ethnicity persist. The objective of this study was to describe the temporal association between colorectal cancer mortality and socioeconomic status by sex and race/ethnicity. Cancer mortality rates in the United States from 1990 to 2007, which were generated by the National Center for Health Statistics, and county-level socioeconomic status, which was estimated as the proportion of county residents living below the national poverty line based on 1990 US Census Bureau data, were obtained from the Surveillance, Epidemiology, and End Results program. The Kunst-Mackenbach relative index of inequality, which considers data across all poverty levels when comparing risks in the poorest (≥ 20%) and richest counties (<10%), was calculated as the measure of association. The study found that colorectal cancer mortality rates were significantly lower in the poorest counties than the richest counties during 1990-1992 among non-Hispanic whites, non-Hispanic black women and non-Hispanic API men. Over time though the tendency was for the poorest counties to have higher mortality rates. By 2003-2007 colorectal cancer mortality rates were significantly higher in the poorest than the richest counties among all sex-race/ethnicity groups. This disparity was most noticeable and appeared to be increasing most among Hispanic men. This suggests that socioeconomic disparities in colorectal cancer mortality were apparent after stratifying by sex and race/ethnicity and reversed over time. Further studies into the causes of these disparities would provide a basis for targeted cancer control interventions and allocation of public health resources.

Asthma and Hispanic Americans

MedlinePlus

... as bronchitis. Children living below or near the poverty level are more likely to have high levels ... www.cdc.gov/nchs/hdi.htm The proportional impact of asthma prevalence, health care use and mortality ...

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.

Poverty, Disease, and the Ecology of Complex Systems

PubMed Central

Pluciński, Mateusz M.; Murray, Megan B.; Farmer, Paul E.; Barrett, Christopher B.; Keenan, Donald C.

2014-01-01

Understanding why some human populations remain persistently poor remains a significant challenge for both the social and natural sciences. The extremely poor are generally reliant on their immediate natural resource base for subsistence and suffer high rates of mortality due to parasitic and infectious diseases. Economists have developed a range of models to explain persistent poverty, often characterized as poverty traps, but these rarely account for complex biophysical processes. In this Essay, we argue that by coupling insights from ecology and economics, we can begin to model and understand the complex dynamics that underlie the generation and maintenance of poverty traps, which can then be used to inform analyses and possible intervention policies. To illustrate the utility of this approach, we present a simple coupled model of infectious diseases and economic growth, where poverty traps emerge from nonlinear relationships determined by the number of pathogens in the system. These nonlinearities are comparable to those often incorporated into poverty trap models in the economics literature, but, importantly, here the mechanism is anchored in core ecological principles. Coupled models of this sort could be usefully developed in many economically important biophysical systems—such as agriculture, fisheries, nutrition, and land use change—to serve as foundations for deeper explorations of how fundamental ecological processes influence structural poverty and economic development. PMID:24690902

Poverty, disease, and the ecology of complex systems.

PubMed

Ngonghala, Calistus N; Pluciński, Mateusz M; Murray, Megan B; Farmer, Paul E; Barrett, Christopher B; Keenan, Donald C; Bonds, Matthew H

2014-04-01

Understanding why some human populations remain persistently poor remains a significant challenge for both the social and natural sciences. The extremely poor are generally reliant on their immediate natural resource base for subsistence and suffer high rates of mortality due to parasitic and infectious diseases. Economists have developed a range of models to explain persistent poverty, often characterized as poverty traps, but these rarely account for complex biophysical processes. In this Essay, we argue that by coupling insights from ecology and economics, we can begin to model and understand the complex dynamics that underlie the generation and maintenance of poverty traps, which can then be used to inform analyses and possible intervention policies. To illustrate the utility of this approach, we present a simple coupled model of infectious diseases and economic growth, where poverty traps emerge from nonlinear relationships determined by the number of pathogens in the system. These nonlinearities are comparable to those often incorporated into poverty trap models in the economics literature, but, importantly, here the mechanism is anchored in core ecological principles. Coupled models of this sort could be usefully developed in many economically important biophysical systems--such as agriculture, fisheries, nutrition, and land use change--to serve as foundations for deeper explorations of how fundamental ecological processes influence structural poverty and economic development.

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.

Pre-end-stage renal disease care not associated with dialysis facility neighborhood poverty in the United States.

PubMed

Plantinga, Laura C; Kim, Min; Goetz, Margarethe; Kleinbaum, David G; McClellan, William; Patzer, Rachel E

2014-01-01

Receipt of nephrology care prior to end-stage renal disease (ESRD) is a strong predictor of decreased mortality and morbidity, and neighborhood poverty may influence access to care. Our objective was to examine whether neighborhood poverty is associated with lack of pre-ESRD care at dialysis facilities. In a multi-level ecological study using geospatially linked 2007-2010 Dialysis Facility Report and 2006-2010 American Community Survey data, we examined whether high neighborhood poverty (≥20% of households in census tract living below poverty) was associated with dialysis facility-level lack of pre-ESRD care (percentage of patients with no nephrology care prior to dialysis start) in mixed-effects models, adjusting for facility and neighborhood confounders and allowing for neighborhood and regional random effects. Among the 5,184 facilities examined, 1,778 (34.3%) were located in a high-poverty area. Lack of pre-ESRD care was similar in poverty areas (30.8%) and other neighborhoods (29.6%). With adjustment, the absolute increase in percentage of patients at a facility with no pre-ESRD care associated with facility location in a poverty area versus other neighborhood was only 0.08% (95% CI -1.32, 1.47; p = 0.9). Potential effect modification by race and income inequality was detected. Despite previously reported detrimental effects of neighborhood poverty on health, facility neighborhood poverty was not associated with receipt of pre-ESRD care, suggesting no need to target interventions to increase access to pre-ESRD care at facilities in poorer geographic areas.

Pre-end-stage renal disease care not associated with dialysis facility neighborhood poverty in the United States

PubMed Central

Plantinga, Laura C.; Kim, Min; Goetz, Margarethe; Kleinbaum, David G.; McClellan, William; Patzer, Rachel E.

2014-01-01

Background Receipt of nephrology care prior to end-stage renal disease (ESRD) is a strong predictor of decreased mortality and morbidity, and neighborhood poverty may influence access to care. Our objective was to examine whether neighborhood poverty is associated with lack of pre-ESRD care at dialysis facilities. Methods In a multi-level ecological study using geospatially linked 2007-2010 Dialysis Facility Report and 2006-2010 American Community Survey data, we examined whether high neighborhood poverty (≥20% of households in census tract living below poverty) was associated with dialysis facility-level lack of pre-ESRD care (percentage of patients with no nephrology care prior to dialysis start) in mixed-effects models, adjusting for facility and neighborhood confounders and allowing for neighborhood and regional random effects. Results Among the 5184 facilities examined, 1778 (34.3%) were located in a high poverty area. Lack of pre-ESRD care was similar in poverty areas (30.8%) and other neighborhoods (29.6%). With adjustment, the absolute increase in percentage of patients at a facility with no pre-ESRD care associated with facility location in a poverty area vs. other neighborhood was only 0.08% (95% CI: -1.32%, 1.47%; P=0.9). Potential effect modification by race and income inequality was detected. Conclusion Despite previously reported detrimental effects of neighborhood poverty on health, facility neighborhood poverty was not associated with receipt of pre-ESRD care, suggesting no need to target interventions to increase access to pre-ESRD care at facilities in poorer geographic areas. PMID:24434854

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.

Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty--a BOLD analysis.

PubMed

Burney, Peter; Jithoo, Anamika; Kato, Bernet; Janson, Christer; Mannino, David; Nizankowska-Mogilnicka, Ewa; Studnicka, Michael; Tan, Wan; Bateman, Eric; Koçabas, Ali; Vollmer, William M; Gislason, Thorarrin; Marks, Guy; Koul, Parvaiz A; Harrabi, Imed; Gnatiuc, Louisa; Buist, Sonia

2014-05-01

Chronic obstructive pulmonary disease (COPD) is a commonly reported cause of death and associated with smoking. However, COPD mortality is high in poor countries with low smoking rates. Spirometric restriction predicts mortality better than airflow obstruction, suggesting that the prevalence of restriction could explain mortality rates attributed to COPD. We have studied associations between mortality from COPD and low lung function, and between both lung function and death rates and cigarette consumption and gross national income per capita (GNI). National COPD mortality rates were regressed against the prevalence of airflow obstruction and spirometric restriction in 22 Burden of Obstructive Lung Disease (BOLD) study sites and against GNI, and national smoking prevalence. The prevalence of airflow obstruction and spirometric restriction in the BOLD sites were regressed against GNI and mean pack years smoked. National COPD mortality rates were more strongly associated with spirometric restriction in the BOLD sites (<60 years: men rs=0.73, p=0.0001; women rs=0.90, p<0.0001; 60+ years: men rs=0.63, p=0.0022; women rs=0.37, p=0.1) than obstruction (<60 years: men rs=0.28, p=0.20; women rs=0.17, p<0.46; 60+ years: men rs=0.28, p=0.23; women rs=0.22, p=0.33). Obstruction increased with mean pack years smoked, but COPD mortality fell with increased cigarette consumption and rose rapidly as GNI fell below US$15 000. Prevalence of restriction was not associated with smoking but also increased rapidly as GNI fell below US$15 000. Smoking remains the single most important cause of obstruction but a high prevalence of restriction associated with poverty could explain the high 'COPD' mortality in poor countries.

42 CFR 491.5 - Location of clinic.

Code of Federal Regulations, 2013 CFR

2013-10-01

... practicing within the area to the resident population; (ii) The infant mortality rate; (iii) The percent of... below the poverty level. (2) The criteria for determination of shortage of primary medical care manpower...

42 CFR 491.5 - Location of clinic.

Code of Federal Regulations, 2011 CFR

2011-10-01

... practicing within the area to the resident population; (ii) The infant mortality rate; (iii) The percent of... below the poverty level. (2) The criteria for determination of shortage of primary medical care manpower...

42 CFR 491.5 - Location of clinic.

Code of Federal Regulations, 2012 CFR

2012-10-01

... practicing within the area to the resident population; (ii) The infant mortality rate; (iii) The percent of... below the poverty level. (2) The criteria for determination of shortage of primary medical care manpower...

Study on temporal variation and spatial distribution for rural poverty in China based on GIS

NASA Astrophysics Data System (ADS)

Feng, Xianfeng; Xu, Xiuli; Wang, Yingjie; Cui, Jing; Mo, Hongyuan; Liu, Ling; Yan, Hong; Zhang, Yan; Han, Jiafu

2009-07-01

Poverty is one of the most serious challenges all over the world, is an obstacle to hinder economics and agriculture in poverty area. Research on poverty alleviation in China is very useful and important. In this paper, we will explore the comprehensive poverty characteristics in China, analyze the current poverty status, spatial distribution and temporal variations about rural poverty in China, and to category the different poverty types and their spatial distribution. First, we achieved the gathering and processing the relevant data. These data contain investigation data, research reports, statistical yearbook, censuses, social-economic data, physical and anthrop geographical data, etc. After deeply analysis of these data, we will get the distribution of poverty areas by spatial-temporal data model according to different poverty given standard in different stages in China to see the poverty variation and the regional difference in County-level. Then, the current poverty status, spatial pattern about poverty area in villages-level will be lucubrated; the relationship among poverty, environment (including physical and anthrop geographical factors) and economic development, etc. will be expanded. We hope our research will enhance the people knowledge of poverty in China and contribute to the poverty alleviation in China.

Correlation of regional cardiovascular disease mortality in India with lifestyle and nutritional factors.

PubMed

Gupta, Rajeev; Misra, Anoop; Pais, Prem; Rastogi, Priyanka; Gupta, V P

2006-04-14

There is a wide disparity in prevalence and cardiovascular disease mortality in different Indian states. To determine significance of various nutritional factors and other lifestyle variables in explaining this difference in cardiovascular disease mortality we performed an analysis. Mortality data were obtained from the Registrar General of India. In 1998 the annual death rate for India was 840/100,000 population. Cardiovascular diseases contribute to 27% of these deaths and its crude mortality rate was 227/100,000. Major differences in cardiovascular disease mortality rates in different Indian states were reported varying from 75-100 in sub-Himalayan states of Nagaland, Meghalaya, Himachal Pradesh and Sikkim to a high of 360-430 in Andhra Pradesh, Tamil Nadu, Punjab and Goa. Lifestyle data were obtained from national surveys conducted by the government of India. The second National Family Health Survey (26 states, 92,447 households, 301,984 adults) conducted in 1998-1999 reported on various demographic and lifestyle variables and India Nutrition Profile Study reported dietary intake of 177,841 adults (18 states, 75,229 men, 102,612 women). Cardiovascular disease mortality rates were correlated with smoking, literacy levels, prevalence of stunted growth at 3-years (as marker of fetal undernutrition), adult mean body mass index, prevalence of overweight and obesity, dietary consumption of calories, cereals and pulses, green leafy vegetables, roots, tubers and other vegetables, milk and milk products, fats and oils, and sugar and jaggery. As a major confounder in different states is poverty, all the partial correlation coefficients were adjusted for illiteracy, fertility rate and infant mortality rate. There was a significant positive correlation of cardiovascular disease mortality with prevalence of obesity (R=0.37) and dietary consumption of fats (R=0.67), milk and its products (R=0.27) and sugars (R=0.51) and negative correlation with green leafy vegetable intake (R=-0.42) (p<0.05). There are large disparities in cardiovascular disease mortality in different Indian states. This can be epidemiologically explained by difference in dietary consumption of fats, milk, sugar and green-leafy vegetables and prevalence of obesity.

Some aspects of socio-economic determinants of mortality in tropical Africa.

PubMed

Gaisie, S K

1980-01-01

Measurements of mortality levels and trends continue to be inadequate in Africa, largely because of the lack of reliable and adequate information on deaths. A series of estimates depicting mortality levels and trends has been prepared by demographers, different kinds of data and employing different estimation procedures, but knowledge of the "true" structure of mortality in tropical Africa is virtually nonexistent. Because of these problems only a "bird's eye view" of the prevailing situation in tropical Africa is presented. The discussion -- directed to mortality by sex and age, by residence, and by cause -- is based on secondary and fragmentary data. Socioeconomic and cultural determinants of mortality are also examined. Available information on male and female mortality indicates that the death rates for males are higher than they are for females. Early childhood mortality (1-4 years) in tropical Africa is relatively high compared with the other age groups, including infants. Mortality differentials have been noted among geographical and administrative units and subdivisions of populations within the various countries of tropical Africa. Also, urban dwellers enjoy a higher expectation of life at birth than do rural dwellers. Communicable diseases are the main killers in tropical Africa. Persistent poverty and malnutrition, poor housing, unhealthy conditions in the growing cities, nonexistence of health facilities in the rural areas, rapid population expansion, and low levels of education are among the factors impeding progress in reducing mortality in tropical Africa. The need exists to express development goals in terms of the progressive reduction and eventual elimination of malnutrition, disease, illiteracy, squalor, and inequalities. Future trends in mortality in tropical Africa may depend more than they have in the recent past on economic and social development.

Global Inequalities in Cervical Cancer Incidence and Mortality are Linked to Deprivation, Low Socioeconomic Status, and Human Development

PubMed Central

Singh, Gopal K.; Azuine, Romuladus E.; Siahpush, Mohammad

2012-01-01

Objectives This study examined global inequalities in cervical cancer incidence and mortality rates as a function of cross-national variations in the Human Development Index (HDI), socioeconomic factors, Gender Inequality Index (GII), and healthcare expenditure. Methods Age-adjusted incidence and mortality rates were calculated for women in 184 countries using the 2008 GLOBOCAN database, and incidence and mortality trends were analyzed using the WHO cancer mortality database. Log-linear regression was used to model annual trends, while OLS and Poisson regression models were used to estimate the impact of socioeconomic and human development factors on incidence and mortality rates. Results Cervical cancer incidence and mortality rates varied widely, with many African countries such as Guinea, Zambia, Comoros, Tanzania, and Malawi having at least 10-to-20-fold higher rates than several West Asian, Middle East, and European countries, including Iran, Saudi Arabia, Syria, Egypt, and Switzerland. HDI, GII, poverty rate, health expenditure per capita, urbanization, and literacy rate were all significantly related to cervical cancer incidence and mortality, with HDI and poverty rate each explaining >52% of the global variance in mortality. Both incidence and mortality rates increased in relation to lower human development and higher gender inequality levels. A 0.2 unit increase in HDI was associated with a 20% decrease in cervical cancer risk and a 33% decrease in cervical cancer mortality risk. The risk of a cervical cancer diagnosis increased by 24% and of cervical cancer death by 42% for a 0.2 unit increase in GII. Higher health expenditure levels were independently associated with decreased incidence and mortality risks. Conclusions and Public Health Implications Global inequalities in cervical cancer are clearly linked to disparities in human development, social inequality, and living standards. Reductions in cervical cancer rates are achievable by reducing inequalities in socioeconomic conditions, availability of preventive health services, and women’s social status. PMID:27621956

Global Inequalities in Cervical Cancer Incidence and Mortality are Linked to Deprivation, Low Socioeconomic Status, and Human Development.

PubMed

Singh, Gopal K; Azuine, Romuladus E; Siahpush, Mohammad

2012-01-01

This study examined global inequalities in cervical cancer incidence and mortality rates as a function of cross-national variations in the Human Development Index (HDI), socioeconomic factors, Gender Inequality Index (GII), and healthcare expenditure. Age-adjusted incidence and mortality rates were calculated for women in 184 countries using the 2008 GLOBOCAN database, and incidence and mortality trends were analyzed using the WHO cancer mortality database. Log-linear regression was used to model annual trends, while OLS and Poisson regression models were used to estimate the impact of socioeconomic and human development factors on incidence and mortality rates. Cervical cancer incidence and mortality rates varied widely, with many African countries such as Guinea, Zambia, Comoros, Tanzania, and Malawi having at least 10-to-20-fold higher rates than several West Asian, Middle East, and European countries, including Iran, Saudi Arabia, Syria, Egypt, and Switzerland. HDI, GII, poverty rate, health expenditure per capita, urbanization, and literacy rate were all significantly related to cervical cancer incidence and mortality, with HDI and poverty rate each explaining >52% of the global variance in mortality. Both incidence and mortality rates increased in relation to lower human development and higher gender inequality levels. A 0.2 unit increase in HDI was associated with a 20% decrease in cervical cancer risk and a 33% decrease in cervical cancer mortality risk. The risk of a cervical cancer diagnosis increased by 24% and of cervical cancer death by 42% for a 0.2 unit increase in GII. Higher health expenditure levels were independently associated with decreased incidence and mortality risks. Global inequalities in cervical cancer are clearly linked to disparities in human development, social inequality, and living standards. Reductions in cervical cancer rates are achievable by reducing inequalities in socioeconomic conditions, availability of preventive health services, and women's social status.

The association of solar ultraviolet B (UVB) with reducing risk of cancer: multifactorial ecologic analysis of geographic variation in age-adjusted cancer mortality rates.

PubMed

Grant, William B; Garland, Cedric F

2006-01-01

Solar ultraviolet B (UVB) irradiance and vitamin D are associated with reduced cancer mortality rates. However, the previous ecologic study of UVB and cancer mortality rates in the U.S. (Grant, 2002) did not include other risk factors in the analysis. An ecologic study was performed using age-adjusted annual mortality rates for Caucasian Americans for 1950-69 and 1970-94, along with state-averaged values for selected years for alcohol consumption, Hispanic heritage, lung cancer (as a proxy for smoking), poverty, degree of urbanization and UVB in multiple regression analyses. Models were developed that explained much of the variance in cancer mortality rates, with stronger correlations for the earlier period. Fifteen types of cancer were inversely-associated with UVB. In the earlier period, most of the associations of cancer death rates with alcohol consumption (nine), Hispanic heritage (six), the proxy for smoking (ten), urban residence (seven) and poverty (inverse for eight) agreed well with the literature. These results provide additional support for the hypothesis that solar UVB, through photosynthesis of vitamin D, is inversely-associated with cancer mortality rates, and that various other cancer risk-modifying factors do not detract from this link. It is thought that sun avoidance practices after 1980, along with improved cancer treatment, led to reduced associations in the latter period. The results regarding solar UVB should be studied further with additional observational and intervention studies of vitamin D indices and cancer incidence, mortality and survival rates.

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.

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.

Income is a stronger predictor of mortality than education in a national sample of US adults.

PubMed

Sabanayagam, Charumathi; Shankar, Anoop

2012-03-01

Low socioeconomic status (SES) is associated with mortality in several populations. SES measures, such as education and income, may operate through different pathways. However, the independent effect of each measure mutually adjusting for the effect of other SES measures is not clear. The association between poverty-income ratio (PIR) and education and all-cause mortality among 15,646 adults, aged >20 years, who participated in the Third National Health and Nutrition Examination Survey in the USA, was examined. The lower PIR quartiles and less than high school education were positively associated with all-cause mortality in initial models adjusting for the demographic, lifestyle and clinical risk factors. After additional adjustment for education, the lower PIR quartiles were still significantly associated with all-cause mortality. The multivariable odds ratio (OR) [95% confidence interval (CI)] of all-cause mortality comparing the lowest to the highest quartile of PIR was 2.11 (1.52-2.95, p trend < or = 0.0001). In contrast, after additional adjustment for income, education was no longer associated with all-cause mortality [multivariable OR (95% CI) of all-cause mortality comparing less than high school to more than high school education was 1.05 (0.85-1.31, p trend=0.57)]. The results suggest that income may be a stronger predictor of mortality than education, and narrowing the income differentials may reduce the health disparities.

Big Earthquakes and Little Children.

ERIC Educational Resources Information Center

Cottle, Thomas J.

1990-01-01

A children's social health index calculated from six aspects of social health indicates that the social health of children is deteriorating in the areas of infant mortality, child abuse, child poverty, teenage suicide, and high school dropouts. (SH)

Health Care Issues in Southern Rural Black America.

ERIC Educational Resources Information Center

Turner, Henrie M.

1986-01-01

High infant and maternal mortality, poverty, isolation, a shortage of health professionals, inadequate health care facilities, and difficult geographic access to care are some of the health-related problems that plague Black rural southerners. (GC)

Associates of Neonatal, Infant and Child Mortality in the Islamic Republic of Pakistan: A Multilevel Analysis Using the 2012-2013 Demographic and Health Surveys.

PubMed

Helova, Anna; Hearld, Kristine R; Budhwani, Henna

2017-02-01

Objectives Pakistan is one of five nations contributing to half of the world's child mortality and holds under-five mortality rates which are nearly double global targets. Reasons for this shortfall include civil conflicts, political uncertainty, low education, poverty, rural-urban disparities, and limited health care access. The aim of this study was to explore associations between individual characteristics, community factors, and child mortality in Pakistan. Methods Data were derived from the 2012 to 2013 Pakistan Demographic and Health Survey, and included 7399 live births and 380 child deaths. Multivariate, multilevel logistic regression was used to model risk of neonatal, infant and under-five child deaths. Results Seventy-one percent of child deaths occurred during the neonatal period. Significant factors (p < 0.05) associated with lower odds of child mortality included adhering to recommended minimum of 24 months interpregnancy interval and higher household wealth. These were significant for neonatal (OR 0.448; 0.871), infancy (OR 0.465; 0.881), and under-five deaths (OR 0.465; 0.879). Employed mothers had higher odds of neonatal (OR 1.479), infant (OR 1.506), and child mortality (OR 1.459). Likewise, women living in consanguineous marriages had higher odds of infant (OR 1.454) and under-five deaths (OR 1.381). Children in Balochistan, Punjab, and Sindh, regions disproportionately poor, rural with low levels of education, were at highest risk of dying. Conclusions for Practice Findings may assist in designing targeted interventions, developing appropriate public health messaging, and implementing policies designed to lower child mortality. Focusing on lowering rates of maternal poverty, increasing opportunities for education, and improving access to health care could assist in reducing child mortality in Pakistan.

Neighborhood Differences in Post-Stroke Mortality

PubMed Central

Osypuk, Theresa L.; Ehntholt, Amy; Moon, J. Robin; Gilsanz, Paola; Glymour, M. Maria

2017-01-01

Background Post-stroke mortality is higher among residents of disadvantaged neighborhoods, but it is not known whether neighborhood inequalities are specific to stroke survival or similar to mortality patterns in the general population. We hypothesized that neighborhood disadvantage would predict higher post-stroke mortality and neighborhood effects would be relatively larger for stroke patients than for individuals with no history of stroke. Methods and Results Health and Retirement Study participants aged 50+ without stroke at baseline (n=15,560) were followed up to 12 years for incident stroke (1,715 events over 159,286 person-years) and mortality (5,325 deaths). Baseline neighborhood characteristics included objective measures based on census tracts (family income, poverty, deprivation, residential stability, and percent white, black or foreign-born) and self-reported neighborhood social ties. Using Cox proportional hazard models, we compared neighborhood mortality effects for people with versus without a history of stroke. Most neighborhood variables predicted mortality for both stroke patients and the general population in demographic-adjusted models. Neighborhood percent white predicted lower mortality for stroke survivors (HR=0.75 for neighborhoods in highest 25th percentile vs. below, 95 % CI: 0.62, 0.91) more strongly than for stroke-free adults (HR=0.92 (0.83, 1.02); p=0.04 for stroke-by-neighborhood interaction). No other neighborhood characteristic had different effects for people with versus without stroke. Neighborhood-mortality associations emerged within three months after stroke, when associations were often stronger than among stroke-free individuals. Conclusions Neighborhood characteristics predict post-stroke mortality, but most effects are similar for individuals without stroke. Eliminating disparities in stroke survival may require addressing pathways that are not specific to traditional post-stroke care. PMID:28228449

Poverty and mortality among the elderly: measurement of performance in 33 countries 1960-92.

PubMed

Wang, J; Jamison, D T; Bos, E; Vu, M T

1997-10-01

This paper analyses the effect of income and education on life expectancy and mortality rates among the elderly in 33 countries for the period 1960-92 and assesses how that relationship has changed over time as a result of technical progress. Our outcome variables are life expectancy at age 60 and the probability of dying between age 60 and age 80 for both males and females. The data are from vital-registration based life tables published by national statistical offices for several years during this period. We estimate regressions with determinants that include GDP per capita (adjusted for purchasing power), education and time (as a proxy for technical progress). As the available measure of education failed to account for variation in life expectancy or mortality at age 60, our reported analyses focus on a simplified model with only income and time as predictors. The results indicate that, controlling for income, mortality rates among the elderly have declined considerably over the past three decades. We also find that poverty (as measured by low average income levels) explains some of the variation in both life expectancy at age 60 and mortality rates among the elderly across the countries in the sample. The explained amount of variation is more substantial for females than for males. While poverty does adversely affect mortality rates among the elderly (and the strength of this effect is estimated to be increasing over time), technical progress appears far more important in the period following 1960. Predicted female life expectancy (at age 60) in 1960 at the mean income level in 1960 was, for example 18.8 years; income growth to 1992 increased this by an estimated 0.7 years, whereas technical progress increased it by 2.0 years. We then use the estimated regression results to compare country performance on life expectancy of the elderly, controlling for levels of poverty (or income), and to assess how performance has varied over time. High performing countries, on female life expectancy at age 60, for the period around 1990, included Chile (1.0 years longer life expectancy), China (1.7 years longer), France (2.0 years longer), Japan (1.9 years longer), and Switzerland (1.3 years longer). Poorly performing countries included Denmark (1.1 years shorter life expectancy than predicted from income), Hungary (1.4 years shorter), Iceland (1.2 years shorter), Malaysia (1.6 years shorter), and Trinidad and Tobago (3.9 years shorter). Chile and Switzerland registered major improvements in relative performance over this period; Norway, Taiwan and the USA, in contrast showed major declines in performance between 1980 and the early 1990s.

A history of noma, the "Face of Poverty".

PubMed

Marck, Klaas W

2003-04-15

Noma (necrotizing ulcerative stomatitis, stomatitis gangrenosa, or cancrum oris) is a devastating orofacial gangrene that occurs mainly among children. The disease has a global yearly incidence of 140,000 cases and a mortality rate of approximately 90 percent. Patients who survive noma generally suffer from its sequelae, including serious facial disfigurement, trismus, oral incontinence, and speech problems. The medical history of noma indicates that the disease was already known in classical and medieval civilizations in Europe. In the sixteenth and seventeenth centuries, Dutch chirurgeons clearly described noma as a clinical entity and realized that the popular name "water canker" was not sufficient, because this quickly spreading ulceration in the faces of children was different from "cancer." In the eighteenth century, awareness that noma is related to poverty, malnutrition, and preceding diseases such as measles increased in northwestern Europe. In the first half of the nineteenth century, extensive surgical procedures were described for the treatment of the sequelae of noma. At the end of that century, noma gradually disappeared in the Western world because of economic progress, which gave the poorest in society the opportunity to feed their children sufficiently. Only in the twentieth century were effective drugs (sulfonamides and penicillin) against noma developed, as well as adequate surgical treatment for the sequelae of noma. These modes of treatment remain inaccessible for the many present-day victims of noma because of their extreme poverty. The only truly effective approach to the problem of noma throughout the world is prevention, namely, combating the extreme poverty with measures that lead to economic progress. In the meantime, medical doctors in the Western world should not forget their own history and ignore this global health problem; rather, they should face "the face of poverty" with the eyes of mercy and concern suited to their profession.

Some socio-economic factors affecting infant and child mortality with special reference to Indonesia.

PubMed

Kristanto, B

1983-06-01

A review of the literature on the socioeconomic factors affecting infant and child mortality is presented, with special reference to Indonesia. Four main factors are identified: parents' education, parents' occupation, urban-rural residence, and housing conditions. The author suggests that, in fact, problems related to health and sanitation are the main causes of infant and child mortality. Also important are problems related to poverty, income, and income distribution. It is suggested that the solution is to be found in general socioeconomic development.

Intra-urban vulnerability to heat-related mortality in New York City, 1997–2006

PubMed Central

Rosenthal, Joyce Klein; Kinney, Patrick L.; Metzger, Kristina B.

2015-01-01

The health impacts of exposure to summertime heat are a significant problem in New York City (NYC) and for many cities and are expected to increase with a warming climate. Most studies on heat-related mortality have examined risk factors at the municipal or regional scale and may have missed the intra-urban variation of vulnerability that might inform prevention strategies. We evaluated whether place-based characteristics (socioeconomic/demographic and health factors, as well as the built and biophysical environment) may be associated with greater risk of heat-related mortality for seniors during heat events in NYC. As a measure of relative vulnerability to heat, we used the natural cause mortality rate ratio among those aged 65 and over (MRR65+), comparing extremely hot days (maximum heat index 100 °F+) to all warm season days, across 1997–2006 for NYC's 59 Community Districts and 42 United Hospital Fund neighborhoods. Significant positive associations were found between the MRR65+ and neighborhood-level characteristics: poverty, poor housing conditions, lower rates of access to air-conditioning, impervious land cover, surface temperatures aggregated to the area-level, and seniors’ hypertension. Percent Black/African American and household poverty were strong negative predictors of seniors’ air conditioning access in multivariate regression analysis. PMID:25199872

The Role of Contextual Socioeconomic Circumstances and Neighborhood Poverty Segregation on Mortality in 4 European Cities.

PubMed

Marinacci, Chiara; Demaria, Moreno; Melis, Giulia; Borrell, Carme; Corman, Diana; Dell'Olmo, Marc Marí; Rodriguez, Maica; Costa, Giuseppe

2017-10-01

Several studies have recognized the health disadvantage of residents in socioeconomically deprived neighborhoods, independent of the influence of individual socioeconomic conditions. The effect of neighborhood socioeconomic deprivation on general mortality has appeared heterogeneous among the cities analyzed: the underlying mechanisms have been less empirically explored, and explanations for this heterogeneous health effect remain unclear. The present study aimed to: (1) analyze the distribution of socioeconomically disadvantaged persons in neighborhoods of 4 European cities-Turin, Barcelona, Stockholm and Helsinki-trying to measure segregation of residents according to their socioeconomic conditions. Two measuring approaches were used, respectively, through dissimilarity index and clustering estimated from Bayesian models. (2) Analyze the distribution of mortality in the above mentioned cities, trying to disentangle the independent effects of both neighborhood socioeconomic deprivation and neighborhood segregation of residents according to their socioeconomic conditions, using multilevel models. A significantly higher risk of death was observed among residents in more deprived neighborhoods in all 4 cities considered, slightly heterogeneous across them. Poverty segregation appeared to be slightly associated with increasing mortality in Turin and, among females and only according to dissimilarity, in Barcelona. Few studies have explored the health effects of social clustering, and results could inform urban policy design with regard to social mix.

Public Health Monitoring of Privilege and Deprivation With the Index of Concentration at the Extremes

PubMed Central

Waterman, Pamela D.; Spasojevic, Jasmina; Li, Wenhui; Maduro, Gil; Van Wye, Gretchen

2016-01-01

Objectives. We evaluated use of the Index of Concentration at the Extremes (ICE) for public health monitoring. Methods. We used New York City data centered around 2010 to assess cross-sectional associations at the census tract and community district levels, for (1) diverse ICE measures plus the US poverty rate, with (2) infant mortality, premature mortality (before age 65 years), and diabetes mortality. Results. Point estimates for rate ratios were consistently greatest for the novel ICE that jointly measured extreme concentrations of income and race/ethnicity. For example, the census tract–level rate ratio for infant mortality comparing the bottom versus top quintile for an ICE contrasting low-income Black versus high-income White equaled 2.93 (95% confidence interval [CI] = 2.11, 4.09), but was 2.19 (95% CI = 1.59, 3.02) for low versus high income, 2.77 (95% CI = 2.02, 3.81) for Black versus White, and 1.56 (95% CI = 1.19, 2.04) for census tracts with greater than or equal to 30% versus less than 10% below poverty. Conclusions. The ICE may be a useful metric for public health monitoring, as it simultaneously captures extremes of privilege and deprivation and can jointly measure economic and racial/ethnic segregation. PMID:26691119

Social, economic, and political factors in progress towards improving child survival in developing nations.

PubMed

Lykens, Kristine; Singh, Karan P; Ndukwe, Elewichi; Bae, Sejong

2009-01-01

Child mortality is a persistent health problem faced by developing nations. In 2000 the United Nations (UN) established a set of high priority goals to address global problems of poverty and health, the Millennium Development Goals, which address extreme poverty, hunger, primary education, child mortality, maternal health, infectious diseases, environmental sustainability, and partnerships for development. Goal 4 aims to reduce by two thirds, between 2000 and 2015, the under-five mortality rate in developing countries. In sub-Saharan Africa from 2000 to 2006 these rates have only been reduced from 167 per 1,000 live births to 157, and 27 nations in this region have made no progress towards the goal. A country-specific database was developed from the UN Millennium Development Goal tracking project and other international sources which include age distribution, under-nutrition, per capita income, government expenditures on health, external resources for health, civil liberties, and political rights. A multiple regression analysis examined the extent to which these factors explain the variance in child mortality rates in developing countries. Nutrition, external resources, and per capita income were shown to be significant factors in child survivability. Policy options include developed countries' renewed commitment of resources, and developing nations' commitments towards governance, development, equity, and transparency.

Global burden, distribution, and interventions for infectious diseases of poverty

PubMed Central

2014-01-01

Infectious diseases of poverty (IDoP) disproportionately affect the poorest population in the world and contribute to a cycle of poverty as a result of decreased productivity ensuing from long-term illness, disability, and social stigma. In 2010, the global deaths from HIV/AIDS have increased to 1.5 million and malaria mortality rose to 1.17 million. Mortality from neglected tropical diseases rose to 152,000, while tuberculosis killed 1.2 million people that same year. Substantial regional variations exist in the distribution of these diseases as they are primarily concentrated in rural areas of Sub-Saharan Africa, Asia, and Latin America, with geographic overlap and high levels of co-infection. Evidence-based interventions exist to prevent and control these diseases, however, the coverage still remains low with an emerging challenge of antimicrobial resistance. Therefore, community-based delivery platforms are increasingly being advocated to ensure sustainability and combat co-infections. Because of the high morbidity and mortality burden of these diseases, especially in resource-poor settings, it is imperative to conduct a systematic review to identify strategies to prevent and control these diseases. Therefore, we attempted to evaluate the effectiveness of one of these strategies, that is community-based delivery for the prevention and treatment of IDoP. In this paper, we describe the burden, epidemiology, and potential interventions for IDoP. In subsequent papers of this series, we describe the analytical framework and the methodology used to guide the systematic reviews, and report the findings and interpretations of our analyses of the impact of community-based strategies on individual IDoPs. PMID:25110585

42 CFR 62.54 - What must applications for the State Loan Repayment Program contain?

Code of Federal Regulations, 2011 CFR

2011-10-01

... accessibility of health care services in the State as measured by poverty levels, the percentage of the service... rates of infant mortality, low birth weight, geographic barriers and other indicators; (3) A proposal...

42 CFR 62.54 - What must applications for the State Loan Repayment Program contain?

Code of Federal Regulations, 2010 CFR

2010-10-01

... rates of infant mortality, low birth weight, geographic barriers and other indicators; (3) A proposal... accessibility of health care services in the State as measured by poverty levels, the percentage of the service...

Dynamics of Economic Well-Being: Poverty 1996-1999. Current Population Reports.

ERIC Educational Resources Information Center

Iceland, John

This report examines patterns of poverty using seven different measures: average monthly poverty, episodic poverty, chronic poverty, annual poverty, poverty spells, poverty entry rates, and poverty exit rates. Data come from the 1996 panel of the Survey of Income and Program Participation (SIPP) and reflect the dynamics of poverty from 1996-1999.…

Tobacco use & social status in Kerala.

PubMed

Thankappan, K R; Thresia, C U

2007-10-01

Health indicators of Kerala State such as infant mortality rate (14/ 1000 live births) and life expectancy at birth (71 yr for men and 76 yr for women) are far ahead of the Indian averages (IMR 58, life expectancy men 62 and women 63) and closer to the developed countries. However, tobacco use prevalence is similar to the national average. Smoking is the commonest form of tobacco usage among men in the State whereas chewing tobacco is more common among women and children. Tobacco chewing among men is increasing in Kerala probably due to the smoking ban and industry strategy to focus on smokeless tobacco. Tobacco use is significantly more among the low socio-economic (SE) groups compared to the high SE group. Mortality and morbidity attributed to tobacco is higher among the poorest people in the State. Age adjusted cancer rate of oral cavity and lung cancer has been increasing in the State in recent years. Heart diseases among the young people are increasing in the State. Cancer and heart diseases are chronic illnesses which may pull the individual and the entire family below the poverty line. Tobacco control therefore should be a top priority not only as a health issue but as a poverty reduction issue. Poverty alleviation is one of the major goals of developing economies. No poverty alleviation programme can ignore the potential impoverishment associated with tobacco use. Kerala with a very strong decentralized government has a very good opportunity to address tobacco control as a priority at the grass root level and reduce the impoverishment due to tobacco use.

Seeking explanations for high levels of infant mortality in Pakistan.

PubMed

Sathar, Z A

1987-01-01

Data from the Fertility Module of the 1979 Population, Labour Force and Migration (PLM) Survey of Pakistan were analyzed to determine which of 4 factors were primarily responsible for the high infant mortality rate. The factors examined were poverty, childbearing and childrearing practices, distribution of health care and lack of individual attention given to children due to ignorance. These items were presented in a discussion format. Infant mortality in Pakistan is high at about 125-140/1000, for a country with mid-level per capita income. Income was not a good indicator of child mortality, primarily because it was difficult to determine, particularly in rural areas where non-cash income predominates. Wealth and status were good indicators of child survival. Child-rearing practices were somewhat important, as judged by birth order, breastfeeding duration and gender. Childbearing practices as shown by spacing were important determinants of survival. Health care facilities were somewhat important, indicated by higher mortality in rural areas. Rural neonates die from tetanus due to lack of immunization, or later from diarrheal disease due to lack of potable water or poor weaning practices. Maternal education was a strong indicator of survival, much more so than paternal education. Similarly, female heads of households increased survival, probably because they control financial allocations. The study suggested that rather than attempting to eliminate poverty overall, improvements in maternal education, nutrition, health care facilities and their use, and childbearing and child-rearing methods would do more to improve child survival in Pakistan.

Marriage, Work, and Racial Inequalities in Poverty: Evidence from the U.S.

PubMed

Thiede, Brian; Kim, Hyojung; Slack, Tim

2017-10-01

This paper explores recent racial and ethnic inequalities in poverty, estimating the share of racial poverty differentials that can be explained by variation in family structure and workforce participation. The authors use logistic regression to estimate the association between poverty and race, family structure, and workforce participation. They then decompose between-race differences in poverty risk to quantify how racial disparities in marriage and work explain observed inequalities in the log odds of poverty. They estimate that 47.7-48.9% of black-white differences in poverty risk can be explained by between-group variance in these two factors, while only 4.3-4.5% of the Hispanic-white differential in poverty risk can be explained by these variables. These findings underscore the continued association between racial disparities in poverty and those in labor and marriage markets. However, clear racial differences in the origin of poverty suggest that family- and worked-related policy interventions will not have uniformly effective or evenly distributed impacts on poverty reduction.

Implementation strategy for achieving replacement level fertility.

PubMed

1993-01-01

The recommendation of the Bali Declaration on Population and Sustainable Development at the ESCAP regional conference was to adopt strategies for attaining replacement-level fertility of 2.1 or 2.2 children by 2010. East Asian countries, except Mongolia and the Democratic People's Republic of Korea, and the Southeast Asian countries Singapore and Thailand have already reached replacement-level fertility. Most larger Oceanic countries have also done so. Only South Asian Sri Lanka and southern India have attained replacement level. The following conditions slow or hinder the goal, but they do not provide an "absolute" barrier to fertility decline: social welfare schemes and old age security, son preference, lack of government family planning, poverty, relatively high mortality, low status of women, and education status. Theories of demographic transition have postulated that economic and social development initially brings a decline in mortality, and later brings a decline in fertility; and high fertility was an adaptation to high mortality. Policy gets caught in the lag between mortality and fertility decline. Eventually the cultural motives for high fertility are undercut by social and economic development. Although the generalization that economic growth slows fertility is true for South Asia, the correlation is uneven. Forceful government-sponsored family planning programs in Bangladesh and China may lead the way to strategies for decline in ESCAP region. A Thailand study suggested important factors were fundamental social change, the increased cost of children, cultural acceptance of birth control, a latent demand for fertility control, and government efforts in family planning. ESCAP countries have in common relatively high morality and inadequate public health programs, patriarchal structures, and limited female autonomy, poverty and landlessness, lack of community cohesiveness, and inadequate family planning programs. Weaknesses in programs are attributed to failure to recognize policies that affect reproduction and the difference between male power and female responsibility. Direct strategies should involve strong government support for male and female contraception, government promotion of delayed marriage, and an emphasis on reproductive health in female family planning programs.

Infant and fetal mortality among a high fertility and mortality population in the Bolivian Amazon

PubMed Central

Gurven, Michael

2012-01-01

Indigenous populations experience higher rates of poverty, disease and mortality than non-indigenous populations. To gauge current and future risks among Tsimane Amerindians of Bolivia, I assess mortality rates and growth early in life, and changes in risks due to modernization, based on demographic interviews conducted Sept. 2002–July 2005. Tsimane have high fertility (Total Fertility Rate = 9) and infant mortality (13%). Infections are the leading cause of infant death (55%). Infant mortality is greatest among women who are young, monolingual, space births close together, and live far from town. Infant mortality declined during the period 1990–2002, and a higher rate of reported miscarriages occurred during the 1950–1989 period. Infant deaths are more frequent among those born in the wet season. Infant stunting, underweight and wasting are common (34%, 15% and 12%, respectively) and greatest for low-weight mothers and high parity infants. Regression analysis of infant growth shows minimal regional differences in anthropometrics but greater stunting and underweight during the first two years of life. Males are more likely to be underweight, wasted, and spontaneously aborted. Whereas morbidity and stunting are prevalent in infancy, greater food availability later in life has not yet resulted in chronic diseases (e.g. hypertension, atherosclerosis and diabetes) in adulthood due to the relatively traditional Tsimane lifestyle. PMID:23092724

Race/Ethnicity, Poverty, Urban Stressors and Telomere Length in a Detroit Community-Based Sample

PubMed Central

Geronimus, Arline T.; Pearson, Jay A.; Linnenbringer, Erin; Schulz, Amy J.; Reyes, Angela G.; Epel, Elissa S.; Lin, Jue; Blackburn, Elizabeth H.

2015-01-01

Residents of distressed urban areas suffer early aging-related disease and excess mortality. Using a community-based participatory research approach in a collaboration between social researchers and cellular biologists, we collected a unique data set of 239 black, white, or Mexican adults from a stratified, multi-stage probability sample of three Detroit neighborhoods. We drew venous blood and measured Telomere Length (TL), an indicator of stress-mediated biological aging, linking respondents’ TL to their community survey responses. We regressed TL on socioeconomic, psychosocial, neighborhood, and behavioral stressors, hypothesizing and finding an interaction between poverty and racial/ethnic group. Poor whites had shorter TL than nonpoor whites; poor and nonpoor blacks had equivalent TL; poor Mexicans had longer TL than nonpoor Mexicans. Findings suggest unobserved heterogeneity bias is an important threat to the validity of estimates of TL differences by race/ethnicity. They point to health impacts of social identity as contingent, the products of structurally-rooted biopsychosocial processes. PMID:25930147

Race-Ethnicity, Poverty, Urban Stressors, and Telomere Length in a Detroit Community-based Sample.

PubMed

Geronimus, Arline T; Pearson, Jay A; Linnenbringer, Erin; Schulz, Amy J; Reyes, Angela G; Epel, Elissa S; Lin, Jue; Blackburn, Elizabeth H

2015-06-01

Residents of distressed urban areas suffer early aging-related disease and excess mortality. Using a community-based participatory research approach in a collaboration between social researchers and cellular biologists, we collected a unique data set of 239 black, white, or Mexican adults from a stratified, multistage probability sample of three Detroit neighborhoods. We drew venous blood and measured telomere length (TL), an indicator of stress-mediated biological aging, linking respondents' TL to their community survey responses. We regressed TL on socioeconomic, psychosocial, neighborhood, and behavioral stressors, hypothesizing and finding an interaction between poverty and racial-ethnic group. Poor whites had shorter TL than nonpoor whites; poor and nonpoor blacks had equivalent TL; and poor Mexicans had longer TL than nonpoor Mexicans. Findings suggest unobserved heterogeneity bias is an important threat to the validity of estimates of TL differences by race-ethnicity. They point to health impacts of social identity as contingent, the products of structurally rooted biopsychosocial processes. © American Sociological Association 2015.

What is the cause of the decline in maternal mortality in India? Evidence from time series and cross-sectional analyses.

PubMed

Goli, Srinivas; Jaleel, Abdul C P

2014-05-01

Summary Studies on the causes of maternal mortality in India have focused on institutional deliveries, and the association of socioeconomic and demographic factors with the decline in maternal mortality has not been sufficiently investigated. By using both time series and cross-sectional data, this paper examines the factors associated with the decline in maternal mortality in India. Relative effects estimated by OLS regression analysis reveal that per capita state net domestic product (-1.49611, p<0.05), poverty ratio (0.02426, p<0.05), female literacy rate (-0.05905, p<0.10), infant mortality rate and total fertility rate (0.11755, p<0.05) show statistically significant association with the decline in the maternal mortality ratio in India. The Barro-regression estimate reveals that improvements in economic and demographic conditions such as growth in state income (β=0.35020, p<0.05) and reduction in poverty (β=0.01867, p<0.01) and fertility (β=0.02598, p<0.05) have a greater association with the decline in the maternal mortality ratio in India than institutional deliveries (β=0.00305). The negative β-coefficient (β=-0.69578, p<0.05), showing the effect of the initial maternal mortality ratio on change in maternal mortality ratio in the Barro-regression model, indicates a greater decline in maternal mortality ratio in laggard states compared with advanced states. Overall, comparing the estimates of relative effects, the socioeconomic and demographic factors have a stronger statistically significant association with the maternal mortality ratio than institutional deliveries. Interestingly, the weak association between 'increase in institutional deliveries' and 'decline in maternal mortality ratio' suggests that merely increasing deliveries alone will not help in ensuring maternal survival in India. Quality of services provided by the health facility, birth preparedness and avoiding delay in reaching health facility are also important. Deliveries in health facilities will not necessarily translate into increased survival chances of mothers unless women receive full antenatal care services and delays in reaching health facility are avoided.

Estimated Deaths Attributable to Social Factors in the United States

PubMed Central

Tracy, Melissa; Hoggatt, Katherine J.; DiMaggio, Charles; Karpati, Adam

2011-01-01

Objectives. We estimated the number of deaths attributable to social factors in the United States. Methods. We conducted a MEDLINE search for all English-language articles published between 1980 and 2007 with estimates of the relation between social factors and adult all-cause mortality. We calculated summary relative risk estimates of mortality, and we obtained and used prevalence estimates for each social factor to calculate the population-attributable fraction for each factor. We then calculated the number of deaths attributable to each social factor in the United States in 2000. Results. Approximately 245 000 deaths in the United States in 2000 were attributable to low education, 176 000 to racial segregation, 162 000 to low social support, 133 000 to individual-level poverty, 119 000 to income inequality, and 39 000 to area-level poverty. Conclusions. The estimated number of deaths attributable to social factors in the United States is comparable to the number attributed to pathophysiological and behavioral causes. These findings argue for a broader public health conceptualization of the causes of mortality and an expansive policy approach that considers how social factors can be addressed to improve the health of populations. PMID:21680937

Exploring Differences in National and International Poverty Estimates: Is Uganda on Track to Halve Poverty by 2015?

ERIC Educational Resources Information Center

Levine, Sebastian

2012-01-01

This paper explores causes of differences in estimates of poverty incidence in Uganda since the early 1990s as measured by the Uganda Bureau of Statistics and the World Bank. While both sets of estimates from the two organisations show a declining trend in poverty incidence there are important differences in the levels of poverty, the speed of the…

SOME FACTS AND FIGURES ABOUT CHILDREN AND YOUTH.

ERIC Educational Resources Information Center

Children's Bureau (DHEW), Washington, DC.

IN QUESTION AND ANSWER FORM, THE PAMPHLET PRESENTS STATISTICAL DATA ON CHILDREN AND YOUTH PRIMARILY IN THE UNITED STATES. INFORMATION CONCERNS POPULATION, RESIDENCE, MOBILITY, POVERTY, WORKING MOTHERS, MARRIAGES, DIVORCES, BIRTHS, LIFE EXPECTANCY, MORTALITY, ILLNESS, HANDICAPS, HOSPITALIZATION, ADOPTIONS, PHENYLKETONURIA (PKU) LAWS, CHILD ABUSE…

Why Are Child Poverty Rates Higher in Britain than in Germany? A Longitudinal Perspective

ERIC Educational Resources Information Center

Jenkins, Stephen P.; Schluter, Christian

2003-01-01

We analyze why child poverty rates were much higher in Britain than in Western Germany during the 1990s, using a framework focusing on poverty transition rates. Child poverty exit rates were significantly lower, and poverty entry rates significantly higher, in Britain. We decompose these cross-national differences into differences in the…

Contextual socioeconomic factors associated with childhood mortality in Nigeria: a multilevel analysis.

PubMed

Adekanmbi, Victor T; Kandala, Ngianga-Bakwin; Stranges, Saverio; Uthman, Olalekan A

2015-11-01

Childhood mortality is a well-known public health issue, particularly in the low and middle income countries. The overarching aim of this study was to examine whether neighbourhood socioeconomic disadvantage is associated with childhood mortality beyond individual-level measures of socioeconomic status in Nigeria. Multilevel logistic regression models were applied to data on 31 482 under-five children whether alive or dead (level 1) nested within 896 neighbourhoods (level 2) from the 37 states in Nigeria (level 3) using the most recent 2013 Nigeria Demographic and Health Survey (DHS). More than 1 of every 10 children studied had died before reaching the age of 5 years (130/1000 live births). The following factors independently increased the odds of childhood mortality: male sex, mother's age at 15-24 years, uneducated mother or low maternal education attainment, decreasing household wealth index at individual level (level 1), residing in rural area and neighbourhoods with high poverty rate at level 2. There were significant neighbourhoods and states clustering in childhood mortality in Nigeria. The study provides evidence that individual-level and neighbourhood-level socioeconomic conditions are important correlates of childhood mortality in Nigeria. The findings of this study also highlight the need to implement public health prevention strategies at the individual level, as well as at the area/neighbourhood level. These strategies include the establishment of an effective publicly funded healthcare system, as well as health education and poverty alleviation programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Trends in maternal and infant health in poor urban neighborhoods: good news from the 1990s, but challenges remain.

PubMed

Howell, Embry M; Pettit, Kathryn L S; Kingsley, G Thomas

2005-01-01

During the 1990s, numerous public policy changes occurred that may have affected the health of mothers and infants in low-income neighborhoods. This article examines trends in key maternal and child health indicators to determine whether disparities between high-poverty neighborhoods and other neighborhoods have declined. Using neighborhood-level vital statistics and U.S. Census data, we categorized "neighborhoods" (Census tracts) as being high poverty (greater than 30% of population below the federal poverty level in 1990) or not. We compared trends in four key indicators--births to teenagers, late prenatal care, low birth-weight; and infant mortality--over the 1990s among high-poverty and other neighborhoods in Cuyahoga County, Ohio; Denver, Colorado; Marion County, Indiana; and Oakland, California. In all four metropolitan areas, trends in high-poverty neighborhoods were more favorable than in other neighborhoods. The most consistently positive trend was the reduction in the rate of teen births. The metropolitan areas with the most intensive programs to improve maternal and child health--Cuyahoga County and Oakland-saw the most consistent improvement across all indicators. Still, great disparities between high-poverty and other neighborhoods remain, and only Oakland shows promise of achieving some of the Healthy People 2010 maternal and child health goals in its high-poverty neighborhoods. While there has been a reduction in maternal and infant health disparities between high-poverty and other neighborhoods, much work remains to eliminate disparities and achieve the 2010 goals. Small area data are useful in isolating the neighborhoods that should be targeted. Experience from the 1990s suggests that a combination of several intensive interventions can be effective at reducing disparities.

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 well-being of adults. Copyright © 2016. Published by Elsevier Inc.

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.

Policy and priorities for national cancer control planning in low- and middle-income countries: Lessons from the Association of Southeast Asian Nations (ASEAN) Costs in Oncology prospective cohort study.

PubMed

2017-03-01

Evidence to guide policymakers in developing affordable and equitable cancer control plans are scarce in low- and middle-income countries (LMIC). The 2012-2014 ASEAN Costs in Oncology Study prospectively followed-up 9513 newly diagnosed cancer patients from eight LMIC in Southeast Asia for 12 months. Overall and country-specific incidence of financial catastrophe (out-of-pocket health costs ≥ 30% of annual household income), economic hardship (inability to make necessary household payments), poverty (living below national poverty line), and all-cause mortality were determined. Stepwise multinomial regression was used to estimate the extent to which health insurance, cancer stage and treatment explained these outcomes. The one-year incidence of mortality (12% in Malaysia to 45% in Myanmar) and financial catastrophe (24% in Thailand to 68% in Vietnam) were high. Economic hardship was reported by a third of families, including inability to pay for medicines (45%), mortgages (18%) and utilities (12%), with 28% taking personal loans, and 20% selling assets (not mutually exclusive). Out of households that initially reported incomes above the national poverty levels, 4·9% were pushed into poverty at one year. The adverse economic outcomes in this study were mainly attributed to medical costs for inpatient/outpatient care, and purchase of drugs and medical supplies. In all the countries, cancer stage largely explained the risk of adverse outcomes. Stage-stratified analysis however showed that low-income patients remained vulnerable to adverse outcomes even when diagnosed with earlier cancer stages. The LMIC need to realign their focus on early detection of cancer and provision of affordable cancer care, while ensuring adequate financial risk protection, particularly for the poor. Copyright © 2017 Elsevier Ltd. All rights reserved.

Application of experimental poverty measures to the aged.

PubMed

Olsen, K A

1999-01-01

The U.S. Census Bureau recently released new, experimental measures of poverty based on a National Academy of Sciences (NAS) panel's recommendations. This article examines the effects of the experimental measures on poverty rates among persons aged 65 or older in order to help inform policy debate. Policymakers and analysts use poverty rates to measure the successes and failures of existing programs and to create and defend new policy initiatives. The Census Bureau computes the official rates of poverty using poverty thresholds and definitions of countable income that have changed little since the official poverty measure was adopted in 1965. Amid growing concerns about the adequacy of the official poverty measure, a NAS panel undertook a study of the concepts, methodology, and data needed to measure poverty. The panel concluded in its 1995 report that the current measure no longer provides an accurate picture of relative rates of poverty for different groups in the population or of changes in poverty over time. The panel recommended changes in establishing the poverty thresholds, defining family resources, and obtaining the required data. The Census Bureau report shows how estimated levels of poverty would differ from the official level as specific recommendations of the NAS panel are implemented individually and how estimated trends would differ when many recommendations are implemented simultaneously. It computes nonstandardized and standardized poverty rates. (The latter constrains the overall poverty rate under the experimental measures to match the official rate.) This article reports poverty rates that have not been standardized and provides considerably more detail than the Census report about the effects of the experimental measures on poverty among the aged. It examines the effects of changing the poverty thresholds and the items included or excluded from the definition of available resources. It also explores the effects of the experimental measures on persons aged 65 or older by age group, gender, race and ethnicity, and marital status. Results indicate that: Poverty rates in 1997 for persons aged 65 or older under the experimental NAS poverty measure are 17.3 percent, compared with 10.5 percent under the official poverty measure. This 65-percent increase is largely driven by the NAS-based measure's subtraction of medical out-of-pocket (MOOP) expenses from resources. Under the NAS-based measures, poverty rates increase for all major groups of older persons, and increase the most for groups for whom the incidence of official poverty is the lowest. The experimental NAS poverty measure shows narrower differences between genders, racial and ethnic groups, and among persons of different marital statuses than the official poverty measure. For example, white Hispanic women aged 65 or older have poverty rates that are 450 percent higher than those for white non-Hispanic men under the official poverty measure and 181 percent higher under the NAS measure. The NAS-based measure's subtraction of MOOP expenses from resources has a disproportionate effect on poverty rates among non-Hispanic whites and men as compared with other groups. However, changes in relative poverty between groups appear to be most influenced by the NAS midpoint equivalence scale. Because this scale decreases poverty rates for persons who live alone or with unrelated individuals and increases them for persons who live with others, poverty rates differ meaningfully under the NAS and official measures among demographic groups. This article highlights issues concerning the elements of the experimental NAS poverty measure that are particularly important to the measurement of poverty among the aged population. Results suggest that the research community's future efforts to refine, enhance, and build upon the NAS panel's recommendations will yield important insights about poverty among the older population.

Integration of family planning with poverty alleviation.

PubMed

Peng, P

1996-12-01

The Chinese Communist Central Committee and the State Council aim to solve food and clothing problems among impoverished rural people by the year 2000. This goal was a priority on the agenda of the recent October 1996 National Conference on Poverty Alleviation and Development and the 1996 National Conference of the State Family Planning Commission. Poverty is attributed to rapid population growth and underdevelopment. Poverty is concentrated in parts of 18 large provinces. These provinces are characterized by Family Planning Minister Peng as having high birth rates, early marriage and childbearing, unplanned births, and multiple births. Overpopulation is tied to overconsumption, depletion of resources, deforestation, soil erosion, pollution, shortages of water, decreases in shares of cultivated land, degraded grasslands, and general destruction of the environment. Illiteracy in poor areas is over 20%, compared to the national average of 15%. Mortality and morbidity are higher. Family planning is harder to enforce in poor areas. Pilot programs in Sichuan and Guizhou provinces are promoting integration of family planning with poverty alleviation. Several conferences have addressed the integrated program strategies. Experience has shown that poverty alleviation occurs by controlled population growth and improved quality of life. Departments should "consolidate" their development efforts under Communist Party leadership at all levels. Approaches should emphasize self-reliance and public mobilization. The emphasis should be on women's participation in development. Women's income should be increased. Family planning networks at the grassroots level need to be strengthened simultaneously with increased poverty alleviation and development. The government strategy is to strengthen leadership, mobilize the public, and implement integrated programs.

The public health benefits of reducing fine particulate matter through conversion to cleaner heating fuels in New York City.

PubMed

Kheirbek, Iyad; Haney, Jay; Douglas, Sharon; Ito, Kazuhiko; Caputo, Steven; Matte, Thomas

2014-12-02

In recent years, both New York State and City issued regulations to reduce emissions from burning heating oil. To assess the benefits of these programs in New York City, where the density of emissions and vulnerable populations vary greatly, we simulated the air quality benefits of scenarios reflecting no action, partial, and complete phase-out of high-sulfur heating fuels using the Community MultiScale Air Quality (CMAQ) model conducted at a high spatial resolution (1 km). We evaluated the premature mortality and morbidity benefits of the scenarios within 42 city neighborhoods and computed benefits by neighborhood poverty status. The complete phase-out scenario reduces annual average fine particulate matter (PM2.5) by an estimated 0.71 μg/m(3) city-wide (average of 1 km estimates, 10-90th percentile: 0.1-1.6 μg/m(3)), avoiding an estimated 290 premature deaths, 180 hospital admissions for respiratory and cardiovascular disease, and 550 emergency department visits for asthma each year. The largest improvements were seen in areas of highest building and population density and the majority of benefits have occurred through the partial phase out of high-sulfur heating fuel already achieved. While emissions reductions were greatest in low-poverty neighborhoods, health benefits are estimated to be greatest in high-poverty neighborhoods due to higher baseline morbidity and mortality rates.

Population dynamics and rural poverty.

PubMed

Fong, M S

1985-01-01

An overview of the relationship between demographic factors and rural poverty in developing countries is presented. The author examines both the micro- and macro-level perspectives of this relationship and the determinants and consequences of population growth. The author notes the prospects for a rapid increase in the rural labor force and considers its implications for the agricultural production structure and the need for institutional change. Consideration is also given to the continuing demand for high fertility at the family level and the role of infant and child mortality in the poverty cycle. "The paper concludes by drawing attention to the need for developing the mechanism for reconciliation of social and individual optima with respect to family size and population growth." The need for rural development projects that take demographic factors into account is stressed as is the need for effective population programs. (summary in FRE, ITA) excerpt

Climate change impacts on rural poverty in low-elevation coastal zones

NASA Astrophysics Data System (ADS)

Barbier, Edward B.

2015-11-01

This paper identifies the low-elevation coastal zone (LECZ) populations and developing regions most vulnerable to sea-level rise and other coastal hazards, such as storm surges, coastal erosion and salt-water intrusion. The focus is on the rural poor in the LECZ, as their economic livelihoods are especially endangered both directly by coastal hazards and indirectly through the impacts of climate change on key coastal and near-shore ecosystems. Using geo-spatially referenced malnutrition and infant mortality data for 2000 as a proxy for poverty, this study finds that just 15 developing countries contain over 90% of the world's LECZ rural poor. Low-income countries as a group have the highest incidence of poverty, which declines somewhat for lower middle-income countries, and then is much lower for upper middle-income economies. South Asia, East Asia and the Pacific and Sub-Saharan Africa account for most of the world's LECZ rural poor, and have a high incidence of poverty among their rural LECZ populations. Although fostering growth, especially in coastal areas, may reduce rural poverty in the LECZ, additional policy actions will be required to protect vulnerable communities from disasters, to conserve and restore key coastal and near-shore ecosystems, and to promote key infrastructure investments and coastal community response capability.

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

Effects of state-level public spending on health on the mortality probability in India.

PubMed

Farahani, Mansour; Subramanian, S V; Canning, David

2010-11-01

This study uses the second National Family Health Survey of India to estimate the effect of state-level public health spending on mortality across all age groups, controlling for individual, household, and state-level covariates. We use a state's gross fiscal deficit as an instrument for its health spending. Our study shows a 10% increase in public spending on health in India decreases the average probability of death by about 2%, with effects mainly on the young, the elderly, and women. Other major factors affecting mortality are rural residence, household poverty, and access to toilet facilities. Copyright © 2009 John Wiley & Sons, Ltd.

Realities for change in child health care: existing patterns and future possibilities.

PubMed Central

Stacey, M

1980-01-01

In assessing some of the existing patterns and future possibilities in child health care it was found that the continuing large social class differences in morbidity and mortality may be attributed to continued poverty, both of income and therefore of diet, and also to environmental deprivation. The absence of safe places for children to play, for example, is related to the high accident rates experienced by children. Doctors admit to awareness of these social and environmental causes of unnecessary morbidity and mortality among children but have failed to address the causes directly. While the causes are outside the immediate professional provenance of doctors, it is argued that, aware as they are of this aetiology, they have a moral and professional responsibility to act collectively as a pressure group urging improvements on the relevant authorities (as they have done in the case of smoking and clean air, for example). PMID:6446349

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.

Childhood Tuberculosis, Still with Us...

ERIC Educational Resources Information Center

Chaulet, Pierre; And Others

1992-01-01

The first section of this report on childhood tuberculosis in developed and developing countries discusses the epidemiology of tuberculosis in children. Information is presented on: (1) sources and prevalence of infection; (2) risks, frequency, and types of tuberculosis; (3) mortality rates; and (4) the relation of poverty and AIDS to…

Us v. Them: Remnants of Urban War Zones

ERIC Educational Resources Information Center

Johnson, Nicole Jeanine

2016-01-01

The definition of poverty in developed nations is "lack of income and productive resources sufficient to ensure sustainable livelihoods, hunger… lack of access to education and other basic services; increased morbidity and mortality from illness… unsafe environments; and social discrimination and exclusion" (Raphael, 2013, p. 5). Tenets…

Poor Quality for Poor Women? Inequities in the Quality of Antenatal and Delivery Care in Kenya.

PubMed

Sharma, Jigyasa; Leslie, Hannah H; Kundu, Francis; Kruk, Margaret E

2017-01-01

Quality of healthcare is an important determinant of future progress in global health. However, the distributional aspects of quality of care have received inadequate attention. We assessed whether high quality maternal care is equitably distributed by (1) mapping the quality of maternal care in facilities located in poorer versus wealthier areas of Kenya; and (2) comparing the quality of maternal care available to Kenyans in and not in poverty. We assessed three measures of maternal care quality: facility infrastructure and clinical quality of antenatal care and delivery care, using indicators from the 2010 Kenya Service Provision Assessment (SPA), a standardized facility survey with direct observation of maternal care provision. We calculated poverty of the area served by antenatal or delivery care facilities using the Multidimensional Poverty Index. We used regression analyses and non-parametric tests to assess differences in maternal care quality in facilities located in more and less impoverished areas. We estimated effective coverage with a minimum standard of care for the full population and those in poverty. A total of 564 facilities offering at least one maternal care service were included in this analysis. Quality of maternal care was low, particularly clinical quality of antenatal and delivery care, which averaged 0.52 and 0.58 out of 1 respectively, compared to 0.68 for structural inputs to care. Maternal healthcare quality varied by poverty level: at the facility level, all quality metrics were lowest for the most impoverished areas and increased significantly with greater wealth. Population access to a minimum standard (≥0.75 of 1.00) of quality maternal care was both low and inequitable: only 17% of all women and 8% of impoverished women had access to minimally adequate delivery care. The quality of maternal care is low in Kenya, and care available to the impoverished is significantly worse than that for the better off. To achieve the national targets of maternal and neonatal mortality reduction, policy initiatives need to tackle low quality of care, starting with high-poverty areas.

Poor Quality for Poor Women? Inequities in the Quality of Antenatal and Delivery Care in Kenya

PubMed Central

Sharma, Jigyasa; Leslie, Hannah H.; Kundu, Francis; Kruk, Margaret E.

2017-01-01

Background Quality of healthcare is an important determinant of future progress in global health. However, the distributional aspects of quality of care have received inadequate attention. We assessed whether high quality maternal care is equitably distributed by (1) mapping the quality of maternal care in facilities located in poorer versus wealthier areas of Kenya; and (2) comparing the quality of maternal care available to Kenyans in and not in poverty. Methods We assessed three measures of maternal care quality: facility infrastructure and clinical quality of antenatal care and delivery care, using indicators from the 2010 Kenya Service Provision Assessment (SPA), a standardized facility survey with direct observation of maternal care provision. We calculated poverty of the area served by antenatal or delivery care facilities using the Multidimensional Poverty Index. We used regression analyses and non-parametric tests to assess differences in maternal care quality in facilities located in more and less impoverished areas. We estimated effective coverage with a minimum standard of care for the full population and those in poverty. Results A total of 564 facilities offering at least one maternal care service were included in this analysis. Quality of maternal care was low, particularly clinical quality of antenatal and delivery care, which averaged 0.52 and 0.58 out of 1 respectively, compared to 0.68 for structural inputs to care. Maternal healthcare quality varied by poverty level: at the facility level, all quality metrics were lowest for the most impoverished areas and increased significantly with greater wealth. Population access to a minimum standard (≥0.75 of 1.00) of quality maternal care was both low and inequitable: only 17% of all women and 8% of impoverished women had access to minimally adequate delivery care. Conclusion The quality of maternal care is low in Kenya, and care available to the impoverished is significantly worse than that for the better off. To achieve the national targets of maternal and neonatal mortality reduction, policy initiatives need to tackle low quality of care, starting with high-poverty areas. PMID:28141840

Poverty determinants of acute respiratory infections among Mapuche indigenous peoples in Chile's Ninth Region of Araucania, using GIS and spatial statistics to identify health disparities

PubMed Central

Rojas, Flavio

2007-01-01

Background This research concerns Araucanía, often called the Ninth Region, the poorest region of Chile where inequalities are most extreme. Araucanía hasn't enjoyed the economic success Chile achieved when the country returned to democracy in 1990. The Ninth Region also has the largest ethnic Mapuche population, located in rural areas and attached to small agricultural properties. Written and oral histories of diseases have been the most frequently used methods to explore the links between an ancestral population's perception of health conditions and their deprived environments. With census data and hospital records, it is now possible to incorporate statistical data about the links between poverty and disease among ethnic communities and compare results with non-Mapuche population. Data sources Hospital discharge records from Health Services North N = 24,126 patients, year 2003, and 7 hospitals), Health Services South (N = 81,780 patients and 25 hospitals); CAS-2/Family records (N = 527,539 individuals, 439 neighborhoods, 32 Comunas). Methods Given the over-dispersion of data and the clustered nature of observations, we used the global Moran's I and General G Gettis-Ord procedures to test spatial dependence. These tests confirmed the clusters of disease and the need to use spatial regression within a General Linear Mixed Model perspective. Results Health outcomes indicate significantly higher morbidity rates for the Mapuche compared to non-Mapuche in both age groups < 5 and 15–44, respectively; for the groups 70–79 and 80 + years of age, this trend is reversed. Mortality rates, however, are higher among Mapuches than non-Mapuches for the entire Ninth Region and for all age groups. Mortality caused by respiratory infections is higher among Mapuches than non-Mapuches in all age-groups. A major finding is the link between poverty and respiratory infections. Conclusion Poverty is significantly associated with respiratory infections in the population of Chile's Ninth Region. High deprivation areas are associated with poverty, and poverty is a predictor of respiratory infections. Mapuches are at higher risk of deaths caused by respiratory infections in all age groups. Exponential and spherical spatial correlation models were tested to estimate the previous association and were compared with non-spatial Poisson, concluding that significant spatial variability was present in the data. PMID:17605804

Poverty determinants of acute respiratory infections among Mapuche indigenous peoples in Chile's Ninth Region of Araucania, using GIS and spatial statistics to identify health disparities.

PubMed

Rojas, Flavio

2007-07-02

This research concerns Araucanía, often called the Ninth Region, the poorest region of Chile where inequalities are most extreme. Araucanía hasn't enjoyed the economic success Chile achieved when the country returned to democracy in 1990. The Ninth Region also has the largest ethnic Mapuche population, located in rural areas and attached to small agricultural properties. Written and oral histories of diseases have been the most frequently used methods to explore the links between an ancestral population's perception of health conditions and their deprived environments. With census data and hospital records, it is now possible to incorporate statistical data about the links between poverty and disease among ethnic communities and compare results with non-Mapuche population. Hospital discharge records from Health Services North N = 24,126 patients, year 2003, and 7 hospitals), Health Services South (N = 81,780 patients and 25 hospitals); CAS-2/Family records (N = 527,539 individuals, 439 neighborhoods, 32 Comunas). Given the over-dispersion of data and the clustered nature of observations, we used the global Moran's I and General G Gettis-Ord procedures to test spatial dependence. These tests confirmed the clusters of disease and the need to use spatial regression within a General Linear Mixed Model perspective. Health outcomes indicate significantly higher morbidity rates for the Mapuche compared to non-Mapuche in both age groups < 5 and 15-44, respectively; for the groups 70-79 and 80 + years of age, this trend is reversed. Mortality rates, however, are higher among Mapuches than non-Mapuches for the entire Ninth Region and for all age groups. Mortality caused by respiratory infections is higher among Mapuches than non-Mapuches in all age-groups. A major finding is the link between poverty and respiratory infections. Poverty is significantly associated with respiratory infections in the population of Chile's Ninth Region. High deprivation areas are associated with poverty, and poverty is a predictor of respiratory infections. Mapuches are at higher risk of deaths caused by respiratory infections in all age groups. Exponential and spherical spatial correlation models were tested to estimate the previous association and were compared with non-spatial Poisson, concluding that significant spatial variability was present in the data.

Parallel realities: exploring poverty dynamics using mixed methods in rural Bangladesh.

PubMed

Davisa, Peter; Baulch, Bob

2011-01-01

This paper explores the implications of using two methodological approaches to study poverty dynamics in rural Bangladesh. Using data from a unique longitudinal study, we show how different methods lead to very different assessments of socio-economic mobility. We suggest five ways of reconciling these differences: considering assets in addition to expenditures, proximity to the poverty line, other aspects of well-being, household division, and qualitative recall errors. Considering assets and proximity to the poverty line along with expenditures resolves three-fifths of the qualitative and quantitative differences. Use of such integrated mixed-methods can therefore improve the reliability of poverty dynamics research.

A Portrait of At-Risk Children.

ERIC Educational Resources Information Center

Gore, Tipper

1991-01-01

Social and economic problems facing U.S. children are reviewed, including poverty, hunger and homelessness, gaps in health and mental health services, infant mortality/morbidity, child abuse, drug use, and violence depicted in the mass media. Risk-taking behaviors that are children's responses and suggestions to remedy these problems are…

The Quiet Revolution: Child Survival Comes of Age.

ERIC Educational Resources Information Center

Bendahmane, Diane B.

1994-01-01

Although child mortality rates have significantly improved in recent decades, most children in Latin America and the Caribbean are still living in poverty and are poorly educated. Investing in education has beneficial effects on birth rates, health, income equality, and the environment. Includes tables describing economic, educational, and infant…

South Dakota Kids Count Factbook, 2001.

ERIC Educational Resources Information Center

Cochran, Carole, Ed.

This Kids Count factbook examines statewide trends in well-being for South Dakota's children. The statistical portrait is based on 24 indicators in the areas of demographics, health, education, economic status, and safety. The indicators are: (1) poverty thresholds; (2) population; (3) population on Indian Reservations; (4) infant mortality; (5)…

South Dakota Kids Count Factbook, 2000.

ERIC Educational Resources Information Center

Cochran, Carole

This Kids Count fact book examines statewide trends in well-being for South Dakota's children. The statistical portrait is based on 26 indicators in the areas of demographics, health, education, economic status, and safety. The indicators are: (1) population; (2) family profile; (3) poverty thresholds; (4) infant mortality; (5) low birth weight…

South Dakota KIDS COUNT Factbook, 1999.

ERIC Educational Resources Information Center

Cochran, Carole, Ed.

This Kids Count fact book examines statewide trends in well-being for South Dakota's children. The statistical portrait is based on 25 indicators in the areas of demographics, health, education, economic status, and safety. The indicators are: (1) population; (2) family profile; (3) poverty thresholds; (4) infant mortality rate; (5) low birth…

Youth Development Needs and Capacities in the District of Columbia.

ERIC Educational Resources Information Center

Cave, George

This report examines, ward-by-ward, indicators of need for youth development services in the District of Columbia (DC), including high school dropout rates, unemployment, poverty, involvement with the criminal justice system, teen parenting, and youth mortality. It discusses capacity to provide various youth development services to address those…

Putting a Name to Cultural Resilience.

ERIC Educational Resources Information Center

Ambler, Marjane

2003-01-01

Examines reasons why, in spite of high rates of poverty, drug use, and mortality, some Native American students thrive--a survival mechanism that scholars have named cultural resilience. Reports that the Family Education Model, developed at tribal colleges, aims to include families in campus events and reduce negative impacts of family…

Rising Poverty, Declining Health: The Nutritional Status of the Rural Poor.

ERIC Educational Resources Information Center

Public Voice for Food and Health Policy, Washington, DC.

Using five key indicators of nutritional status (dietary intake, biochemical tests for circulating levels of nutrients or their metabolites, anthropometric measures, low birth weight and infant mortality rates, and food, health, and income assistance program participation rates and benefit levels), this 1-year research project identified national,…

Association of a Negative Wealth Shock With All-Cause Mortality in Middle-aged and Older Adults in the United States.

PubMed

Pool, Lindsay R; Burgard, Sarah A; Needham, Belinda L; Elliott, Michael R; Langa, Kenneth M; Mendes de Leon, Carlos F

2018-04-03

A sudden loss of wealth-a negative wealth shock-may lead to a significant mental health toll and also leave fewer monetary resources for health-related expenses. With limited years remaining to regain lost wealth in older age, the health consequences of these negative wealth shocks may be long-lasting. To determine whether a negative wealth shock was associated with all-cause mortality during 20 years of follow-up. The Health and Retirement Study, a nationally representative prospective cohort study of US adults aged 51 through 61 years at study entry. The study population included 8714 adults, first assessed for a negative wealth shock in 1994 and followed biennially through 2014 (the most recent year of available data). Experiencing a negative wealth shock, defined as a loss of 75% or more of total net worth over a 2-year period, or asset poverty, defined as 0 or negative total net worth at study entry. Mortality data were collected from the National Death Index and postmortem interviews with family members. Marginal structural survival methods were used to account for the potential bias due to changes in health status that may both trigger negative wealth shocks and act as the mechanism through which negative wealth shocks lead to increased mortality. There were 8714 participants in the study sample (mean [SD] age at study entry, 55 [3.2] years; 53% women), 2430 experienced a negative wealth shock during follow-up, 749 had asset poverty at baseline, and 5535 had continuously positive wealth without shock. A total of 2823 deaths occurred during 80 683 person-years of follow-up. There were 30.6 vs 64.9 deaths per 1000 person-years for those with continuously positive wealth vs negative wealth shock (adjusted hazard ratio [HR], 1.50; 95% CI, 1.36-1.67). There were 73.4 deaths per 1000 person-years for those with asset poverty at baseline (adjusted HR, 1.67; 95% CI, 1.44-1.94; compared with continuously positive wealth). Among US adults aged 51 years and older, loss of wealth over 2 years was associated with an increased risk of all-cause mortality. Further research is needed to better understand the possible mechanisms for this association and determine whether there is potential value for targeted interventions.

A population-based study of premature mortality in relation to neighbourhood density of alcohol sales and cheque cashing outlets in Toronto, Canada

PubMed Central

Matheson, Flora I; Creatore, Maria Isabella; Gozdyra, Piotr; Park, Alison L; Ray, Joel G

2014-01-01

Objective Alcohol overuse and poverty, each associated with premature death, often exist within disadvantaged neighbourhoods. Cheque cashing places (CCPs) may be opportunistically placed in disadvantaged neighbourhoods, where customers abound. We explored whether neighbourhood density of CCPs and alcohol outlets are each related to premature mortality among adults. Design Retrospective population-based study. Setting 140 neighbourhoods in Toronto, Ontario, 2005–2009. Participants Adults aged 20–59 years. Measures Our primary outcome was premature all-cause mortality among adults aged 20–59 years. Across neighbourhoods we explored neighbourhood density, in km2, of CCPs and alcohol outlets, and the relation of each to premature mortality. Poisson regression provided adjusted relative risks (aRRs) and 95% CIs, adjusting for material deprivation quintile (Q), crime Q and number of banks. Results Intentional self-harm, accidental poisoning and liver disease were among the top five causes of premature death among males aged 20–59 years. The overall premature mortality rate was 96.3/10 000 males and 55.9/10 000 females. Comparing the highest versus lowest CCP density Q, the aRR for death was 1.25 (95% CI 1.15 to 1.36) among males and 1.11 (95% CI 0.99 to 1.24) among females. The corresponding aRR comparing the highest Q versus lowest Q alcohol outlet density in relation to premature mortality was 1.36 (95% CI 1.25 to 1.48) for males and 1.11 (95% CI 1.00 to 1.24) for females. The pattern of the relation between either CCPs or alcohol outlet density and premature mortality was typically J shaped. Conclusions There is a J-shaped relation between CCP or alcohol outlet density and premature mortality, even on controlling for conventional measures of poverty. Formal banking and alcohol reduction strategies might be added to health promotion policies aimed at reducing premature mortality in highly affected neighbourhoods. PMID:25518874

A population-based study of premature mortality in relation to neighbourhood density of alcohol sales and cheque cashing outlets in Toronto, Canada.

PubMed

Matheson, Flora I; Creatore, Maria Isabella; Gozdyra, Piotr; Park, Alison L; Ray, Joel G

2014-12-17

Alcohol overuse and poverty, each associated with premature death, often exist within disadvantaged neighbourhoods. Cheque cashing places (CCPs) may be opportunistically placed in disadvantaged neighbourhoods, where customers abound. We explored whether neighbourhood density of CCPs and alcohol outlets are each related to premature mortality among adults. Retrospective population-based study. 140 neighbourhoods in Toronto, Ontario, 2005-2009. Adults aged 20-59 years. Our primary outcome was premature all-cause mortality among adults aged 20-59 years. Across neighbourhoods we explored neighbourhood density, in km(2), of CCPs and alcohol outlets, and the relation of each to premature mortality. Poisson regression provided adjusted relative risks (aRRs) and 95% CIs, adjusting for material deprivation quintile (Q), crime Q and number of banks. Intentional self-harm, accidental poisoning and liver disease were among the top five causes of premature death among males aged 20-59 years. The overall premature mortality rate was 96.3/10,000 males and 55.9/10,000 females. Comparing the highest versus lowest CCP density Q, the aRR for death was 1.25 (95% CI 1.15 to 1.36) among males and 1.11 (95% CI 0.99 to 1.24) among females. The corresponding aRR comparing the highest Q versus lowest Q alcohol outlet density in relation to premature mortality was 1.36 (95% CI 1.25 to 1.48) for males and 1.11 (95% CI 1.00 to 1.24) for females. The pattern of the relation between either CCPs or alcohol outlet density and premature mortality was typically J shaped. There is a J-shaped relation between CCP or alcohol outlet density and premature mortality, even on controlling for conventional measures of poverty. Formal banking and alcohol reduction strategies might be added to health promotion policies aimed at reducing premature mortality in highly affected neighbourhoods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

A thought on the integration of poverty relief with family planning.

PubMed

Yang, K

1997-01-01

This article discusses the relationship between population growth and poverty in China, the issue of overpopulation in poor areas, and the need for programs that integrate population control with economic development. The number of Chinese living in poverty declined from about 250 million in 1978 to 80 million in 1993. In March 1994, the government initiated a poverty relief program that aimed to eliminate all poverty by 2001. By 1995, the number of poor declined to 65 million. The causes of poverty are numerous, but include overpopulation. Over the decades, demographic trends in poor areas reveal higher fertility, lower mortality, and higher growth. Poverty appears to be concentrated in 18 provinces and autonomous regions. Poor areas have higher rates of early marriage, early childbirth, and multiple children. Poor areas also have higher rates of disabilities and disease and lower levels of education. Poor areas have double the national percentage of illiterates. Many people living in poor areas are disadvantaged by poor transportation, remote locations, backward production methods, and a lack of a social security system. Scientific knowledge about contraception and quality child care are difficult to diffuse in poor areas. The size of the population denominator directly affects per capita income and per capita grain production. Increases in population put pressure on investment resources for production and development. A larger work force adds to the problem of unemployment. A large population size puts pressure on arable land. Poor areas need a better educated population. Sustainable development requires fertility decline. Integrated family planning programs popularize slogans such as "stabilize grain yield, increase income, and control population growth." Integrated programs have had variable success. Countermeasures must be taken to prevent the association of large families with wealth. Leadership is essential.

Can cash transfers improve determinants of maternal mortality? Evidence from the household and community programs in Indonesia.

PubMed

Kusuma, Dian; Cohen, Jessica; McConnell, Margaret; Berman, Peter

2016-08-01

Despite global efforts in maternal health, 303,000 maternal deaths still occurred globally in 2015. One explanation is a considerable inequality in maternal mortality and the sources such as nutritional status and health utilization. One strategy to fight health inequality due to poverty is conditional cash transfer (CCT). Taking advantage of two large clustered-randomized trials in Indonesia from 2007 to 2009, this paper provides evidence on the effects of household cash transfers (PKH) and community cash transfers (Generasi) on determinants of maternal mortality. The sample sizes are 14,000 households for PKH and 12,000 households for Generasi. After two years of implementation, difference-in-differences (DID) analyses show that the two programs can improve determinants of maternal mortality with Generasi provides positive impact in some aspects of determinants, but PKH does not. Generasi improves maternal health knowledge, reduces financial barriers to accessing health services and improves utilization of health services, increases utilization among higher-risk women, improves posyandu equipment, and increases nutritional intake. As for PKH, evidence shows its strongest effects only on utilization of health services. Both programs, however, are unlikely to have a large effect on maternal mortality due to design and implementation issues that might significantly reduce program effectiveness. While the programs improved utilization, they did so at community-based facilities not equipped with emergency obstetric care. In the midst of popularity of household cash transfer, our results show that community cash transfer offers a viable policy alternative to improve the determinants of maternal mortality by allowing more flexibility in activities and at lower cost by monitoring at community level. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prioritizing the Components of Vulnerability: A Genetic Algorithm Minimization of Flood Risk

NASA Astrophysics Data System (ADS)

Bongolan, Vena Pearl; Ballesteros, Florencio; Baritua, Karessa Alexandra; Junne Santos, Marie

2013-04-01

We define a flood resistant city as an optimal arrangement of communities according to their traits, with the goal of minimizing the flooding vulnerability via a genetic algorithm. We prioritize the different components of flooding vulnerability, giving each component a weight, thus expressing vulnerability as a weighted sum. This serves as the fitness function for the genetic algorithm. We also allowed non-linear interactions among related but independent components, viz, poverty and mortality rate, and literacy and radio/ tv penetration. The designs produced reflect the relative importance of the components, and we observed a synchronicity between the interacting components, giving us a more consistent design.

Measuring human betterment through avoidable mortality: a case for universal health care in the USA.

PubMed

Hisnanick, J J; Coddington, D A

1995-10-01

The USA system of health care has begun a monumental change that will affect everyone, irrespective of their socioeconomic status, professional status or pre-existing health insurance status. Whatever type of plan is finally implemented through the legislative process, there will need to be a way to evaluate its success (or failure). One way to evaluate the plan's effectiveness is through its impact on human betterment as viewed by a reduction in 'avoidable mortality' for those most in need of health care; the poor and uninsured. For one USA minority population, universal health care has improved human betterment by reducing avoidable mortality, even in the face of a severe burden of poverty.

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.

Fiscal decentralisation and infant mortality rate: the Colombian case.

PubMed

Soto, Victoria Eugenia; Farfan, Maria Isabel; Lorant, Vincent

2012-05-01

There is a paucity of research analysing the influence of fiscal decentralisation on health outcomes. Colombia is an interesting case study, as health expenditure there has been decentralising since 1993, leading to an improvement in health care insurance. However, it is unclear whether fiscal decentralisation has improved population health. We assess the effect of fiscal decentralisation of health expenditure on infant mortality rates in Colombia. Infant mortality rates for 1080 municipalities over a 10-year period (1998-2007) were related to fiscal decentralisation by using an unbalanced fixed-effect regression model with robust errors. Fiscal decentralisation was measured as the locally controlled health expenditure as a proportion of total health expenditure. We also evaluated the effect of transfers from central government and municipal institutional capacity. In addition, we compared the effect of fiscal decentralisation at different levels of municipal poverty. Fiscal decentralisation decreased infant mortality rates (the elasticity was equal to -0.06). However, this effect was stronger in non-poor municipalities (-0.12) than poor ones (-0.081). We conclude that decentralising the fiscal allocation of responsibilities to municipalities decreased infant mortality rates. However, this improved health outcome effect depended greatly on the socio-economic conditions of the localities. The policy instrument used by the Health Minister to evaluate municipal institutional capacity in the health sector needs to be revised. Copyright © 2012 Elsevier Ltd. All rights reserved.

Adequacy of dietary intakes and poverty in India: trends in the 1990s.

PubMed

Mahal, Ajay; Karan, Anup K

2008-03-01

Linear programming methods, indicators of nutritional adequacy from the Indian Council of Medical Research and household expenditure survey data from the National Sample Survey Organization were used to construct poverty lines for India. Poverty ratios were calculated for 1993--1994 and 1999--2000 on the basis of nutritional adequacy poverty lines and compared to official estimates of poverty based on energy requirements. Nutritional adequacy poverty lines are higher than official poverty lines, particularly in rural areas. The application of nutritional adequacy poverty lines points to greater rural-urban poverty differences than in official estimates. Declines in rural poverty during the 1990s were also slower under the nutritional adequacy definition, especially in south India. There is a greater degree of rural-urban and regional bias in nutritional adequacy poverty reduction than suggested by official data. Inter-state variations in changes in nutritional poverty and official poverty in the 1990s are largely explained by differences in assumptions on overall price movements. However, relative price movements in food items also played a role, particularly the slow increase in prices of cereals and edible oils in comparison to the prices of pulses, and in some southern states, compared to milk and vegetable prices as well.

Socioeconomic factors and adolescent pregnancy outcomes: distinctions between neonatal and post-neonatal deaths?

PubMed Central

Markovitz, Barry P; Cook, Rebeka; Flick, Louise H; Leet, Terry L

2005-01-01

Background Young maternal age has long been associated with higher infant mortality rates, but the role of socioeconomic factors in this association has been controversial. We sought to investigate the relationships between infant mortality (distinguishing neonatal from post-neonatal deaths), socioeconomic status and maternal age in a large, retrospective cohort study. Methods We conducted a population-based cohort study using linked birth-death certificate data for Missouri residents during 1997–1999. Infant mortality rates for all singleton births to adolescent women (12–17 years, n = 10,131; 18–19 years, n = 18,954) were compared to those for older women (20–35 years, n = 28,899). Logistic regression was used to estimate adjusted odds ratios (OR) and 95% confidence intervals (CI) for all potential associations. Results The risk of infant (OR 1.95, CI 1.54–2.48), neonatal (1.69, 1.24–2.31) and post-neonatal mortality (2.47, 1.70–3.59) were significantly higher for younger adolescent (12–17 years) than older (20–34 years) mothers. After adjusting for race, marital status, age-appropriate education level, parity, smoking status, prenatal care utilization, and poverty status (indicated by participation in WIC, food stamps or Medicaid), the risk of post-neonatal mortality (1.73, 1.14–2.64) but not neonatal mortality (1.43, 0.98–2.08) remained significant for younger adolescent mothers. There were no differences in neonatal or post-neonatal mortality risks for older adolescent (18–19 years) mothers. Conclusion Socioeconomic factors may largely explain the increased neonatal mortality risk among younger adolescent mothers but not the increase in post-neonatal mortality risk. PMID:16042801

Poverty, social stress & mental health.

PubMed

Kuruvilla, A; Jacob, K S

2007-10-01

While there is increasing evidence of an association between poor mental health and the experience of poverty and deprivation, the relationship is complex. We discuss the epidemiological data on mental illness among the different socio-economic groups, look at the cause -effect debate on poverty and mental illness and the nature of mental distress and disorders related to poverty. Issues related to individual versus area-based poverty, relative poverty and the impact of poverty on woman's and child mental health are presented. This review also addresses factors associated with poverty and the difficulties in the measurement of mental health and illness and levels/impact of poverty.

The role of welfare state principles and generosity in social policy programmes for public health: an international comparative study.

PubMed

Lundberg, Olle; Yngwe, Monica Aberg; Stjärne, Maria Kölegård; Elstad, Jon Ivar; Ferrarini, Tommy; Kangas, Olli; Norström, Thor; Palme, Joakim; Fritzell, Johan

2008-11-08

Many important social determinants of health are also the focus for social policies. Welfare states contribute to the resources available for their citizens through cash transfer programmes and subsidised services. Although all rich nations have welfare programmes, there are clear cross-national differences with respect to their design and generosity. These differences are evident in national variations in poverty rates, especially among children and elderly people. We investigated to what extent variations in family and pension policies are linked to infant mortality and old-age excess mortality. Infant mortality rates and old-age excess mortality rates were analysed in relation to social policy characteristics and generosity. We did pooled cross-sectional time-series analyses of 18 OECD (Organisation for Economic Co-operation and Development) countries during the period 1970-2000 for family policies and 1950-2000 for pension policies. Increased generosity in family policies that support dual-earner families is linked with lower infant mortality rates, whereas the generosity in family policies that support more traditional families with gainfully employed men and homemaking women is not. An increase by one percentage point in dual-earner support lowers infant mortality by 0.04 deaths per 1000 births. Generosity in basic security type of pensions is linked to lower old-age excess mortality, whereas the generosity of earnings-related income security pensions is not. An increase by one percentage point in basic security pensions is associated with a decrease in the old age excess mortality by 0.02 for men as well as for women. The ways in which social policies are designed, as well as their generosity, are important for health because of the increase in resources that social policies entail. Hence, social policies are of major importance for how we can tackle the social determinants of health.

[Growth in height of indigenous and non indigenous Chilean children].

PubMed

Bustos, Patricia; Weitzman, Mariana; Amigo, Hugo

2004-06-01

The aim of this study was to compare growth curves of stature in indigenous and non-indigenous children belonging to two levels of poverty and to establish the onset and evolution of the deficit. Children of indigenous and non-indigenous background living in communities of extreme and low poverty in Chile were studied and their height-for-age Z-score from birth until 6 year of age were compared. Mean weight at birth was within normal range, and no differences were found in ethnicity and levels of poverty. Length at birth was below the reference with the exception of the non indigenous newborn from counties of low poverty. Deficit in growth showed an early start, furthermore in indigenous children belonging to the extreme poverty, is from birth and progress through the 18 months. At 72 months the deficit reached -1.1 z scores in the indigenous of the extreme poverty versus -0.7 in the non indigenous group. Children from the low poverty had a Z-score of -0.4 z scores at 72 months without differences between ethnias. Indigenous of the extreme poverty had less accumulative growth while the indigenous of the low poverty areas growth satisfactory without differences with the non indigenous.

Associations of census-tract poverty with subsite-specific colorectal cancer incidence rates and stage of disease at diagnosis in the United States.

PubMed

Henry, Kevin A; Sherman, Recinda L; McDonald, Kaila; Johnson, Christopher J; Lin, Ge; Stroup, Antoinette M; Boscoe, Francis P

2014-01-01

Background. It remains unclear whether neighborhood poverty contributes to differences in subsite-specific colorectal cancer (CRC) incidence. We examined associations between census-tract poverty and CRC incidence and stage by anatomic subsite and race/ethnicity. Methods. CRC cases diagnosed between 2005 and 2009 from 15 states and Los Angeles County (N = 278,097) were assigned to 1 of 4 groups based on census-tract poverty. Age-adjusted and stage-specific CRC incidence rates (IRs) and incidence rate ratios (IRRs) were calculated. Analyses were stratified by subsite (proximal, distal, and rectum), sex, race/ethnicity, and poverty. Results. Compared to the lowest poverty areas, CRC IRs were significantly higher in the most impoverished areas for men (IRR = 1.14 95% CI 1.12-1.17) and women (IRR = 1.06 95% CI 1.05-1.08). Rate differences between high and low poverty were strongest for distal colon (male IRR = 1.24 95% CI 1.20-1.28; female IRR = 1.14 95% CI 1.10-1.18) and weakest for proximal colon. These rate differences were significant for non-Hispanic whites and blacks and for Asian/Pacific Islander men. Inverse associations between poverty and IRs of all CRC and proximal colon were found for Hispanics. Late-to-early stage CRC IRRs increased monotonically with increasing poverty for all race/ethnicity groups. Conclusion. There are differences in subsite-specific CRC incidence by poverty, but associations were moderated by race/ethnicity.

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 rights reserved.

Infant Mortality on the Yakama Indian Reservation, 1914-1964.

ERIC Educational Resources Information Center

Trafzer, Clifford E.

1999-01-01

Infants under age 1 constituted the most deaths recorded for any age group among Native people on the Yakama Indian Reservation (Washington), between 1914 and 1964. Poverty conditions, including poor diet and unsanitary housing; social anomie; and lack of adequate health care contributed to infant deaths. Data tables and figures detail infant…

Kids Count Alaska Data Book, 2002.

ERIC Educational Resources Information Center

Leask, Linda, Ed.

This Kids Count Data Book examines statewide trends in the well-being of Alaska's children. The statistical portrait is based on key indicators in six areas: (1) infancy, including prenatal care, low birth weight, and infant mortality; (2) economic well-being, including child poverty, children with no parent working full-time, children in single…

Kids Count Alaska Data Book, 2001.

ERIC Educational Resources Information Center

Leask, Linda, Ed.

This Kids Count Data Book examines statewide trends in the well-being of Alaska's children. The statistical portrait is based on key indicators in six areas: (1) infancy, including prenatal care, low birth weight, and infant mortality; (2) economic well-being, including child poverty, children with no parent working full-time, and teen births; (3)…

Kids Count Alaska, 2000 Data Book.

ERIC Educational Resources Information Center

Leask, Linda, Ed.

This Kids Count Data Book examines statewide trends in the well-being of Alaska's children. The statistical portrait is based on key indicators in six areas: (1) infancy, including prenatal care, low birth weight, and infant mortality; (2) economic well-being, including child poverty, children with no parent working full-time, and teen births; (3)…

Kids Count Alaska Data Book, 1998-99.

ERIC Educational Resources Information Center

Leask, Linda, Ed.

This Kids Count Data Book examines statewide trends in the well-being of Alaska's children. The statistical portrait is based on key indicators in six areas: (1) infancy, including prenatal care, low birth weight, and infant mortality; (2) economic well-being, including children living in poverty, children in single-parent households, and births…

Maryland's Kids Count Factbook 1996.

ERIC Educational Resources Information Center

Advocates for Children and Youth, Baltimore, MD.

This Kids Count report details statewide trends in the well-being of Maryland's children. The statistical portrait is based on 14 indicators of child well being: (1) child poverty; (2) child support; (3) births to teens; (4) low birthweight infants; (5) infant mortality; (6) lead screening; (7) child abuse and neglect; (8) child death rate; (9)…

Of the Community, by the Community, and for the Community.

ERIC Educational Resources Information Center

Ambler, Marjane

2001-01-01

States that tribal colleges are not Ivory Towers standing above and beyond their communities. American Indians have higher rates of poverty, unemployment, sickness, mortality than others in the United States. Tribal colleges must provide health services, childcare and other community services as well as education to meet the needs of their…

[Characteristics of non-exertional heat-related illness in Japan].

PubMed

Miyake, Yasufumi

2012-06-01

This report shows characteristics of non-exertional heat-related illness in Japan. The findings are similar to those of previous reports in heatwaves of Europe and The United States. Eldery people with pre-existing diseases, homeless, living alone, poverty are independent risk factors of heatstoke and are strongly associated with severity and mortality.

Disadvantaged Children: Health, Nutrition and School Failure.

ERIC Educational Resources Information Center

Birch, Herbert G.; Gussow, Joan Dye

This book examines the relationships between poverty, disadvantage, and educational failure in a way considered to be more comprehensive and complex than is possible when such an examination is based solely on a concept of cultural disadvantage and defective experience. The mortality of infants and their mothers around birth, held to be both the…

7 CFR 1780.13 - Rates and terms.

Code of Federal Regulations, 2012 CFR

2012-01-01

... the market rate will be used to determine the poverty and intermediate interest rates. (b) Poverty... 23, 2008, will have the poverty interest rate set at 60 percent of the market rate. All poverty rate... the difference between the poverty rate and the market rate, not to exceed 7 percent per annum. Loans...

7 CFR 1780.13 - Rates and terms.

Code of Federal Regulations, 2013 CFR

2013-01-01

... the market rate will be used to determine the poverty and intermediate interest rates. (b) Poverty... 23, 2008, will have the poverty interest rate set at 60 percent of the market rate. All poverty rate... the difference between the poverty rate and the market rate, not to exceed 7 percent per annum. Loans...

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).

An urban neo-poverty population-based quality of life and related social characteristics investigation from northeast China.

PubMed

Ou, Fengrong; Li, Kai; Gao, Qian; Liu, Dan; Li, Jinghai; Hu, Liwen; Wu, Xian; Edmiston, E Kale; Liu, Yang

2012-01-01

To investigate quality of life (QOL) and related characteristics among an urban neo-poverty population in northeast China, and to compare this population with a traditional poverty cohort. The research was a cross-sectional survey executed from June 2005 to October 2007, with a sample of 2940 individuals ages 36 to 55 in three different industrial cities of northeast China. Data were collected on QOL status and sociodemographic characteristics. QOL was assessed using the 36-item Short Form Health Survey (Chinese version). Multiple regression analysis was employed to analyze association between sociodemographic variables and QOL. The scores for QOL in the neo-poverty group were higher than those in the traditional poverty group, but lower than those in the general population. When the neo-poverty population was divided into two subgroups by age, 36-45 years and 46-55 years, the differences in QOL scores were not significant. However, there were significant differences in several dimensions between two subgroups according to unemployment time (<5 years and >5 years). Additionally, stepwise regression analysis indicated that disease burden, including disease and medical expenditures, was a common risk factor for declining QOL in the neo-poverty group. Despite some limitations, this study provides initial evidence that the QOL of the urban neo-poverty population lies between that of the general population and traditional poverty. QOL of the neo-poverty group approached QOL of the traditional poverty group with increased unemployment years. In addition to decreased income, disease burden is the most important factor influencing QOL status in urban neo-poverty.

Urbanisation and child health in resource poor settings with special reference to under-five mortality in Africa.

PubMed

Garenne, Michel

2010-06-01

The health of children improved dramatically worldwide during the 20th century, although with major contrasts between developed and developing countries, and urban and rural areas. The quantitative evidence on urban child health from a broad historical and comparative perspective is briefly reviewed here. Before the sanitary revolution, urban mortality tended to be higher than rural mortality. However, after World War I, improvements in water, sanitation, hygiene, nutrition and child care resulted in lower urban child mortality in Europe. Despite a similar mortality decline, urban mortality in developing countries since World War II has been generally lower than rural mortality, probably because of better medical care, higher socio-economic status and better nutrition in urban areas. However, higher urban mortality has recently been seen in the slums of large cities in developing countries as a result of extreme poverty, family disintegration, lack of hygiene, sanitation and medical care, low nutritional status, emerging diseases (HIV/AIDS and tuberculosis) and other health hazards (environmental hazards, accidents, violence). These emerging threats need to be addressed by appropriate policies and programmes.

Three perspectives on the mismatch between measures of material poverty.

PubMed

Hick, Rod

2015-03-01

The two most prominent measures of material poverty within contemporary European poverty analysis are low income and material deprivation. However, it is by now well-known that these measures identify substantially different people as being poor. In this research note, I seek to demonstrate that there are at least three ways to understand the mismatch between low income and material deprivation, relating to three different forms of identification: identifying poor households, identifying groups at risk of poverty and identifying trends in material poverty over time. Drawing on data from the British Household Panel Survey, I show that while low income and material deprivation identify very different households as being poor, and display distinct trends over time, in many cases they identify the same groups at being at risk of material poverty. © London School of Economics and Political Science 2014.

Slum residence and child health in developing countries.

PubMed

Fink, Günther; Günther, Isabel; Hill, Kenneth

2014-08-01

Continued population growth and increasing urbanization have led to the formation of large informal urban settlements in many developing countries in recent decades. The high prevalence of poverty, overcrowding, and poor sanitation observed in these settlements-commonly referred to as "slums"-suggests that slum residence constitutes a major health risk for children. In this article, we use data from 191 Demographic and Health Surveys (DHS) across 73 developing countries to investigate this concern empirically. Our results indicate that children in slums have better health outcomes than children living in rural areas yet fare worse than children in better-off neighborhoods of the same urban settlements. A large fraction of the observed health differences appears to be explained by pronounced differences in maternal education, household wealth, and access to health services across residential areas. After we control for these characteristics, children growing up in the slums and better-off neighborhoods of towns show levels of morbidity and mortality that are not statistically different from those of children living in rural areas. Compared with rural children, children living in cities (irrespective of slum or formal residence) fare better with respect to mortality and stunting but not with respect to recent illness episodes.

Changing disparities in invasive pneumococcal disease by socioeconomic status and race/ ethnicity in Connecticut, 1998-2008.

PubMed

Soto, Kristen; Petit, Susan; Hadler, James L

2011-01-01

We compared invasive pneumococcal disease (IPD) incidence by race/ethnicity and neighborhood poverty level and assessed their relative utility to describe disparities in IPD in 1998-1999 and again in 2007-2008, after introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). We conducted laboratory surveillance for pneumococcal isolates from sterile body sites and serotyped the isolates. Home address was geocoded to the census-tract level. Census-tract data on the percentage of people below poverty were grouped into three categories. The difference in the magnitude of incidence by race/ethnicity and by census-tract socioeconomic status (SES) (high poverty minus low poverty) was compared for 1998-1999 and 2007-2008 for PCV7 and non-PCV7 serotypes. In 1998-1999, incidence difference (all per 100,000 population) for PCV7 serotypes for black people compared with white people was 14.3 and by poverty level was 13.9. The highest rate was among white people in high-poverty tracts (77.3). By 2007-2008, there were only slight differences between rates for black and white people (0.7) and SES (1.4). In 1998-1999, the incidence difference for non-PCV7 serotypes was 4.7 between black and white people and 6.0 by SES. By 2007-2008, the differences were 11.6 and 11.7, respectively. Among those living in the highest-poverty tracts, white people had the highest rate (42.9). In the absence of vaccine, IPD incidence is higher among people living in higher-poverty census tracts and among black people. Emerging serotypes also follow this trend. Differences in neighborhood poverty levels reveal disparities in rates of IPD as large as those seen by race/ethnicity and could be used to routinely describe disparities and target prevention.

Modelling determinants, impact, and space-time risk of age-specific mortality in rural South Africa: integrating methods to enhance policy relevance.

PubMed

Sartorius, Benn

2013-01-24

There is a lack of reliable data in developing countries to inform policy and optimise resource allocation. Health and socio-demographic surveillance sites (HDSS) have the potential to address this gap. Mortality levels and trends have previously been documented in rural South Africa. However, complex space-time clustering of mortality, determinants, and their impact has not been fully examined. To integrate advanced methods enhance the understanding of the dynamics of mortality in space-time, to identify mortality risk factors and population attributable impact, to relate disparities in risk factor distributions to spatial mortality risk, and thus, to improve policy planning and resource allocation. Agincourt HDSS supplied data for the period 1992-2008. Advanced spatial techniques were used to identify significant age-specific mortality 'hotspots' in space-time. Multivariable Bayesian models were used to assess the effects of the most significant covariates on mortality. Disparities in risk factor profiles in identified hotspots were assessed. Increasing HIV-related mortality and a subsequent decrease possibly attributable to antiretroviral therapy introduction are evident in this rural population. Distinct space-time clustering and variation (even in a small geographic area) of mortality were observed. Several known and novel risk factors were identified, and population impact was quantified. Significant differences in the risk factor profiles of the identified 'hotspots' included ethnicity; maternal, partner, and household deaths; household head demographics; migrancy; education; and poverty. A complex interaction of highly attributable multilevel factors continues to demonstrate differential space-time influences on mortality risk (especially for HIV). High-risk households and villages displayed differential risk factor profiles. This integrated approach could prove valuable to decision makers. Tailored interventions for specific child and adult high-risk mortality areas are needed, such as preventing vertical transmission, ensuring maternal survival, and improving water and sanitation infrastructure. This framework can be applied in other settings within the region.

Differential female mortality and health care in South Asia.

PubMed

Harriss, B

1989-04-01

This report examines differential female mortality in South Asia--India, Sri Lanka, Bangladesh, and Pakistan. Under conditions of mortality decline and an aggregate trend toward convergence of life expectancy, disequilibria which are comparatively unusual, persist. The converging life expectancies are a product of changes unique to each sex. Female mortality gains after the reproductive period conceal excess female mortality from the post-neonatal period to 5 years and in most regions of South Asia during the reproductive years as well. These imbalances appear to be most exaggerated on the upper Gangetic plain and among communities such as the Jats and Rajputs. The most marked imbalances do not bear a consistent relationship to economic conditions. They may, however, be declining over time. In certain regions of India, most notably in the peripheral south, discrimination against women is not seen in demographic data and has not been for several decades. Male life expectancy is being affected by only slow improvement in male mortality from age 35. Major social changes are accompanying these changes in gender differences in vital statistics, including changes in the technology of agricultural production, falling female participation rates, the education of girls, the increasing practice of dowry, and fertility decision making changes. It is not clear whether child mortality or maternal mortality is the key to the political economy of Indian demography, whether maldistribution of food or health care is the prime determinant of excess female child mortality, whether excess female mortality is the result of being neglect or conscious selection, whether regional contrasts result from differences in the religious roles of sons between north and south India, whether the female sex is culturally inferior and the male sex superior, whether food scarcity is more important than food availability in the determination of sex bias, whether poverty results in greater discrimination, whether class position determines reproductive strategy, whether major contrasts in demographic regime exist between north and south India, or whether material conditions or cultural practices determine demographic regimes. The workshop papers contributed data for the decision process, advocacy for the agenda, and details on the results of implementation, and the realities of access.

An Urban Neo-Poverty Population-Based Quality of Life and Related Social Characteristics Investigation from Northeast China

PubMed Central

Ou, Fengrong; Li, Kai; Gao, Qian; Liu, Dan; Li, Jinghai; Hu, Liwen; Wu, Xian; Edmiston, E. Kale; Liu, Yang

2012-01-01

Objective To investigate quality of life (QOL) and related characteristics among an urban neo-poverty population in northeast China, and to compare this population with a traditional poverty cohort. Design The research was a cross-sectional survey executed from June 2005 to October 2007, with a sample of 2940 individuals ages 36 to 55 in three different industrial cities of northeast China. Data were collected on QOL status and sociodemographic characteristics. QOL was assessed using the 36-item Short Form Health Survey (Chinese version). Multiple regression analysis was employed to analyze association between sociodemographic variables and QOL. Results The scores for QOL in the neo-poverty group were higher than those in the traditional poverty group, but lower than those in the general population. When the neo-poverty population was divided into two subgroups by age, 36–45 years and 46–55 years, the differences in QOL scores were not significant. However, there were significant differences in several dimensions between two subgroups according to unemployment time (<5 years and >5 years). Additionally, stepwise regression analysis indicated that disease burden, including disease and medical expenditures, was a common risk factor for declining QOL in the neo-poverty group. Conclusions Despite some limitations, this study provides initial evidence that the QOL of the urban neo-poverty population lies between that of the general population and traditional poverty. QOL of the neo-poverty group approached QOL of the traditional poverty group with increased unemployment years. In addition to decreased income, disease burden is the most important factor influencing QOL status in urban neo-poverty. PMID:22719968

Poverty concentration in an affluent city: Geographic variation and correlates of neighborhood poverty rates in Hong Kong

PubMed Central

Guo, Yingqi; Chang, Shu-Sen; Sha, Feng

2018-01-01

Previous investigations of geographic concentration of urban poverty indicate the contribution of a variety of factors, such as economic restructuring and class-based segregation, racial segregation, demographic structure, and public policy. However, the models used by most past research do not consider the possibility that poverty concentration may take different forms in different locations across a city, and most studies have been conducted in Western settings. We investigated the spatial patterning of neighborhood poverty and its correlates in Hong Kong, which is amongst cities with the highest GDP in the region, using the city-wide ordinary least square (OLS) regression model and the local-specific geographically weighted regression (GWR) model. We found substantial geographic variations in small-area poverty rates and identified several poverty clusters in the territory. Factors found to contribute to urban poverty in Western cities, such as socioeconomic factors, ethnicity, and public housing, were also mostly associated with local poverty rates in Hong Kong. Our results also suggest some heterogeneity in the associations of poverty with specific correlates (e.g. access to hospitals) that would be masked in the city-wide OLS model. Policy aimed to alleviate poverty should consider both city-wide and local-specific factors. PMID:29474393

Poverty concentration in an affluent city: Geographic variation and correlates of neighborhood poverty rates in Hong Kong.

PubMed

Guo, Yingqi; Chang, Shu-Sen; Sha, Feng; Yip, Paul S F

2018-01-01

Previous investigations of geographic concentration of urban poverty indicate the contribution of a variety of factors, such as economic restructuring and class-based segregation, racial segregation, demographic structure, and public policy. However, the models used by most past research do not consider the possibility that poverty concentration may take different forms in different locations across a city, and most studies have been conducted in Western settings. We investigated the spatial patterning of neighborhood poverty and its correlates in Hong Kong, which is amongst cities with the highest GDP in the region, using the city-wide ordinary least square (OLS) regression model and the local-specific geographically weighted regression (GWR) model. We found substantial geographic variations in small-area poverty rates and identified several poverty clusters in the territory. Factors found to contribute to urban poverty in Western cities, such as socioeconomic factors, ethnicity, and public housing, were also mostly associated with local poverty rates in Hong Kong. Our results also suggest some heterogeneity in the associations of poverty with specific correlates (e.g. access to hospitals) that would be masked in the city-wide OLS model. Policy aimed to alleviate poverty should consider both city-wide and local-specific factors.

Facts about Texas Children. Excerpted from Children, Choice, and Change.

ERIC Educational Resources Information Center

Harris, Lorwen Connie

The environment in which Texas children grow up is crucial to their future and to the future of the state. Almost 500,000 Texas families were poor in 1985. Poverty sets the stage for numerous childhood maladies: infant mortality, health problems, child abuse, learning disabilities, malnutrition, and mental health problems. As poor children grow up…

Deepest Spring in the Heart: KIDS COUNT Mississippi, 1994 Data Book.

ERIC Educational Resources Information Center

Mississippi Kids Count, Jackson.

This data book for 1994 describes the condition of children in each of Mississippi's 82 counties. The statistical profiles focus on 12 key indicators of child well-being: (1) low birth-weight; (2) infant mortality; (3) poverty; (4) participation in WIC, the special Supplemental Food Program for Women, Infants and Children; (5) school food…

Kansas KIDS COUNT Data Book, 2001.

ERIC Educational Resources Information Center

Kansas Action for Children, Inc., Topeka.

This Kids Count Data Book provides state and county trends in the well-being of Kansas' children. The statistical portrait is based on 21 indicators of well-being: (1) births to single teens; (2) children in poverty; (3) children approved for free school meals; (4) childhood deaths; (5) infant mortality; (6) births with early prenatal care; (7)…

Nevada Kids Count Data Book, 1997.

ERIC Educational Resources Information Center

We Can, Inc., Las Vegas, NV.

This Kids Count data book is the first to examine statewide indicators of the well being of Nevada's children. The statistical portrait is based on 15 indicators of child well being: (1) percent low birth-weight babies; (2) infant mortality rate; (3) percent of children in poverty; (4) percent of children in single-parent families; (5) percent of…

Kids Count Alaska Data Book: 1996.

ERIC Educational Resources Information Center

Alaska Univ., Anchorage. Inst. of Social and Economic Research.

This statistical report examines findings on 15 indicators of children's well-being in Alaska: (1) percent of births with low birth weight; (2) infant mortality rate; (3) child poverty rate; (4) children in single parent families; (5) births to teenagers age 15 to 17; (6) teen (age 16 to 19) high school dropout rate; (7) teens not in school and…

Idaho Kids Count Data Book, 1996: Profiles of Child Well-Being.

ERIC Educational Resources Information Center

Idaho KIDS COUNT Project, Boise.

This Kids Count report examines statewide trends in the well-being of Idaho's children. The statistical portrait is based on 15 indicators of child and family well-being: (1) poverty; (2) single parent families; (3) infant mortality; (4) low birth weight babies; (5) percent of all mothers not receiving adequate prenatal care; (6) mothers ages…

Pakistan and the Millennium Development Goals for Maternal and Child Health: progress and the way forward.

PubMed

Rizvi, Arjumand; Bhatti, Zaid; Das, Jai K; Bhutta, Zulfiqar A

2015-01-01

The world has made substantial progress in reducing maternal and child mortality, but many countries are projected to fall short of achieving their Millennium Development Goals (MDGs) 4 and 5 targets. The major objective of this paper is to examine progress in Pakistan in reducing maternal and child mortality and malnutrition over the last two decades. Data from recent national and international surveys suggest that Pakistan lags behind on all of its MDGs related to maternal and child health and, for some indicators especially related to nutrition, the situation has worsened from the baseline of 1990. Progress in addressing key social determinants such as poverty, female education and empowerment has also been slow and unregulated population growth has further compromised progress. There is a need to integrate the various different sectors and programmes to achieve the desired results effectively and efficiently as many of the determinants and influencing factors are outside the health sector.

Associations of subsite-specific colorectal cancer incidence rates and stage of disease at diagnosis with county-level poverty, by race and sex.

PubMed

Wu, Xiaocheng; Cokkinides, Vilma; Chen, Vivien W; Nadel, Marion; Ren, Yuan; Martin, Jim; Ellison, Gary L

2006-09-01

This study examined associations of subsite-specific colorectal cancer incidence rates and stage of the disease with county-level poverty. The 1998-2001 colorectal cancer incidence data, covering 75% of the United States population, were from 38 states and metropolitan areas. The county-level poverty data were categorized into 3 groups according to the percentage of the population below the poverty level in 1999: <10% (low-poverty), 10%-19% (middle-poverty), and >or=20% (high-poverty). Age-adjusted subsite-specific incidence rates (for all ages) and stage-specific incidence rates (for ages >or=50) were examined by race (whites and blacks), sex, and the county's poverty level. The differences in the incidence rates were examined using the 2-tailed z-statistic. The incidence rates of proximal colon cancer were higher among white males (11% higher) and white females (15% higher) in the low-poverty than in the high-poverty counties. No differences across county poverty levels were observed among whites for distal colon and rectal cancers or among blacks for all the subsites. The late-to-early stage incidence rate ratios were higher in the high-poverty than in the low-poverty counties among white and black males for distal colon and rectal cancers, among white females for distal colon cancer, and among black females for rectal cancer. For proximal colon cancer, however, the late-to-early stage rate ratios were similar across all county poverty levels. Higher incidence rates of proximal cancer were observed among white males and females in the low-poverty counties relative to the high-poverty counties. The higher late-to-early stage rate ratios in high-poverty than in low-poverty counties is observed for distal colon and rectal cancers, but not for proximal colon cancer.

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.

Child survival and changing fertility patterns in Pakistan.

PubMed

Sathar, Z A

1992-01-01

Pakistan is a country with high fertility and high infant and child mortality, and declines in total mortality and substantial development initiatives. The discussion considers whether fertility patterns in Pakistan can be related to changes in child mortality, and whether current and future changes in fertility influence child survival favorably. Omran's study linked large family size to child survival. Resources, which are divided, become more important deficits in households below the poverty line: a situation common in Pakistan. High fertility is associated with short birth intervals, which are related to higher infant and child mortality. In Pakistan, the spacing and mortality link was found among both poverty and higher socioeconomic households. There is some support for the notion that it is birth weight and general health that are linked to survival rather than competition for resources. Other studies link the maternal age at birth and birth order with child mortality (Alam and Cleland). Trussel argues for limiting births in high risk ages of under 20 years and over 35 years. The exact casual link is not well documented. Institutional and community factors are also considered important in influencing child survival: sanitation, potable water, access to roads, electricity, health and family planning services, and sewage. Young infants are more vulnerable to these factors. Bangladesh and some Indian states have shown that population programs and raising per captia incomes are necessary to fertility decline. In India, female autonomy, access to education, and more equal income distribution were considered more important than economic development to child survival. In Pakistan, Sathar and Kazi have linked at least 2 years of elementary, maternal education with reductions in child mortality. The pervasiveness of female illiteracy hinders the chances of child survival. Sex preferences also impact on female children. The probably impacts of declines in breast feeding, smaller family sizes, and delayed childbearing on child survival are discussed. Lessons to be learned from sub-Saharan Africa are that countries should not be caught in social cutbacks due to structural adjustment packages, and should use approaches, such as in Matlab in Bangladesh, to provide contraceptives and immunization. Policy must emphasize female education at least through the primary level for long lasting effects.

Child growth in urban deprived settings: Does household poverty status matter? At which stage of child development?

PubMed Central

Fotso, Jean Christophe; Madise, Nyovani; Baschieri, Angela; Cleland, John; Zulu, Eliya; Kavao Mutua, Martin; Essendi, Hildah

2012-01-01

This paper uses longitudinal data from two informal settlements of Nairobi, Kenya to examine patterns of child growth and how these are affected by four different dimensions of poverty at the household level namely, expenditures poverty, assets poverty, food poverty, and subjective poverty. The descriptive results show a grim picture, with the prevalence of overall stunting reaching nearly 60% in the age group 15–17 months and remaining almost constant thereafter. There is a strong association between food poverty and stunting among children aged 6–11 months (p<0.01), while assets poverty and subjective poverty have stronger relationships (p<0.01) with undernutrition at older age (24 months or older for assets poverty, and 12 months or older for subjective poverty). The effect of expenditures poverty does not reach statistical significant in any age group. These findings shed light on the degree of vulnerability of urban poor infants and children and on the influences of various aspects of poverty measures. PMID:22221652

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.

Maternal-related deaths and impoverishment among adolescent girls in India and Niger: findings from a modelling study

PubMed Central

Verguet, Stéphane; Nandi, Arindam; Filippi, Véronique; Bundy, Donald A P

2016-01-01

Background High levels of maternal mortality and large associated inequalities exist in low-income and middle-income countries. Adolescent pregnancies remain common, and pregnant adolescent women face elevated risks of maternal mortality and poverty. We examined the distribution across socioeconomic groups of maternal deaths and impoverishment among adolescent girls (15–19 years old) in Niger, which has the highest total fertility rate globally, and India, which has the largest number of maternal deaths. Methods In Niger and India, among adolescent girls, we estimated the distribution per income quintile of: the number of maternal deaths; and the impoverishment, measured by calculating the number of cases of catastrophic health expenditure incurred, caused by complicated pregnancies. We also examined the potential impact on maternal deaths and poverty of increasing adolescent girls' level of education by 1 year. We used epidemiological and cost inputs sourced from surveys and the literature. Results The number of maternal deaths would be larger among the poorer adolescents than among the richer adolescents in Niger and India. Impoverishment would largely incur among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational attainment of adolescent girls might avert both a large number of maternal deaths and a significant number of cases of catastrophic health expenditure in the 2 countries. Conclusions Adolescent pregnancies can lead to large equity gaps and substantial impoverishment in low-income and middle-income countries. Increasing female education can reduce such inequalities and provide financial risk protection and poverty alleviation to adolescent girls. PMID:27670517

Cardiometabolic diseases of civilization: history and maturation of an evolving global threat. An update and call to action.

PubMed

Kones, Richard; Rumana, Umme

2017-05-01

Despite striking extensions of lifespan, leading causes of death in most countries now constitute chronic, degenerative diseases which outpace the capacity of health systems. Cardiovascular disease is the most common cause of death in both developed and undeveloped countries. In America, nearly half of the adult population has at least one chronic disease, and polypharmacy is commonplace. Prevalence of ideal cardiovascular health has not meaningfully improved over the past two decades. The fall in cardiovascular deaths in Western countries, half due to a fall in risk factors and half due to improved treatments, have plateaued, and this reversal is due to the dual epidemics of obesity and diabetes type 2. High burdens of cardiovascular risk factors are also evident globally. Undeveloped nations bear the burdens of both infectious diseases and high childhood death rates. Unacceptable rates of morbidity and mortality arise from insufficient resources to improve sanitation, pure water, and hygiene, ultimately linked to poverty and disparities. Simultaneously, about 80% of cardiovascular deaths now occur in low- and middle-income nations. For these reasons, risk factors for noncommunicable diseases, including poverty, health illiteracy, and lack of adherence, must be targeted with unprecedented vigor worldwide. Key messages In developed and relatively wealthy countries, chronic "degenerative" diseases have attained crisis proportions that threaten to reverse health gains made within the past decades. Although poverty, disparities, and poor sanitation still cause unnecessary death and despair in developing nations, they are now also burdened with increasing cardiovascular mortality. Poor adherence and low levels of health literacy contribute to the high background levels of cardiovascular risk.

Neighborhood Environmental Health and Premature Death From Cardiovascular Disease.

PubMed

Gaglioti, Anne H; Xu, Junjun; Rollins, Latrice; Baltrus, Peter; O'Connell, Laura Kathryn; Cooper, Dexter L; Hopkins, Jammie; Botchwey, Nisha D; Akintobi, Tabia Henry

2018-02-01

Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes.

Neighborhood Environmental Health and Premature Death From Cardiovascular Disease

PubMed Central

Xu, Junjun; Rollins, Latrice; Baltrus, Peter; O’Connell, Laura Kathryn; Cooper, Dexter L.; Hopkins, Jammie; Botchwey, Nisha D.; Akintobi, Tabia Henry

2018-01-01

Introduction Cardiovascular disease (CVD) is the leading cause of death in the United States and disproportionately affects racial/ethnic minority groups. Healthy neighborhood conditions are associated with increased uptake of health behaviors that reduce CVD risk, but minority neighborhoods often have poor food access and poor walkability. This study tested the community-driven hypothesis that poor access to food at the neighborhood level and poor neighborhood walkability are associated with racial disparities in premature deaths from CVD. Methods We examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates at the census tract level for the city of Atlanta using multivariable logistic regression models. We produced maps to illustrate premature CVD mortality, food access, and walkability by census tract for the city. Results We found significant racial differences in premature CVD mortality rates and geographic disparities in food access and walkability among census tracts in Atlanta. Improved food access and walkability were associated with reduced overall premature CVD mortality in unadjusted models, but this association did not persist in models adjusted for census tract population composition and poverty. Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality. Conclusion This study highlights disparities in premature CVD mortality and neighborhood food access and walkability at the census tract level in the city of Atlanta. Improving food access may have differential effects for subpopulations living in the same area. These results can be used to calibrate neighborhood-level interventions, and they highlight the need to examine race-specific health outcomes. PMID:29389312

Strategies of Successful Poverty Reduction: Case Studies of Tanzania and Zambia

DTIC Science & Technology

2015-03-01

same policy may yield different results or different policies may yield the same results, depending upon a country’s institutions or growth strategies...population living on less than $1.25 per day rose from 29.2 percent in 1992 to 41.2 percent in 2000 (poverty gap at $1.25 a day PPP percent).107 By 2000...improvements made in the last decade. The poverty headcount ratio at $1.25 a day (poverty gap at $1.25 a day PPP percent) reflects dramatic improvements

The design and research of poverty alleviation monitoring and evaluation system: a case study in the Jiangxi province

NASA Astrophysics Data System (ADS)

Mo, Hong-yuan; Wang, Ying-jie; Yu, Zhuo-yuan

2009-07-01

The Poverty Alleviation Monitoring and Evaluation System (PAMES) is introduced in this paper. The authors present environment platform selection, and details of system design and realization. Different with traditional research of poverty alleviation, this paper develops a new analytical geo-visualization approach to study the distribution and causes of poverty phenomena within Geographic Information System (GIS). Based on the most detailed poverty population data, the spatial location and population statistical indicators of poverty village in Jiangxi province, the distribution characteristics of poverty population are detailed. The research results can provide much poverty alleviation decision support from a spatial-temporal view. It should be better if the administrative unit of poverty-stricken area to be changed from county to village according to spatial distribution pattern of poverty.

Feasibility and pilot study of the effects of microfinance on mortality and nutrition in children under five amongst the very poor in India: study protocol for a cluster randomized controlled trial.

PubMed

Ojha, Shalini; Szatkowski, Lisa; Sinha, Ranjeet; Yaron, Gil; Fogarty, Andrew; Allen, Stephen; Choudhary, Sunil; Smyth, Alan R

2014-07-23

The United Nations Millennium Development Goals include targets for the health of children under five years old. Poor health is linked to poverty and microfinance initiatives are economic interventions that may improve health by breaking the cycle of poverty. However, there is a lack of reliable evidence to support this. In addition, microfinance schemes may have adverse effects on health, for example due to increased indebtedness. Rojiroti UK and the Centre for Promoting Sustainable Livelihood run an innovative microfinance scheme that provides microcredit via women's self-help groups (SHGs). This pilot study, conducted in rural Bihar (India), will establish whether it is feasible to collect anthropometric and mortality data on children under five years old and to conduct a limited cluster randomized trial of the Rojiroti intervention. We have designed a cluster randomized trial in which participating tolas (small communities within villages) will be randomized to either receive early (SHGs and microfinance at baseline) or late intervention (SHGs and microfinance after 18 months). Using predesigned questionnaires, demographic, and mortality data for the last year and information about participating mothers and their children will be collected and the weight, height, and mid upper arm circumference (MUAC) of children will be measured at baseline and at 18 months. The late intervention group will establish SHGs and microfinance support at this point and data collection will be repeated at 36 months.The primary outcome measure will be the mean weight for height z-score of children under five years old in the early and late intervention tolas at 18 months. Secondary outcome measures will be the mortality rate, mean weight for age, height for age, prevalence of underweight, stunting, and wasting among children under five years of age. Despite economic progress, marked inequalities in child health persist in India and Bihar is one of the worst affected states. There is a need to evaluate programs that may alleviate poverty and improve health. This study will help to inform the design of a definitive trial to determine if the Rojiroti scheme can improve the nutrition and survival of children under five years of age in deprived rural communities. Clinicaltrials.gov (study ID: NCT01845545). Registered on 24 April 2013.

Nonmetro Poverty: Assessing the Effect of the 1990s.

ERIC Educational Resources Information Center

Jolliffe, Dean

2003-01-01

During the 1990s, the poverty rate in nonmetropolitan areas declined to a record low of 13.4 percent. Drawing on census data, aspects of nonmetro poverty during the 1990s are outlined, including effects of urbanization, regional differences, racial and ethnic differences, importance of family structure, needs for assistance and human services,…

Poverty concentration and determinants in China's urban low-income neighbourhoods and social groups.

PubMed

He, Shenjing; Wu, Fulong; Webster, Chris; Liu, Yuting

2010-01-01

Based on a large-scale household survey conducted in 2007, this article reports on poverty concentration and determinants in China's low-income neighbourhoods and social groups. Three types of neighbourhood are recognized: dilapidated inner-city neighbourhoods, declining workers' villages and urban villages. Respondents are grouped into four categories: working, laid-off/unemployed and retired urban residents, together with rural migrants. We first measure poverty concentration across different types of neighbourhood and different groups. The highest concentrations are found in dilapidated inner-city neighbourhoods and among the laid-off/unemployed. Mismatches are found between actual hardships, sense of deprivation and distribution of social welfare provision. Second, we examine poverty determinants. Variations in institutional protection and market remuneration are becoming equally important in predicting poverty generation, but are differently associated with it in the different neighbourhoods and groups. As China's urban economy is increasingly shaped by markets, the mechanism of market remuneration is becoming a more important determinant of poverty patterns, especially for people who are excluded from state institutions, notably laid-off workers and rural migrants.

Poverty and program participation among immigrant children.

PubMed

Borjas, George J

2011-01-01

Researchers have long known that poverty in childhood is linked with a range of negative adult socioeconomic outcomes, from lower educational achievement and behavioral problems to lower earnings in the labor market. But few researchers have explored whether exposure to a disadvantaged background affects immigrant children and native children differently. George Borjas uses Current Population Survey (CPS) data on two specific indicators of poverty-the poverty rate and the rate of participation in public assistance programs-to begin answering that question. He finds that immigrant children have significantly higher rates both of poverty and of program participation than do native children. Nearly half of immigrant children are being raised in households that receive some type of public assistance, compared with roughly one-third of native children. Although the shares of immigrant and native children living in poverty are lower, the rate for immigrant children is nonetheless about 15 percentage points higher than that for native children-about the same as the gap in public assistance. Poverty and program participation rates among different groups of immigrant children also vary widely, depending in part on place of birth (foreign- or U.S.-born), parents (immigrant or native), and national origin. According to the CPS data, these native-immigrant differences persist into young adulthood. In particular, the program participation and poverty status of immigrant children is strongly correlated with their program participation and poverty status when they become young adults. But it is not possible, says Borjas, to tell whether the link results from a set of permanent factors associated with specific individuals or groups that tends to lead to "good" or "bad" outcomes systematically over time or from exposure during childhood to adverse socioeconomic outcomes, such as poverty or welfare dependency. Future research must explore the causal impact of childhood poverty on immigrant adult outcomes and why it might differ between immigrant and native families. Developing successful policies to address problems caused by the intergenerational breeding of poverty and program participation in the immigrant population depends on understanding this causal mechanism.

Financial incentives to influence maternal mortality in a low-income setting: making available 'money to transport' - experiences from Amarpatan, India.

PubMed

De Costa, Ayesha; Patil, Rajkumar; Kushwah, Surgiv Singh; Diwan, Vinod Kumar

2009-03-18

Only 40.7% women in India deliver in an institution; leaving many vulnerable to maternal morbidity and mortality (India has 22% of global maternal deaths). While limited accessibility to functioning institutions may account in part, a common reason why women deliver at home is poverty. A lack of readily available financial resources for families to draw upon at the time of labor to transport the mother to an institution, is often observed. This paper reports a yearlong collaborative intervention (between the University and Department of Health) to study if providing readily available and easily accessible funds for emergency transportation would reduce maternal deaths in a rural, low income, and high maternal mortality setting in central India. It aimed to obviate a deterrent to emergency obstetric care; the non-availability of resources with mothers when most needed. Issues in implementation are also discussed. Maternal deaths were actively identified in block Amarpatan (0.2 million population) over a 2-year period. The project, with participation from local government and other groups, trained 482 local health care providers (public and private) to provide antenatal care. Emergency transport money (in cash) was placed with one provider in each village. Maternal mortality in the adjacent block (Maihar) was followed (as a 'control' block). Maternal deaths in Amarpatan decreased during the project year relative to the previous year, or in the control block the same year. Issues in implementation of the cash incentive scheme are discussed. Although the intervention reduced maternal deaths in this low-income setting, chronic poverty and malnutrition are underlying structural problems that need to be addressed.

For blacks in America, the gap in neighborhood poverty has declined faster than segregation

PubMed Central

Acciai, Francesco

2016-01-01

Black residential segregation has been declining in the United States. That accomplishment rings hollow, however, if blacks continue to live in much poorer neighborhoods than other Americans. This study uses census data for all US metropolitan areas in 1980 and 2010 to compare decline in the neighborhood poverty gap between blacks and other Americans with decline in the residential segregation of blacks. We find that both declines resulted primarily from narrowing differences between blacks and whites as opposed to narrowing differences between blacks and Hispanics or blacks and Asians. Because black–white differences in neighborhood poverty declined much faster than black–white segregation, the neighborhood poverty disadvantage of blacks declined faster than black segregation—a noteworthy finding because the narrowing of the racial gap in neighborhood poverty for blacks has gone largely unnoticed. Further analysis reveals that the narrowing of the gap was produced by change in both the medians and shapes of the distribution of poverty across the neighborhoods where blacks, whites, Hispanics, and Asians reside. PMID:27821759

For blacks in America, the gap in neighborhood poverty has declined faster than segregation.

PubMed

Firebaugh, Glenn; Acciai, Francesco

2016-11-22

Black residential segregation has been declining in the United States. That accomplishment rings hollow, however, if blacks continue to live in much poorer neighborhoods than other Americans. This study uses census data for all US metropolitan areas in 1980 and 2010 to compare decline in the neighborhood poverty gap between blacks and other Americans with decline in the residential segregation of blacks. We find that both declines resulted primarily from narrowing differences between blacks and whites as opposed to narrowing differences between blacks and Hispanics or blacks and Asians. Because black-white differences in neighborhood poverty declined much faster than black-white segregation, the neighborhood poverty disadvantage of blacks declined faster than black segregation-a noteworthy finding because the narrowing of the racial gap in neighborhood poverty for blacks has gone largely unnoticed. Further analysis reveals that the narrowing of the gap was produced by change in both the medians and shapes of the distribution of poverty across the neighborhoods where blacks, whites, Hispanics, and Asians reside.

One-Stop Shopping: The Road to Healthy Mothers and Children. A Report of the National Commission To Prevent Infant Mortality.

ERIC Educational Resources Information Center

National Commission To Prevent Infant Mortality, Washington, DC.

This report promotes one-stop shopping for health and social services as an effective strategy for accommodating the needs of pregnant women and their children. Roadblocks to receipt of care by pregnant women include ignorance of prenatal or preventive pediatric services, poverty, weak referral networks, and the fragmentation of programs and…

The economic and social burden of malaria.

PubMed

Sachs, Jeffrey; Malaney, Pia

2002-02-07

Where malaria prospers most, human societies have prospered least. The global distribution of per-capita gross domestic product shows a striking correlation between malaria and poverty, and malaria-endemic countries also have lower rates of economic growth. There are multiple channels by which malaria impedes development, including effects on fertility, population growth, saving and investment, worker productivity, absenteeism, premature mortality and medical costs.

Factors associated with fertility moderation in India.

PubMed

Sharma, S; Singhal, D S; Sharma, B B; Gupta, Y P

1991-04-01

The authors analyze intermediate variables associated with fertility decline in India from the 1960s to 1988. The focus is on comparisons among states as revealed primarily by data on couples protected from unwanted pregnancies by family planning methods. Variables considered include female age at marriage, female literacy, infant mortality, poverty, expenditure on health and family welfare, and income. Data are from official sources.

Kids Count in Indiana 2001 Data Book: County Profiles of Child Well-Being.

ERIC Educational Resources Information Center

Erickson, Judith; King, Mindy Hightower

This Kids Count data book examines statewide trends in the well-being of Indiana's children. The statistical portrait is based on indicators in 10 general areas: (1) child and family demographics; (2) economic well-being; (3) poverty; (4) child safety; (5) child abuse and neglect; (6) education; (7) child health; (8) mortality; (9) high risk…

It Doesn't Take a Rocket Scientist. It Just Takes You! Kansas Children's Report Card, 2001.

ERIC Educational Resources Information Center

Kansas Action for Children, Inc., Topeka.

This document uses a school report card format to present information on the current well-being of Kansas' children. "Grades" are based on 17 indicators of well-being in five areas: (1) safety and security (violent crime, child abuse and neglect, and childhood poverty); (2) health (early prenatal care, low birthweight, infant mortality,…

Idaho Kids Count Data Book, 1994: Profiles of Child Well-Being.

ERIC Educational Resources Information Center

Idaho KIDS COUNT Project, Boise.

This Kids Count data book examines county and statewide trends of Idaho children's well-being. The statistical profile is based on 14 indicators: (1) children under age 18 in poverty; (2) children in single parent families; (3) births with adequate prenatal care; (4) infant mortality rate; (5) births to mothers age 10 to 19 without prenatal care;…

Child growth in urban deprived settings: does household poverty status matter? At which stage of child development?

PubMed

Fotso, Jean Christophe; Madise, Nyovani; Baschieri, Angela; Cleland, John; Zulu, Eliya; Mutua, Martin Kavao; Essendi, Hildah

2012-03-01

This paper uses longitudinal data from two informal settlements of Nairobi, Kenya to examine patterns of child growth and how these are affected by four different dimensions of poverty at the household level namely, expenditures poverty, assets poverty, food poverty, and subjective poverty. The descriptive results show a grim picture, with the prevalence of overall stunting reaching nearly 60% in the age group 15-17 months and remaining almost constant thereafter. There is a strong association between food poverty and stunting among children aged 6-11 months (p<0.01), while assets poverty and subjective poverty have stronger relationships (p<0.01) with undernutrition at older age (24 months or older for assets poverty, and 12 months or older for subjective poverty). The effect of expenditures poverty does not reach statistical significant in any age group. These findings shed light on the degree of vulnerability of urban poor infants and children and on the influences of various aspects of poverty measures. Copyright © 2011 Elsevier Ltd. All rights reserved.

What can Pakistan do to address maternal and child health over the next decade?

PubMed

Bhutta, Zulfiqar A; Hafeez, Assad

2015-11-25

Pakistan faces huge challenges in meeting its international obligations and agreed Millennium Development Goal targets for reducing maternal and child mortality. While there have been reductions in maternal and under-5 child mortality, overall rates are barely above secular trends and neonatal mortality has not reduced much. Progress in addressing basic determinants, such as poverty, undernutrition, safe water, and sound sanitary conditions as well as female education, is unsatisfactory and, not surprisingly, population growth hampers economic growth and development across the country. The devolution of health to the provinces has created challenges as well as opportunities for action. This paper presents a range of actions needed for change within the health and social sectors, including primary care, social determinants, strategies to reach the unreached, and accountability.

Hierarchical cluster analysis of labour market regulations and population health: a taxonomy of low- and middle-income countries.

PubMed

Muntaner, Carles; Chung, Haejoo; Benach, Joan; Ng, Edwin

2012-04-18

An important contribution of the social determinants of health perspective has been to inquire about non-medical determinants of population health. Among these, labour market regulations are of vital significance. In this study, we investigate the labour market regulations among low- and middle-income countries (LMICs) and propose a labour market taxonomy to further understand population health in a global context. Using Gross National Product per capita, we classify 113 countries into either low-income (n = 71) or middle-income (n = 42) strata. Principal component analysis of three standardized indicators of labour market inequality and poverty is used to construct 2 factor scores. Factor score reliability is evaluated with Cronbach's alpha. Using these scores, we conduct a hierarchical cluster analysis to produce a labour market taxonomy, conduct zero-order correlations, and create box plots to test their associations with adult mortality, healthy life expectancy, infant mortality, maternal mortality, neonatal mortality, under-5 mortality, and years of life lost to communicable and non-communicable diseases. Labour market and health data are retrieved from the International Labour Organization's Key Indicators of Labour Markets and World Health Organization's Statistical Information System. Six labour market clusters emerged: Residual (n = 16), Emerging (n = 16), Informal (n = 10), Post-Communist (n = 18), Less Successful Informal (n = 22), and Insecure (n = 31). Primary findings indicate: (i) labour market poverty and population health is correlated in both LMICs; (ii) association between labour market inequality and health indicators is significant only in low-income countries; (iii) Emerging (e.g., East Asian and Eastern European countries) and Insecure (e.g., sub-Saharan African nations) clusters are the most advantaged and disadvantaged, respectively, with the remaining clusters experiencing levels of population health consistent with their labour market characteristics. The labour market regulations of LMICs appear to be important social determinant of population health. This study demonstrates the heuristic value of understanding the labour markets of LMICs and their health effects using exploratory taxonomy approaches.

[A mid-term review of the Millennium Development Goals: where are we with the goals on health?].

PubMed

Kaddar, Miloud

2009-01-01

The eight Millennium Development Goals (MDGs) are the expressed commitment by world leaders to combat the most obvious forms of social inequality in the world: poverty, illiteracy and disease. The MDGs set health priorities and serve as markers of the most fundamental problems to solve: the maternal and child health high mortality, and the fight against major endemic diseases. Thus, health appears in three of the eight goals, and plays a decisive role in achieving the other MDGs such as the eradication of poverty and hunger, promotion of education and gender equality. While progress has been made in various domains and in numerous countries, enormous gaps and lack of funding remain. This is the case for infant mortality and HIV/AIDS, and even more so in the area of maternal mortality reduction especially in sub-Saharan Africa and Southeast Asia. The recent proliferation of forums and international partnerships for health have put at the forefront the targeted health-related MDG, increased financial resources for the benefit of poor countries but have made the architecture of global health even more fragmented and complex. Attempts to align on country priorities, needs and national health plans, and also to harmonize donors and partners' actions and funding according to the 2005 Paris Declaration principles, were difficult to actually materialize. The revitalization of primary health care and the strengthening of health systems are now back on the international and national health agenda.

The mis-measurement of extreme global poverty: A case study in the Pacific Islands

PubMed Central

Gubhaju, Bina

2015-01-01

Debate over the measurement of global poverty in low- and middle-income countries continues unabated. There is considerable controversy surrounding the ‘dollar a day’ measure used to monitor progress against the Millennium Development Goals. This article shines fresh light on the debate with new empirical analyses of poverty (including child poverty), inequality and deprivation levels in the Pacific island state of Vanuatu. The study focuses not only on economic and monetary metrics and measures, but also the measures of deprivation derived from sociology in relation to shelter, sanitation, water, information, nutrition, health and education. Until recently, there had been few, if any, attempts to study poverty and deprivation disparities among children in this part of the world. Different measures yield strikingly different estimates of poverty. The article, therefore, attempts to situate the study findings in the broader international context of poverty measurement and discusses their implications for future research and the post-2015 development agenda. PMID:26336359

Breastfeeding or bottled milk? Poverty and feeding choices in the native and immigrant population in Belgium.

PubMed

Vanderlinden, Karen; Levecque, Katia; Van Rossem, Ronan

2015-04-01

In many European countries, mothers in poverty show a preference for bottled milk over breastfeeding. What remains unknown is whether the impact of poverty on feeding choices differs between immigrants and natives. We first assessed whether being born into poverty indicates a higher chance of being bottle-fed, then evaluated whether region of origin of the mother moderates the impact of poverty on feeding choice. Based on population data from nearly all newborns in Belgium in 2004 (N = 34,314), we performed several binary logistic analyses to answer these research questions. Analyses showed a strong difference in feeding choices between native and migrant mothers in poverty: for Belgian mothers, the choice to breastfeed significantly decreased; no such effect was observed for migrant women. Southern European mothers living in poverty have an even higher chance of breastfeeding than those who are better off. We suggest possible explanations and set a direction for future research regarding breastfeeding choices for migrant mothers.

Census Tract Poverty and Racial Disparities in HIV Rates in Milwaukee County, Wisconsin, 2009-2014.

PubMed

Gibson, Crystal; Grande, Katarina; Schumann, Casey; Gasiorowicz, Mari

2018-02-22

Previous work has documented associations between poverty and HIV. Understanding of these relationships at local levels could help target prevention efforts; however, HIV surveillance systems do not capture individual-level poverty measures. We utilized the Public Health Disparities Geocoding Project methods to examine HIV rates by census tract poverty. HIV rates and rate ratios were computed by census tract poverty (< 5.0, 5.0-9.9, 10.0-19.9, > 20.0% of individual below the federal poverty level) for all races and stratified by Black and White race using Poisson regression. We observed higher HIV rates in the highest poverty gradient compared to the lowest poverty gradient for all races combined and among White cases. After adjustment, HIV rates were similar across poverty gradients for all comparisons. Our findings suggest that the association between poverty and HIV may differ by subpopulation, while demonstrating the potential for HIV prevention targeting residents of high poverty areas.

Effect of asthma on falling into poverty: the overlooked costs of illness.

PubMed

Callander, Emily J; Schofield, Deborah J

2015-05-01

Studies on the indirect costs of asthma have taken a narrow view of how the condition affects the living standards of patients by examining only the association with employment and income. To build on the current cost-of-illness literature and identify whether having asthma is associated with an increased risk of poverty, thus giving a more complete picture of the costs of asthma to individuals and society. Longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian survey to estimate the relative risk of income poverty, multidimensional poverty, and long-term multidimensional poverty between 2007 and 2012 and population attributable risk method to estimate the proportion of poverty between 2007 and 2012 directly attributable to asthma. No significant difference was found in the risk of falling into income poverty between those with and without asthma (P = .07). Having asthma increased the risk of falling into multidimensional poverty by 1.35 (95% confidence interval [CI], 1.01-1.83) and the risk of falling into chronic multidimensional poverty by 2.22 (95% CI, 1.20-4.10). Between 2007 and 2012, a total of 5.2% of income poverty cases (95% CI, 5.1%-5.4%), 7.8% of multidimensional poverty cases (95% CI, 7.7%-8.0%), and 19.6% of chronic multidimensional poverty cases (95% CI, 19.2%-20.0%) can be attributed to asthma. Asthma is associated with an increased risk of falling into poverty. This should be taken into consideration when considering the suitability of different treatment options for patients with asthma. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Vital Signs: Disparities in Tobacco-Related Cancer Incidence and Mortality - United States, 2004-2013.

PubMed

Henley, S Jane; Thomas, Cheryll C; Sharapova, Saida R; Momin, Behnoosh; Massetti, Greta M; Winn, Deborah M; Armour, Brian S; Richardson, Lisa C

2016-11-11

Tobacco use causes at least 12 types of cancer and is the leading preventable cause of cancer. Data from the United States Cancer Statistics dataset for 2004-2013 were used to assess incidence and death rates and trends for cancers that can be caused by tobacco use (tobacco-related cancers: oral cavity and pharynx; esophagus; stomach; colon and rectum; liver; pancreas; larynx; lung, bronchus, and trachea; kidney and renal pelvis; urinary bladder; cervix; and acute myeloid leukemia) by sex, age, race, ethnicity, state, county-level poverty and educational attainment, and cancer site. Each year during 2009-2013, on average, 660,000 persons in the United States received a diagnosis of a tobacco-related cancer, and 343,000 persons died from these cancers. Tobacco-related cancer incidence and death rates were higher among men than women; highest among black men and women; higher in counties with low proportion of college graduates or high level of poverty; lowest in the West; and differed two-fold among states. During 2004-2013, incidence of tobacco-related cancer decreased 1.3% per year and mortality decreased 1.6% per year, with decreases observed across most groups, but not at the same rate. Tobacco-related cancer declined during 2004-2013. However, the burden remains high, and disparities persist among certain groups with higher rates or slower declines in rates. The burden of tobacco-related cancers can be reduced through efforts to prevent and control tobacco use and other comprehensive cancer control efforts focused on reducing cancer risk, detecting cancer early, improving cancer treatments, helping more persons survive cancer, improving cancer survivors' quality of life, and better assisting communities disproportionately impacted by cancer.

Gender apartheid and its impact on Indian women's reproductive health.

PubMed

Sarin, A R

1992-01-01

In India the 1991 census showed a declining sex ratio. The number of females was 929 per 1000 males compared to 934 in 1981. Early childhood mortality, malnutrition, high maternal mortality, and female feticide may all be contributing to this disturbing trend. Only 39.42% of women are literate compared to 63.86% of males. At least 50% of women suffer from anemia. Indian women face a 50-times higher rate of pregnancy- and delivery-related deaths than the women in the industrialized countries, a consequence of difficult access to health care, ignorance, poverty, and repeated and close pregnancies. Reproductive tract infections (RTIs) are common with outcomes such as ectopic pregnancy, infertility, and chronic pelvic pain. Also, cervical cancer is still a major killer of Indian women. Another area of concern is the population explosion. Overpopulation brings malnourished and dying children, slums, unemployment, deforestation, desertification and an unending cycle of poverty, illiteracy, and disease. India's population has reached 862 million, and according to the 1991 census there has been an increase of 23.5% during the past decade. India's annual population growth rate of 2.11% is only marginally less than the 2.23% of the preceding decade. The density of population has increased to 267 per square km compared to 216 in 1981. At the present rate of growth, the population by the turn of the century would reach 1 billion. Perhaps the real cause of failing to halt the galloping population growth is related to different human rights standards for men and women. Society accepts that men have the ultimate say when it comes to family planning and determining the size of the family. The medical profession can be an instrument of change, especially in regard to women's health related to wider sociological, cultural, historical, and economic issues.

The Sensitivity of the Incidence of Poverty to Different Measures of Income: School-Aged Children and Families. The Measure of Poverty, Technical Paper XVII.

ERIC Educational Resources Information Center

Coe, Richard D.; And Others

This study is a two-part analysis aimed at determining what differences occur in the incidence of poverty when different definitions of income are employed and when the time frame of analysis is changed. The first part of the analysis concentrates on school-aged children, while the second part studies families. The study is based on data from the…

The association between chronic airflow obstruction and poverty in 12 sites of the multinational BOLD study.

PubMed

Townend, John; Minelli, Cosetta; Mortimer, Kevin; Obaseki, Daniel O; Al Ghobain, Mohammed; Cherkaski, Hamid; Denguezli, Myriam; Gunesekera, Kirthi; Hafizi, Hasan; Koul, Parvaiz A; Loh, Li C; Nejjari, Chakib; Patel, Jaymini; Sooronbayev, Talant; Buist, Sonia A; Burney, Peter G J

2017-06-01

Poverty is strongly associated with mortality from COPD, but little is known of its relation to airflow obstruction.In a cross-sectional study of adults aged ≥40 years from 12 sites (N=9255), participating in the Burden of Obstructive Lung Disease (BOLD) study, poverty was evaluated using a wealth score (0-10) based on household assets. Obstruction, measured as forced expiratory volume in 1 s (FEV 1 )/forced vital capacity (FVC) (%) after administration of 200 μg salbutamol, and prevalence of FEV 1 /FVC

Impact of income and income inequality on infant health outcomes in the United States.

PubMed

Olson, Maren E; Diekema, Douglas; Elliott, Barbara A; Renier, Colleen M

2010-12-01

The goal was to investigate the relationships of income and income inequality with neonatal and infant health outcomes in the United States. The 2000-2004 state data were extracted from the Kids Count Data Center. Health indicators included proportion of preterm births (PTBs), proportion of infants with low birth weight (LBW), proportion of infants with very low birth weight (VLBW), and infant mortality rate (IMR). Income was evaluated on the basis of median family income and proportion of federal poverty levels; income inequality was measured by using the Gini coefficient. Pearson correlations evaluated associations between the proportion of children living in poverty and the health indicators. Linear regression evaluated predictive relationships between median household income, proportion of children living in poverty, and income inequality for the 4 health indicators. Median family income was negatively correlated with all birth outcomes (PTB, r = -0.481; LBW, r = -0.295; VLBW, r = -0.133; IMR, r = -0.432), and the Gini coefficient was positively correlated (PTB, r = 0.339; LBW, r = 0.398; VLBW, r = 0.460; IMR, r = 0.114). The Gini coefficient explained a significant proportion of the variance in rate for each outcome in linear regression models with median family income. Among children living in poverty, the role of income decreased as the degree of poverty decreased, whereas the role of income inequality increased. Both income and income inequality affect infant health outcomes in the United States. The health of the poorest infants was affected more by absolute wealth than relative wealth.

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.

Understanding Differences in Black and White Child Poverty Rates. A Report of the Heritage Center for Data Analysis.

ERIC Educational Resources Information Center

Rector, Robert; Johnson, Kirk A.; Fagan, Patrick F.

This study uses National Longitudinal Survey of Youth (NLSY) data to analyze differences in black and white child poverty. The NLSY documents family income and underlying conditions such as employment, educational attainment, welfare use, and marriage or divorce. This analysis examines: time in poverty, time on welfare, time in a single parent…

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%.

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.

Infrastructure and social tie: Spatial model approach on understanding poverty in Malang regency, Indonesia

NASA Astrophysics Data System (ADS)

Ari, I. R. D.; Hasyim, A. W.; Pratama, B. A.; Helmy, M.; Sheilla, M. N.

2017-06-01

Poverty is a problem that requires attention from the government especially in developing countries such as Indonesia. This Research takes Place at Kasembon District because it has 53,19% family below poverty line in the region. The purpose of this research is to measure poverty based on 3 poverty indicators published by World Bank and 1 multidimensional poverty index. Furthermore, this research invesitigas the relationship between poverty with social and infrastructure in Kasembon District. This study using social network analysis, hot spots analysis, and regression analysis with ordinary least squares. From the poverty indicators known that Pondokagung Village has the highest poverty rate compared to another region. Results from regression model indicate that social and infrastructure affecting poverty in Kasembon District. Social parameter that affecting poverty is density. Infrastructure parameter that affecting poverty is length of paved road. Coefficient value of density is the largest in the model. Therefore it can be concluded that social factors can give more opportunity to reduce poverty rates in Kasembon District. In the local model of paved road coefficient, it is known that the coefficient for each village has not much different value from the global model.

Gender Inequality in Poverty in Affluent Nations: The Role of Single Motherhood and the State.

ERIC Educational Resources Information Center

Christopher, Karen; England, Paula; McLanahan, Sara; Ross, Katherin; Smeeding, Tim

Women have higher rates of poverty than men in almost all societies. This paper compares the difference between male and female poverty in modern nations, using data from the Luxembourg Income Study (LIS) to compare men's and women's poverty rates in eight Western industrialized countries in the 1990s. The LIS contains information on household…

Fighting Poverty: Attentive Policy Can Make a Huge Difference

ERIC Educational Resources Information Center

Smeeding, Timothy M.; Waldfogel, Jane

2010-01-01

This article discusses the implication of the implementation of anti-poverty policy in both the United Kingdom and the United States. International studies of child poverty usually find that the United States and United Kingdom are at the bottom of the league table in terms of child poverty. Indeed, the U.S. and U.K do not fare well in…

Labor Force Participation and Poverty Status among Rural and Urban Women Who Head Families.

ERIC Educational Resources Information Center

Cautley, Eleanor; Slesinger, Doris P.

1988-01-01

Urban women are better off in labor force participation and poverty than women in central city and rural areas. Differences in access to jobs and welfare benefits explain the urban-rural variation. Finds that the most important factor for not living in poverty is earning income. Recommends policies for reducing poverty among single, working…

Neglect Subtypes, Race, and Poverty: Individual, Family, and Service Characteristics

PubMed Central

Jonson-Reid, Melissa; Drake, Brett; Zhou, Pan

2013-01-01

Recent child maltreatment research has highlighted the very different context of poverty for Black and White children. Neglect is the most common form of maltreatment and strongly associated with poverty. Neglect is, however, not a unitary construct. We lack an understanding of whether reporting of and responding to different types of neglect may vary by poverty, race, or the intersection of the two. Administrative census, child welfare, welfare, health, and education data were used to examine how family and community poverty factors associate with various subtypes of neglect and subsequent case dispositions for Black and White children. Black children reported to child welfare reside in far poorer communities than Whites, even after taking into account family income (Aid to Families with Dependent Children [AFDC]/Temporary Aid to Needy Families [TANF]). Black children were more commonly reported and substantiated for severe and basic needs neglect. Community poverty indicators had a different relationship to report disposition for Black as compared to White children after controlling for neglect subtypes, child and family characteristics. Implications for practice and policy are discussed. PMID:23109353

Maternal-related deaths and impoverishment among adolescent girls in India and Niger: findings from a modelling study.

PubMed

Verguet, Stéphane; Nandi, Arindam; Filippi, Véronique; Bundy, Donald A P

2016-09-26

High levels of maternal mortality and large associated inequalities exist in low-income and middle-income countries. Adolescent pregnancies remain common, and pregnant adolescent women face elevated risks of maternal mortality and poverty. We examined the distribution across socioeconomic groups of maternal deaths and impoverishment among adolescent girls (15-19 years old) in Niger, which has the highest total fertility rate globally, and India, which has the largest number of maternal deaths. In Niger and India, among adolescent girls, we estimated the distribution per income quintile of: the number of maternal deaths; and the impoverishment, measured by calculating the number of cases of catastrophic health expenditure incurred, caused by complicated pregnancies. We also examined the potential impact on maternal deaths and poverty of increasing adolescent girls' level of education by 1 year. We used epidemiological and cost inputs sourced from surveys and the literature. The number of maternal deaths would be larger among the poorer adolescents than among the richer adolescents in Niger and India. Impoverishment would largely incur among the richer adolescents in Niger and among the poorer adolescents in India. Increasing educational attainment of adolescent girls might avert both a large number of maternal deaths and a significant number of cases of catastrophic health expenditure in the 2 countries. Adolescent pregnancies can lead to large equity gaps and substantial impoverishment in low-income and middle-income countries. Increasing female education can reduce such inequalities and provide financial risk protection and poverty alleviation to adolescent girls. 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/

Psychological Stress in Childhood and Susceptibility to the Chronic Diseases of Aging: Moving toward a Model of Behavioral and Biological Mechanisms

ERIC Educational Resources Information Center

Miller, Gregory E.; Chen, Edith; Parker, Karen J.

2011-01-01

Among people exposed to major psychological stressors in early life, there are elevated rates of morbidity and mortality from chronic diseases of aging. The most compelling data come from studies of children raised in poverty or maltreated by their parents, who show heightened vulnerability to vascular disease, autoimmune disorders, and premature…

Evolution of a nursing education program delivered to baccalaureate-prepared Haitian nurses.

PubMed

Lev, Elise L; Lindgren, Teri G; Pearson, Gayle A; Alcindor, Hilda

2013-01-01

Haiti has high morbidity and mortality rates, a large proportion of people living in poverty, and a shortage of nurses and nursing faculty members. A partnership program between a US and Haitian university was formed to deliver a certificate program in nursing education. The authors describe their experiences developing, delivering, and evaluating the blended on-site and online program and their future goals.

The impact of diabetes on the labour force participation and income poverty of workers aged 45-64 years in Australia.

PubMed

Schofield, Deborah J; Cunich, Michelle; Shrestha, Rupendra N; Callander, Emily J; Passey, Megan E; Kelly, Simon J; Tanton, Robert; Veerman, Lennert

2014-01-01

To quantify the poverty status and level of disadvantage experienced by Australians aged 45-64 years who have left the labour force due to diabetes in 2010. A purpose-built microsimulation model, Health&WealthMOD2030, was used to estimate the poverty status and level of disadvantage of those aged 45-64 years who prematurely retire from the workforce due to diabetes. A multiple regression model was used to identify significant differences in rates of income poverty and the degree of disadvantage between those out of the labour force due to diabetes and those employed full- or part-time with no diabetes. 63.9% of people aged 45-64 years who were out of the labour force due to diabetes were in poverty in 2010. The odds of being in poverty for those with no diabetes and employed full-time (OR of being in poverty 0.02 95%CI: 0.01-0.04) or part-time (OR of being in poverty 0.10 95%CI: 0.05-0.23) are significantly lower than those for persons not in the labour force due to diabetes. Amongst those with diabetes, those who were able to stay in either full- or part-time employment were as much as 97% less likely to be in poverty than those who had to retire early because of the condition. Sensitivity analysis was used to assess impacts of different poverty line thresholds and key socioeconomic predictors of poverty. This study has shown that having diabetes and not being in the labour force because of this condition significantly increases the chances of living in poverty. Intervening to prevent or delay the onset of diabetes is likely to improve their living standards.

Critical considerations about the use of poverty measures in the study of cognitive development.

PubMed

Lipina, Sebastián J

2017-06-01

Developmental psychology and developmental cognitive neuroscience generated evidence at different levels of analysis about the influences of poverty on neurocognitive development (i.e., molecular, neural activation, cognition, behaviour). In addition, different individual and environmental factors were identified as mediators of such influences. Such a complexity is also illustrated through the many poverty conceptual and operational definitions generated by social, human and health sciences. However, to establish the causal relationships between the different factors of poverty and neurocognitive outcomes is still an issue under construction. Most studies of this area apply classic unidimensional poverty indicators such as income and maternal education. Nonetheless, this approach does not take into adequate consideration the variability of neurocognitive outcomes depending on the type of poverty measures, and the dynamic nature of changes during development. This creates a virtual underestimation of the complexity imposed by the involved mediating mechanisms. The scientific and policy implications of this underestimation include the risk of not adequately addressing children rights and developmental opportunities. This article proposes to explore such scenario, which is necessary for the reconsideration of the criteria used to analyse the influences of poverty on child development in general and neurocognitive development in particular. © 2016 International Union of Psychological Science.

Lung cancer, proximity to industry, and poverty in northeast England.

PubMed Central

Pless-Mulloli, T; Phillimore, P; Moffatt, S; Bhopal, R; Foy, C; Dunn, C; Tate, J

1998-01-01

This study assesses whether deprived populations living close to industry experience greater mortality from lung cancer than populations with comparable socioeconomic characteristics living farther away. Mortality data, census data, a postal survey of living circumstances, historic and contemporary data on air quality and a historic land-use survey were used. Analysis was based on two conurbations in England, Teesside and Sunderland. Housing estates in Teesside were selected based on socioeconomic criteria and distinguished by proximity to steel and chemical industries; they were grouped into three zones: near (A), intermediate (B), and farther (C), with a single zone in Sunderland. We included 14,962 deaths in 27 estates. Standardized mortality ratios (SMR) for lung cancer [International Classification of Diseases #9 (ICD-9) 162] and cancers other than lung (ICD-9 140-239, excluding 162), and sex ratios were calculated. Mortality from lung cancer was well above national levels in all zones. For men, a weak gradient corresponding with proximity to industry at younger ages reversed at older ages. In women 0-64 years of age, stronger gradients in lung cancer mortality corresponded with proximity to industry across zones A, B, and C (SMR = 393, 251, 242, respectively). Overall rates in Teesside were higher than Sunderland rates for women aged 0-64 years (SMR = 287 vs. 185) and 65-74 years (SMR = 190 vs. 157). The association between raised lung cancer mortality and proximity to industry in women under 75 years of age could not be explained by smoking, occupation, socioeconomic factors, or artifact. Explanations for differences between men and women may include gender-specific occupational experiences and smoking patterns. Our judgment is that the observed gradient in women points to a role for industrial air pollution. Images Figure 1 Figure 2 PMID:9485483

Travel distance influences readmissions in colorectal cancer patients-what the primary operative team needs to know.

PubMed

Kelley, Katherine A; Young, J Isaac; Bassale, Solange; Herzig, Daniel O; Martindale, Robert G; Sheppard, Brett C; Lu, Kim C; Tsikitis, V Liana

2018-07-01

Many colorectal cancer patients receive complex surgical care remotely. We hypothesized that their readmission rates would be adversely affected after accounting for differences in travel distance from primary/index hospital and correlate with mortality. We identified 48,481 colorectal cancer patients in the Surveillance, Epidemiology and End Results (SEER)-Medicare database. Travel distance was calculated, using Google Maps, and SAS. Multivariate negative binomial regression was used to identify factors associated with readmission rates. Overall survival was analyzed, using Kaplan-Meier and Cox proportional hazard. Thirty-day readmissions occurred in 14.9% of the cohort, 27.5% of which were to a nonindex hospital. In the colon and rectal cancer cohorts, readmissions were 14.5% and 16.5%, respectively. Rectal cancer patients had an increase in readmission by 13% (incidence rate ratios [IRR] 1.13; 95% confidence interval [CI] 1.05-1.21). Factors associated with readmission were male gender, advanced disease, length of stay (LOS), discharge disposition, hospital volume, Charlson score, and poverty level (P < 0.05). Greater distance traveled increased the likelihood of readmission but did not affect mortality. Travel distance influences readmission rates but not mortality. Discharge readiness to decrease readmissions is essential for colorectal cancer patients discharged from index hospitals. Copyright © 2018 Elsevier Inc. 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

Child health and nutrition in Peru within an antipoverty political agenda: a Countdown to 2015 country case study.

PubMed

Huicho, Luis; Segura, Eddy R; Huayanay-Espinoza, Carlos A; de Guzman, Jessica Niño; Restrepo-Méndez, Maria Clara; Tam, Yvonne; Barros, Aluisio J D; Victora, Cesar G

2016-06-01

Peru is an upper-middle-income country with wide social and regional disparities. In recent years, sustained multisectoral antipoverty programmes involving governments, political parties, and civil society have included explicit health and nutrition goals and spending increased sharply. We did a country case study with the aim of documenting Peru's progress in reproductive, maternal, neonatal, and child health from 2000-13, and explored the potential determinants. We examined the outcomes of health interventions coverage, under-5 mortality, neonatal mortality, and prevalence of under-5 stunting. We obtained data from interviews with key informants, a literature review of published and unpublished data, national censuses, and governmental reports. We obtained information on social determinants of health, including economic growth, poverty, unmet basic needs, urbanisation, women's education, water supply, fertility rates, and child nutrition from the annual national households surveys and the Peruvian Demographic and Health Surveys. We obtained national mortality data from the Interagency Group for Child Mortality Estimation, and calculated subnational rates from 11 surveys. Analyses were stratified by region, wealth quintiles, and urban or rural residence. We calculated coverage indicators for the years 2000-13, and we used the Lives Saved Tool (LiST) to estimate the effect of changes in intervention coverage and in nutritional status on mortality. From 2000 to 2013, under-5 mortality fell by 58% from 39·8 deaths per 1000 livebirths to 16·7. LiST, which was used to predict the decline in mortality arising from changes in fertility rates, water and sanitation, undernutrition, and coverage of indicators of reproductive, maternal, neonatal, and child health predicted that the under-5 mortality rate would fall from 39·8 to 28·4 per 1000 livebirths, accounting for 49·2% of the reported reduction. Neonatal mortality fell by 51% from 16·2 deaths per 1000 livebirths to 8·0. Stunting prevalence remained stable at around 30% until 2007, decreasing to 17·5% by 2013, and the composite coverage index for essential health interventions increased from 75·1% to 82·6%, with faster increases among the poor, in rural areas, and in the Andean region. Socioeconomic, urban-rural, and regional inequalities in coverage, mortality, and stunting were substantially reduced. The proportion of the population living below the poverty line reduced from 47·8% to 23·9%, women with fewer than 4 years of schooling reduced from 11·5% to 6·9%, urbanisation increased from 68·1% to 75·6%, and the total fertility rate decreased from 3·0 children per woman to 2·4. We interviewed 175 key informants and they raised the following issues: economic growth, improvement of social determinants, civil society empowerment and advocacy, out-of-health and within-health-sector changes, and sustained implementation of evidence-based, pro-poor reproductive, maternal, neonatal, and child health interventions. Peru has made substantial progress in reducing neonatal and under-5 mortality, and child stunting. This country is a good example of how a combination of political will, economic growth, broad societal participation, strategies focused on poor people, and increased spending in health and related sectors can achieve significant progress in reproductive, maternal, neonatal, and child health. The remaining challenges include continuing to address inequalities in wealth distribution, poverty, and access to basic services, especially in the Amazon and Andean rural areas. Bill & Melinda Gates Foundation. Copyright © 2016 Huicho et al. Open Access article distributed under the terms of CC BY 4.0. Published by Elsevier Ltd.. All rights reserved.

Measuring Child Poverty in South Africa: Sensitivity to the Choice of Equivalence Scale and an Updated Profile

ERIC Educational Resources Information Center

Streak, Judith Christine; Yu, Derek; Van der Berg, Servaas

2009-01-01

This paper offers evidence on the sensitivity of child poverty in South Africa to changes in the adult equivalence scale (AES) and updates the child poverty profile based on the Income and Expenditure Survey 2005/06. Setting the poverty line at the 40th percentile of households calculated with different AESs the scope and composition of child…

THE STRATEGY AND POLITICAL ECONOMY OF THE WAR AGAINST POVERTY.

ERIC Educational Resources Information Center

ORNATI, OSCAR

SUGGESTIONS FOR STRATEGIES TO WIN THE WAR ON POVERTY ARE BASED ON AN UNDERSTANDING OF WHAT POVERTY IS, HOW IT IS TO BE FOUGHT, AND THE MEANING OF LOSING THE WAR. THERE HAVE BEEN MANY DEFINITIONS OF POVERTY, FOR INDIVIDUALS DIFFER IN THEIR VALUES AND THEIR IDEAS OF NEED. SUBJECTIVE ESTIMATES OF NEED DEPEND ON WHETHER THE ESTIMATOR IS RICH OR POOR,…

Using Multiple Intelligences to Bridge the Educational Poverty Gap

ERIC Educational Resources Information Center

Goebel, Kym

2009-01-01

Students living in poverty have needs that are not being addressed in traditional classrooms. Students from "generational poverty" process information differently (Payne 1996). Information is processed based on their living conditions and upbringing. Differentiating instruction using Howard Gardener's Multiple Intelligence theory…

Education, Poverty and Insecurity. A New Social Contract To Restore the Dignity of the Very Poor and Strengthen General Solidarity.

ERIC Educational Resources Information Center

Bogard, Gerald

The chains that link economic, social, cultural, and other factors to produce poverty need to be broken. The number of poor people has increased: one European in eight lives below poverty thresholds. New social categories are affected; the proportion of adults of working age is rising. The new poverty is also different because of its geographical…

Poverty among Young Children in Black Immigrant, US-Born Black, and Non-Black Immigrant Families: The Role of Familial Contexts. Discussion Paper Series. DP 2010-02

ERIC Educational Resources Information Center

Thomas, Kevin J. A.

2010-01-01

This study examines how familial contexts affect poverty disparities between the children of immigrant and US-born Blacks, and among Black and non-Black children of immigrants. Despite lower gross child poverty rates in immigrant than US-born Black families, accounting for differences in family structure reveals that child poverty risks among…

Race-ethnicity and poverty after spinal cord injury.

PubMed

Krause, J S; Dismuke, C E; Acuna, J; Sligh-Conway, C; Walker, E; Washington, K; Reed, K S

2014-02-01

Secondary analysis of existing data. Our objective was to examine the relationship between race-ethnicity and poverty status after spinal cord injury (SCI). A large specialty hospital in the southeastern United States. Participants were 2043 adults with traumatic SCI in the US. Poverty status was measured using criteria from the US Census Bureau. Whereas only 14% of non-Hispanic White participants were below the poverty level, 41.3% of non-Hispanic Blacks were in poverty. Logistic regression with three different models identified several significant predictors of poverty, including marital status, years of education, level of education, age and employment status. Non-Hispanic Blacks had 2.75 greater odds of living in poverty after controlling for other factors, including education and employment. We may need to consider quality of education and employment to better understand the elevated risk of poverty among non-Hispanic Blacks in the US.

The Social Consequences of Poverty: An Empirical Test on Longitudinal Data.

PubMed

Mood, Carina; Jonsson, Jan O

Poverty is commonly defined as a lack of economic resources that has negative social consequences, but surprisingly little is known about the importance of economic hardship for social outcomes. This article offers an empirical investigation into this issue. We apply panel data methods on longitudinal data from the Swedish Level-of-Living Survey 2000 and 2010 (n = 3089) to study whether poverty affects four social outcomes-close social relations (social support), other social relations (friends and relatives), political participation, and activity in organizations. We also compare these effects across five different poverty indicators. Our main conclusion is that poverty in general has negative effects on social life. It has more harmful effects for relations with friends and relatives than for social support; and more for political participation than organizational activity. The poverty indicator that shows the greatest impact is material deprivation (lack of cash margin), while the most prevalent poverty indicators-absolute income poverty, and especially relative income poverty-appear to have the least effect on social outcomes.

The conceptual framework and assessment methodology for the systematic reviews of community-based interventions for the prevention and control of infectious diseases of poverty.

PubMed

Lassi, Zohra S; Salam, Rehana A; Das, Jai K; Bhutta, Zulfiqar A

2014-01-01

This paper describes the conceptual framework and the methodology used to guide the systematic reviews of community-based interventions (CBIs) for the prevention and control of infectious diseases of poverty (IDoP). We adapted the conceptual framework from the 3ie work on the 'Community-Based Intervention Packages for Preventing Maternal Morbidity and Mortality and Improving Neonatal Outcomes' to aid in the analyzing of the existing CBIs for IDoP. The conceptual framework revolves around objectives, inputs, processes, outputs, outcomes, and impacts showing the theoretical linkages between the delivery of the interventions targeting these diseases through various community delivery platforms and the consequent health impacts. We also describe the methodology undertaken to conduct the systematic reviews and the meta-analyses.

The Distributional Impact of Social Security Policy Options.

PubMed

Couch, Kenneth A; Reznik, Gayle L; Tamborini, Christopher R; Iams, Howard M

2017-01-01

Using microsimulation, we estimate the effects of three policy proposals that would alter Social Security's eligibility rules or benefit structure to reflect changes in women's labor force activity, marital patterns, and differential mortality among the aged. First, we estimate a set of options related to the duration of marriage required to receive divorced spouse and survivor benefits. Second, we estimate the effects of an earnings sharing proposal with survivor benefits, in which benefits are based entirely on earned benefits with spouses sharing their earnings during years of marriage. Third, we estimate the effects of adjusting benefits to reflect the increasing differential life expectancy by lifetime earnings. The results advance our understanding of the distributional effects of these alternative policy options on projected benefits and retirement income, including poverty and supplemental poverty status, of divorced and widowed women aged 60 or older in 2030.

Differential Associations of Socioeconomic Status With Global Brain Volumes and White Matter Lesions in African American and White Adults: the HANDLS SCAN Study.

PubMed

Waldstein, Shari R; Dore, Gregory A; Davatzikos, Christos; Katzel, Leslie I; Gullapalli, Rao; Seliger, Stephen L; Kouo, Theresa; Rosenberger, William F; Erus, Guray; Evans, Michele K; Zonderman, Alan B

2017-04-01

The aim of the study was to examine interactive relations of race and socioeconomic status (SES) to magnetic resonance imaging (MRI)-assessed global brain outcomes with previously demonstrated prognostic significance for stroke, dementia, and mortality. Participants were 147 African Americans (AAs) and whites (ages 33-71 years; 43% AA; 56% female; 26% below poverty) in the Healthy Aging in Neighborhoods of Diversity across the Life Span SCAN substudy. Cranial MRI was conducted using a 3.0 T unit. White matter (WM) lesion volumes and total brain, gray matter, and WM volumes were computed. An SES composite was derived from education and poverty status. Significant interactions of race and SES were observed for WM lesion volume (b = 1.38; η = 0.036; p = .028), total brain (b = 86.72; η = 0.042; p < .001), gray matter (b = 40.16; η = 0.032; p = .003), and WM (b = 46.56; η = 0.050; p < .001). AA participants with low SES exhibited significantly greater WM lesion volumes than white participants with low SES. White participants with higher SES had greater brain volumes than all other groups (albeit within normal range). Low SES was associated with greater WM pathology-a marker for increased stroke risk-in AAs. Higher SES was associated with greater total brain volume-a putative global indicator of brain health and predictor of mortality-in whites. Findings may reflect environmental and interpersonal stressors encountered by AAs and those of lower SES and could relate to disproportionate rates of stroke, dementia, and mortality.

Measles vaccination improves the equity of health outcomes: evidence from Bangladesh.

PubMed

Bishai, David; Koenig, Michael; Ali Khan, Mehrab

2003-05-01

This paper asks whether measles vaccination can reduce socioeconomic differentials in under five mortality rates (U5MR) in a setting characterized by extreme poverty and high levels of childhood mortality. Longitudinal cohort study based on quasi experimental design. Data come from the phased introduction of a measles vaccine intervention in Matlab, Bangladesh in 1982. There were 16 270 Bangladeshi children aged 9-60 months. The intervention cohort received measles vaccine. Socioeconomic differentials in U5MR between the lowest and highest socioeconomic status (SES) quintiles in a cohort of 8135 vaccinated children and a cohort of unvaccinated age matched controls. Mantel-Haenszel rate ratios for the lowest to highest SES quintile were computed. SES was measured by factor analysis of maternal schooling, land holdings, dwelling size, and number of rooms. The U5MR ratio of lowest SES to highest was 2.27 (95% CI=1.62-3.19) in the unvaccinated population and 1.42 (95%CI=0.94-2.15) in the vaccinated population. The difference between unvaccinated and vaccinated U5MR ratios was statistically significant (p<0.10) and robust across alternative measures of SES. Children from the poorest quintile were more than twice as likely to die as those from the least quintile in the absence of measles vaccination. Universal distribution of measles vaccination largely nullified SES related mortality differentials within a high mortality population of children. Copyright 2002 John Wiley & Sons, Ltd.

Social Security Privatization and the Annuities Market

DTIC Science & Technology

1998-02-01

34Economic Status as a Determinant of Mortality Among Black and White Older Men: Does Poverty Kill?" Population Studies, vol. 47 (1993), pp. 427-436. 43...have been analyzing the financial pressures on Social Security and devising new ways Americans could prepare for retirement. Those proposals...loosely called "pri- vatization"—would prefund retirement income in personal accounts that workers could invest in the financial market and then spend

Kids Count in Indiana: 1999 Data Book. County Profiles of Child Well-Being [and] Highlights of "Kids Count" Data: State and County Statistics.

ERIC Educational Resources Information Center

Erickson, Judith

This Kids Count data book examines statewide trends in the well-being of Indiana's children. The statistical portrait is based on indicators in ten general areas: (1) child and family demographics; (2) economic well-being; (3) poverty; (4) child safety; (5) education; (6) health and well-being; (7) mental health and additions; (8) mortality; (9)…

Key Facts about the Children. A Report on the Status of Florida's Children: Volume VI. The 1996 Florida Kids Count Data Book.

ERIC Educational Resources Information Center

University of South Florida, Tampa. Florida Center for Children and Youth.

This Kids Count report investigates county and statewide trends in the well-being of Florida's children. The statistical report is based on indicators of well-being in six areas: (1) child poverty; (2) births, including prenatal care access, infant mortality, low birth weight, and percent of births to unwed mothers; (3) teen parenthood; (4) child…

Health, livelihoods, and nutrition in low-income rural systems.

PubMed

Joffe, Michael

2007-06-01

Absolute poverty remains a major challenge: the proportion of the world population living with hunger, food insecurity, and undernutrition has fallen, but the absolute number remains stubbornly large. An even larger number of people have enough to eat but suffer from severe micronutrient deficiencies. To provide a conceptual framework showing the interdependence of hunger and poverty with ill health among the rural poor. Review of the relevant health, nutrition, agriculture, and economics literature and organization of the findings into a systems framework. Economic growth is not a sufficient answer to rural poverty. The predicament of poor households can be represented in terms of a self-reinforcing cycle involving nutrition, health, and productivity. The degree of poverty limits the quantity and quality of food intake. Macro- and micronutrient deficiencies interfere with child growth and development and impair immune function, resulting in a predisposition to infectious diseases. Health status strongly influences the quantity and quality of labor and achieved educational status. The high risk of child mortality prevents households from going through the demographic transition to smaller families and better-educated children. The death of a working adult may be catastrophic for the household. This self-reinforcing cycle means that the beneficial effects of an intervention are propagated around the cycle, potentiating its impact. Each main element--nutrition, health, and productivity--also has numerous other determinants and can be influenced by interventions. Interventions that increase the carrying capacity of the household's environment are likely to be more sustainable than "technical fixes," such as lifesaving medical treatment. The self-reinforcing cycle is likely to be self-perpetuating without outside intervention. For any rural area where poverty reduction is planned, the key bottlenecks need to be identified. This can be done by using a causal diagram, as described in this paper.

Resilience offers escape from trapped thinking on poverty alleviation

PubMed Central

Lade, Steven J.; Haider, L. Jamila; Engström, Gustav; Schlüter, Maja

2017-01-01

The poverty trap concept strongly influences current research and policy on poverty alleviation. Financial or technological inputs intended to “push” the rural poor out of a poverty trap have had many successes but have also failed unexpectedly with serious ecological and social consequences that can reinforce poverty. Resilience thinking can help to (i) understand how these failures emerge from the complex relationships between humans and the ecosystems on which they depend and (ii) navigate diverse poverty alleviation strategies, such as transformative change, that may instead be required. First, we review commonly observed or assumed social-ecological relationships in rural development contexts, focusing on economic, biophysical, and cultural aspects of poverty. Second, we develop a classification of poverty alleviation strategies using insights from resilience research on social-ecological change. Last, we use these advances to develop stylized, multidimensional poverty trap models. The models show that (i) interventions that ignore nature and culture can reinforce poverty (particularly in agrobiodiverse landscapes), (ii) transformative change can instead open new pathways for poverty alleviation, and (iii) asset inputs may be effective in other contexts (for example, where resource degradation and poverty are tightly interlinked). Our model-based approach and insights offer a systematic way to review the consequences of the causal mechanisms that characterize poverty traps in different agricultural contexts and identify appropriate strategies for rural development challenges. PMID:28508077

Resilience offers escape from trapped thinking on poverty alleviation.

PubMed

Lade, Steven J; Haider, L Jamila; Engström, Gustav; Schlüter, Maja

2017-05-01

The poverty trap concept strongly influences current research and policy on poverty alleviation. Financial or technological inputs intended to "push" the rural poor out of a poverty trap have had many successes but have also failed unexpectedly with serious ecological and social consequences that can reinforce poverty. Resilience thinking can help to (i) understand how these failures emerge from the complex relationships between humans and the ecosystems on which they depend and (ii) navigate diverse poverty alleviation strategies, such as transformative change, that may instead be required. First, we review commonly observed or assumed social-ecological relationships in rural development contexts, focusing on economic, biophysical, and cultural aspects of poverty. Second, we develop a classification of poverty alleviation strategies using insights from resilience research on social-ecological change. Last, we use these advances to develop stylized, multidimensional poverty trap models. The models show that (i) interventions that ignore nature and culture can reinforce poverty (particularly in agrobiodiverse landscapes), (ii) transformative change can instead open new pathways for poverty alleviation, and (iii) asset inputs may be effective in other contexts (for example, where resource degradation and poverty are tightly interlinked). Our model-based approach and insights offer a systematic way to review the consequences of the causal mechanisms that characterize poverty traps in different agricultural contexts and identify appropriate strategies for rural development challenges.

The international child poverty gap: does demography matter?

PubMed

Heuveline, Patrick; Weinshenker, Matthew

2008-02-01

According to the Luxembourg Income Study data, the U.S. child poverty rate is the second highest among 15 high-income nations. The present work reveals that 55% of all American children living in a household headed by a single female with no other adult present live in poverty-the highest rate for any of the five living arrangements in the 15 countries examined in this study. While previous analyses have focused on market forces and governmental redistribution across households, we question the contribution of demographic factors that place children in family structures with different poverty risks relative to other factors such as differential market opportunities and governmental benefits for adults caring for children in various living arrangements. Applying a classic demographic decomposition technique to the overall poverty gap, we find that the distributional effect of demographic behavior contributes little to the U.S. poverty gap with other nations (and none with respect to the United Kingdom). Overall differences in labor markets and welfare schemes best explain the U.S. child poverty gap, although for some countries, the gap is accentuated by the gradient of governmental transfers, and for most countries, by the gradient of market earnings across living arrangements.

Does household composition explain welfare regime poverty risks for older adults and other household members?

PubMed

Tai, Tsui-o; Treas, Judith

2009-11-01

This cross-national study examines the poverty of older adults and their household members and relates the risk of poverty to macrolevel state approaches to welfare as well as to microlevel composition of households. Data on individuals in households with older adults for 22 countries come from the Luxembourg Income Survey. Robust cluster analysis relates the risk of poverty to the type of state welfare regime; the characteristics of the household head (age, gender, marital status, and education); as well as the household's numbers of earners, older adults, and children. Persons in households with older adults are significantly less likely to be poor in countries with social democratic and conservative welfare regimes than in Taiwan, an exemplar of limited social welfare programs. Controlling for country differences in household composition increases the differences in poverty risks. Living with fewer children, more older adults, and more earners lowers the risk of poverty, as does having a married and better educated household head. Countries with more generous social welfare provisions have lower risks of poverty despite having household characteristics that are comparatively unfavorable. As Taiwan demonstrates, household composition, particularly a reliance on multigenerational households, compensates for limited state welfare programs.

An explanatory analysis of economic and health inequality changes among Mexican indigenous people, 2000-2010

PubMed Central

2014-01-01

Introduction Mexico faces important problems concerning income and health inequity. Mexico’s national public agenda prioritizes remedying current inequities between its indigenous and non-indigenous population groups. This study explores the changes in social inequalities among Mexico’s indigenous and non-indigenous populations for the time period 2000 to 2010 using routinely collected poverty, welfare and health indicator data. Methods We described changes in socioeconomic indicators (housing condition), poverty (Foster-Greer-Thorbecke and Sen-Shorrocks-Sen indexes), health indicators (childhood stunting and infant mortality) using diverse sources of nationally representative data. Results This analysis provides consistent evidence of disparities in the Mexican indigenous population regarding both basic and crucial developmental indicators. Although developmental indicators have improved among the indigenous population, when we compare indigenous and non-indigenous people, the gap in socio-economic and developmental indicators persists. Conclusions Despite a decade of efforts to promote public programs, poverty persists and is a particular burden for indigenous populations within Mexican society. In light of the results, it would be advisable to review public policy and to specifically target future policy to the needs of the indigenous population. PMID:24576113

Low income, community poverty and risk of end stage renal disease.

PubMed

Crews, Deidra C; Gutiérrez, Orlando M; Fedewa, Stacey A; Luthi, Jean-Christophe; Shoham, David; Judd, Suzanne E; Powe, Neil R; McClellan, William M

2014-12-04

The risk of end stage renal disease (ESRD) is increased among individuals with low income and in low income communities. However, few studies have examined the relation of both individual and community socioeconomic status (SES) with incident ESRD. Among 23,314 U.S. adults in the population-based Reasons for Geographic and Racial Differences in Stroke study, we assessed participant differences across geospatially-linked categories of county poverty [outlier poverty, extremely high poverty, very high poverty, high poverty, neither (reference), high affluence and outlier affluence]. Multivariable Cox proportional hazards models were used to examine associations of annual household income and geospatially-linked county poverty measures with incident ESRD, while accounting for death as a competing event using the Fine and Gray method. There were 158 ESRD cases during follow-up. Incident ESRD rates were 178.8 per 100,000 person-years (105 py) in high poverty outlier counties and were 76.3 /105 py in affluent outlier counties, p trend=0.06. In unadjusted competing risk models, persons residing in high poverty outlier counties had higher incidence of ESRD (which was not statistically significant) when compared to those persons residing in counties with neither high poverty nor affluence [hazard ratio (HR) 1.54, 95% Confidence Interval (CI) 0.75-3.20]. This association was markedly attenuated following adjustment for socio-demographic factors (age, sex, race, education, and income); HR 0.96, 95% CI 0.46-2.00. However, in the same adjusted model, income was independently associated with risk of ESRD [HR 3.75, 95% CI 1.62-8.64, comparing the <$20,000 income group to the >$75,000 group]. There were no statistically significant associations of county measures of poverty with incident ESRD, and no evidence of effect modification. In contrast to annual family income, geospatially-linked measures of county poverty have little relation with risk of ESRD. Efforts to mitigate socioeconomic disparities in kidney disease may be best appropriated at the individual level.

The Impact of Diabetes on the Labour Force Participation and Income Poverty of Workers Aged 45–64 Years in Australia

PubMed Central

Schofield, Deborah J.; Cunich, Michelle; Shrestha, Rupendra N.; Callander, Emily J.; Passey, Megan E.; Kelly, Simon J.; Tanton, Robert; Veerman, Lennert

2014-01-01

Objective To quantify the poverty status and level of disadvantage experienced by Australians aged 45–64 years who have left the labour force due to diabetes in 2010. Research Design and Methods A purpose-built microsimulation model, Health&WealthMOD2030, was used to estimate the poverty status and level of disadvantage of those aged 45–64 years who prematurely retire from the workforce due to diabetes. A multiple regression model was used to identify significant differences in rates of income poverty and the degree of disadvantage between those out of the labour force due to diabetes and those employed full- or part-time with no diabetes. Results 63.9% of people aged 45–64 years who were out of the labour force due to diabetes were in poverty in 2010. The odds of being in poverty for those with no diabetes and employed full-time (OR of being in poverty 0.02 95%CI: 0.01–0.04) or part-time (OR of being in poverty 0.10 95%CI: 0.05–0.23) are significantly lower than those for persons not in the labour force due to diabetes. Amongst those with diabetes, those who were able to stay in either full- or part-time employment were as much as 97% less likely to be in poverty than those who had to retire early because of the condition. Sensitivity analysis was used to assess impacts of different poverty line thresholds and key socioeconomic predictors of poverty. Conclusions This study has shown that having diabetes and not being in the labour force because of this condition significantly increases the chances of living in poverty. Intervening to prevent or delay the onset of diabetes is likely to improve their living standards. PMID:24586716

Efficacy of World Health Organization guideline in facility-based reduction of mortality in severely malnourished children from low and middle income countries: A systematic review and meta-analysis.

PubMed

Hossain, Muttaquina; Chisti, Mohammod J; Hossain, Mohammod Iqbal; Mahfuz, Mustafa; Islam, Mohammad Munirul; Ahmed, Tahmeed

2017-05-01

Globally more than 19 million under-five children suffer from severe acute malnutrition (SAM). Data on efficacy of World Health Organization's (WHO's) guideline in reducing SAM mortality are limited. We aimed to assess the efficacy of WHO's facility-based guideline for the reduction of under-five SAM children mortality from low and middle income countries (LMICs). A systematic search of literature published in 1980-2015 was conducted using electronic databases. Additional articles were identified from the reference lists and grey literature. Studies from LMICs where SAM children (0-59 months) were managed in facilities according to WHO's guideline were included. Outcome was reduction in SAM mortality measured by case fatality rate (CFR). The review was reported following the Grading of Recommendations Assessment Development and Evaluation and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and meta-analyses done using RevMan 5.3®. This review identified nine studies, which demonstrated reductions in SAM mortality. CFR ranged from 8 to 16% where WHO guideline applied. High rates of poverty, malnutrition, severe co-morbid condition, lack of resources and differences in treatment practices played a key role in large CFR variation. Most death occurred within 48 h of admission in Asia, between 4 days and 4 weeks in Africa and in Latin America. CFR was reduced by 41% (odds ratio: 0.59; 95% confidence interval: 0.46-0.76) when WHO guideline were applied. A 45% reduction in CFR was achieved after excluding human immunodeficiency virus positive cases. Dietary management also differed among WHO and conventional management. Children receiving SAM inpatient care as per WHO guideline have reduced CFR compared to conventional treatment. © 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

Trends in Financial Satisfaction: Does Poverty Make a Difference?

ERIC Educational Resources Information Center

Hsieh, Chang-Ming

2002-01-01

Gerontological studies on financial satisfaction have been limited by the dearth of longitudinal research and the lack of research that includes the concept of poverty. In order to bridge these gaps, this longitudinal study examines and compares the intracohort and intercohort effects on financial satisfaction trends by poverty status among…

Teacher Performance Trajectories in High- and Lower-Poverty Schools

ERIC Educational Resources Information Center

Xu, Zeyu; Özek, Umut; Hansen, Michael

2015-01-01

This study explores whether teacher performance trajectory over time differs by school-poverty settings. Focusing on elementary school mathematics teachers in North Carolina and Florida, we find no systematic relationship between school student poverty rates and teacher performance trajectories. In both high- (=60% free/reduced-price lunch [FRPL])…

Promoting the Positive Development of Boys in High-Poverty Neighborhoods: Evidence From Four Anti-Poverty Experiments

PubMed Central

Snell, Emily K.; Castells, Nina; Duncan, Greg; Gennetian, Lisa; Magnuson, Katherine; Morris, Pamela

2012-01-01

This study uses geocoded address data and information about parent’s economic behavior and children’s development from four random-assignment welfare and anti-poverty experiments conducted during the 1990s. We find that the impacts of these welfare and anti-poverty programs on boys’ and girls’ developmental outcomes during the transition to early adolescence differ as a function of neighborhood poverty levels. The strongest positive impacts of these programs are among boys who lived in high-poverty neighborhoods at the time their parents enrolled in the studies, with smaller or non-statistically significant effects for boys in lower poverty neighborhoods and for girls across all neighborhoods. This research informs our understanding of how neighborhood context and child gender may interact with employment-based policies to affect children’s well-being. PMID:24348000

Tuberculosis Mortality and Living Conditions in Bern, Switzerland, 1856-1950.

PubMed

Zürcher, Kathrin; Ballif, Marie; Zwahlen, Marcel; Rieder, Hans L; Egger, Matthias; Fenner, Lukas

2016-01-01

Tuberculosis (TB) is a poverty-related disease that is associated with poor living conditions. We studied TB mortality and living conditions in Bern between 1856 and 1950. We analysed cause-specific mortality based on mortality registers certified by autopsies, and public health reports 1856 to 1950 from the city council of Bern. TB mortality was higher in the Black Quarter (550 per 100,000) and in the city centre (327 per 100,000), compared to the outskirts (209 per 100,000 in 1911-1915). TB mortality correlated positively with the number of persons per room (r = 0.69, p = 0.026), the percentage of rooms without sunlight (r = 0.72, p = 0.020), and negatively with the number of windows per apartment (r = -0.79, p = 0.007). TB mortality decreased 10-fold from 330 per 100,000 in 1856 to 33 per 100,000 in 1950, as housing conditions improved, indoor crowding decreased, and open-air schools, sanatoria, systematic tuberculin skin testing of school children and chest radiography screening were introduced. Improved living conditions and public health measures may have contributed to the massive decline of the TB epidemic in the city of Bern even before effective antibiotic treatment became finally available in the 1950s.

Faces of poverty: sensitivity and specificity of economic classifications in rural Vietnam.

PubMed

Khe, Nguyen Duy; Eriksson, Bo; Phuong, Do Nguyen; Höjer, Bengt; Diwan, Vinod K

2003-01-01

Poverty concepts and measurements have occupied philosophers for centuries and are subject to debate by researchers. A wide range of possible measures have been developed and used. Most research is country specific and different methods produce different pictures of poverty. This study aimed to compare measures of poverty within an epidemiological field laboratory in Bavi District, northern Vietnam (FilaBavi) and specifically to find out whether the official economic classification made by the local authority matched other measurements of socioeconomic status. Structured questionnaires were used to collect socioeconomic information in 11,547 households. In addition, the official classification for individual households was recorded. Five economic indicators were constructed: income, expenditure, household assets, housing conditions, and local authority's estimation. Official economic classification and housing score were symmetrically distributed, while assets score and particularly income were highly skewed. Design effects were high because of high intra-cluster correlations. No indicator was closely correlated with any other. Sensitivity and positive predictive value for poverty were generally low for all indicators. The authors' findings do not suggest that any of the indicators used is substantially better than the other or better than the Official Economic Classification made by local authority. The results also show that no indicator is particularly useful to predict the values of any other indicator and different poverty indicators may classify different socioeconomic groups as poor.

Social security and mortality: the role of income support policies and population health in the United States.

PubMed

Arno, Peter S; House, James S; Viola, Deborah; Schechter, Clyde

2011-05-01

Social Security is the most important and effective income support program ever introduced in the United States, alleviating the burden of poverty for millions of elderly Americans. We explored the possible role of Social Security in reducing mortality among the elderly. In support of this hypothesis, we found that declines in mortality among the elderly exceeded those among younger age groups following the initial implementation of Social Security in 1940, and also in the periods following marked improvements in Social Security benefits via legislation and indexing of benefits that occurred between the mid-1960s and the early 1970s. A better understanding of the link between Social Security and health status among the elderly would add a significant and missing dimension to the public discourse over the future of Social Security, and the potential role of income support programs in reducing health-related socioeconomic disparities and improving population health.

Cultural diversity and anti-poverty policy.

PubMed

Lamont, Michèle; Small, Mario Luis

2010-01-01

This article examines how anti-poverty policy has considered the role of culture and how it ought to do so. While some have explained poverty as a function of the presumed cultural deficiency or distinctiveness of the poor, we suggest that these explanations have not been convincing and that policy requires a broader and more sophisticated understanding of the relationship between culture and behaviour. In fact, we suggest that cultural differences may be positively employed in comprehensive anti-poverty strategies.

Gender, equity: new approaches for effective management of communicable diseases.

PubMed

Theobald, Sally; Tolhurst, Rachel; Squire, S Bertel

2006-04-01

This editorial article examines what is meant by sex, gender and equity and argues that these are critical concepts to address in the effective management of communicable disease. Drawing on examples from the three major diseases of poverty (HIV, tuberculosis [TB] and malaria), the article explores how, for women and men, gender and poverty can lead to differences in vulnerability to illness; access to quality preventive and curative measures; and experience of the impact of ill health. This exploration sets the context for the three companion papers which outline how gender and poverty shape responses to the three key diseases of poverty in different geographical settings: HIV/AIDS in Kenya; TB in India; and malaria in Ghana.

Cross-sectional relations of race and poverty status to cardiovascular risk factors in the Healthy Aging in Neighborhoods of Diversity across the Lifespan (HANDLS) study.

PubMed

Waldstein, Shari R; Moody, Danielle L Beatty; McNeely, Jessica M; Allen, Allyssa J; Sprung, Mollie R; Shah, Mauli T; Al'Najjar, Elias; Evans, Michele K; Zonderman, Alan B

2016-03-14

Examine interactive relations of race and poverty status with cardiovascular disease (CVD) risk factors in a socioeconomically diverse sample of urban-dwelling African American (AA) and White adults. Participants were 2,270 AAs and Whites (57% AA; 57% female; ages 30-64 years) who completed the first wave of the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. CVD risk factors assessed included body mass index (BMI), waist circumference (WC), total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C, LDL-C), triglycerides (TG), glycated hemoglobin (HbA1c), high-sensitivity C-reactive protein (CRP), and systolic, diastolic, and pulse pressure (SBP, DBP, PP). Interactive and independent relations of race, poverty status, and sex were examined for each outcome via ordinary least squares regression adjusted for age, education, literacy, substance use, depressive symptoms, perceived health care barriers, medical co-morbidities, and medications. Significant interactions of race and poverty status (p's < .05) indicated that AAs living in poverty had lower BMI and WC and higher HDL-C than non-poverty AAs, whereas Whites living in poverty had higher BMI and WC and lower HDL-C than non-poverty Whites. Main effects of race revealed that AAs had higher levels of HbA1c, SBP, and PP, and Whites had higher levels of TC, LDL-C and TG (p's < .05). Poverty status moderated race differences for BMI, WC, and HDL-C, conveying increased risk among Whites living in poverty, but reduced risk in their AA counterparts. Race differences for six additional risk factors withstood extensive statistical adjustments including SES indicators.

Trends in Child Poverty in Sweden: Parental and Child Reports.

PubMed

Mood, Carina; Jonsson, Jan O

We use several family-based indicators of household poverty as well as child-reported economic resources and problems to unravel child poverty trends in Sweden. Our results show that absolute (bread-line) household income poverty, as well as economic deprivation, increased with the recession 1991-96, then reduced and has remained largely unchanged since 2006. Relative income poverty has however increased since the mid-1990s. When we measure child poverty by young people's own reports, we find few trends between 2000 and 2011. The material conditions appear to have improved and relative poverty has changed very little if at all, contrasting the development of household relative poverty. This contradictory pattern may be a consequence of poor parents distributing relatively more of the household income to their children in times of economic duress, but future studies should scrutinze potentially delayed negative consequences as poor children are lagging behind their non-poor peers. Our methodological conclusion is that although parental and child reports are partly substitutable, they are also complementary, and the simultaneous reporting of different measures is crucial to get a full understanding of trends in child poverty.

Geographic variation of gallbladder cancer mortality and risk factors in Chile: a population-based ecologic study

PubMed Central

Andia, Marcelo E.; Hsing, Ann W.; Andreotti, Gabriella; Ferreccio, Catterina

2010-01-01

Chile’s gallbladder cancer rates are among the highest in the world, being the first cancer killer among Chilean women. To provide insights into the etiology of gallbladder cancer, we conducted an ecologic study examining the geographical variation of gallbladder cancer and several putative risk factors. The relative risk of dying from gallbladder cancer (relative to the national average mortality rate) between 1985 and 2003 was estimated for each of the 333 Chilean counties, using a hierarchical Poisson regression model, adjusting for age, sex, and geographical location. The risk of gallbladder cancer mortality was analyzed in relation to region (costal, inland, northern, and southern), poverty, Amerindian (Mapuche) population, typhoid fever, and access to cholecystectomy, using logistic regression analysis. There were 27,183 gallbladder cancer deaths, age-sex-adjusted county mortality rates ranging from 8.2 to 12.4 per 100,000 inhabitants, being higher in inland and southern regions; compare to the north-coastal, the northern-inland region had a 10-fold risk odds ratio (OR) (95% of confidence interval (95% CI): 2.4–42.2) and the southern-inland region had a 26-fold risk (OR 95%CI: 6.0–114.2). Independent risk factors for gallbladder cancer were: ethnicity (Mapuche) OR:3.9 (95%CI 1.8–8.7), typhoid fever OR:2.9 (95%CI 1.2–6.9), poverty OR:5.1 (95%CI 1.6–15.9), low access to cholecystectomy OR:3.9 (95%CI 1.5–10.1), low access to hospital care OR:14.2 (95%CI 4.2–48.7) and high urbanization OR:8.0 (95%CI 3.4–18.7). Our results suggest that gallbladder cancer in Chile may be related to both genetic factors and poor living conditions. Future analytic studies are needed to further clarify the role of these factors in gallbladder cancer etiology. PMID:18566990

Neighborhood racial composition and poverty in association with pre-pregnancy weight and gestational weight gain.

PubMed

Mendez, Dara D; Thorpe, Roland J; Amutah, Ndidi; Davis, Esa M; Walker, Renee E; Chapple-McGruder, Theresa; Bodnar, Lisa

2016-12-01

Studies of neighborhood racial composition or neighborhood poverty in association with pregnancy-related weight are limited. Prior studies of neighborhood racial density and poverty has been in association with adverse birth outcomes and suggest that neighborhoods with high rates of poverty and racial composition of black residents are typically segregated and systematically isolated from opportunities and resources. These neighborhood factors may help explain the racial disparities in pre-pregnancy weight and inadequate weight gain. This study examined whether neighborhood racial composition and neighborhood poverty was associated with weight before pregnancy and weight gain during pregnancy and if this association differed by race. We used vital birth records of singleton births of 73,061 non-Hispanic black and white women in Allegheny County, PA (2003-2010). Maternal race and ethnicity, pre-pregnancy body-mass-index (BMI), gestational weight gain and other individual-level characteristics were derived from vital birth record data, and measures of neighborhood racial composition (percentage of black residents in the neighborhood) and poverty (percentage of households in the neighborhood below the federal poverty) were derived using US Census data. Multilevel log binomial regression models were performed to estimate neighborhood racial composition and poverty in association with pre-pregnancy weight (i.e., overweight/obese) and gestational weight gain (i.e., inadequate and excessive). Black women as compared to white women were more likely to be overweight/obese before pregnancy and to have inadequate gestational weight gain (53.6% vs. 38.8%; 22.5% vs. 14.75 respectively). Black women living in predominately black neighborhoods were slightly more likely to be obese prior to pregnancy compared to black women living in predominately white neighborhoods (PR 1.10; 95% CI: 1.03, 1.16). Black and white women living in high poverty areas compared with women living in lower poverty areas were more likely to be obese prior to pregnancy; while only white women living in high poverty areas compared to low poverty areas were more likely gain an inadequate amount of weight during pregnancy. Neighborhood racial composition and poverty may be important in understanding racial differences in weight among childbearing women.

Does context matter for the relationship between deprivation and all-cause mortality? The West vs. the rest of Scotland

PubMed Central

2011-01-01

Background A growing body of research emphasizes the importance of contextual factors on health outcomes. Using postcode sector data for Scotland (UK), this study tests the hypothesis of spatial heterogeneity in the relationship between area-level deprivation and mortality to determine if contextual differences in the West vs. the rest of Scotland influence this relationship. Research into health inequalities frequently fails to recognise spatial heterogeneity in the deprivation-health relationship, assuming that global relationships apply uniformly across geographical areas. In this study, exploratory spatial data analysis methods are used to assess local patterns in deprivation and mortality. Spatial regression models are then implemented to examine the relationship between deprivation and mortality more formally. Results The initial exploratory spatial data analysis reveals concentrations of high standardized mortality ratios (SMR) and deprivation (hotspots) in the West of Scotland and concentrations of low values (coldspots) for both variables in the rest of the country. The main spatial regression result is that deprivation is the only variable that is highly significantly correlated with all-cause mortality in all models. However, in contrast to the expected spatial heterogeneity in the deprivation-mortality relationship, this relation does not vary between regions in any of the models. This result is robust to a number of specifications, including weighting for population size, controlling for spatial autocorrelation and heteroskedasticity, assuming a non-linear relationship between mortality and socio-economic deprivation, separating the dependent variable into male and female SMRs, and distinguishing between West, North and Southeast regions. The rejection of the hypothesis of spatial heterogeneity in the relationship between socio-economic deprivation and mortality complements prior research on the stability of the deprivation-mortality relationship over time. Conclusions The homogeneity we found in the deprivation-mortality relationship across the regions of Scotland and the absence of a contextualized effect of region highlights the importance of taking a broader strategic policy that can combat the toxic impacts of socio-economic deprivation on health. Focusing on a few specific places (e.g. 15% of the poorest areas) to concentrate resources might be a good start but the impact of socio-economic deprivation on mortality is not restricted to a few places. A comprehensive strategy that can be sustained over time might be needed to interrupt the linkages between poverty and mortality. PMID:21569408

Hierarchical cluster analysis of labour market regulations and population health: a taxonomy of low- and middle-income countries

PubMed Central

2012-01-01

Background An important contribution of the social determinants of health perspective has been to inquire about non-medical determinants of population health. Among these, labour market regulations are of vital significance. In this study, we investigate the labour market regulations among low- and middle-income countries (LMICs) and propose a labour market taxonomy to further understand population health in a global context. Methods Using Gross National Product per capita, we classify 113 countries into either low-income (n = 71) or middle-income (n = 42) strata. Principal component analysis of three standardized indicators of labour market inequality and poverty is used to construct 2 factor scores. Factor score reliability is evaluated with Cronbach's alpha. Using these scores, we conduct a hierarchical cluster analysis to produce a labour market taxonomy, conduct zero-order correlations, and create box plots to test their associations with adult mortality, healthy life expectancy, infant mortality, maternal mortality, neonatal mortality, under-5 mortality, and years of life lost to communicable and non-communicable diseases. Labour market and health data are retrieved from the International Labour Organization's Key Indicators of Labour Markets and World Health Organization's Statistical Information System. Results Six labour market clusters emerged: Residual (n = 16), Emerging (n = 16), Informal (n = 10), Post-Communist (n = 18), Less Successful Informal (n = 22), and Insecure (n = 31). Primary findings indicate: (i) labour market poverty and population health is correlated in both LMICs; (ii) association between labour market inequality and health indicators is significant only in low-income countries; (iii) Emerging (e.g., East Asian and Eastern European countries) and Insecure (e.g., sub-Saharan African nations) clusters are the most advantaged and disadvantaged, respectively, with the remaining clusters experiencing levels of population health consistent with their labour market characteristics. Conclusions The labour market regulations of LMICs appear to be important social determinant of population health. This study demonstrates the heuristic value of understanding the labour markets of LMICs and their health effects using exploratory taxonomy approaches. PMID:22512892

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.

Implementation of a symptomatic approach leads to increased efficiency of a cholera treatment unit.

PubMed

Ticona, Eduardo; Kirwan, Daniela E; Soria, Jaime; Gilman, Robert H

2014-09-01

Cholera is a disease of poverty that remains prevalent in resource-limited countries. The abrupt emergence of an epidemic frequently takes communities and health systems by surprise. Spread is rapid and initial mortality high: delays in organizing an appropriate response, lack of health worker training, and high patient numbers contribute to high rates of complications and deaths. © The American Society of Tropical Medicine and Hygiene.

Barriers to Change: Findings from Three Literacy Professional Learning Initiatives

ERIC Educational Resources Information Center

Parsons, Allison Ward; Parsons, Seth A.; Morewood, Aimee; Ankrum, Julie W.

2016-01-01

In this article, we describe lessons learned from three separate literacy professional learning initiatives that took place in elementary schools in three different locations: high-poverty urban, medium-poverty rural, and low-poverty suburban. The professional learning initiatives were also diverse in scope: one was a three-year, school-wide…

Presidential Address: How to Improve Poverty Measurement in the United States

ERIC Educational Resources Information Center

Blank, Rebecca M.

2008-01-01

This paper discusses the reasons why the current official U.S. poverty measure is outdated and nonresponsive to many anti-poverty initiatives. A variety of efforts to update and improve the statistic have failed, for political, technical, and institutional reasons. Meanwhile, the European Union is taking a very different approach to poverty…

Escape from Poverty: What Makes a Difference for Children?

ERIC Educational Resources Information Center

Chase-Lansdale, P. Lindsay, Ed.; Brooks-Gunn, Jeanne, Ed.

Children's poverty rate in the United States, over 20%, exceeds that of all industrialized nations except Australia. This interdisciplinary book examines the impact of changing public policies on children. Section 1 gives a current and historical overview of children in poverty. Sections 2 through 5 address arenas of possible change from policy…

Global Inequality and Poverty in Perspectives of Geography

ERIC Educational Resources Information Center

Altmann, Michael; Eisenreich, Sophie; Lehner, Daniela; Moser, Stefanie; Neidl, Tobias; Ruscher, Valentina; Vogeler, Thilo

2013-01-01

Purpose: On the educational level, this paper aims to show a practical case of dialogic web-based learning. It has provided a consensus during a web-based negotiation game between four different parties on poverty and inequality. On a multicultural level, this paper seeks to offer diverse cultures of argumentation on global poverty.…

Escaping and Falling into Poverty in India Today.

PubMed

Thorat, Amit; Vanneman, Reeve; Desai, Sonalde; Dubey, Amaresh

2017-05-01

The study examines the dynamic nature of movements into and out of poverty over a period when poverty has fallen substantially in India. The analysis identifies people who escaped poverty and those who fell into it over the period 2005 to 2012. The analysis identifies people who escaped poverty and those who fell into it over the period 2005 to 2012. Using panel data from the India Human Development Survey for 2005 and 2012, we find that the risks of marginalized communities such as Dalits and Adivasis of falling into or remaining in poverty were higher than those for more privileged groups. Some, but not all of these higher risks are explained by educational, financial, and social disadvantages of these groups in 2005. Results from a logistic regression show that some factors that help people escape poverty differ from those that push people into it and that the strength of their effects varies.

Tourism Contribution to Poverty Alleviation in Kenya: A Dynamic Computable General Equilibrium Analysis.

PubMed

Njoya, Eric Tchouamou; Seetaram, Neelu

2018-04-01

The aim of this article is to investigate the claim that tourism development can be the engine for poverty reduction in Kenya using a dynamic, microsimulation computable general equilibrium model. The article improves on the common practice in the literature by using the more comprehensive Foster-Greer-Thorbecke (FGT) index to measure poverty instead of headcount ratios only. Simulations results from previous studies confirm that expansion of the tourism industry will benefit different sectors unevenly and will only marginally improve poverty headcount. This is mainly due to the contraction of the agricultural sector caused the appreciation of the real exchange rates. This article demonstrates that the effect on poverty gap and poverty severity is, nevertheless, significant for both rural and urban areas with higher impact in the urban areas. Tourism expansion enables poorer households to move closer to the poverty line. It is concluded that the tourism industry is pro-poor.

Poverty and Awakening Cortisol in Adolescence: The Importance of Timing in Early Life

PubMed Central

McFarland, Michael J.; Hayward, Mark D.

2015-01-01

The deleterious effects of poverty on mental and physical health are routinely argued to operate, at least in part, via dysregulation of the hypothalamus-pituitary-adrenal (HPA) axis, although empirical examinations connecting poverty with HPA axis functioning are rare. Research on the effects of timing of poverty is a particularly neglected aspect of this relationship. This study uses 15 years of prospective data from the Study of Early Child Care and Youth Development to assess how exposure to poverty during infancy, childhood, and adolescence is related to awakening cortisol (n = 826), a marker of HPA axis functioning. Among female participants, poverty exposure in infancy and adolescence, but not childhood, was negatively associated with awakening cortisol. Poverty exposure was unrelated to cortisol among male participants. The importance of timing and gender differences are discussed along with directions for future research. PMID:26140229

Childhood Social Inequalities Influences Neural Processes in Young Adult Caregiving

PubMed Central

Kim, Pilyoung; Ho, S. Shaun; Evans, Gary W.; Liberzon, Israel; Swain, James E.

2016-01-01

Childhood poverty is associated with harsh parenting with a risk of transmission to the next generation. This prospective study examined the relations between childhood poverty and non-parent adults’ neural responses to infant cry sounds. While no main effects of poverty were revealed in contrasts of infant cry vs. acoustically matched white noise, a gender by childhood poverty interaction emerged. In females, childhood poverty was associated with increased neural activations in the posterior insula, striatum, calcarine sulcus, hippocampus and fusiform gyrus, while, in males, childhood poverty was associated with reduced levels of neural responses to infant cry in the same regions. Irrespective of gender, neural activation in these regions was associated with higher levels of annoyance with the cry sound and reduced desire to approach the crying infant. The findings suggest gender differences in neural and emotional responses to infant cry sounds among young adults growing up in poverty. PMID:25981334

Growth in indigenous and nonindigenous Chilean schoolchildren from 3 poverty strata.

PubMed

Bustos, P; Amigo, H; Muñoz, S R; Martorell, R

2001-10-01

This study sought to determine whether the short stature of Mapuche children, an indigenous group in Chile, reflects poverty or genetic heritage and whether the international reference population, derived from studies of US children of mostly European origin, is appropriate for assessing growth failure in indigenous peoples of the Americas. The study assessed 768 schoolchildren of Mapuche and non-Mapuche ancestry, aged 6 to 9 years, living under conditions of extreme, medium, and low poverty. Growth retardation was strongly related to poverty in both ethnic groups. Within poverty levels, there were no significant differences in stature between ethnic groups, and in low-poverty areas in Santiago, the capital city, mean stature was only slightly less than in the reference population. Poverty, not ancestry, explains the short stature of Mapuche children, and use of the international reference to assess growth in this population is appropriate.

Growth in Indigenous and Nonindigenous Chilean Schoolchildren From 3 Poverty Strata

PubMed Central

Bustos, Patricia; Amigo, Hugo; Muñoz, Sergio R.; Martorell, Reynaldo

2001-01-01

Objectives. This study sought to determine whether the short stature of Mapuche children, an indigenous group in Chile, reflects poverty or genetic heritage and whether the international reference population, derived from studies of US children of mostly European origin, is appropriate for assessing growth failure in indigenous peoples of the Americas. Methods. The study assessed 768 schoolchildren of Mapuche and non-Mapuche ancestry, aged 6 to 9 years, living under conditions of extreme, medium, and low poverty. Results. Growth retardation was strongly related to poverty in both ethnic groups. Within poverty levels, there were no significant differences in stature between ethnic groups, and in low-poverty areas in Santiago, the capital city, mean stature was only slightly less than in the reference population. Conclusions. Poverty, not ancestry, explains the short stature of Mapuche children, and use of the international reference to assess growth in this population is appropriate. PMID:11574328

Tourism Contribution to Poverty Alleviation in Kenya: A Dynamic Computable General Equilibrium Analysis

PubMed Central

Njoya, Eric Tchouamou; Seetaram, Neelu

2017-01-01

The aim of this article is to investigate the claim that tourism development can be the engine for poverty reduction in Kenya using a dynamic, microsimulation computable general equilibrium model. The article improves on the common practice in the literature by using the more comprehensive Foster-Greer-Thorbecke (FGT) index to measure poverty instead of headcount ratios only. Simulations results from previous studies confirm that expansion of the tourism industry will benefit different sectors unevenly and will only marginally improve poverty headcount. This is mainly due to the contraction of the agricultural sector caused the appreciation of the real exchange rates. This article demonstrates that the effect on poverty gap and poverty severity is, nevertheless, significant for both rural and urban areas with higher impact in the urban areas. Tourism expansion enables poorer households to move closer to the poverty line. It is concluded that the tourism industry is pro-poor. PMID:29595836

Escaping and Falling into Poverty in India Today

PubMed Central

Thorat, Amit; Vanneman, Reeve; Desai, Sonalde; Dubey, Amaresh

2017-01-01

The study examines the dynamic nature of movements into and out of poverty over a period when poverty has fallen substantially in India. The analysis identifies people who escaped poverty and those who fell into it over the period 2005 to 2012. The analysis identifies people who escaped poverty and those who fell into it over the period 2005 to 2012. Using panel data from the India Human Development Survey for 2005 and 2012, we find that the risks of marginalized communities such as Dalits and Adivasis of falling into or remaining in poverty were higher than those for more privileged groups. Some, but not all of these higher risks are explained by educational, financial, and social disadvantages of these groups in 2005. Results from a logistic regression show that some factors that help people escape poverty differ from those that push people into it and that the strength of their effects varies. PMID:28966435

Tracking exposure to child poverty during the first 10 years of life in a Quebec birth cohort.

PubMed

Séguin, Louise; Nikiema, Beatrice; Gauvin, Lise; Lambert, Marie; Thanh Tu, Mai; Kakinami, Lisa; Paradis, Gilles

2012-04-27

Early childhood poverty is associated with adult chronic diseases. The objectives of this study were to examine patterns of exposure to poverty during the first 10 years of life in the Quebec Longitudinal Study of Child Development (QLSCD) cohort according to three measures of poverty and to explore family characteristics associated with different poverty exposures. Data from 1,334 participants from the QLSCD were collected annually at home from ages 5 months through 10 years. Household income (previous 12 months) and sources of income were recorded at each data round. Poverty status was operationalized as 1) living below the low income cut-off of Statistics Canada, 2) receiving social welfare and 3) being in the lowest quintile of socio-economic status. We plotted trends in the prevalence of child poverty over time. We used latent class growth modelling to identify subgroups with similar poverty trajectories. Duration of poverty according to each measure was computed separately for early childhood, middle childhood, and the entire 10 years of life. Four trajectories of poverty were identified: stable poor, decreasing likelihood, increasing likelihood, and never poor. The three measures of poverty do not cover the same population, yet the characteristics of those identified as poor are similar. Children of non-European, immigrant mothers were most likely to be poor, and there was a higher likelihood of children from single-parent families to live in chronic poverty during the first 10 years. A large proportion of children are exposed to poverty before 10 years of age. More effective public policies could reduce child poverty.

Report examines links among women's equality, smaller families, healthier children.

PubMed

1997-06-01

This article reports on a new study by Nancy Riley about the relationship between gender equality and fertility and mortality declines in developing countries. Findings indicate that mortality and fertility has declined in countries without gender equality. Fertility and child mortality decline is related to women's educational status and employment. Riley argues that women's power to make decisions about health care, contraception, and the timing and number of children, if affected by education and paid employment, is more likely to lower mortality and fertility. Women's power may decline in countries where women's education and employment are advanced, but their role in society remains that of mothers. All developing countries showed a relationship between the amount of education and family size and child health. Fertility tends to be lowest among highly educated women. However, women's education has a stronger effect on child health and mortality. Maternal education also affects child nutritional status. Women's education offers women the option of job opportunities and new values or ideas. Women's employment may result in increased resources and status or in poverty and heavy physical labor. Societal views of women's work may reflect an increased self-worth for working women or lower status or the failure of a husband to adequately provide for family welfare. The key to the impact of women's employment is whether work becomes a way to achieve greater power for women in decision making about child welfare and family planning. Employment outside the home educates. In most countries, women who worked for cash had fewer children, but differences in fertility between working and nonworking women range from small to large. Higher income for Nigerian women means more children. Women's work also has inconsistent effects on child health.

[A possible objective from now to the year 2000: reducing infant mortality by one half in Third World countries].

PubMed

Berthet, E

1984-06-01

Every day 40.000 children die throughout the world. Most of them in developing countries. There is a close relationship between infant mortality, life expectancy at birth, the adult illiteracy rate and national income per capita. Why such huge differences between the infant mortality rate of 7 per 1.000 (live births) in Sweden and 208 in Upper Volta? The four scourges which afflict developing countries: hunger (malnutrition), disease, ignorance and poverty are responsible for this state of affairs. The author suggests that coordinated action by governments and International Agencies should be taken to halve the infant mortality rate by the year 2.000. He notes that in the past three mistakes were made which should not be repeated. The first was to improve the living conditions of the population. The green Revolution in India provides a striking example of an important progress which benefited only the wealthier farmers. A second mistake was to believe that only a medical approach reduce the infant mortality rate. A third error was to overlook the importance of health education and not to seek the active participation of the people concerned. The author recalls that the International Union for Health Education carried out a sanitary and social programme from 1975 to 1978 in Africa, south of the Sahara. To this effect, the IUHE had to find out what the people really wanted, could be motivated, to increase the welfare of the villagers by measures adapted to existing possibilities, to study how the people could recruit among the villagers health workers and train them, to create village health committees.(ABSTRACT TRUNCATED AT 250 WORDS)

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.

Health inequalities and the health of the poor: what do we know? What can we do?

PubMed Central

Gwatkin, D. R.

2000-01-01

The contents of this theme section of the Bulletin of the World Health Organization on "Inequalities in health" have two objectives: to present the initial findings from a new generation of research that has been undertaken in response to renewed concern for health inequalities; and to stimulate movement for action in order to correct the problems identified by this research. The research findings are presented in the five articles which follow. This Critical Reflection proposes two initial steps for the action needed to alleviate the problem; other suggestions are given by the participants in a Round Table discussion which is published after these articles. The theme section concludes with extracts from the classic writings of the nineteenth-century public health pioneer, William Farr, who is widely credited as one of the founders of the scientific study of health inequalities, together with a commentary. This Critical Reflection contributes to the discussion of the action needed by proposing two initial steps for action. That professionals who give very high priority to the distinct but related objectives of poverty alleviation, inequality reduction, and equity enhancement recognize that their shared concern for the distributional aspects of health policy is far more important than any differences that may divide them. That health policy goals, currently expressed as societal averages, be reformulated so that they point specifically to conditions among the poor and to poor-rich differences. For example, infant mortality rates among the poor or the differences in infant mortality between rich and poor sectors would be more useful indicators than the average infant mortality rates for the whole population. PMID:10686729

Hispanic Concentrated Poverty in Traditional and New Destinations, 2010-2014.

PubMed

Ludwig-Dehm, Sarah; Iceland, John

2017-12-01

This paper examines patterns of Hispanic concentrated poverty in traditional, new, and minor destinations. Using data from 2010 to 2014 from the American Community Survey, we find that without controlling for group characteristics, Hispanics experience a lower level of concentrated poverty in new destinations compared to traditional gateways. Metropolitan level factors explain this difference, including ethnic residential segregation, the Hispanic poverty rate, and the percentage of Hispanics who are foreign born. Overall, this study sheds new light on the Hispanic geographic dispersal in the United States and offers support for the argument that the Hispanic settlement into new destinations is associated with lower levels of concentrated poverty.

Cross-sectional analysis of two social determinants of health in California cities: racial/ethnic and geographic disparities

PubMed Central

Bustamante-Zamora, Dulce; Maizlish, Neil

2017-01-01

Objective To study the magnitude and direction of city-level racial and ethnic differences in poverty and education to characterise health equity and social determinants of health in California cities. Design We used data from the American Community Survey, United States Census Bureau, 2006–2010, and calculated differences in the prevalence of poverty and low educational attainment in adults by race/ethnicity and by census tracts within California cities. For race/ethnicity comparisons, when the referent group (p2) to calculate the difference (p1−p2) was the non-Hispanic White population (considered a historically advantaged group), a positive difference was considered a health inequity. Differences with a non-White reference group were considered health disparities. Setting Cities of the State of California, USA. Results Within-city differences in the prevalence of poverty and low educational attainment disfavoured Black and Latinos compared with Whites in over 78% of the cities. Compared with Whites, the median within-city poverty difference was 7.0% for Latinos and 6.2% for Blacks. For education, median within-city difference was 26.6% for Latinos compared with Whites. In a small, but not negligible proportion of cities, historically disadvantaged race/ethnicity groups had better social determinants of health outcomes than Whites. The median difference between the highest and lowest census tracts within cities was 14.3% for poverty and 15.7% for low educational attainment. Overall city poverty rate was weakly, but positively correlated with within-city racial/ethnic differences. Conclusions Disparities and inequities are widespread in California. Local health departments can use these findings to partner with cities in their jurisdiction and design strategies to reduce racial, ethnic and geographic differences in economic and educational outcomes. These analytic methods could be used in an ongoing surveillance system to monitor these determinants of health. PMID:28588108

Cross-sectional analysis of two social determinants of health in California cities: racial/ethnic and geographic disparities.

PubMed

Bustamante-Zamora, Dulce; Maizlish, Neil

2017-06-06

To study the magnitude and direction of city-level racial and ethnic differences in poverty and education to characterise health equity and social determinants of health in California cities. We used data from the American Community Survey, United States Census Bureau, 2006-2010, and calculated differences in the prevalence of poverty and low educational attainment in adults by race/ethnicity and by census tracts within California cities. For race/ethnicity comparisons, when the referent group (p 2 ) to calculate the difference (p 1 -p 2 ) was the non-Hispanic White population (considered a historically advantaged group), a positive difference was considered a health inequity. Differences with a non-White reference group were considered health disparities. Cities of the State of California, USA. Within-city differences in the prevalence of poverty and low educational attainment disfavoured Black and Latinos compared with Whites in over 78% of the cities. Compared with Whites, the median within-city poverty difference was 7.0% for Latinos and 6.2% for Blacks. For education, median within-city difference was 26.6% for Latinos compared with Whites. In a small, but not negligible proportion of cities, historically disadvantaged race/ethnicity groups had better social determinants of health outcomes than Whites. The median difference between the highest and lowest census tracts within cities was 14.3% for poverty and 15.7% for low educational attainment. Overall city poverty rate was weakly, but positively correlated with within-city racial/ethnic differences. Disparities and inequities are widespread in California. Local health departments can use these findings to partner with cities in their jurisdiction and design strategies to reduce racial, ethnic and geographic differences in economic and educational outcomes. These analytic methods could be used in an ongoing surveillance system to monitor these determinants of health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Poverty, health, and nutrition in Germany.

PubMed

Helmert, U; Mielck, A; Shea, S

1997-01-01

To investigate the relation between poverty and several variables describing health and nutrition behavior in East Germany and West Germany. Data are from the third National Health Survey in West Germany and the first Health Survey for the new federal states of Germany (1991/92). Both health surveys included a self-administered questionnaire ascertaining sociodemographic variables, smoking history, nutritional behavior (using a food-frequency list), physical activity, and a medical examination comprising measurements of height, weight, blood pressure, and blood sampling for serum cholesterol determination. Participants included 4958 subjects in the West Survey and 2186 subjects in the East Survey aged 25-69 years, with a respective net response rate of 69.0% and 70.2%. Poverty was defined as a household equivalence income of 62.5% or less of the median income of the general population. The lowest income group (poverty or near poverty) comprised 11.6% of East German versus 15.9% of West German males and 14.8% of East German versus 19.3% of West German females. For most but not all health and nutrition parameters, less favorable results were obtained for subjects with an equivalence income below or near poverty. The most striking poverty-related differences regarding cardiovascular disease risk factors were found for lack of regular exercise for both genders and obesity in females. No poverty-related differences were found for the prevalence of hypercholesterolemia, despite a much higher prevalence of obesity in persons with an income below the poverty line. Current nutritional behavior and changes in nutritional behavior during the last three years was strongly related to income status, with a more unhealthy status for low-income population groups in both East and West Germany. In Germany, poverty has strong effects on individual health status and nutritional behavior. Because of rising unemployment rates and reductions in social security payments for low-income groups, it is likely that the negative consequences of poverty on health are increasing.

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

Trajectories of neighborhood poverty and associations with subclinical atherosclerosis and associated risk factors: the multi-ethnic study of atherosclerosis.

PubMed

Murray, Emily T; Diez Roux, Ana V; Carnethon, Mercedes; Lutsey, Pamela L; Ni, Hanyu; O'Meara, Ellen S

2010-05-15

The authors used data from the Multi-Ethnic Study of Atherosclerosis and latent trajectory class modeling to determine patterns of neighborhood poverty over 20 years (1980-2000 residential history questionnaires were geocoded and linked to US Census data). Using these patterns, the authors examined 1) whether trajectories of neighborhood poverty were associated with differences in the amount of subclinical atherosclerosis (common carotid intimal-media thickness) and 2) associated risk factors (body mass index, hypertension, diabetes, current smoking) at baseline (January 2000-August 2002). The authors found evidence of 5 stable trajectory groups with differing levels of neighborhood poverty ( approximately 6%, 12%, 20%, 30%, and 45%) and 1 group with 29% poverty in 1980 and approximately 11% in 2000. Mostly for women, higher cumulative neighborhood poverty was generally significantly associated with worse cardiovascular outcomes. Trends generally persisted after adjustment for adulthood socioeconomic position and race/ethnicity, although they were no longer statistically significant. Among women who had moved during the 20 years, the long-term measure had stronger associations with outcomes (except smoking) than a single, contemporaneous measure. Results indicate that cumulative 20-year exposure to neighborhood poverty is associated with greater cardiovascular risk for women. In residentially mobile populations, single-point-in-time measures underestimate long-term effects.

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.

Comments on "Differentials on Child Mortality and Health Care in Pakistan".

PubMed

Manzoor, K

1992-01-01

Critical comments are provided on M. Framurz Kiani's examination of differentials in child mortality by parents' education, urban/rural status, work status, availability of maternal and child health services, immunization status, and diarrheal treatment and age of the mother. The findings emphasize the importance of literacy, particularly maternal education, as a major influence in child survival. There were 5 areas of discussion. The first pertained to the absence of factors for fertility, which had been shown to be interactive with mortality. Higher fertility was associated with higher mortality, and higher mortality was associated with higher fertility, and both were influenced by poverty and literacy. The second comment pertained to the lack of control variables for income and socioeconomic status in order to separate out the effects of educational status. It may well be that educational status was capturing the affordability and accessibility of health care, and increased consciousness due to education, even in an urban setting. Work status of the mother, rather than mothers working in a family business of working as housewives, may be representing women's mobility. Salaried fathers may enjoy lower mortality because of full or partial medical benefits that are included in their salary package, that those in agriculture would not have. The third point focused on the lack of specification of what "clinic" referred to, in the findings that urban and rural mothers with postnatal care had lower child mortality. The fourth point noted that the findings (maternal education was important in maternal and child health care and paternal education was important in immunization) reflected women's lack of decision making. Other findings were that education differences influenced child survival, but child immunization was not a significant factor. The policy implications are that health services and outreach are needed in rural areas in order to increase the level of awareness about the importance of immunization and complete immunization. Access to services must be assured as well. The last point noted the lack of specification of male vs. female mortality. The study was commended for identifying major factors in determining child mortality.

GIS-based poverty and population distribution analysis in China

NASA Astrophysics Data System (ADS)

Cui, Jing; Wang, Yingjie; Yan, Hong

2009-07-01

Geographically, poverty status is not only related with social-economic factors but also strongly affected by geographical environment. In the paper, GIS-based poverty and population distribution analysis method is introduced for revealing their regional differences. More than 100000 poor villages and 592 national key poor counties are chosen for the analysis. The results show that poverty distribution tends to concentrate in most of west China and mountainous rural areas of mid China. Furthermore, the fifth census data are overlaid to those poor areas in order to gain its internal diversity of social-economic characteristics. By overlaying poverty related social-economic parameters, such as sex ratio, illiteracy, education level, percentage of ethnic minorities, family composition, finding shows that poverty distribution is strongly correlated with high illiteracy rate, high percentage minorities, and larger family member.

Effects of sustained nurse/mother contact on infant outcomes among low-income African-American families.

PubMed

Barnes-Boyd, C

1995-12-01

This study examined the effect on infant morbidity and mortality of sustained nursing contact with mothers of healthy infants who are considered medically low risk but socially are at high risk due to poverty, low maternal education, and parenting at an early age. A quasi-experimental approach using a pretest-posttest design was used to evaluate the effect of the sustained nursing contact intervention (N = 97) compared with the instructions traditionally provided to the mothers of such infants (N = 48). In general, intervention and control infants did not differ on variables measuring health and development, morbidity, incidence of accidents, utilization of health care services, or immunization rates. Intervention infants scored significantly higher on advanced gross motor skills and had significantly fewer upper respiratory symptoms at the final visit. Highest morbidity was experienced by infants of teenaged mothers in the control group who had more than one infant. It was concluded that sustained nursing contact during the first eight months of infant life was beneficial to low-income African-American mothers, especially teenaged mothers with more than one infant. Infant morbidity and mortality were lower in both groups than would have been expected for their risk level, indicating that even minimal sustained nursing contact enhances outcomes of healthy infants at high risk for mortality and morbidity due to social factors.

Community-Acquired Pneumonia in Latin America.

PubMed

Iannella, Hernán A; Luna, Carlos M

2016-12-01

Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality in Latin America and the Caribbean (LAC) region. Poverty, socioeconomic factors, and malnutrition influence the incidence and outcome of CAP in LAC. In LAC, Streptococcus pneumoniae is the most frequent microorganism responsible for CAP, (incidence: 24-78%); the incidence of atypical microorganisms is similar to other regions of the world. Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) is a growing problem in the LAC region, with the Caribbean being the second most affected area worldwide after Sub-Saharan Africa. Pneumococcal pneumonia remains the most common cause of CAP in HIV-infected patients, but Pneumocystis jirovecii and tuberculosis (TB) are also common in this population. The heterogeneity of the health care systems and social inequity between different countries in LAC, and even between different settings inside the same country, is a difficult issue. TB, including multidrug-resistant TB, is several times more common in South American and Central American countries compared with North America. Furthermore, hantaviruses circulating in the Americas (new world hantaviruses) generate a severe respiratory disease called hantavirus pulmonary syndrome, with an associated mortality as high as 50%. More than 30 hantaviruses have been reported in the Western Hemisphere, with more frequent cases registered in the southern cone (Argentina, Chile, Uruguay, Paraguay, Bolivia, and Brazil). Respiratory viruses (particularly influenza) remain an important cause of morbidity and mortality, particularly in the elderly. Low rates of vaccination (against influenza as well as pneumococcus) may heighten the risk of these infections in low- and middle-income countries. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Exiting and Entering High-Poverty Neighborhoods: Latinos, Blacks and Anglos Compared

ERIC Educational Resources Information Center

South, Scott J.; Crowder, Kyle; Chavez, Erick

2005-01-01

A special sample from the 1990-1995 waves of the Panel Study of Income Dynamics is used to examine differences in the patterns and determinants of residential mobility between high-poverty and lower-poverty neighborhoods among Latinos, blacks and Anglos. Householders of Mexican, Puerto Rican and Cuban origin are significantly less likely than…

Real Income, Poverty, Resources. Rural Development, Poverty, and Natural Resources Working Paper Series, Part III.

ERIC Educational Resources Information Center

Hoch, Irving; And Others

This paper reports progress on the development of improved measures of income and poverty by accounting for differences in living costs between regions, and on the tracing of relationships between natural resources and income; a reviewer's comments conclude the contents of this workshop collection. The overview describes how a measure of income…

Working Memory Differences between Children Living in Rural and Urban Poverty

ERIC Educational Resources Information Center

Tine, Michele

2014-01-01

This study was designed to investigate if the working memory profiles of children living in rural poverty are distinct from the working memory profiles of children living in urban poverty. Verbal and visuospatial working memory tasks were administered to sixth-grade students living in low-income rural, low-income urban, high-income rural, and…

Combating Poverty and Social Exclusion in France. OECD Economics Department Working Papers No. 569

ERIC Educational Resources Information Center

Jamet, Stephanie

2007-01-01

Reducing poverty and social exclusion is an important objective for all French governments. Even though conventionally measured poverty is in fact lower than in most other countries, it is still higher than can be easily accepted. The current policy approach involves a large number of measures tailored to different circumstances. Some policies…

Do Parenting and the Home Environment, Maternal Depression, Neighborhood, and Chronic Poverty Affect Child Behavioral Problems Differently in Different Racial-Ethnic Groups?

PubMed Central

Pachter, Lee M.; Auinger, Peggy; Palmer, Ray; Weitzman, Michael

2006-01-01

OBJECTIVE To determine whether the processes through which parenting practices, maternal depression, neighborhood, and chronic poverty affect child behavioral problems are similar or different in minority and nonminority children in the United States. METHODS Data from 884 white, 538 black, and 404 Latino families with children who were 6 to 9 years of age in the National Longitudinal Survey of Youth were analyzed. The outcome, child behavioral problems, was measured using the Behavior Problems Index externalizing and internalizing subscales. The effects of chronic poverty, neighborhood, maternal depression, and parenting on the outcome were analyzed using multigroup structural equation modeling. RESULTS Chronic poverty affected child behavioral problems indirectly through the other variables, and parenting practices had direct effects in each racial/ethnic group. The effects of maternal depression were partially mediated through parenting in the white and Latino samples but were direct and unmediated through parenting practices in the black sample. Neighborhood effects were present in the white and black samples but were not significant for the Latino sample. CONCLUSIONS Chronic poverty, neighborhood, maternal depression, and parenting practices have effects on child behavioral problems in white, black, and Latino children, but the processes and mechanisms through which they exert their effects differ among the groups. The differences may be related to social stratification mechanisms as well as sociocultural differences in family and childrearing practices. PMID:16585331

Multidimensional poverty measure and analysis: a case study from Hechi City, China.

PubMed

Wang, Yanhui; Wang, Baixue

2016-01-01

Aiming at the anti-poverty outline of China and the human-environment sustainable development, we propose a multidimensional poverty measure and analysis methodology for measuring the poverty-stricken counties and their contributing factors. We build a set of multidimensional poverty indicators with Chinese characteristics, integrating A-F double cutoffs, dimensional aggregation and decomposition approach, and GIS spatial analysis to evaluate the poor's multidimensional poverty characteristics under different geographic and socioeconomic conditions. The case study from 11 counties of Hechi City shows that, firstly, each county existed at least four respects of poverty, and overall the poverty level showed the spatial pattern of surrounding higher versus middle lower. Secondly, three main poverty contributing factors were unsafe housing, family health and adults' illiteracy, while the secondary factors include fuel type and children enrollment rate, etc., generally demonstrating strong autocorrelation; in terms of poverty degree, the western of the research area shows a significant aggregation effect, whereas the central and the eastern represent significant spatial heterogeneous distribution. Thirdly, under three kinds of socioeconomic classifications, the intra-classification diversities of H, A, and MPI are greater than their inter-classification ones, while each of the three indexes has a positive correlation with both the rocky desertification degree and topographic fragmentation degree, respectively. This study could help policymakers better understand the local poverty by identifying the poor, locating them and describing their characteristics, so as to take differentiated poverty alleviation measures according to specific conditions of each county.

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.

Working Memory Differences Between Children Living in Rural and Urban Poverty

PubMed Central

Tine, Michele

2014-01-01

This study was designed to investigate if the working memory profiles of children living in rural poverty are distinct from the working memory profiles of children living in urban poverty. Verbal and visuospatial working memory tasks were administered to sixth-grade students living in low-income rural, low-income urban, high-income rural, and high-income urban developmental contexts. Both low-income rural and low-income urban children showed working memory deficits compared with their high-income counterparts, but their deficits were distinct. Low-income urban children exhibited symmetrical verbal and visuospatial working memory deficits compared with their high-income urban counterparts. Meanwhile, low-income rural children exhibited asymmetrical deficits when compared with their high-income rural counterparts, with more extreme visuospatial working memory deficits than verbal working memory deficits. These results suggest that different types of poverty are associated with different working memory abilities. PMID:25554726

Working Memory Differences Between Children Living in Rural and Urban Poverty.

PubMed

Tine, Michele

2014-10-02

This study was designed to investigate if the working memory profiles of children living in rural poverty are distinct from the working memory profiles of children living in urban poverty. Verbal and visuospatial working memory tasks were administered to sixth-grade students living in low-income rural, low-income urban, high-income rural, and high-income urban developmental contexts. Both low-income rural and low-income urban children showed working memory deficits compared with their high-income counterparts, but their deficits were distinct. Low-income urban children exhibited symmetrical verbal and visuospatial working memory deficits compared with their high-income urban counterparts. Meanwhile, low-income rural children exhibited asymmetrical deficits when compared with their high-income rural counterparts, with more extreme visuospatial working memory deficits than verbal working memory deficits. These results suggest that different types of poverty are associated with different working memory abilities.

Brazil's conditional cash transfer program associated with declines in infant mortality rates.

PubMed

Shei, Amie

2013-07-01

Conditional cash transfer programs are innovative social safety-net programs that aim to relieve poverty. They provide a regular source of income to poor families and are "conditional" in that they require poor families to invest in the health and education of their children through greater use of educational and preventive health services. Brazil's Bolsa Família conditional cash transfer program, created in 2003, is the world's largest program of its kind. During the first five years of the program, it was associated with a significant 9.3 percent reduction in overall infant mortality rates, with greater declines in postneonatal mortality rates than in mortality rates at an earlier age and in municipalities with many users of Brazil's Family Health Program than in those with lower use rates. There were also larger effects in municipalities with higher infant mortality rates at baseline. Programs like Bolsa Família can improve child health and reduce long-standing health inequalities. Policy makers should review the adequacy of basic health services to ensure that the services can respond to the increased demand created by such programs. Programs should also target vulnerable groups at greatest risk and include careful monitoring and evaluation.

Infant mortality in Pelotas, Brazil: a comparison of risk factors in two birth cohorts.

PubMed

Menezes, Ana Maria Baptista; Hallal, Pedro Curi; Santos, Iná Silva dos; Victora, Cesar Gomes; Barros, Fernando Celso

2005-12-01

To compare two population-based birth cohorts to assess trends in infant mortality rates and the distribution of relevant risk factors, and how these changed after an 11-year period. Data from two population-based prospective birth cohorts (1982 and 1993) were analyzed. Both studies included all children born in a hospital (> 99% of all births) in the city of Pelotas, Southern Brazil. Infant mortality was monitored through surveillance of all maternity hospitals, mortality registries and cemeteries. There were 5,914 live-born children in 1982 and 5,249 in 1993. The infant mortality rate decreased by 41%, from 36.0 per 1,000 live births in 1982 to 21.1 per 1,000 in 1993. Socioeconomic and maternal factors tended to become more favorable during the study period, but there were unfavorable changes in birthweight and gestational age. Poverty, high parity, low birthweight, preterm delivery, and intrauterine growth restriction were the main risk factors for infant mortality in both cohorts. The 41% reduction in infant mortality between 1982 and 1993 would have been even greater had the prevalence of risk factors remained constant during the period studied here. There were impressive declines in infant mortality which were not due to changes in the risk factors we studied. Because no reduction was seen in the large social inequalities documented in the 1982 cohort, it is likely that the reduction in infant mortality resulted largely from improvements in health care.

Socioeconomic and gender group differences in early literacy skills: a multiple-group confirmatory factor analysis approach

PubMed Central

Lee, Julia Ai Cheng; Otaiba, Stephanie Al

2015-01-01

Socioeconomic status and gender are important demographic variables that strongly relate to academic achievement. This study examined the early literacy skills differences between 4 sociodemographic groups, namely, boys ineligible for free or reduced-price lunch (FRL), girls ineligible for FRL, boys eligible for FRL, and girls eligible for FRL. Data on kindergarteners (N = 462) were analysed using multiple-group confirmatory factory analysis. Early literacy skill differences between boys and girls are more nuanced than previously reported; subsidy status and gender interact. Both boys and girls from high-poverty households performed significantly lower than the girls from low-poverty households in alphabet knowledge, phonological awareness, and spelling. There were gender gaps, with a female advantage, among children from high-poverty households in alphabet knowledge and spelling and among children from low-poverty households in alphabet knowledge. These results highlight the importance of employing methodologically sound techniques to ascertain group differences in componential early literacy skills. PMID:25750582

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

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.

The impact of preventive screening resource distribution on geographic and population-based disparities in colorectal cancer in Mississippi.

PubMed

Faruque, Fazlay S; Zhang, Xu; Nichols, Elizabeth N; Bradley, Denae L; Reeves-Darby, Royce; Reeves-Darby, Vonda; Duhé, Roy J

2015-09-08

The state of Mississippi has the highest colorectal cancer (CRC) mortality rate in the USA. The geographic distribution of CRC screening resources and geographic- and population-based CRC characteristics in Mississippi are investigated to reveal the geographic disparity in CRC screening. The primary practice sites of licensed gastroenterologists and the addresses of licensed medical facilities offering on-site colonoscopies were verified via telephone surveys, then these CRC screening resource data were geocoded and analyzed using Geographic Information Systems. Correlation analyses were performed to detect the strength of associations between CRC screening resources, CRC screening behavior and CRC outcome data. Age-adjusted colorectal cancer incidence rates, mortality rates, mortality-to-incidence ratios, and self-reported endoscopic screening rates from the years 2006 through 2010 were significantly different for Black and White Mississippians; Blacks fared worse than Whites in all categories throughout all nine Public Health Districts. CRC screening rates were negatively correlated with CRC incidence rates and CRC mortality rates. The availability of gastroenterologists varied tremendously throughout the state; regions with the poorest CRC outcomes tended to be underserved by gastroenterologists. Significant population-based and geographic disparities in CRC screening behaviors and CRC outcomes exist in Mississippi. The effects of CRC screening resources are related to CRC screening behaviors and outcomes at a regional level, whereas at the county level, socioeconomic factors are more strongly associated with CRC outcomes. Thus, effective control of CRC in rural states with high poverty levels requires both adequate preventive CRC screening capacity and a strategy to address fundamental causes of health care disparities.

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.

Is HIV/AIDS Epidemic Outcome of Poverty in Sub-Saharan Africa?

PubMed Central

Dzimnenani Mbirimtengerenji, Noel

2007-01-01

Undisputable fact is that 14 000 people in Sub-Saharan Africa are being infected daily with HIV and 11 000 are dying every day due to HIV/AIDS related illnesses. In this region more than 60% of the people live below UN poverty line of US$ 1 per day. Some studies have shown that poverty and HIV infection are in correlation, but none has shown whether HIV/AIDS in Sub-Saharan Africa is an outcome of poverty. This article, therefore, shows that HIV is an important outcome of poverty, with sexual trade, migration, polygamy, and teenage marriages as its predictors in the Sub Saharan region. I used the examples of 20 countries with the highest poverty level in the region to demonstrate the gravity of the HIV scourge, using the data from different international databases. PMID:17948947

Income inequality, poverty and crime across nations.

PubMed

Pare, Paul-Philippe; Felson, Richard

2014-09-01

We examine the relationship between income inequality, poverty, and different types of crime. Our results are consistent with recent research in showing that inequality is unrelated to homicide rates when poverty is controlled. In our multi-level analyses of the International Crime Victimization Survey we find that inequality is unrelated to assault, robbery, burglary, and theft when poverty is controlled. We argue that there are also theoretical reasons to doubt that the level of income inequality of a country affects the likelihood of criminal behaviour. © London School of Economics and Political Science 2014.

Cairo conference to link population and sustainable development.

PubMed

1994-09-01

Couples who want to limit the size of their families but whom family planning services elude are a key factor in the persistence of high rates of fertility and rapid population growth in some countries of the Asian and Pacific region (ESCAP). High fertility and rapid growth are linked to high rates of maternal and child mortality, poverty, and increasing pressure on the environment. These issues will be considered at the International Conference on Population and Development at Cairo from 5 to 13 September, 1994. The Conference objectives entail the promotion of more effective national programs to meet individual needs of women, and to bring population into balance with available resources. The Conference is expected to adopt a program of action covering the period 1995-2015. A preparatory meeting, the Fourth Asian and Pacific Population Conference, adopted the Bali Declaration on Population and Development as a blueprint for ESCAP region countries. Unprecedented growth in human numbers, widespread poverty, social and economic in equality and wasteful consumption are accelerating the depletion of resources and environmental degradation. Rural-to-urban migration will also be major concerns at the Conference. Real poverty and unemployment are the leading causes of urbanization. Recent United Nations data show that by 2005 half the world's population will be urban. Development policies affecting the rural work-force need to emphasize gender equity and access to land tenure and credit. Economic growth and improvement in the quality of life have been fastest in those areas where the status of women is highest, therefore population policies will succeed only if women are equal to men in making and directing policy. The draft Program of Action would commit the world community to goals in education, especially for girls; reduction of infant, child and maternal mortality; and universal access to family planning and reproductive health services.

South African Zulu Widows in a Time of Poverty and Social Change

ERIC Educational Resources Information Center

Rosenblatt, Paul C.; Nkosi, Busisiwe Catherine

2007-01-01

Interviews were carried out with 16 South African Zulu widows. Much of what the widows had to say seemed like what one might hear from widows in economically developed countries, but there were also striking differences. All the widows lived in poverty, and for some their grief seemed much more about the poverty than about the husband's death.…

The Bidirectional Effects of Early Poverty on Children's Reading and Home Environment Scores: Associations and Ethnic Differences

ERIC Educational Resources Information Center

Lee, Kyunghee

2009-01-01

Using data from the National Longitudinal Survey of Youth, the author reports secondary analyses that examine the bidirectional effects of the duration of early poverty on children's reading and home environment scores. The author focuses on three specific questions: (1) Does the duration of early childhood poverty affect children's reading scores…

Income and Poverty. What the 1990 Census Says about Minnesota.

ERIC Educational Resources Information Center

Tichy, John; Craig, William J.

This report is a look at what the 1990 Census has to say about income and poverty in Minnesota and its major metropolitan area, the Twin Cities (Minneapolis and Saint Paul). The report is organized into five parts, each addressing a different variation on the central theme of income and poverty: (1) Income Overview; (2) Income Types; (3) Poverty…

Analyzing the Attitude of Undergraduate Students toward Poverty and Impoverished Persons: Does Social Work Education Make a Difference?

ERIC Educational Resources Information Center

Weaver, Robert D.; Yun, Sung Hyun

2011-01-01

This study evaluated the impact that undergraduate social work education had on students' attitude toward poverty as pretest and posttest data were collected from 166 university students enrolled in an undergraduate social work course that included a focus on poverty. At both stages of the study participants responded to a 37-item validated…

77 FR 30266 - Annual Updates to the Income Contingent Repayment (ICR) Plan Formula for 2012; William D. Ford...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-22

... disbursed. In the examples, the Poverty Guideline amounts used are from the 2012 U.S. Department of Health and Human Services (HHS) Poverty Guidelines for the 48 contiguous States and the District of Columbia, as published in the Federal Register on January 26, 2012 (77 FR 4034). Different Poverty Guidelines...

78 FR 33395 - Annual Updates to the Income Contingent Repayment (ICR) Plan Formula for 2013-William D. Ford...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-04

... the postsecondary institution first disbursed the Direct Loan to the borrower. The Poverty Guideline amounts used in the examples are from the 2013 U.S. Department of Health and Human Services (HHS) Poverty... January 24, 2013 (78 FR 5182). Different Poverty Guidelines apply to residents of Alaska and Hawaii. All...

Contribution of health workforce to health outcomes: empirical evidence from Vietnam.

PubMed

Nguyen, Mai Phuong; Mirzoev, Tolib; Le, Thi Minh

2016-11-16

In Vietnam, a lower-middle income country, while the overall skill- and knowledge-based quality of health workforce is improving, health workers are disproportionately distributed across different economic regions. A similar trend appears to be in relation to health outcomes between those regions. It is unclear, however, whether there is any relationship between the distribution of health workers and the achievement of health outcomes in the context of Vietnam. This study examines the statistical relationship between the availability of health workers and health outcomes across the different economic regions in Vietnam. We constructed a panel data of six economic regions covering 8 years (2006-2013) and used principal components analysis regressions to estimate the impact of health workforce on health outcomes. The dependent variables representing the outcomes included life expectancy at birth, infant mortality, and under-five mortality rates. Besides the health workforce as our target explanatory variable, we also controlled for key demographic factors including regional income per capita, poverty rate, illiteracy rate, and population density. The numbers of doctors, nurses, midwives, and pharmacists have been rising in the country over the last decade. However, there are notable differences across the different categories. For example, while the numbers of nurses increased considerably between 2006 and 2013, the number of pharmacists slightly decreased between 2011 and 2013. We found statistically significant evidence of the impact of density of doctors, nurses, midwives, and pharmacists on improvement to life expectancy and reduction of infant and under-five mortality rates. Availability of different categories of health workforce can positively contribute to improvements in health outcomes and ultimately extend the life expectancy of populations. Therefore, increasing investment into more equitable distribution of four main categories of health workforce (doctors, nurses, midwives, and pharmacists) can be an important strategy for improving health outcomes in Vietnam and other similar contexts. Future interventions will also need to consider an integrated approach, building on the link between the health and the development.

One Size Fits All? The Validity of a Composite Poverty Index Across Urban and Rural Households in South Africa.

PubMed

Steinert, Janina Isabel; Cluver, Lucie Dale; Melendez-Torres, G J; Vollmer, Sebastian

2018-01-01

Composite indices have been prominently used in poverty research. However, validity of these indices remains subject to debate. This paper examines the validity of a common type of composite poverty indices using data from a cross-sectional survey of 2477 households in urban and rural KwaZulu-Natal, South Africa. Multiple-group comparisons in structural equation modelling were employed for testing differences in the measurement model across urban and rural groups. The analysis revealed substantial variations between urban and rural respondents both in the conceptualisation of poverty as well as in the weights and importance assigned to individual poverty indicators. The validity of a 'one size fits all' measurement model can therefore not be confirmed. In consequence, it becomes virtually impossible to determine a household's poverty level relative to the full sample. Findings from our analysis have important practical implications in nuancing how we can sensitively use composite poverty indices to identify poor people.

Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA.

PubMed

D'Agostino, Emily M; Patel, Hersila H; Hansen, Eric; Mathew, M Sunil; Nardi, Maria; Messiah, Sarah E

2018-03-01

The WHO calls for affordable population-based prevention strategies for reducing the global burden of cardiovascular disease (CVD) on morbidity and mortality; however, effective, sustainable and accessible community-based approaches for CVD prevention in at-risk youth have yet to be identified. We examined the effects of implementing a daily park-based afterschool fitness programme on youth CVD risk profiles over 5 years and across area poverty subgroups. The study included 2264 youth (mean age 9.4 years, 54% male, 50% Hispanic, 47% non-Hispanic black, 70% high/very high area poverty) in Miami, Florida, USA. We used three-level repeated measures mixed models to determine the longitudinal effects of programme participation on modifiable CVD outcomes (2010-2016). Duration of programme participation was significantly associated with CVD risk profile improvements, including body mass index (BMI) z-score, diastolic/systolic blood pressure, skinfold thicknesses, waist-hip ratio, sit-ups, push-ups, Progressive Aerobic Cardiovascular Endurance Run (PACER) score, 400 m run time, probability of developing systolic/diastolic hypertension and overweight/obesity in high/very high poverty neighbourhoods (P<0.001). Diastolic blood pressure decreased 3.4 percentile points (95% CI -5.85 to -0.85), 8.1 percentile points (95% CI -11.98 to -4.26), 6.1 percentile points (95% CI -11.49 to -0.66), 7.6 percentile points (95% CI -15.33 to -0.15) and 11.4 percentile points (95% CI -25.32 to 2.61) for 1-5 years, respectively, in high/very high poverty areas. In contrast, significant improvements were found only for PACER score and waist-hip ratio in low/mid poverty areas. This analysis presents compelling evidence demonstrating that park-based afterschool programmes can successfully maintain or improve at-risk youth CVD profiles over multiple years. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Inequality, poverty, and material deprivation in new and old members of the European Union.

PubMed

Matković, Teo; Sucur, Zoran; Zrinscak, Sinsa

2007-10-01

To analyze the main indicators of income inequality, objective and subjective poverty, material deprivation, and the role of public social transfers in the reduction of poverty in 15 old and 10 new member states of the European Union (EU), undergoing post-communist socio-economic transition, as well as in Croatia, a candidate EU country. Objective poverty rates, poverty reduction rates, poverty thresholds in purchasing power standards (PPS), total social expenditure, inequality indicators, and risks of poverty according to demographics were calculated using the data from the Eurostat databases, in particular, Household Budget Survey. For Croatia, Central Bureau of Statistics first releases on poverty indicators were used, as well as database of the Ministry of Finance (social expenditure). Subjective poverty rates and non-monetary deprivation index were calculated using the European Quality of Life Survey, which was carried out in 2003 in EU countries and in 2006 in Croatia. According to the indicators of income inequality and objective poverty, there was a divide among old EU member states (EU15), with UK, Ireland and South European countries having higher and Continental and Nordic countries lower indicators of inequality and poverty. Among new member states (NMS10), Baltic countries and Poland had the highest and Slovenia and the Czech Republic the lowest indicators of inequality and poverty. In all EU15 countries, except Greece, subjective poverty rates were lower than objective ones, whereas in all NMS10 countries the levels of subjective poverty were much higher than those of objective poverty. With some exceptions, NMS10 countries had low or even decreasing social expenditures. The share of respondents who were deprived of more than 50% of items was 6 times higher in the NMS10 than in the EU15 countries. When standard of living was measured by income inequality, relative poverty rates, poverty reduction rates, total social protection expenditures, and non-monetary deprivation, only Slovenia, the Czech Republic, and Hungary, out of the NMS10, were in the upper half of the distribution, while Croatia had a medium position among NMS10 states. Our analysis demonstrated that poverty in countries undergoing post-socialist socioeconomic transition is widespread and could seriously limit human development. Continual research and monitoring of different aspects of poverty is needed for setting appropriate policies across the EU to effectively combat poverty and social exclusion and to promote convergence process.

Poverty and racial disparities in kidney disease: the REGARDS study.

PubMed

McClellan, William M; Newsome, Britt B; McClure, Leslie A; Howard, George; Volkova, Nataliya; Audhya, Paul; Warnock, David G

2010-01-01

There are pronounced disparities among black compared to white Americans for risk of end-stage renal disease. This study examines whether similar relationships exist between poverty and racial disparities in chronic kidney disease (CKD) prevalence. We studied 22,538 participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study. We defined individual poverty as family income below USD 15,000 and a neighborhood as poor if 25% or more of the households were below the federal poverty level. As the estimated glomerular filtration rate (GFR) declined from 50-59 to 10-19 ml/min/ 1.73 m2, the black:white odds ratio (OR) for impaired kidney function increased from 0.74 (95% CI 0.66, 0.84) to 2.96 (95% CI 1.96, 5.57). Controlling for individual income below poverty, community poverty, demographic and comorbid characteristics attenuated the black:white prevalence to an OR of 0.65 (95% CI 0.57, 0.74) among individuals with a GFR of 59-50 ml/min/1.73 m2 and an OR of 2.21 (95% CI 1.25, 3.93) among individuals with a GFR between 10 and 19 ml/min/ 1.73 m2. Household, but not community poverty, was independently associated with CKD and attenuated but did not fully account for differences in CKD prevalence between whites and blacks. Copyright 2010 S. Karger AG, Basel.

Multiplicative disadvantage of being an unmarried and inadequately insured woman living in poverty with colon cancer: historical cohort exploration in California.

PubMed

Levitz, Naomi R; Haji-Jama, Sundus; Munro, Tonya; Gorey, Kevin M; Luginaah, Isaac N; Bartfay, Emma; Zou, Guangyong; Wright, Frances C; Kanjeekal, Sindu M; Hamm, Caroline; Balagurusamy, Madhan K; Holowaty, Eric J

2015-01-01

Many Americans diagnosed with colon cancer do not receive indicated chemotherapy. Certain unmarried women may be particularly disadvantaged. A 3-way interaction of the multiplicative disadvantages of being an unmarried and inadequately insured woman living in poverty was explored. California registry data were analyzed for 2,319 women diagnosed with stage II to IV colon cancer between 1996 and 2000 and followed until 2014. Socioeconomic data from the 2000 census classified neighborhoods as high poverty (≥30% of households poor), middle (5-29%) or low poverty (<5% poor). Primary health insurance was private, Medicare, Medicaid or none. Comparisons of chemotherapy rates used standardized rate ratios (RR). We respectively used logistic and Cox regression models to assess chemotherapy and survival. A statistically significant 3-way marital status by health insurance by poverty interaction effect on chemotherapy receipt was observed. Chemotherapy rates did not differ between unmarried (39.0%) and married (39.7%) women who lived in lower poverty neighborhoods and were privately insured. But unmarried women (27.3%) were 26% less likely to receive chemotherapy than were married women (37.1%, RR = 0.74, 95% CI 0.58, 0.95) who lived in high poverty neighborhoods and were publicly insured or uninsured. When this interaction and the main effects of health insurance, poverty and chemotherapy were accounted for, survival did not differ by marital status. The multiplicative barrier to colon cancer care that results from being inadequately insured and living in poverty is worse for unmarried than married women. Poverty is more prevalent among unmarried women and they have fewer assets so they are probably less able to absorb the indirect and direct, but uncovered, costs of colon cancer care. There seem to be structural inequities related to the institutions of marriage, work and health care that particularly disadvantage unmarried women that policy makers ought to be cognizant of as future reforms of the American health care system are considered.

Household income disparities in fruit and vegetable consumption by state and territory: results of the 2009 Behavioral Risk Factor Surveillance System.

PubMed

Grimm, Kirsten A; Foltz, Jennifer L; Blanck, Heidi M; Scanlon, Kelley S

2012-12-01

Few studies take into account the influence of family size on household resources when assessing income disparities in fruit and vegetable (F/V) consumption. Poverty income ratio (PIR) is a measure that utilizes both reported income and household size. We sought to examine state-specific disparities in meeting Healthy People 2010 objectives for F/V consumption by percent PIR. This analysis included 353,005 adults in 54 states and territories reporting data to the 2009 Behavioral Risk Factor Surveillance System in the United States. Percent PIR was calculated using the midpoint of self-reported income range and family size. The prevalences consuming at least two fruits and at least three vegetables per day were examined by percent PIR (<130% [greatest poverty], 130% to <200%, 200% to <400%, and ≥ 400% [least poverty]). The percent of adults consuming vegetables at least three times daily was significantly lower (21.3%) among those living at greatest poverty (<130% PIR) compared with 30.7% among those with least poverty (≥ 400% PIR). Daily consumption of vegetables at least three times was significantly lower among those with greatest poverty in a majority of states and territories surveyed (43 of 54). The overall percent of adults consuming fruits at least 2 times daily was also lower among those living at greatest vs least poverty, but the difference was smaller (32.0% vs 34.2%), with 14 states reporting a difference that was significantly lower among those with greatest poverty. Our study revealed that in 2009 a significantly lower proportion of US adults living at greatest poverty consumed fruits at least two times daily or vegetables at least three times daily compared with those with the least poverty, with greater disparity in vegetable intake. Policy and environmental strategies for increased affordability, access, availability, and point-of-decision information are approaches that may help disparate households purchase and consume F/V. Published by Elsevier Inc.

Child wellbeing and income inequality in rich societies: ecological cross sectional study.

PubMed

Pickett, Kate E; Wilkinson, Richard G

2007-11-24

To examine associations between child wellbeing and material living standards (average income), the scale of differentiation in social status (income inequality), and social exclusion (children in relative poverty) in rich developed societies. Ecological, cross sectional studies. Cross national comparisons of 23 rich countries; cross state comparisons within the United States. Children and young people. The Unicef index of child wellbeing and its components for rich countries; eight comparable measures for the US states and District of Columbia (teenage births, juvenile homicides, infant mortality, low birth weight, educational performance, dropping out of high school, overweight, mental health problems). The overall index of child wellbeing was negatively correlated with income inequality (r=-0.64, P=0.001) and percentage of children in relative poverty (r=-0.67, P=0.001) but not with average income (r=0.15, P=0.50). Many more indicators of child wellbeing were associated with income inequality or children in relative poverty, or both, than with average incomes. Among the US states and District of Columbia all indicators were significantly worse in more unequal states. Only teenage birth rates and the proportion of children dropping out of high school were lower in richer states. Improvements in child wellbeing in rich societies may depend more on reductions in inequality than on further economic growth.

Climate Risk and Vulnerability in the Caribbean and Gulf of Mexico Region: Interactions with Spatial Population and Land Cover Change

NASA Astrophysics Data System (ADS)

Chen, R. S.; Levy, M.; Baptista, S.; Adamo, S.

2010-12-01

Vulnerability to climate variability and change will depend on dynamic interactions between different aspects of climate, land-use change, and socioeconomic trends. Measurements and projections of these changes are difficult at the local scale but necessary for effective planning. New data sources and methods make it possible to assess land-use and socioeconomic changes that may affect future patterns of climate vulnerability. In this paper we report on new time series data sets that reveal trends in the spatial patterns of climate vulnerability in the Caribbean/Gulf of Mexico Region. Specifically, we examine spatial time series data for human population over the period 1990-2000, time series data on land use and land cover over 2000-2009, and infant mortality rates as a proxy for poverty for 2000-2008. We compare the spatial trends for these measures to the distribution of climate-related natural disaster risk hotspots (cyclones, floods, landslides, and droughts) in terms of frequency, mortality, and economic losses. We use these data to identify areas where climate vulnerability appears to be increasing and where it may be decreasing. Regions where trends and patterns are especially worrisome include coastal areas of Guatemala and Honduras.

Pakistan and the Millennium Development Goals for Maternal and Child Health: progress and the way forward.

PubMed

Rizvi, Arjumand; Bhatti, Zaid; Das, Jai K; Bhutta, Zulfiqar A

2015-04-03

The world has made substantial progress in reducing maternal and child mortality, but many countries are projected to fall short of achieving their Millennium Development Goals (MDGs) 4 and 5 targets. The major objective of this paper is to examine progress in Pakistan in reducing maternal and child mortality and malnutrition over the last two decades. Data from recent national and international surveys suggest that Pakistan lags behind on all of its MDGs related to maternal and child health and, for some indicators especially related to nutrition, the situation has worsened from the baseline of 1990. Progress in addressing key social determinants such as poverty, female education and empowerment has also been slow and unregulated population growth has further compromised progress. There is a need to integrate the various different sectors and programmes to achieve the desired results effectively and efficiently as many of the determinants and influencing factors are outside the health sector. Pakistan has to accelerate improvement of access to maternal health services, particularly contraception, emergency obstetric care and skilled birth attendance; the need to improve maternal and child nutrition cannot be over-emphasised.

Comparing two survey methods for estimating maternal and perinatal mortality in rural Cambodia.

PubMed

Chandy, Hoeuy; Heng, Yang Van; Samol, Ha; Husum, Hans

2008-03-01

We need solid estimates of maternal mortality rates (MMR) to monitor the impact of maternal care programs. Cambodian health authorities and WHO report the MMR in Cambodia at 450 per 100,000 live births. The figure is drawn from surveys where information is obtained by interviewing respondents about the survival of all their adult sisters (sisterhood method). The estimate is statistically imprecise, 95% confidence intervals ranging from 260 to 620/100,000. The MMR estimate is also uncertain due to under-reporting; where 80-90% of women deliver at home maternal fatalities may go undetected especially where mortality is highest, in remote rural areas. The aim of this study was to attain more reliable MMR estimates by using survey methods other than the sisterhood method prior to an intervention targeting obstetric rural emergencies. The study was carried out in rural Northwestern Cambodia where access to health services is poor and poverty, endemic diseases, and land mines are endemic. Two survey methods were applied in two separate sectors: a community-based survey gathering data from public sources and a household survey gathering data direct from primary sources. There was no statistically significant difference between the two survey results for maternal deaths, both types of survey reported mortality rates around the public figure. The household survey reported a significantly higher perinatal mortality rate as compared to the community-based survey, 8.6% versus 5.0%. Also the household survey gave qualitative data important for a better understanding of the many problems faced by mothers giving birth in the remote villages. There are detection failures in both surveys; the failure rate may be as high as 30-40%. PRINCIPLE CONCLUSION: Both survey methods are inaccurate, therefore inappropriate for evaluation of short-term changes of mortality rates. Surveys based on primary informants yield qualitative information about mothers' hardships important for the design of future maternal care interventions.

Race/ethnicity, socioeconomic status, and ALS mortality in the United States.

PubMed

Roberts, Andrea L; Johnson, Norman J; Chen, Jarvis T; Cudkowicz, Merit E; Weisskopf, Marc G

2016-11-29

To determine whether race/ethnicity and socioeconomic status are associated with amyotrophic lateral sclerosis (ALS) mortality in the United States. The National Longitudinal Mortality Study (NLMS), a United States-representative, multistage sample, collected race/ethnicity and socioeconomic data prospectively. Mortality information was obtained by matching NLMS records to the National Death Index (1979-2011). More than 2 million persons (n = 1,145,368 women, n = 1,011,172 men) were included, with 33,024,881 person-years of follow-up (1,299 ALS deaths , response rate 96%). Race/ethnicity was by self-report in 4 categories. Hazard ratios (HRs) for ALS mortality were calculated for race/ethnicity and socioeconomic status separately and in mutually adjusted models. Minority vs white race/ethnicity predicted lower ALS mortality in models adjusted for socioeconomic status, type of health insurance, and birthplace (non-Hispanic black, HR 0.61, 95% confidence interval [CI] 0.48-0.78; Hispanic, HR 0.64, 95% CI 0.46-0.88; other races, non-Hispanic, HR 0.52, 95% CI 0.31-0.86). Higher educational attainment compared with < high school was in general associated with higher rate of ALS (high school, HR 1.23, 95% CI 1.07-1.42; some college, HR 1.24, 95% CI 1.04-1.48; college, HR 1.10, 95% CI 0.90-1.36; postgraduate, HR 1.31, 95% CI 1.06-1.62). Income, household poverty, and home ownership were not associated with ALS after adjustment for race/ethnicity. Rates did not differ by sex. Higher rate of ALS among whites vs non-Hispanic blacks, Hispanics, and non-Hispanic other races was not accounted for by multiple measures of socioeconomic status, birthplace, or type of health insurance. Higher rate of ALS among whites likely reflects actual higher risk of ALS rather than ascertainment bias or effects of socioeconomic status on ALS risk. © 2016 American Academy of Neurology.

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

Alcohol availability and neighborhood poverty and their relationship to binge drinking and related problems among drinkers in committed relationships

PubMed Central

McKinney, Christy M.; Chartier, Karen G.; Caetano, Raul; Harris, T. Robert

2012-01-01

The authors examined the relationship of alcohol outlet density (AOD) and neighborhood poverty with binge drinking and alcohol-related problems among drinkers in married and cohabitating relationships and assessed whether these associations differed across sex. A U.S. national population couples survey was linked to U.S. Census data on AOD and neighborhood poverty. The 1,784 current drinkers in the survey reported on their binge drinking, alcohol-related problems, and other covariates. AOD was defined as the number of alcohol outlets per 10,000 persons and was obtained at the zip code level. Neighborhood poverty was as having a low (<20%) or high (≥20%) proportion of residents living in poverty at the census tract level. We used logistic regression for survey data to estimate odds ratios and 95% confidence intervals and tested for differences of associations by sex. Associations of neighborhood poverty with binge drinking were stronger for male than for female drinkers. The association of neighborhood poverty with alcohol-related problems was also stronger for men than for women. We observed no relationships between AOD and binge drinking or alcohol-related problems in this couples survey. Efforts to reduce binge drinking or alcohol-related problems among partners in committed relationships may have the greatest impact if targeted to male drinkers living in high-poverty neighborhoods. Binge drinking and alcohol-related problems, as well as residence in an impoverished neighborhood are risk factors for intimate partner violence (IPV) and other relationship conflicts. PMID:22890980

Alcohol availability and neighborhood poverty and their relationship to binge drinking and related problems among drinkers in committed relationships.

PubMed

McKinney, Christy M; Chartier, Karen G; Caetano, Raul; Harris, T Robert

2012-09-01

The authors examined the relationship of alcohol outlet density (AOD) and neighborhood poverty with binge drinking and alcohol-related problems among drinkers in married and cohabitating relationships and assessed whether these associations differed across sex. A U.S. national population couples survey was linked to U.S. Census data on AOD and neighborhood poverty. The 1,784 current drinkers in the survey reported on their binge drinking, alcohol-related problems, and other covariates. AOD was defined as the number of alcohol outlets per 10,000 persons and was obtained at the zip code level. Neighborhood poverty was defined as having a low (<20%) or high (≥20%) proportion of residents living in poverty at the census tract level. We used logistic regression for survey data to estimate odds ratios and 95% confidence intervals and tested for differences of associations by sex. Associations of neighborhood poverty with binge drinking were stronger for male than for female drinkers. The association of neighborhood poverty with alcohol-related problems was also stronger for men than for women. We observed no relationships between AOD and binge drinking or alcohol-related problems in this couples survey. Efforts to reduce binge drinking or alcohol-related problems among partners in committed relationships may have the greatest impact if targeted to male drinkers living in high-poverty neighborhoods. Binge drinking and alcohol-related problems, as well as residence in an impoverished neighborhood are risk factors for intimate partner violence (IPV) and other relationship conflicts.

The School-Parent Relationship across Different Income Levels

ERIC Educational Resources Information Center

Matthews, Alison; McPherson-Berg, Sherry L.; Quinton, Adalcy; Rotunda, Robert S.; Morote, Elsa-Sofia

2017-01-01

The purpose of this study was to investigate how the school-parent relationship (volunteering, outreach, and communicating) in schools differs among the poverty level of students. One hundred eighty-nine middle school parents answered a parental involvement survey. Comparisons were made between the poverty level of students (free and reduced…

Patterns of poverty exposure and children's trajectories of externalizing and internalizing behaviors.

PubMed

Comeau, Jinette; Boyle, Michael H

2018-04-01

Using data from the Child Supplement of the National Longitudinal Survey of Youth, we compare trajectories of externalizing and internalizing behaviors among children exposed to five patterns of poverty from birth to age 14: always or never poor - stable patterns; a single transition into or out of poverty, or repeated fluctuations in and out of poverty - changing patterns. We also examine how low maternal education and single parenthood interact with these poverty exposures to compound their adverse effects. Finally, we compare the magnitude of effects associated with the patterns of poverty exposure, as well as their interactions with low maternal education and single parenthood, on trajectories of externalizing and internalizing behaviors to determine if they are significantly different. Results reveal that initial levels and rates of change in children's trajectories of externalizing and internalizing behaviors are similar across the three changing patterns of poverty exposure, leading us to combine them into a single group representing intermittent poverty. Initial disparities between children who are never poor and their counterparts who are always or intermittently poor are constant over time for internalizing behaviors and grow in magnitude for externalizing behaviors. The cumulative negative effect of poverty exposure over time is stronger for externalizing vs. internalizing behaviors. Low maternal education compounds the adverse effects of persistent poverty, an effect that is similar for externalizing and internalizing behaviors.

Understanding the Link between Poverty and Food Insecurity among Children: Does the Definition of Poverty Matter?

PubMed

Wight, Vanessa; Kaushal, Neeraj; Waldfogel, Jane; Garfinkel, Irv

2014-01-02

This paper examines the association between poverty and food insecurity among children, using two different definitions of poverty-the official poverty measure (OPM) and the new supplemental poverty measure (SPM) of the Census Bureau, which is based on a more inclusive definition of family resources and needs. Our analysis is based on data from the 2001-11 Current Population Survey and shows that food insecurity and very low food security among children decline as income-to-needs ratio increases. The point estimates show that the associations are stronger as measured by the new supplemental measure of income-to-needs ratio than when estimated through the official measure. Statistical tests reject the hypothesis that poor households' odds of experiencing low food security are the same whether the SPM or OPM measure is used; but the tests do not reject the hypothesis when very low food security is the outcome.

Geographically Weighted Regression Model with Kernel Bisquare and Tricube Weighted Function on Poverty Percentage Data in Central Java Province

NASA Astrophysics Data System (ADS)

Nugroho, N. F. T. A.; Slamet, I.

2018-05-01

Poverty is a socio-economic condition of a person or group of people who can not fulfil their basic need to maintain and develop a dignified life. This problem still cannot be solved completely in Central Java Province. Currently, the percentage of poverty in Central Java is 13.32% which is higher than the national poverty rate which is 11.13%. In this research, data of percentage of poor people in Central Java Province has been analyzed through geographically weighted regression (GWR). The aim of this research is therefore to model poverty percentage data in Central Java Province using GWR with weighted function of kernel bisquare, and tricube. As the results, we obtained GWR model with bisquare and tricube kernel weighted function on poverty percentage data in Central Java province. From the GWR model, there are three categories of region which are influenced by different of significance factors.

Adjusted Poverty Measures and the Distribution of Title I Aid: Does Title I Really Make the Rich States Richer?

ERIC Educational Resources Information Center

Baker, Bruce D.; Taylor, Lori; Levin, Jesse; Chambers, Jay; Blankenship, Charles

2013-01-01

Federal and state governments in the United States make extensive use of student poverty rates in compensatory aid programs like Title I. Unfortunately, the measures of student poverty that drive funding allocations under such programs are biased because they fail to reflect geographic differences in the cost of living. In this study, we construct…

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.

Higher mortality in areas of lower socioeconomic position measured by a single index of deprivation in Japan.

PubMed

Fukuda, Yoshiharu; Nakamura, Keiko; Takano, Takehito

2007-03-01

To formulate an index representing area deprivation and elucidate the relation between the index and mortality in Japan. Ecological study for prefectures (N=47) and municipalities (N=3366) across Japan. Based on socioeconomic indicators of seven domains of deprivation (i.e. unemployment, overcrowding, low social class and poverty, low education, no home ownership, low income and vulnerable group), an index was formulated using the z-scoring method. The relation between the index and mortality was examined by correlation analysis, hierarchical Poisson regression and comparison of standardized mortality ratio according to the index. The deprivation index ranged from -7.48 to 10.98 for prefectures and from -16.97 to 13.82 for municipalities. The index was significantly positively correlated with prefectural mortality, especially in the population aged under 74 years: r=0.65 for men and r=0.41 for women. At the municipal level, hierarchical Poisson regression showed a significant positive coefficient of the index to mortality for both men and women, and excess mortality in the most deprived fifth compared to the least deprived fifth was 26.4% in men and 11.8% in women. We formulated a deprivation index, which was substantially related to mortality at the prefectural and municipal levels. This study highlights the higher risk of dying among populations in socially disadvantaged areas and encourages the use of indices representing area socioeconomic conditions for further studies of area effects on health.

The Hungarian country profile: inequalities in health and health care in Hungary.

PubMed

Orosz, E

1990-01-01

Analysis of occupational, educational, urban/rural and regional data over several decades demonstrate large disparities in the availability of health care and in infant and adult mortality. Life expectancy increased in the immediate post-war period but in the late sixties improvement ceased and life expectancy at age 40 began to fall. Mortality has been particularly high for middle-aged males. Analysis by cause of death suggests the persistence of older poverty-type diseases co-existing with the newer lifestyle diseases. Reasons for system dysfunctioning are discussed--lack of health resources, rigid institutional structures, lack of integrated health policies, failure to adjust the distribution of resources to changing needs etc. The analysis raises the question of how to achieve a balance between equity and efficiency.

Maternal and neonatal health expenditure in mumbai slums (India): A cross sectional study

PubMed Central

2011-01-01

Background The cost of maternity care can be a barrier to access that may increase maternal and neonatal mortality risk. We analyzed spending on maternity care in urban slum communities in Mumbai to better understand the equity of spending and the impact of spending on household poverty. Methods We used expenditure data for maternal and neonatal care, collected during post-partum interviews. Interviews were conducted in 2005-2006, with a sample of 1200 slum residents in Mumbai (India). We analysed expenditure by socio-economic status (SES), calculating a Kakwani Index for a range of spending categories. We also calculated catastrophic health spending both with and without adjustment for coping strategies. This identified the level of catastrophic payments incurred by a household and the prevalence of catastrophic payments in this population. The analysis also gave an understanding of the protection from medical poverty afforded by coping strategies (for example saving and borrowing). Results A high proportion of respondents spent catastrophically on care. Lower SES was associated with a higher proportion of informal payments. Indirect health expenditure was found to be (weakly) regressive as the poorest were more likely to use wage income to meet health expenses, while the less poor were more likely to use savings. Overall, the incidence of catastrophic maternity expenditure was 41%, or 15% when controlling for coping strategies. We found no significant difference in the incidence of catastrophic spending across wealth quintiles, nor could we conclude that total expenditure is regressive. Conclusions High expenditure as a proportion of household resources should alert policymakers to the burden of maternal spending in this context. Differences in informal payments, significantly regressive indirect spending and the use of savings versus wages to finance spending, all highlight the heavier burden borne by the most poor. If a policy objective is to increase institutional deliveries without forcing households deeper into poverty, these inequities will need to be addressed. Reducing out-of-pocket payments and better regulating informal payments should have direct benefits for the most poor. Alternatively, targeted schemes aimed at assisting the most poor in coping with maternal spending (including indirect spending) could reduce the household impact of high costs. PMID:21385404

Challenges experienced by South Africa in attaining Millennium Development Goals 4, 5 and 6.

PubMed

Mulaudzi, Fhumulani M; Phiri, Seepaneng S; Peu, Doriccah M; Mataboge, Mmamakwa L S; Ngunyulu, Nkhensani R; Mogale, Ramadimetja S

2016-05-06

Despite progress made by other countries worldwide in achieving Millennium Development Goals (MDGs) 4, 5 and 6, South Africa is experiencing a challenge in attaining positive outcomes for these goals. To describe the challenges experienced by South Africa regarding the successful implementation of MDGs 4, 5 and 6. An integrative literature review was used to identify and synthesise various streams of literature on the challenges experienced by South Africa in attaining MDGs 4, 5 and 6. The integrative review revealed the following themes: (1) interventions related to child mortality reduction, (2) implementation of maternal mortality reduction strategies, and (3) identified barriers to zero HIV and TB infections and management. It is recommended that poverty relief mechanisms be intensified to improve the socio-economic status of women. There is a need for sectoral planning towards maternal health, and training of healthcare workers should emphasise the reduction of maternal deaths. Programmes addressing the reduction of maternal and child mortality rates, HIV, STIs and TB need to be put in place.

Social security and mortality: The role of income support policies and population health in the United States

PubMed Central

Arno, Peter S.; House, James S.; Viola, Deborah; Schechter, Clyde

2011-01-01

Social Security is the most important and effective income support program ever introduced in the United States, alleviating the burden of poverty for millions of elderly Americans. We explored the possible role of Social Security in reducing mortality among the elderly. In support of this hypothesis, we found that declines in mortality among the elderly exceeded those among younger age groups following the initial implementation of Social Security in 1940, and also in the periods following marked improvements in Social Security benefits via legislation and indexing of benefits that occurred between the mid-1960s and the early 1970s. A better understanding of the link between Social Security and health status among the elderly would add a significant and missing dimension to the public discourse over the future of Social Security, and the potential role of income support programs in reducing health-related socioeconomic disparities and improving population health. PMID:21326333

The impact of development and population policies on fertility in India.

PubMed

Jain, A K

1985-01-01

This article examines the impact of development and population policies on fertility decline and regional variations in India during the 1970s. Indicators of development at the household level include female literacy and education, infant mortality, and poverty; at the village level they include availability of such social services as schools, medical facilities, and transportation and communication facilities. Multiple regression analysis of data aggregated at the state level demonstrates that conditions conducive to fertility decline include high adult female literacy and low infant mortality as indicators of social development, and high contraceptive use and, to a lesser extent, high female age at marriage as proximate determinants of fertility. There are reasons to believe that India's national family planning program contributed to the decline in fertility observed since the 1960s. The pace of fertility decline in the future will depend upon the pace of infant mortality decline, enhancement in female education, and improvements in family planning programs.

Maternal care receptivity and its relation to perinatal and neonatal mortality. A rural study.

PubMed

Bhardwaj, N; Hasan, S B; Zaheer, M

1995-04-01

A longitudinal study was conducted on 212 pregnant women from May 1987 to April 1988. Maternal Care Receptivity (MCR) "an innovative approach" was adopted for the assessment of maternal care services provided to pregnant mothers at their door steps. During follow-up, scores were allotted to each of the services rendered and antenatal status of pregnant women. Depending on the score--MCR was classified as high (11 to 8), moderate (7 to 4) or poor (3 to 0). Perinatal and neonatal deaths were recorded and an inverse relationship between MCR and perinatal and mortalities was observed (z = 5.46, p < 0.0001). Significantly, no perinatal or neonatal deaths occurred in women with high MCR. One of the most important cause of high PNMR and neonatal mortality rate in developing countries is poor MCR, i.e., under utilization of even the existing maternal health services. The main reasons for this under utilization appear to be poverty, illiteracy, ignorance and lack of faith in modern medicine.

Psychological distress increases the risk of falling into poverty amongst older Australians: the overlooked costs-of-illness.

PubMed

Callander, Emily J; Schofield, Deborah J

2018-04-17

This paper aimed to identify whether high psychological distress is associated with an increased risk of income and multidimensional poverty amongst older adults in Australia. We undertook longitudinal analysis of the nationally representative Household Income and Labour Dynamics in Australian (HILDA) survey using modified Poisson regression models to estimate the relative risk of falling into income poverty and multidimensional poverty between 2010 and 2012 for males and females, adjusting for age, employment status, place of residence, marital status and housing tenure; and Population Attributable Risk methodology to estimate the proportion of poverty directly attributable to psychological distress, measured by the Kessler 10 scale. For males, having high psychological distress increased the risk of falling into income poverty by 1.68 (95% CI: 1.02 to 2.75) and the risk of falling into multidimensional poverty by 3.40 (95% CI: 1.91 to 6.04). For females, there was no significant difference in the risk of falling into income poverty between those with high and low psychological distress (p = 0.1008), however having high psychological distress increased the risk of falling into multidimensional poverty by 2.15 (95% CI: 1.30 to 3.55). Between 2009 and 2012, 8.0% of income poverty cases for people aged 65 and over (95% CI: 7.8% to 8.4%), and 19.5% of multidimensional poverty cases for people aged 65 and over (95% CI: 19.2% to 19.9%) can be attributed to high psychological distress. The elevated risk of falling into income and multidimensional poverty has been an overlooked cost of poor mental health.

Inequality, Poverty, and Material Deprivation in New and Old Members of European Union

PubMed Central

Matković, Teo; Šućur, Zoran; Zrinščak, Siniša

2007-01-01

Aim To analyze the main indicators of income inequality, objective and subjective poverty, material deprivation, and the role of public social transfers in the reduction of poverty in 15 old and 10 new member states of the European Union (EU), undergoing post-communist socio-economic transition, as well as in Croatia, a candidate EU country. Method Objective poverty rates, poverty reduction rates, poverty thresholds in purchasing power standards (PPS), total social expenditure, inequality indicators, and risks of poverty according to demographics were calculated using the data from the Eurostat databases (in particular, Household Budget Survey). For Croatia, Central Bureau of Statistics first releases on poverty indicators were used, as well as database of the Ministry of Finance (social expenditure). Subjective poverty rates and non-monetary deprivation index were calculated using the European Quality of Life Survey, which was carried out in 2003 in EU countries and in 2006 in Croatia. Results According to the indicators of income inequality and objective poverty, there was a divide among old EU member states (EU15), with UK, Ireland and South European countries having higher and Continental and Nordic countries lower indicators of inequality and poverty. Among new member states (NMS10), Baltic countries and Poland had the highest and Slovenia and the Czech Republic the lowest indicators of inequality and poverty. In all EU15 countries, except Greece, subjective poverty rates were lower than objective ones, whereas in all NMS10 countries the levels of subjective poverty were much higher than those of objective poverty. With some exceptions, NMS10 countries had low or even decreasing social expenditures. The share of respondents who were deprived of more than 50% of items was 6 times higher in the NMS10 than in the EU15 countries. When standard of living was measured by income inequality, relative poverty rates, poverty reduction rates, total social protection expenditures, and non-monetary deprivation, only Slovenia, the Czech Republic, and Hungary, out of the NMS10, were in the upper half of the distribution, while Croatia had a medium position among NMS10 states. Conclusion Our analysis demonstrated that poverty in countries undergoing post-socialist socioeconomic transition is widespread and could seriously limit human development. Continual research and monitoring of different aspects of poverty is needed for setting appropriate policies across the EU to effectively combat poverty and social exclusion and to promote convergence process. PMID:17948950

How Poverty Affects Classroom Engagement

ERIC Educational Resources Information Center

Jensen, Eric

2013-01-01

"Poverty" is an uncomfortable word. Teachers are often unsure what to expect from kids from low-income households and what to do differently as a result. Well-known author and educator Eric Jensen points to seven differences that show up in school between low- and middle-income children. By understanding what they are and how to address…

Income, Deprivation and Economic Stress in the Enlarged European Union

ERIC Educational Resources Information Center

Whelan, Christopher T.; Maitre, Bertrand

2007-01-01

At risk of poverty indicators based on relative income measures suggest that within the enlarged EU societies located at quite different points on a continuum of affluence have similar levels of poverty. Substantial differences in levels of income between societies do not in themselves invalidate this approach. However, the relative income…

The geography of mortality from Hurricane Katrina in New Orleans

NASA Astrophysics Data System (ADS)

Mutter, J. C.; Mara, V.; Jayaprakash, S.; None

2011-12-01

Hurricane Katrina was one of the highest mortality disasters in US history. Typical hurricanes of the same strength take very few lives. Katrina's mortality is exceeded only by the so-called Galveston Flood (a hurricane) of 1900 that occurred at a time when forecasting was poor and evacuation was possible only by train or horse. The levee failures in New Orleans were a major contributing factor unique to Katrina. An examination of the characteristics of mortality may give insight into the cause of the great scope of the tragedy and the special vulnerability of those who died. We examine the spatial aspects of mortality. The locations of deceased victims were matched with victim information including age, race and gender for approximately 800 victims (data from Louisiana Department of Health and Hospitals). From this we can analyze for spatial clustering of mortality. We know that Katrina took a particularly heavy toll on the elderly so we can analyze, for instance, whether the elderly were more likely to die in some locations than in others. Similarly, we analyze for gender and race against age (dividing age into five groups this gives 20 categories) as a factory in the geographic distribution of mortality as a way to recover measures of vulnerability. We can also correlate the spatial characteristics of mortality with underlying causes that might contribute to vulnerability. Data is available at a census block level on household income, poverty rates, education, home ownership, car ownership and a variety of other factors that can be correlated with the spatial mortality data. This allows for a multi-parameter estimation of factors that govern mortality in this unusually high mortality event.

The association between household poverty rates and tuberculosis case notification rates in Cambodia, 2010.

PubMed

Wong, Man Kai; Yadav, Rajendra-Prasad; Nishikiori, Nobuyuku; Eang, Mao Tan

2013-01-01

Poverty is a risk factor for tuberculosis (TB); it increases the risk of infection and active disease but limits diagnostic opportunities. The role of poverty in the stagnant case detection in Cambodia is unclear. This study aims to assess the relationship between district household poverty rates and sputum-positive TB case notification rates (CNRs) in Cambodia in 2010. Poisson regression models were used to calculate the relative risk of new sputum-positive TB CNR for Operational Districts (ODs) with different poverty rates using data from the National Centre for Tuberculosis and Leprosy Control and the National Committee for SubNational Democratic Development. Models were adjusted for other major covariates and a geographical information system was used to examine the spatial distribution of these covariates in the country. The univariate model showed a positive association between household poverty rates and sputum-positive TB CNRs. However, in multivariate models, after adjusting for major covariates, household poverty rates showed a significantly negative association with sputum-positive TB CNRs (relative risk [RR] = 0.95 per 5% increase in poverty rate). The negative association was stronger among males than females (RR = 0.93 versus 0.96 per 5% increase in poverty rate). Similar spatial patterns were observed between household poverty rates and other covariates, particularly OD population density. Household poverty rate is associated with a decrease in sputum-positive TB CNR in Cambodia, particularly in men. The potential of combining surveillance data and socioeconomic variables should be explored further to provide more insights for TB control programme planning.

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.

Children in Immigrant Families--The U.S. and 50 States: Economic Need beyond the Official Poverty Measure. Research Brief Series. Publication #2009-19

ERIC Educational Resources Information Center

Hernandez, Donald J.; Denton, Nancy A.; Macartney, Suzanne

2009-01-01

This Research Brief, the second in Child Trends series on immigrant children, draws on new results from Census 2000 data to examine differences in the poverty rates between children in immigrant families and children in native-born families. The brief reports results for the official poverty measure, but also for two alternatives to the official…

Community air pollution and mortality: Analysis of 1980 data from US metropolitan areas. 1: Particulate air pollution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lipfert, F.W.

1992-11-01

1980 data from up to 149 metropolitan areas were used to define cross-sectional associations between community air pollution and excess human mortality. The regression model proposed by Oezkaynak and Thurston, which accounted for age, race, education, poverty, and population density, was evaluated and several new models were developed. The new models also accounted for population change, drinking water hardness, and smoking, and included a more detailed description of race. Cause-of-death categories analyzed include all causes, all non-external causes, major cardiovascular diseases, and chronic obstructive pulmonary diseases (COPD). Both annual mortality rates and their logarithms were analyzed. The data on particulatesmore » were averaged across all monitoring stations available for each SMSA and the TSP data were restricted to the year 1980. The associations between mortality and air pollution were found to be dependent on the socioeconomic factors included in the models, the specific locations included din the data set, and the type of statistical model used. Statistically significant associations were found between TSP and mortality due to non-external causes with log-linear models, but not with a linear model, and between TS and COPD mortality for both linear and log-linear models. When the sulfate contribution to TSP was subtracted, the relationship with COPD mortality was strengthened. Scatter plots and quintile analyses suggested a TSP threshold for COPD mortality at around 65 ug/m{sup 3} (annual average). SO{sub 4}{sup {minus}2}, Mn, PM{sup 15}, and PM{sub 2.5} were not significantly associated with mortality using the new models.« less

"Love thy neighbour"-it's good for your health: a study of racial homogeneity, mortality and social cohesion in the United States.

PubMed

Reidpath, Daniel D

2003-07-01

This paper explores the idea that in societies that experience racial tension, increasing racial heterogeneity will be associated with poorer health outcomes, and this effect will be observable in the health of both the minority and the majority group. Here, the association between mortality and racial homogeneity in the United States is examined. The level of racial homogeneity, indexed by the proportion of blacks in each state of the 50 states in the US, was examined in relation to all-cause mortality, adjusted for age and disaggregated by race and sex. The level of poverty in each state was controlled for in ordinary least squares regression models. The level of racial homogeneity was significantly associated with age adjusted mortality rates for both blacks and whites, accounting for around 30% of the variance in mortality rates in the total population and the white population. Every 1% increase in the percentage of the state population who were black was associated with an increase in the total mortality rate of 5.06 per 100000 and an increase in the white mortality rate of 3.58 per 100000. Based on the data, this suggests, for example, that racial heterogeneity in Mississippi accounts for around 14% of the white mortality rate and in New York and Delaware it accounts for around 7%. These results appear to support the social cohesion thesis that in societies that are intolerant, mortality rates will increase as the proportion of racial or ethnic minorities increase in population. Limitations and explanations for the findings are discussed.

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.

Ethnic variations in immigrant poverty exit and female employment: the missing link.

PubMed

Kaida, Lisa

2015-04-01

Despite widespread interest in poverty among recent immigrants and female immigrant employment, research on the link between the two is limited. This study evaluates the effect of recently arrived immigrant women's employment on the exit from family poverty and considers the implications for ethnic differences in poverty exit. It uses the bivariate probit model and the Fairlie decomposition technique to analyze data from the Longitudinal Survey of Immigrants to Canada (LSIC), a nationally representative survey of immigrants arriving in Canada, 2000-2001. Results show that the employment of recently arrived immigrant women makes a notable contribution to lifting families out of poverty. Moreover, the wide ethnic variations in the probability of exit from poverty between European and non-European groups are partially explained by the lower employment rates among non-European women. The results suggest that the equal earner/female breadwinner model applies to low-income recent immigrant families in general, but the male breadwinner model explains the low probability of poverty exit among select non-European groups whose female employment rates are notably low.

Poverty and mental health in Indonesia.

PubMed

Tampubolon, Gindo; Hanandita, Wulung

2014-04-01

Community and facility studies in developing countries have generally demonstrated an inverse relationship between poverty and mental health. However, recent population-based studies contradict this. In India and Indonesia the poor and non-poor show no difference in mental health. We revisit the relationship between poverty and mental health using a validated measure of depressive symptoms (CES-D) and a new national sample from Indonesia - a country where widespread poverty and deep inequality meet with a neglected mental health service sector. Results from three-level overdispersed Poisson models show that a 1% decrease in per capita household expenditure was associated with a 0.05% increase in CES-D score (depressive symptoms), while using a different indicator (living on less than $2 a day) it was estimated that the poor had a 5% higher CES-D score than the better off. Individual social capital and religiosity were found to be positively associated with mental health while adverse events were negatively associated. These findings provide support for the established view regarding the deleterious association between poverty and mental health in developed and developing countries. Copyright © 2014 Elsevier Ltd. All rights reserved.

The increasing risk of poverty across the American life course.

PubMed

Sandoval, Daniel A; Rank, Mark R; Hirschl, Thomas A

2009-11-01

This article extends the emerging body of life course research on poverty by empirically identifying the incidence, chronicity, and age pattern of American poverty and how these dimensions have changed during the period 1968-2000. Using the Panel Study of Income Dynamics, we construct a series of life tables that estimate the risk of poverty for adults during their 20s, 30s, 40s, 50s, 60s, and 70s, and compare these estimates for Americans in the 1970s, 1980s, and 1990s. Our empirical results suggest that the risk of acute poverty increased substantially, particularly in the 1990s. This observed increase was especially pronounced for individuals in their 20s, 30s, and 40s; for all age groups with respect to extreme poverty; and for white males. On the other hand, the risk of chronic poverty declined during the 1990s (as measured by the percentage of the poor who experienced five or more years of poverty within a 10-year interval). The results in this article tell a very different story than the Census Bureau's yearly cross-sectional rates, which have shown little overall change in the U.S. poverty rate during this 30-year period. In contrast, a life course approach reveals a rising economic risk of acute poverty for individuals, one that is consistent with recent observations and research suggesting that a growing number of Americans will eventually find themselves in an economically precarious position.

Reducing Food Poverty and Vulnerability among the Rural Elderly with Chronic Diseases: The Role of the New Rural Pension Scheme in China.

PubMed

Zhang, Zhaohua; Luo, Yuxi; Robinson, Derrick

2018-06-13

Vulnerability to food poverty is the probability of an individual falling below the food poverty line in the near future, which provides a forward-looking welfare analysis. Applying a nationally representative survey dataset, this study investigates the role of the New Rural Pension Scheme (NRPS) in reducing food poverty and vulnerability among the rural elderly with chronic diseases. By designing province-specific food poverty lines to account for variations in the elderly’s needs, as well as the prices across provinces using a least-cost linear programming approach, the food poverty incidences among the elderly with chronic diseases are calculated. Applying a three-stage feasible generalized least squares (FGLS) procedure, the vulnerability to food poverty is estimated. Our results show that food poverty incidence and vulnerability of the elderly with chronic diseases in rural China is 41.9% and 35% respectively, which is 8% and 6% higher, respectively, than the elderly that are in good health. To address the potential endogeneity of pension payment, a fuzzy regression discontinuity (RD) regression is employed to investigate the effects of pension income on food poverty and vulnerability for different population groups. We found that pension income decreases the probability of being food poor and the vulnerability to food poverty among the elderly with chronic diseases by 12.9% and 16.8% respectively, while it has no significant effect on the elderly in good health.

The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment.

PubMed

Pronyk, Paul M; Muniz, Maria; Nemser, Ben; Somers, Marie-Andrée; McClellan, Lucy; Palm, Cheryl A; Huynh, Uyen Kim; Ben Amor, Yanis; Begashaw, Belay; McArthur, John W; Niang, Amadou; Sachs, Sonia Ehrlich; Singh, Prabhjot; Teklehaimanot, Awash; Sachs, Jeffrey D

2012-06-09

Simultaneously addressing multiple Millennium Development Goals (MDGs) has the potential to complement essential health interventions to accelerate gains in child survival. The Millennium Villages project is an integrated multisector approach to rural development operating across diverse sub-Saharan African sites. Our aim was to assess the effects of the project on MDG-related outcomes including child mortality 3 years after implementation and compare these changes to local comparison data. Village sites averaging 35,000 people were selected from rural areas across diverse agroecological zones with high baseline levels of poverty and undernutrition. Starting in 2006, simultaneous investments were made in agriculture, the environment, business development, education, infrastructure, and health in partnership with communities and local governments at an annual projected cost of US$120 per person. We assessed MDG-related progress by monitoring changes 3 years after implementation across Millenium Village sites in nine countries. The primary outcome was the mortality rate of children younger than 5 years of age. To assess plausibility and attribution, we compared changes to reference data gathered from matched randomly selected comparison sites for the mortality rate of children younger than 5 years of age. Analyses were done on a per-protocol basis. This trial is registered with ClinicalTrials.gov, number NCT01125618. Baseline levels of MDG-related spending averaged $27 per head, increasing to $116 by year 3 of which $25 was spent on health. After 3 years, reductions in poverty, food insecurity, stunting, and malaria parasitaemia were reported across nine Millennium Village sites. Access to improved water and sanitation increased, along with coverage for many maternal-child health interventions. Mortality rates in children younger than 5 years of age decreased by 22% in Millennium Village sites relative to baseline (absolute decrease 25 deaths per 1000 livebirths, p=0·015) and 32% relative to matched comparison sites (30 deaths per 1000 livebirths, p=0·033). An integrated multisector approach for addressing the MDGs can produce rapid declines in child mortality in the first 3 years of a long-term effort in rural sub-Saharan Africa. UN Human Security Trust Fund, the Lenfest Foundation, Bill & Melinda Gates Foundation, and Becton Dickinson. Copyright © 2012 Elsevier Ltd. All rights reserved.

Impact of Infrastructure on Mortality in Marginalised and Segregated Communities in the Slovak Republic.

PubMed

Kováč, Viliam; Gavurová, Beáta

2017-12-01

Poverty and social exclusion is measured through different criteria and one of them is the health sector. The relationship between Roma population and the health sector is on the edge of researchers' interest in the Slovak Republic. The purpose of this paper is a quantification of the regional disparities in the development of mortality which is causally linked with selected infrastructural determinants - namely access to water and sewerage. These determinants differently participate in the structure of mortality in marginalised and segregated communities and they deepen regional disparities in health. It is a spatial analysis of the districts of the Slovak Republic. The data from the Atlas of Roma communities in Slovakia 2013 is applied. Through the multiple linear regression model the relationship between mortality of the Roma population and water and sewerage availability in the Roma settlements is examined. Similarity between the districts is measured by the Euclidean metric system. The most appropriate district for representing the Slovak Republic average is the Dunajská Streda district in a field of arithmetic mean and the Veľký Krtíš district in a field of median value. The outermost district is represented by the Košice-okolie district, conversely, the Trnava district is the closest to the rest of the Slovak Republic. The highest statistically significant impacts on mortality are explored in public water supply extension plan and public sewerage supply extension plan. It seems that water play a greater role in determining health of Roma population. The highest number of inhabitants with supplied public water and public sewerage is kept by the Kežmarok district, the Košice district, and the Spišská Nová Ves district. Our results can be beneficial for health decision making, since in the Strategic Framework for Health of the Slovak Republic metrics for measuring and evaluating health aspects in Roma communities absent and that prevents them to be correlated with the planned interventions. Copyright© by the National Institute of Public Health, Prague 2017.

Neighborhood Racial and Socioeconomic Disparities in the Food and Alcohol Environment: Are There Differences by Commercial Data Sources?

PubMed

Mendez, Dara D; Kim, Kevin H; Hardaway, Cecily R; Fabio, Anthony

2016-03-01

This study examined neighborhood racial and socioeconomic disparities and the density of food and alcohol establishments. We also examined whether these disparities differed by data source. This study included commercial data for 2003 and 2009 from InfoUSA and Dun and Bradstreet (D&B) in 416 census tracts in Allegheny County, PA. Food and alcohol establishment densities were calculated by using area and population data from the 2000 US census. Differences between InfoUSA and D&B of food and alcohol densities across neighborhood racial and socioeconomic characteristics were tested using correlations and two-way mixed analysis of variance (ANOVA). There were differences by data source in the association between neighborhood racial and socioeconomic characteristics and food/alcohol establishment density. There was a positive correlation between grocery store/supermarket density and percentage black, poverty, and percentage without a car among D&B data but not in InfoUSA. Alcohol outlet density (AOD) increased as neighborhood poverty increased for both data sources, but the mean difference in AOD between InfoUSA and D&B was highest among neighborhoods with 25-50 % poverty (Cohen's d -0.49, p < 0.001) compared to neighborhoods with lower or higher poverty (2003 data). Mean grocery store density increased as percentage poverty increased, but only among D&B (2009 data). Differences in commercial data in the location and numeration of food and alcohol establishments are associated with neighborhood racial and socioeconomic characteristics and may introduce biases concerning neighborhood food and alcohol environments, racial and socioeconomic disparities, and health.

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

Familial Influences on Poverty Among Young Children in Black Immigrant, U.S.-born Black, and Nonblack Immigrant Families

PubMed Central

Thomas, Kevin J. A.

2014-01-01

This study examines how familial contexts affect poverty disparities between the children of immigrant and U.S.-born blacks, and among black and nonblack children of immigrants. Despite lower gross child poverty rates in immigrant than in U.S.-born black families, accounting for differences in family structure reveals that child poverty risks among blacks are highest in single-parent black immigrant families. In addition, within two-parent immigrant families, child poverty declines associated with increasing assimilation are greater than the respective declines in single-parent families. The heads of black immigrant households have more schooling than those of native-black households. However, increased schooling has a weaker negative association with child poverty among the former than among the latter. In terms of racial disparities among the children of immigrants, poverty rates are higher among black than nonblack children. This black disadvantage is, however, driven by the outcomes of first-generation children of African and Hispanic-black immigrants. The results also show that although children in refugee families face elevated poverty risks, these risks are higher among black than among nonblack children of refugees. In addition, the poverty-reducing impact associated with having an English-proficient household head is about three times lower among black children of immigrants than among non-Hispanic white children of immigrants. PMID:21491186

Lower vitamin-D production from solar ultraviolet-B irradiance may explain some differences in cancer survival rates.

PubMed Central

Grant, William B.

2006-01-01

Black Americans diagnosed with cancer generally have lower survival rates than white Americans, even after adjustment for stage of cancer at time of discovery and level of treatment received. The hypothesis developed in this work is that these lower cancer survival rates may be due to lower serum 25-hydroxyvitamin D [25(OH)DI for black Americans attributed to lower production rates of vitamin D from solar ultraviolet-B (UVB) irradiance due to darker skin. Black Americans generally have 50-75% as much serum 25(OH)D as white Americans, and vitamin D is now thought to reduce the risk of incidence and mortality for 18 types of cancer. To explore this hypothesis, data for mortality rates for various types of cancer for the period 1970-1994 for black Americans were used with indices for solar UVB levels for July, smoking, alcohol consumption, urban residence and poverty level, all averaged by state, in multiple linear regression analyses using the ecologic approach. Solar UVB was found significantly inversely correlated with mortality rates for breast, colon, esophageal, gastric and rectal cancers for black Americans, albeit with lower associations than for white Americans. Smoking and alcohol consumption were also significantly correlated with several cancers. Based on these results, it seems worthwhile to conduct observational, prevention and intervention studies to further test the hypothesis that vitamin D can reduce the risk of cancer incidence and death. PMID:16573299

Successes and challenges of the millennium development goals in Ethiopia: lessons for the sustainable development goals.

PubMed

Assefa, Yibeltal; Damme, Wim Van; Williams, Owain D; Hill, Peter S

2017-01-01

We analysed the performance of Ethiopia in achieving the health-related millennium development goals (MDGs) with the aim of acquiring lessons for the sustainable development goals (SDGs). Ethiopia achieved most of the health MDGs: a 67% reduction in under-five mortality, a 71% decline in maternal mortality ratio, a 90% decline in new HIV infections, a decrease in malaria-related deaths by 73% and a more than 50% decline in mortality due to tuberculosis. We argue that these achievements are due to implementation of a mix of comprehensive strategies within the health system and across other sectors of the government. Scaling up of interventions by disease control programmes (including the health extension programme) and strengthening of the health system have played important roles towards the achievements. These health gains could not have been realised without progress in the other MDGs: poverty reduction, education, access to safe drinking-water and peace and stability of the country. However, the gains were not equitable, with differences between urban and rural areas, among regions and socioeconomic strata. Ethiopia's remarkable success in meeting most of the targets of the health-related MDGs could be explained by its comprehensive and multisectoral approach for health development. The inequity gap remains a challenge that achieving the health-related SDGs requires the country to implement strategies, which specifically target more marginal populations and geographic areas. This also needs peace and stability, without which it is almost impossible to improve health.

Policy implications of differential health status in East and West Europe. The case of Hungary.

PubMed

Makara, P

1994-11-01

Morbidity and mortality trends in Western and Eastern Europe have differed considerably during the past three decades, although the major unfavourable processes have been essentially the same in each of the Central European countries. The most striking feature has been the decline in average life expectancy and deterioration of age-specific mortality rates for the middle-aged, especially men. The former socialist government took no effective action. Due to the denial of social and environmental problems, social, health and environmental policy were underdeveloped and deformed. Partly inherited from previous historical traditions, wishful thinking, victimization and a patronizing attitude were primary ways of dealing with problems. In these circumstances even the few specially supported health education campaigns were doomed to fail. People depended on the omnipotent central state in vain to solve their problems so that health promotion based on the community and self-empowerment did not develop. During the early nineties, in Eastern and Central Europe no central political strategies were initiated or launched to combat the mortality and morbidity tendences. The economic and social prerequisites of a long-term gradual improvement in the health status are missing in Central and Eastern Europe. A declining standard of living due to recession, growing deprivation, poverty, unemployment and migration are unfavourable to improvements in health. In a time of crisis, with stress but without adequate skills of coping, forced adaptation associated with sudden changes and perceived failure have only made matters worse. There are no short-term 'solutions'.

Social determinants and their interference in homicide rates in a city in northeastern Brazil.

PubMed

de Sousa, Geziel dos Santos; Magalhães, Francismeire Brasileiro; Gama, Isabelle da Silva; de Lima, Maria Vilma Neves; de Almeida, Rosa Lívia Freitas; Vieira, Luiza Jane Eyre de Souza; Bezerra Filho, José Gomes

2014-01-01

This paper aims to analyze the possible relationship between social determinants and homicide mortality in Fortaleza (CE), Brazil. To investigate whether the rate of mortality by homicides is related to social determinants, an ecological study with emphasis on spatial analysis was conducted in the city of Fortaleza. Social, economic, demographic and sanitation data, as well as information regarding years of potential life lost, and Human Development Index were collected. The dependent variable was the rate of homicides in the period 2004 to 2006. In order to verify the relationship between the outcome variable and the predictor variables, we performed a multivariate linear regression model. We found associations between social determinants and the rate of mortality by homicides. Variables related to income and education were proven determinants for mortality. The multiple regression model showed that 51% of homicides in Fortaleza neighborhoods are explained by years of potential life lost, proportion of households with poor housing, average years of schooling, per capita income and percentage of household heads with 15 or more years of study. The coefficients for years of potential life lost and households with poor housing were positive. The findings indicate that the mortality by homicide is associated with high levels of poverty and uncontrolled urbanization, which migrates to the peripheries of urban centers.

Longitudinal patterns of poverty and health in early childhood: exploring the influence of concurrent, previous, and cumulative poverty on child health outcomes

PubMed Central

2012-01-01

Background Although the links between poverty and health have often been studied , the dynamics of poverty and physical health in early childhood remain under-investigated. In particular, it is not known whether the health of young children is affected differently from that of adults by patterns of poverty unique to them. Methods We examined patterns of health from 5 to 41 months of age as a function of concurrent, lagged, and chronic exposure to insufficient income. Using data from the first four rounds of the Quebec Longitudinal Study of Child Development, we performed multilevel logistic and multilevel Poisson regressions and latent growth curve analyses to explore associations between exposure to poverty and mother-reported asthma-like attacks, and maternal perception of health status controlling for neonatal, maternal, and environmental characteristics. Results The mean number of mother-reported asthma-like attacks significantly decreased as children aged. The likelihood of being perceived in a poorer health status also decreased across time. Concurrent poverty was associated with more mother-reported asthma-like attacks and with a higher risk of being perceived in poorer health status. One-period-lagged poverty was associated with more mother-reported asthma-like attacks and this remained significant after controlling for concurrent poverty. The number of mother-reported asthma-like attacks was significantly higher among children in the chronic poverty class compared to those in the never-poor class, particularly at 17 and 29 months. Perceived health status at 5-months was significantly poorer among chronically poor children compared to never-poor children. Conclusion Exposure to poverty negatively affects two major health indicators in early childhood – maternal perception of child health and mother-reported asthma-like attacks. Patterns of the effects vary according to timing and duration of poverty exposure. Further longitudinal research is warranted to disentangle time-specific from cumulative effects of poverty on child health. PMID:22947499

Challenging Hydrological Panaceas: Water poverty governance accounting for spatial scale in the Niger River Basin

NASA Astrophysics Data System (ADS)

Ward, John; Kaczan, David

2014-11-01

Water poverty in the Niger River Basin is a function of physical constraints affecting access and supply, and institutional arrangements affecting the ability to utilise the water resource. This distinction reflects the complexity of water poverty and points to the need to look beyond technical and financial means alone to reduce its prevalence and severity. Policy decisions affecting water resources are generally made at a state or national level. Hydrological and socio-economic evaluations at these levels, or at the basin level, cannot be presumed to be concordant with the differentiation of poverty or livelihood vulnerability at more local levels. We focus on three objectives: first, the initial mapping of observed poverty, using two health metrics and a household assets metric; second, the estimation of factors which potentially influence the observed poverty patterns; and third, a consideration of spatial non-stationarity, which identifies spatial correlates of poverty in the places where their effects appear most severe. We quantify the extent to which different levels of analysis influence these results. Comparative analysis of correlates of poverty at basin, national and local levels shows limited congruence. Variation in water quantity, and the presence of irrigation and dams had either limited or no significant correlation with observed variation in poverty measures across levels. Education and access to improved water quality were the only variables consistently significant and spatially stable across the entire basin. At all levels, education is the most consistent non-water correlate of poverty while access to protected water sources is the strongest water related correlate. The analysis indicates that landscape and scale matter for understanding water-poverty linkages and for devising policy concerned with alleviating water poverty. Interactions between environmental, social and institutional factors are complex and consequently a comprehensive understanding of poverty and its causes requires analysis at multiple spatial resolutions.

Longitudinal patterns of poverty and health in early childhood: exploring the influence of concurrent, previous, and cumulative poverty on child health outcomes.

PubMed

Béatrice, Nikiéma; Lise, Gauvin; Victoria, Zunzunegui Maria; Louise, Séguin

2012-09-04

Although the links between poverty and health have often been studied , the dynamics of poverty and physical health in early childhood remain under-investigated. In particular, it is not known whether the health of young children is affected differently from that of adults by patterns of poverty unique to them. We examined patterns of health from 5 to 41 months of age as a function of concurrent, lagged, and chronic exposure to insufficient income. Using data from the first four rounds of the Quebec Longitudinal Study of Child Development, we performed multilevel logistic and multilevel Poisson regressions and latent growth curve analyses to explore associations between exposure to poverty and mother-reported asthma-like attacks, and maternal perception of health status controlling for neonatal, maternal, and environmental characteristics. The mean number of mother-reported asthma-like attacks significantly decreased as children aged. The likelihood of being perceived in a poorer health status also decreased across time. Concurrent poverty was associated with more mother-reported asthma-like attacks and with a higher risk of being perceived in poorer health status. One-period-lagged poverty was associated with more mother-reported asthma-like attacks and this remained significant after controlling for concurrent poverty. The number of mother-reported asthma-like attacks was significantly higher among children in the chronic poverty class compared to those in the never-poor class, particularly at 17 and 29 months. Perceived health status at 5-months was significantly poorer among chronically poor children compared to never-poor children. Exposure to poverty negatively affects two major health indicators in early childhood - maternal perception of child health and mother-reported asthma-like attacks. Patterns of the effects vary according to timing and duration of poverty exposure. Further longitudinal research is warranted to disentangle time-specific from cumulative effects of poverty on child health.

Hypovitaminosis D, neighborhood poverty, and progression of chronic kidney disease in disadvantaged populations.

PubMed

Mehrotra, R; Norris, K

2010-11-01

In the United States, there are significant racial disparities in the incidence and prevalence of end-stage renal disease. The disparities are greatest for the Blacks and the magnitude of disparity is significantly greater than is evident from the incidence and prevalence data of end-stage renal disease - early stage chronic kidney disease is less common in Blacks and during that stage, mortality rate is significantly higher for that racial group. Recent studies have identified a genetic predisposition for non-diabetic renal disease among Blacks. However, genetic factors explain only part of the higher risk and the racial disparities are a result of a complex interplay of biology and sociology. Herein we focus on two factors and their role in explaining the higher risk for progression of chronic kidney disease among Blacks - one biologic (vitamin D deficiency) and one sociologic (neighborhood poverty). A greater Understanding of these factors is important in order to reduce the racial disparities in the United States.

Water for Two Worlds: Designing Terrestrial Applications for Exploration-class Sanitation Systems

NASA Technical Reports Server (NTRS)

Adams, Constance; Andersson, Ingvar; Feighery, John

2004-01-01

At the United Nations Millennium Summit in September of 2000, the world leaders agreed on an ambitious agenda for reducing poverty and improving lives: the Millennium Development Goals (MDGs) , a list of issues they consider highly pernicious, threatening to human welfare and, thereby, to global security and prosperity. Among the eight goals are included fundamental human needs such as the eradication of extreme poverty and hunger, the promotion of gender equality, the reduction of child mortality and improvement of maternal health, and ensuring the sustainability of our shared environment. In order to help focus the efforts to meet these goals, the United Nations (UN) has established a set of eighteen concrete targets, each with an associated schedule. Among these is Target 10: "By 2015, reduce by half the proportion of people without access to safe drinking water." A closely related target of equal dignity was agreed at the World Summit on Sustainable Development (Johannesburg, September 2002): "By 2015, reduce by half the proportion of people without access to basic sanitation".

Poverty, child undernutrition and morbidity: new evidence from India.

PubMed Central

Nandy, Shailen; Irving, Michelle; Gordon, David; Subramanian, S. V.; Smith, George Davey

2005-01-01

Undernutrition continues to be a primary cause of ill-health and premature mortality among children in developing countries. This paper examines how the prevalence of undernutrition in children is measured and argues that the standard indices of stunting, wasting and underweight may each be underestimating the scale of the problem. This has important implications for policy-makers, planners and organizations seeking to meet international development targets. Using anthropometric data on 24 396 children in India, we constructed an alternative composite index of anthropometric failure (CIAF) and compared it with conventional indices. The CIAF examines the relationship between distinct subgroups of anthropometric failure, poverty and morbidity, showing that children with multiple anthropometric failures are at a greater risk of morbidity and are more likely to come from poorer households. While recognizing that stunting, wasting and underweight reflect distinct biological processes of clear importance, the CIAF is the only measure that provides a single, aggregated figure of the number of undernourished children in a population. PMID:15798845

Poverty, child undernutrition and morbidity: new evidence from India.

PubMed

Nandy, Shailen; Irving, Michelle; Gordon, David; Subramanian, S V; Smith, George Davey

2005-03-01

Undernutrition continues to be a primary cause of ill-health and premature mortality among children in developing countries. This paper examines how the prevalence of undernutrition in children is measured and argues that the standard indices of stunting, wasting and underweight may each be underestimating the scale of the problem. This has important implications for policy-makers, planners and organizations seeking to meet international development targets. Using anthropometric data on 24 396 children in India, we constructed an alternative composite index of anthropometric failure (CIAF) and compared it with conventional indices. The CIAF examines the relationship between distinct subgroups of anthropometric failure, poverty and morbidity, showing that children with multiple anthropometric failures are at a greater risk of morbidity and are more likely to come from poorer households. While recognizing that stunting, wasting and underweight reflect distinct biological processes of clear importance, the CIAF is the only measure that provides a single, aggregated figure of the number of undernourished children in a population.

Understanding Poverty in the Classroom: Changing Perceptions for Student Success

ERIC Educational Resources Information Center

Templeton, Beth Lindsay

2011-01-01

People who live in poverty consider life in different ways than those who have adequate basic resources. Many educators tend to see the world through their middle-class worldview. Because of this, they do not understand these significant and often rational differences. They may misinterpret behavior they see and ascribe negative connations to how…

Being Poor at School: Exploring Conditions of Educability in the "Favela"

ERIC Educational Resources Information Center

Bonal, Xavier; Tarabini, Aina

2016-01-01

This article explores how different ways of experiencing poverty affect the possibilities of poor children to make the most of their education. The study uses the concept of conditions of educability to reflect how the different dimensions of the experience of poverty facilitate or hinder the success of educational practices and the learning of…

Benefits of the Michiana Daily Mathtracks Programme for Students Living in Poverty

ERIC Educational Resources Information Center

Davies, Randall S.; Qudisat, Rasha M.

2015-01-01

This paper summarizes results from a math intervention implemented in a high-poverty urban community. Over 7,300 students from kindergarten to 4th grade in 1 low-socioeconomic-status school district participated in the study. Students from 13 different schools (36 different classroom) participated in the treatment. Comparisons were made to…

Poverty and Child Behavioral Problems: The Mediating Role of Parenting and Parental Well-Being

PubMed Central

Kaiser, Till; Li, Jianghong; Pollmann-Schult, Matthias; Song, Anne Y.

2017-01-01

The detrimental impact of poverty on child behavioral problems is well-established, but the mechanisms that explain this relationship are less well-known. Using data from the Families in Germany Study on parents and their children at ages 9–10 (middle childhood), this study extends previous research by examining whether or not and to what extent different parenting styles and parents’ subjective well-being explain the relationship between poverty and child behavior problems. The results show that certain parenting styles, such as psychological control, as well as mothers’ life satisfaction partially mediate the correlation between poverty and child behavioral problems. PMID:28867777

Poverty and Child Behavioral Problems: The Mediating Role of Parenting and Parental Well-Being.

PubMed

Kaiser, Till; Li, Jianghong; Pollmann-Schult, Matthias; Song, Anne Y

2017-08-30

The detrimental impact of poverty on child behavioral problems is well-established, but the mechanisms that explain this relationship are less well-known. Using data from the Families in Germany Study on parents and their children at ages 9-10 (middle childhood), this study extends previous research by examining whether or not and to what extent different parenting styles and parents' subjective well-being explain the relationship between poverty and child behavior problems. The results show that certain parenting styles, such as psychological control, as well as mothers' life satisfaction partially mediate the correlation between poverty and child behavioral problems.

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 cent and about half the children are undernourished. While poverty and mortality rates came down by 50 per cent, fertility rate by 40 per cent, the reduction in undernutrition in children is only 20 per cent. National surveys indicate that a third of the children from high income group who have not experienced any deprivations are undernourished. The high undernutrition rates among children appears to be mainly due to high low birthweight rates, poor infant and young child feeding and caring practices. At the other end of the spectrum, surveys in school children from high income groups indicate that between 10-20 per cent are overnourished; the major factor responsible appears to be reduction in physical activity. Some aspects of the rapidly changing, complex relationship between economic status, poverty, dietary intake, nutritional and health status are explored in this review.

Equity and geography: the case of child mortality in Papua New Guinea.

PubMed

Bauze, Anna E; Tran, Linda N; Nguyen, Kim-Huong; Firth, Sonja; Jimenez-Soto, Eliana; Dwyer-Lindgren, Laura; Hodge, Andrew; Lopez, Alan D

2012-01-01

Recent assessments show continued decline in child mortality in Papua New Guinea (PNG), yet complete subnational analyses remain rare. This study aims to estimate under-five mortality in PNG at national and subnational levels to examine the importance of geographical inequities in health outcomes and track progress towards Millennium Development Goal (MDG) 4. We performed retrospective data validation of the Demographic and Health Survey (DHS) 2006 using 2000 Census data, then applied advanced indirect methods to estimate under-five mortality rates between 1976 and 2000. The DHS 2006 was found to be unreliable. Hence we used the 2000 Census to estimate under-five mortality rates at national and subnational levels. During the period under study, PNG experienced a slow reduction in national under-five mortality from approximately 103 to 78 deaths per 1,000 live births. Subnational analyses revealed significant disparities between rural and urban populations as well as inter- and intra-regional variations. Some of the provinces that performed the best (worst) in terms of under-five mortality included the districts that performed worst (best), with district-level under-five mortality rates correlating strongly with poverty levels and access to services. The evidence from PNG demonstrates substantial within-province heterogeneity, suggesting that under-five mortality needs to be addressed at subnational levels. This is especially relevant in countries, like PNG, where responsibility for health services is devolved to provinces and districts. This study presents the first comprehensive estimates of under-five mortality at the district level for PNG. The results demonstrate that for countries that rely on few data sources even greater importance must be given to the quality of future population surveys and to the exploration of alternative options of birth and death surveillance.

Understanding Local Spatial Variation Along the Care Continuum: The Potential Impact of Transportation Vulnerability on HIV Linkage to Care and Viral Suppression in High-Poverty Areas, Atlanta, Georgia.

PubMed

Goswami, Neela D; Schmitz, Michelle M; Sanchez, Travis; Dasgupta, Sharoda; Sullivan, Patrick; Cooper, Hannah; Rane, Deepali; Kelly, Jane; Del Rio, Carlos; Waller, Lance A

2016-05-01

Engagement in care is central to reducing mortality for HIV-infected persons and achieving the White House National AIDS Strategy of 80% viral suppression in the US by 2020. Where an HIV-infected person lives impacts his or her ability to achieve viral suppression. Reliable transportation access for healthcare may be a key determinant of this place-suppression relationship. ZIP code tabulation areas (ZCTAs) were the units of analysis. We used geospatial and ecologic analyses to examine spatial distributions of neighborhood-level variables (eg, transportation accessibility) and associations with: (1) community linkage to care, and (2) community viral suppression. Among Atlanta ZCTAs with data for newly diagnosed HIV cases (2006-2010), we used Moran I to evaluate spatial clustering and linear regression models to evaluate associations between neighborhood variables and outcomes. In 100 ZCTAs with 8413 newly diagnosed HIV-positive residents, a median of 60 HIV cases were diagnosed per ZCTA during the 5-year period. We found significant clustering of ZCTAs with low linkage to care and viral suppression (Moran I = 0.218, P < 0.05). In high-poverty ZCTAs, a 10% point increase in ZCTA-level household vehicle ownership was associated with a 4% point increase in linkage to care (P = 0.02, R = 0.16). In low-poverty ZCTAs, a 10% point increase in ZCTA-level household vehicle ownership was associated with a 30% point increase in ZCTA-level viral suppression (P = 0.01, R = 0.08). Correlations between transportation variables and community-level care linkage and viral suppression vary by area poverty level and provide opportunities for interventions beyond individual-level factors.

Single Mother Families and Employment, Race, and Poverty in Changing Economic Times*

PubMed Central

Damaske, Sarah; Bratter, Jenifer L.; Frech, Adrianne

2016-01-01

Using American Community Survey data from 2001, 2005, and 2010, this paper assesses the relationships between employment, race, and poverty for households headed by single women across different economic periods. While poverty rates rose dramatically among single-mother families between 2001 and 2010, surprisingly many racial disparities in poverty narrowed by the end of the decade. This was due to a greater increase in poverty among whites, although gaps between whites and Blacks, whites and Hispanics, and whites and American Indians remained quite large in 2010. All employment statuses were at higher risk of poverty in 2010 than 2001 and the risk increased most sharply for those employed part-time, the unemployed, and those not in the labor force. Given the concurrent increase in part-time employment and unemployment between 2000 and 2010, findings paint a bleak picture of the toll the last decade has had on the well being of single-mother families. PMID:28126093

Poverty, economic growth, deprivation, and water: the cases of Cambodia and Vietnam.

PubMed

Varis, Olli

2008-05-01

Poverty reduction decorates all development agendas, but the complexity of the poverty issue is too often hidden behind simplistic indicators and development goals. Here, a closer look is taken at the concepts of "deprivation" and "vulnerability" as outcomes of poverty. Deprivation leads typically to social exclusion and marginalization; such groups are particularly weak in getting themselves out of poverty by "self-help," and economic growth does not trickle down to these people. When looking at the connections between poverty reduction and economic growth, special emphasis should be put on the differences between modern and more traditional sectors: development of the modern sector should not marginalize and exclude those dependent on more traditional livelihoods. Two case studies--The Tonle Sap area, Cambodia, and the Mekong Delta, Vietnam--reveal that investment in education, empowerment of small-scale entrepreneurship and other means of microeconomic environment, along with good governance, infrastructure, and income distribution can ensure that economic growth includes the poorer echelons of society.

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.

Connecting race and place: a county-level analysis of White, Black, and Hispanic HIV prevalence, poverty, and level of urbanization.

PubMed

Vaughan, Adam S; Rosenberg, Eli; Shouse, R Luke; Sullivan, Patrick S

2014-07-01

We evaluated the role of poverty in racial/ethnic disparities in HIV prevalence across levels of urbanization. Using national HIV surveillance data from the year 2009, we constructed negative binomial models, stratified by urbanization, with an outcome of race-specific, county-level HIV prevalence rates and covariates of race/ethnicity, poverty, and other publicly available data. We estimated model-based Black-White and Hispanic-White prevalence rate ratios (PRRs) across levels of urbanization and poverty. We observed racial/ethnic disparities for all strata of urbanization across 1111 included counties. Poverty was associated with HIV prevalence only in major metropolitan counties. At the same level of urbanization, Black-White and Hispanic-White PRRs were not statistically different from 1.0 at high poverty rates (Black-White PRR = 1.0, 95% confidence interval [CI] = 0.4, 2.9; Hispanic-White PRR = 0.4, 95% CI = 0.1, 1.6). In nonurban counties, racial/ethnic disparities remained after we controlled for poverty. The association between HIV prevalence and poverty varies by level of urbanization. HIV prevention interventions should be tailored to this understanding. Reducing racial/ethnic disparities will require multifactorial interventions linking social factors with sexual networks and individual risks.

Analysis of the distributional impact of out-of-pocket health payments: evidence from a public health insurance program for the poor in Mexico.

PubMed

Garcia-Diaz, Rocio; Sosa-Rubi, Sandra G; Sosa-Rub, Sandra G

2011-07-01

Many governments have health programs focused on improving health among the poor and these have an impact on out-of-pocket health payments made by individuals. Therefore, one of the objectives of these programs is to reach the poorest and reduce their out-of-pocket expenditure. In this paper we propose the distributional poverty impact approach to measure the poverty impact of out-of-pocket health payments of different health financing policies. This approach is comparable to the impoverishment methodology proposed by Wagstaff and van Doorslaer (2003) that compares poverty indices before and after out-of-pocket health payments. In order to escape the specification of a particular poverty index, we use the marginal dominance approach that uses non-intersecting curves and can rank poverty reducing health financing policies. We present an empirical application of the out-of-pocket health payments for an innovative social financing policy implemented in Mexico named Seguro Popular. The paper finds evidence that Seguro Popular program has a better distributional poverty impact when families face illness when compared to other poverty reducing policies. The empirical dominance approach uses data from Mexico in 2006 and considers international poverty standards of $2 per person per day. Copyright © 2011 Elsevier B.V. All rights reserved.

Relationship of school context to rural youth's educational achievement and aspirations.

PubMed

Irvin, Matthew J; Meece, Judith L; Byun, Soo-Yong; Farmer, Thomas W; Hutchins, Bryan C

2011-09-01

Though the poverty encountered by many rural youth encompasses numerous developmental challenges and substantially increases the chances for educational problems, the school context is central to promoting and constraining their development. Therefore, the purpose of this study was to investigate the relationship of school characteristics and schooling experiences to the educational achievement and aspirations of youth from high-poverty rural communities. Differences in the relationship of school characteristics and schooling experiences to the educational outcomes of students from high- versus low-poverty rural communities were also examined. Participants included 6,247 high school students from 43 low-poverty and 21 high-poverty rural communities. Approximately 51.7% of participants were female and the sample was racially/ethnically diverse (66.4% White, 9.2% African American, 8.1% Hispanic/Latino(a), 4.4% Native American, and 11.8% Multiracial). After controlling for student and family background, school characteristics (e.g., lower student-teacher ratio) were predictive of achievement for rural youth from high-poverty communities. Schooling experiences (e.g., positive perceptions of their ability, a sense of school valuing and belonging, and preparation for postsecondary education) were predictive of educational achievement and aspirations for rural youth from high- and low-poverty communities. Overall, the study highlights unique ways schools can positively shape the educational outcomes for rural youth despite community poverty.

Time trends in the association of ESRD incidence with area-level poverty in the US population.

PubMed

Garrity, Bridget H; Kramer, Holly; Vellanki, Kavitha; Leehey, David; Brown, Julia; Shoham, David A

2016-01-01

The objective of this study was to examine the temporal trends of the association between area-level poverty status and end-stage renal disease (ESRD) incidence. We hypothesized that the association between area-level poverty status and ESRD incidence has increased significantly over time. Patient data from the United States Renal Data System were linked with data from the 2000 and 2010 US census. Area-level poverty was defined as living in a zip code-defined area with ≥20% of households living below the federal poverty line. Negative binomial regression models were created to examine the association between area-level poverty status and ESRD incidence by time period in the US adult population while simultaneously adjusting for the distribution of age, sex, and race/ethnicity within a zip code. Time was categorized as January 1, 1995 through December 31, 2004 (Period 1) and January 1, 2005 through December 31, 2010 (Period 2). The percentage of adults initiating dialysis with area-level poverty increased from 27.4% during Period 1 to 34.0% in Period 2. After accounting for the distribution of age, sex, and race/ethnicity within a zip code, area-level poverty status was associated with a 1.24 (95% confidence interval [CI] 1.22, 1.25)-fold higher ESRD incidence. However, this association differed by time period with 1.04-fold (95% CI 1.02, 1.05) higher ESRD incidence associated with poverty status for Period 2 compared with the association between ESRD and poverty status in Period 1. Area-level poverty and its association with ESRD incidence is not static over time. © 2015 International Society for Hemodialysis.

Anthropometric and gynaecological history according to the socioeconomic status of postmenopausal women: poverty and the menopause.

PubMed

Navarro, Manuel Carmen; Sosa, Manuel; Saavedra, Pedro; Gil-Antullano, Santiago Palacios; Castro, Rosa; Bonet, Mario; Travesí, Isabel; de Miguel, Emilio

2010-03-01

Less advantaged social classes usually have unhealthier lifestyles and have more difficult access to health resources. In this work we study the possible association between poverty and the prevalence of obesity and oophorectomy in a population of postmenopausal women. Cross-sectional observational study. To study in a population of postmenopausal women in poverty the possible differences in the prevalence of obesity and oophorectomy, and to compare some other gynaecological data: age at menarche, age at menopause, fertile years, number of pregnancies, breastfeeding and the use of hormonal replacement therapy (HRT). All patients were interviewed personally. A questionnaire was used to find out about their lifestyles and the medication they were taking. Their medical records were reviewed to confirm the existence of some diseases. A complete physical examination was performed with every patient. Weight and height were measured with the patient dressed in light clothes. Blood was obtained in a fasting state in order to carry out some analyses. Poverty was defined according to the Spanish National Institute of Statistics criteria. We enrolled 1225 postmenopausal women; 449 (36.6%) were under the threshold of poverty, defined by the Spanish National Institute of Statistics. Postmenopausal women in poverty had higher body mass index (29.2 +/- 4.8 versus 27.0 +/- 4.7 kg/m(2) P < 0.001), and a higher prevalence of obesity than postmenopausal women not in poverty (44.2% versus 24.3%, P = 0.001). The prevalence of oophorectomy was also higher in women in poverty (32.7% versus 27.2%, P < 0.04). Women in poverty had had a greater number of pregnancies (3 versus 2, P = 0.001). They also showed a higher rate of breastfeeding than women in medium and high social classes (65% versus 59%, P = 0.037). There were no statistically significant differences between the groups in either the age of menopause or fertile years, nor in the use of HRT. Postmenopausal women in poverty have higher levels of obesity, and also a greater prevalence of oophorectomy than women of medium and high social classes. They also presented a higher rate of breastfeeding and a greater number of pregnancies than those women not in poverty.

[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 standard approach measures stronger shortages of wealth and is relatively robust towards gender differences. This study expands the current debate about complementary research on the association between poverty and health. © Georg Thieme Verlag KG Stuttgart · New York.

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, "dose" of poverty, and exiting poverty suggest that poverty plays a critical role in the accumulation of damage in patients with SLE. © 2017, American College of Rheumatology.

34 CFR 200.25 - Schoolwide programs in general.

Code of Federal Regulations, 2014 CFR

2014-07-01

... families under paragraph (b)(1)(ii) of this section, the LEA may use a measure of poverty that is different from the measure or measures of poverty used by the LEA to identify and rank school attendance areas...

34 CFR 200.25 - Schoolwide programs in general.

Code of Federal Regulations, 2011 CFR

2011-07-01

... families under paragraph (b)(1)(ii) of this section, the LEA may use a measure of poverty that is different from the measure or measures of poverty used by the LEA to identify and rank school attendance areas...

34 CFR 200.25 - Schoolwide programs in general.

Code of Federal Regulations, 2010 CFR

2010-07-01

... families under paragraph (b)(1)(ii) of this section, the LEA may use a measure of poverty that is different from the measure or measures of poverty used by the LEA to identify and rank school attendance areas...

Neuroscience of Childhood Poverty: Evidence of Impacts and Mechanisms as Vehicles of Dialog With Ethics.

PubMed

Lipina, Sebastián J; Evers, Kathinka

2017-01-01

Several studies have identified associations between poverty and development of self-regulation during childhood, which is broadly defined as those skills involved in cognitive, emotional, and stress self-regulation. These skills are influenced by different individual and contextual factors at multiple levels of analysis (i.e., individual, family, social, and cultural). Available evidence suggests that the influences of those biological, psychosocial, and sociocultural factors on emotional and cognitive development can vary according to the type, number, accumulation of risks, and co-occurrence of adverse circumstances that are related to poverty, the time in which these factors exert their influences, and the individual susceptibility to them. Complementary, during the past three decades, several experimental interventions that were aimed at optimizing development of self-regulation of children who live in poverty have been designed, implemented, and evaluated. Their results suggest that it is possible to optimize different aspects of cognitive performance and that it would be possible to transfer some aspects of these gains to other cognitive domains and academic achievement. We suggest that it is an important task for ethics, notably but not exclusively neuroethics, to engage in this interdisciplinary research domain to contribute analyses of key concepts, arguments, and interpretations. The specific evidence that neuroscience brings to the analyses of poverty and its implications needs to be spelled out in detail and clarified conceptually, notably in terms of causes of and attitudes toward poverty, implications of poverty for brain development, and for the possibilities to reduce and reverse these effects.

The neglected role of adolescent emotional well-being in national educational achievement: bridging the gap between education and mental health policies.

PubMed

Sznitman, Sharon R; Reisel, Liza; Romer, Daniel

2011-02-01

Although child poverty is recognized as a critical determinant of poor educational achievement in the United States, policy discussions on raising academic achievement rarely include the importance of the effects of poverty on the mental health of adolescents. This article examines the role of adolescent emotional well-being (indicators of depression) as a mediator of the effects of poverty on differences in educational achievement at the national and U.S. state levels. Differences in standardized adolescent academic achievement across 23 developed countries and 39 U.S. states were analyzed using path analytic techniques to test the hypothesis that indicators of adolescent emotional well-being mediate relations between child poverty rates and academic achievement. Child poverty rates were related to both adolescent emotional well-being and educational achievement across both U.S. states and developed countries. Path analyses showed that the status of a country's or state's adolescent emotional well-being is a strong predictor of its educational achievement and that emotional well-being mediates the relationship between poverty and educational achievement. Policies designed to ameliorate the adverse effects of poverty on mental health are critical as they are likely to improve both average educational achievement and student emotional well-being. Attention to improving mental health care not only has the potential to reduce societal and individual costs directly related to health but also to reduce the indirect costs of poor educational achievement. Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Neuroscience of Childhood Poverty: Evidence of Impacts and Mechanisms as Vehicles of Dialog With Ethics

PubMed Central

Lipina, Sebastián J.; Evers, Kathinka

2017-01-01

Several studies have identified associations between poverty and development of self-regulation during childhood, which is broadly defined as those skills involved in cognitive, emotional, and stress self-regulation. These skills are influenced by different individual and contextual factors at multiple levels of analysis (i.e., individual, family, social, and cultural). Available evidence suggests that the influences of those biological, psychosocial, and sociocultural factors on emotional and cognitive development can vary according to the type, number, accumulation of risks, and co-occurrence of adverse circumstances that are related to poverty, the time in which these factors exert their influences, and the individual susceptibility to them. Complementary, during the past three decades, several experimental interventions that were aimed at optimizing development of self-regulation of children who live in poverty have been designed, implemented, and evaluated. Their results suggest that it is possible to optimize different aspects of cognitive performance and that it would be possible to transfer some aspects of these gains to other cognitive domains and academic achievement. We suggest that it is an important task for ethics, notably but not exclusively neuroethics, to engage in this interdisciplinary research domain to contribute analyses of key concepts, arguments, and interpretations. The specific evidence that neuroscience brings to the analyses of poverty and its implications needs to be spelled out in detail and clarified conceptually, notably in terms of causes of and attitudes toward poverty, implications of poverty for brain development, and for the possibilities to reduce and reverse these effects. PMID:28184204

Association of Child Poverty, Brain Development, and Academic Achievement.

PubMed

Hair, Nicole L; Hanson, Jamie L; Wolfe, Barbara L; Pollak, Seth D

2015-09-01

Children living in poverty generally perform poorly in school, with markedly lower standardized test scores and lower educational attainment. The longer children live in poverty, the greater their academic deficits. These patterns persist to adulthood, contributing to lifetime-reduced occupational attainment. To determine whether atypical patterns of structural brain development mediate the relationship between household poverty and impaired academic performance. Longitudinal cohort study analyzing 823 magnetic resonance imaging scans of 389 typically developing children and adolescents aged 4 to 22 years from the National Institutes of Health Magnetic Resonance Imaging Study of Normal Brain Development with complete sociodemographic and neuroimaging data. Data collection began in November 2001 and ended in August 2007. Participants were screened for a variety of factors suspected to adversely affect brain development, recruited at 6 data collection sites across the United States, assessed at baseline, and followed up at 24-month intervals for a total of 3 periods. Each study center used community-based sampling to reflect regional and overall US demographics of income, race, and ethnicity based on the US Department of Housing and Urban Development definitions of area income. One-quarter of sample households reported the total family income below 200% of the federal poverty level. Repeated observations were available for 301 participants. Household poverty measured by family income and adjusted for family size as a percentage of the federal poverty level. Children's scores on cognitive and academic achievement assessments and brain tissue, including gray matter of the total brain, frontal lobe, temporal lobe, and hippocampus. Poverty is tied to structural differences in several areas of the brain associated with school readiness skills, with the largest influence observed among children from the poorest households. Regional gray matter volumes of children below 1.5 times the federal poverty level were 3 to 4 percentage points below the developmental norm (P < .05). A larger gap of 8 to 10 percentage points was observed for children below the federal poverty level (P < .05). These developmental differences had consequences for children's academic achievement. On average, children from low-income households scored 4 to 7 points lower on standardized tests (P < .05). As much as 20% of the gap in test scores could be explained by maturational lags in the frontal and temporal lobes. The influence of poverty on children's learning and achievement is mediated by structural brain development. To avoid long-term costs of impaired academic functioning, households below 150% of the federal poverty level should be targeted for additional resources aimed at remediating early childhood environments.

Risk of Mortality after Spinal Cord Injury: An 8-year Prospective Study

PubMed Central

Krause, James S.; Zhai, Yusheng; Saunders, Lee L.; Carter, Rickey E.

2011-01-01

Objective To evaluate a theoretical model for mortality after spinal cord injury (SCI) by sequentially analyzing 4 sets of risk factors in relation to mortality (i.e., adding 1 set of factors to the regression equation at a time). Design Prospective cohort study of data collected in late 1997 and early 1998 with mortality status ascertained in December 2005. We evaluated the significance of 4 successive sets of predictors (biographic and injury, psychologic and environmental, behavioral, health and secondary conditions) using Cox proportional hazards modeling and built a full model based on the optimal predictors. Setting A specialty hospital. Participants 1,386 adults with traumatic SCI, at least 1 year post-injury, participated. There were 224 deaths. After eliminating cases with missing data, there were 1,209 participants, with 179 deceased at follow-up. Interventions N/A. Main Outcome Measures Mortality status was determined using the National Death Index and the Social Security Death Index. Results The final model included one environmental variable (poverty), 2 behavioral factors (prescription medication use, binge drinking), and 4 health factors or secondary conditions (hospitalizations, fractures/amputations, surgeries for pressure ulcers, probable major depression). Conclusions The results supported the major premise of the theoretical model that risk factors are more important the more proximal they are in a theoretical chain of events leading to mortality. According to this model, mortality results from declining health, precipitated by high-risk behaviors. These findings may be used to target individuals who are at high risk for early mortality as well as directing interventions to the particular risk factor. PMID:19801060

HIV/AIDS, growth and poverty in KwaZulu-Natal and South Africa: an integrated survey, demographic and economy-wide analysis

PubMed Central

2009-01-01

Background This paper estimates the economic impact of HIV/AIDS on the KwaZulu-Natal province and the rest of South Africa. Methods We extended previous studies by employing: an integrated analytical framework that combined firm surveys of workers' HIV prevalence by sector and occupation; a demographic model that produced both population and workforce projections; and a regionalized economy-wide model linked to a survey-based micro-simulation module. This framework permits a full macro-microeconomic assessment. Results Results indicate that HIV/AIDS greatly reduces annual economic growth, mainly by lowering the long-run rate of technical change. However, impacts on income poverty are small, and inequality is reduced by HIV/AIDS. This is because high unemployment among low-income households minimises the economic costs of increased mortality. By contrast, slower economic growth hurts higher income households despite lower HIV prevalence. Conclusion We conclude that the increase in economic growth that results from addressing HIV/AIDS is sufficient to offset the population pressure placed on income poverty. Moreover, incentives to mitigate HIV/AIDS lie not only with poorer infected households, but also with uninfected higher income households. Our findings reveal the substantial burden that HIV/AIDS places on future economic development in KwaZulu-Natal and South Africa, and confirms the need for policies to curb the economic costs of the pandemic. PMID:19758444

The IMEA project: an intervention based on microfinance, entrepreneurship, and adherence to treatment for women with HIV/AIDS living in poverty.

PubMed

Arrivillaga, Marcela; Salcedo, Juan Pablo; Pérez, Mauricio

2014-10-01

A number of issues affect adherence to treatment and quality of life among women living with HIV/AIDS. In particular, women living in poverty have a higher risk of mortality due to their vulnerable conditions and socioeconomic exclusion. The objective of this study was to evaluate the effectiveness of an intervention that combines microfinance, entrepreneurship and adherence to treatment (IMEA) for women with HIV/AIDS and living in poverty in Cali, Colombia. A pre-post research design without a control was utilized, and 48 women were included in the study. The evaluation showed effectiveness of the program in the majority of the results (knowledge of HIV and treatment, adherence to treatment, self-efficacy, and the formation of a microenterprise) (p < 0.001); the global indicator increased from 28.3% to 85.5% (p < 0.001). The findings of this study demonstrate that the intervention was partially effective; the health outcomes showed beneficial effects. However, at the end of the study and throughout the follow-up phase, only one third of the participants were able to develop and maintain a legal operating business. It is concluded that the IMEA project should be tested in other contexts and that its consequent results should be analyzed; so it could be converted into a large scale public health program.

Asymmetries of poverty: why global burden of disease valuations underestimate the burden of neglected tropical diseases.

PubMed

King, Charles H; Bertino, Anne-Marie

2008-03-26

The disability-adjusted life year (DALY) initially appeared attractive as a health metric in the Global Burden of Disease (GBD) program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that the DALY would be useful in policy settings, reflecting normative valuations as a standardized unit of ill health. However, the design of the DALY and its use in policy estimates contain inherent flaws that result in systematic undervaluation of the importance of chronic diseases, such as many of the neglected tropical diseases (NTDs), in world health. The conceptual design of the DALY comes out of a perspective largely focused on the individual risk rather than the ecology of disease, thus failing to acknowledge the implications of context on the burden of disease for the poor. It is nonrepresentative of the impact of poverty on disability, which results in the significant underestimation of disability weights for chronic diseases such as the NTDs. Finally, the application of the DALY in policy estimates does not account for the nonlinear effects of poverty in the cost-utility analysis of disease control, effectively discounting the utility of comprehensively treating NTDs. The present DALY framework needs to be substantially revised if the GBD is to become a valid and useful system for determining health priorities.

A systematic review of cognitive functioning among young people who have experienced homelessness, foster care, or poverty.

PubMed

Fry, Charlotte E; Langley, Kate; Shelton, Katherine H

2017-11-01

Young people who have experienced homelessness, foster care, or poverty are among the most disadvantaged in society. This review examines whether young people who have these experiences differ from their non-disadvantaged peers with respect to their cognitive skills and abilities, and whether cognitive profiles differ between these three groups. Three electronic databases were systematically searched for articles published between 1 January 1995 and 1 February 2015 on cognitive functioning among young people aged 15 to 24 years who have experienced homelessness, foster care, or poverty. Articles were screened using pre-determined inclusion criteria, then the data were extracted, and its quality assessed. A total of 31 studies were included. Compared to non-disadvantaged youth or published norms, cognitive performance was generally found to be impaired in young people who had experienced homelessness, foster care, or poverty. A common area of difficulty across all groups is working memory. General cognitive functioning, attention, and executive function deficits are shared by the homeless and poverty groups. Creativity emerges as a potential strength for homeless young people. The cognitive functioning of young people with experiences of impermanent housing and poverty has been relatively neglected and more research is needed to further establish cognitive profiles and replicate the findings reviewed here. As some aspects of cognitive functioning may show improvement with training, these could represent a target for intervention.

Brazilian Dental Students' Attitudes About Provision of Care for Patients Living in Poverty.

PubMed

Dos Santos, Beatriz Ferraz; Madathil, Sreenath; Zuanon, Angela Cristina Cilense; Bedos, Christophe; Nicolau, Belinda

2017-11-01

The aims of this study were to investigate dental students' attitudes toward people living in poverty and the extent to which their perceptions were associated with their willingness to treat those patients in their future practice. All 910 dental students enrolled in three Brazilian public universities in 2010 were invited to take part in a cross-sectional survey. A total of 766 students (83.7% response rate) completed the self-administered questionnaire on their perceptions of and attitudes about poverty and their intention to provide dental care to poor people. The responding students showed slightly positive attitudes about people living in poverty; however, a high percentage (35%) reported thinking they were different from the rest of the population. Nevertheless, most of these students expressed willingness to provide care to underserved populations in their future practice; this willingness was found to be associated with their beliefs about poverty (OR 1.65; 95% CI=1.41-1.94). Overall, the study found that these dental students had altruistic views toward people living in poverty. However, they seemed to lack a deep understanding of poverty that may prevent them from acting on their good intentions.

Trends in Gender Differences in Poverty: 1950-1980.

ERIC Educational Resources Information Center

McLanahan, Sara; And Others

In 1980 the poverty rates for women were about one and a half times greater than those for men. Between 1950 and 1980 the degree of inequality between the sexes increased by about 30 percent. This paper describes those trends, focusing on the sex of the individual rather than sex of the household head. It also examines differences in the risk of…

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.

Achieving Millennium Development Goals 4 and 5 in India.

PubMed

Chatterjee, A; Paily, V P

2011-09-01

This review relates to achieving the Millennium Development Goals (MDGs), especially MDGs 4 and 5, by India by the year 2015. India contributes the maximum number of maternal deaths (68,000) to the global estimate of 358,000 maternal deaths annually. Infant mortality rate (IMR) is also high at 50 per 1000 (2009). Low budgetary spending on health, poverty, lower literacy, poor nutritional status, rural-urban divide and lack of trained workers in the health sector are cited as reasons for a high maternal mortality ratio and IMR. Increased spending by the Government of India on the health sector has started to show encouraging results. Recent assessments by world bodies like the World Health Organisation have given hope that MDGs 4 and 5 are achievable. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Did Health Care Reform Help Kentucky Address Disparities in Coverage and Access to Care among the Poor?

PubMed

Benitez, Joseph A; Adams, E Kathleen; Seiber, Eric E

2018-06-01

To evaluate the impact of Kentucky's full rollout of the Affordable Care Act on disparities in access to care due to poverty. Restricted version of the Behavioral Risk Factor Surveillance System (BRFSS) for Kentucky and years 2011-2015. We use a difference-in-differences framework to compare trends before and after implementation of the Affordable Care Act (ACA) in health insurance coverage, several access measures, and health care utilization for residents in higher versus lower poverty ZIP codes. Much of the reduction in Kentucky's uninsured rate appears driven by large uptakes in coverage from areas with higher concentrations of poverty. Residents in high-poverty communities experienced larger reductions, 8 percentage points (pp) in uninsured status and 7.5 pp in reporting unmet needs due to costs, than residents of lower poverty areas. These effects helped remove pre-ACA disparities in uninsured rates across these areas. Because we observe positive effects on coverage and reductions in financial barriers to care among those from poorer communities, our findings suggest that expanding Medicaid helps address the health care needs of the impoverished. © Health Research and Educational Trust.

Mortality trends and risk of dying from pulmonary tuberculosis in the 7 socioeconomic regions and the 32 States of Mexico, 2000-2009.

PubMed

Sánchez-Barriga, Juan Jesús

2015-01-01

Tuberculosis (TB) is a world public health problem that still has a high morbidity and mortality rate mainly in countries with significant wealth gaps. Poverty, malnutrition, HIV infection, drug resistance, diabetes and addictions (mainly alcoholism) have been seen to contribute to the persistence of TB as an important health problem in Mexico. Death certificates associated with pulmonary tuberculosis (PTB) for 2000-2009 were obtained from the National Information System of the Secretariat of Health. Rates of mortality nationwide, by state, and by socioeconomic region were calculated. The strength of association between states where individuals resided, socioeconomic regions, and education with mortality from PTB was determined. Age-adjusted mortality rates per 100,000 inhabitants who died from PTB decreased from 4.1 to 2 between 2000 and 2009. Men (67.7%) presented higher mortality than women (32.3%). Individuals failing to complete elementary education presented a higher risk of dying from PTB (RR 1.08 [95%CI: 1.05-1.12]). The socioeconomic region and the entities with the strongest association were region 1, 5, Chiapas and Baja California. Region 1 in 2007 presented RR 7.34 (95%CI: 5.32-10.13), and region 5 in 2009 had RR 10.08 (95%CI: 6.83-14.88). In Mexico, the annual mortality rate from PTB decreased. Men presented higher mortality than women. Individuals failing to complete elementary education showed a higher risk of dying from PTB. The states and regions of Mexico that presented a stronger association with mortality from PTB were Chiapas and Baja California, region 1 and 5. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

Reducing infant mortality.

PubMed

Johnson, T R

1994-01-01

Public health and social policies at the population level (e.g., oral rehydration therapy and immunization) are responsible for the major reduction in infant mortality worldwide. The gap in infant mortality rates between developing and developed regions is much less than that in maternal mortality rates. This indicates that maternal and child health (MCH) programs and women's health care should be combined. Since 1950, 66% of infant deaths occur in the 1st 28 days, indicating adverse prenatal and intrapartum events (e.g., congenital malformation and birth injuries). Infection, especially pneumonia and diarrhea, and low birth weight are the major causes of infant mortality worldwide. An estimated US$25 billion are needed to secure the resources to control major childhood diseases, reduce malnutrition 50%, reduce child deaths by 4 million/year, provide potable water and sanitation to all communities, provide basic education, and make family planning available to all. This cost for saving children's lives is lower than current expenditures for cigarettes (US$50 billion in Europe/year). Vitamin A supplementation, breast feeding, and prenatal diagnosis of congenital malformations are low-cost strategies that can significantly affect infant well-being and reduce child mortality in many developing countries. The US has a higher infant mortality rate than have other developed countries. The American College of Obstetricians and Gynecologists and the US National Institutes of Health are focusing on prematurity, low birth weight, multiple pregnancy, violence, alcohol abuse, and poverty to reduce infant mortality. Obstetricians should be important members of MCH teams, which also include traditional birth attendants, community health workers, nurses, midwives, and medical officers. We have the financial resources to allocate resources to improve MCH care and to reduce infant mortality.

Differential Impact of Message Appeals, Food Healthiness, and Poverty Status on Evaluative Responses to Nutrient-Content Claimed Food Advertisements.

PubMed

Choi, Hojoon; Reid, Leonard N

2015-01-01

A 2 × 3 × 2 mixed factorial experimental design was used to examine how three message appeals (benefit-seeking vs. risk-avoidance vs. taste appeals), food healthiness (healthy vs. unhealthy foods), and consumer poverty status (poverty vs. nonpoverty groups) impact evaluative responses to nutrient-content claimed food advertisements. Subjects were partitioned into two groups, those below and those above the poverty line, and exposed to nutrient-content claimed advertisement treatments for healthy and unhealthy foods featuring the three appeals. The findings reaffirmed the interaction effects between perceivably healthy and unhealthy foods and different appeals reported in previous studies, and found interaction effects between consumer poverty level and response to the message appeals featured in the experimental food advertisements. Age, body mass index, current dieting status, education, and gender were examined as covariates.

Panzootics and the poor: devising a global livestock disease prioritisation framework for poverty alleviation.

PubMed

Heffernan, C

2009-12-01

Panzootics such as highly pathogenic avian influenza and Rift Valley fever have originated from the South, largely among poor communities. On a global level, approximately two-thirds of those individuals living on less than US$2 per day keep livestock. Consequently, there is a need to better target animal health interventions for poverty reduction using an evidence-based approach. Therefore, the paper offers a three-step prioritisation framework using calculations derived from standard poverty measures: the poverty gap and the head count ratio. Data from 265 poor livestock-keeping households in Kenya informed the study. The results demonstrate that, across a spectrum of producers, the dependence upon particular species varies. Furthermore, the same livestock disease has differing impacts on the depth and severity of poverty. Consequently, animal health interventions need to account for variability in income effects at the species and disease levels.

Understanding the Link between Poverty and Food Insecurity among Children: Does the Definition of Poverty Matter?

PubMed Central

Wight, Vanessa; Kaushal, Neeraj; Waldfogel, Jane; Garfinkel, Irv

2014-01-01

This paper examines the association between poverty and food insecurity among children, using two different definitions of poverty—the official poverty measure (OPM) and the new supplemental poverty measure (SPM) of the Census Bureau, which is based on a more inclusive definition of family resources and needs. Our analysis is based on data from the 2001–11 Current Population Survey and shows that food insecurity and very low food security among children decline as income-to-needs ratio increases. The point estimates show that the associations are stronger as measured by the new supplemental measure of income-to-needs ratio than when estimated through the official measure. Statistical tests reject the hypothesis that poor households’ odds of experiencing low food security are the same whether the SPM or OPM measure is used; but the tests do not reject the hypothesis when very low food security is the outcome. PMID:25045244

Can AIDS stigma be reduced to poverty stigma? Exploring Zimbabwean children's representations of poverty and AIDS.

PubMed

Campbell, C; Skovdal, M; Mupambireyi, Z; Madanhire, C; Robertson, L; Nyamukapa, C A; Gregson, S

2012-09-01

We use children's drawings to investigate social stigmatization of AIDS-affected and poverty-affected children by their peers, in the light of suggestions that the stigmatization of AIDS-affected children might derive more from the poverty experienced by these children than from their association with AIDS. A qualitative study, in rural Zimbabwe, used draw-and-write techniques to elicit children's (10-12 years) representations of AIDS-affected children (n= 30) and poverty-affected children (n= 33) in 2009 and 2010 respectively. Representations of children affected by AIDS and by poverty differed significantly. The main problems facing AIDS-affected children were said to be the psychosocial humiliations of AIDS stigma and children's distress about sick relatives. Contrastingly, poverty-affected children were depicted as suffering from physical and material neglect and deprivation. Children affected by AIDS were described as caregivers of parents whom illness prevented from working. This translated into admiration and respect for children's active contribution to household survival. Poverty-affected children were often portrayed as more passive victims of their guardians' inability or unwillingness to work or to prioritize their children's needs, with these children having fewer opportunities to exercise agency in response to their plight. The nature of children's stigmatization of their AIDS-affected peers may often be quite distinct from poverty stigma, in relation to the nature of suffering (primarily psychosocial and material respectively), the opportunities for agency offered by each affliction, and the opportunities each condition offers for affected children to earn the respect of their peers and community. We conclude that the particular nature of AIDS stigma offers greater opportunities for stigma reduction than poverty stigma. © 2011 Blackwell Publishing Ltd.

Can AIDS stigma be reduced to poverty stigma? Exploring Zimbabwean children's representations of poverty and AIDS

PubMed Central

Campbell, C; Skovdal, M; Mupambireyi, Z; Madanhire, C; Robertson, L; Nyamukapa, C A; Gregson, S

2012-01-01

Objective We use children's drawings to investigate social stigmatization of AIDS-affected and poverty-affected children by their peers, in the light of suggestions that the stigmatization of AIDS-affected children might derive more from the poverty experienced by these children than from their association with AIDS. Methods A qualitative study, in rural Zimbabwe, used draw-and-write techniques to elicit children's (10–12 years) representations of AIDS-affected children (n= 30) and poverty-affected children (n= 33) in 2009 and 2010 respectively. Results Representations of children affected by AIDS and by poverty differed significantly. The main problems facing AIDS-affected children were said to be the psychosocial humiliations of AIDS stigma and children's distress about sick relatives. Contrastingly, poverty-affected children were depicted as suffering from physical and material neglect and deprivation. Children affected by AIDS were described as caregivers of parents whom illness prevented from working. This translated into admiration and respect for children's active contribution to household survival. Poverty-affected children were often portrayed as more passive victims of their guardians' inability or unwillingness to work or to prioritize their children's needs, with these children having fewer opportunities to exercise agency in response to their plight. Conclusions The nature of children's stigmatization of their AIDS-affected peers may often be quite distinct from poverty stigma, in relation to the nature of suffering (primarily psychosocial and material respectively), the opportunities for agency offered by each affliction, and the opportunities each condition offers for affected children to earn the respect of their peers and community. We conclude that the particular nature of AIDS stigma offers greater opportunities for stigma reduction than poverty stigma. PMID:21985490

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 interventions aimed at reducing disparities in CKD. PMID:25238697

Trends in financial satisfaction: does poverty make a difference?

PubMed

Hsieh, Chang-Ming

2002-01-01

Gerontological studies on financial satisfaction have been limited by the dearth of longitudinal research and the lack of research that includes the concept of poverty. In order to bridge these gaps, this longitudinal study examines and compares the intracohort and intercohort effects on financial satisfaction trends by poverty status among Americans age 45 and above, using data from the General Social Surveys. The results suggest that for both the poor and the non-poor, changes in financial satisfaction trends are mostly due to strong negative intercohort effects, indicating that younger cohorts are less satisfied financially than the older ones. There appears to be a significant difference in the intercohort effects of financial satisfaction trends between the poor and the non-poor. However, such difference can be accounted for by the differences in the effects of education and social comparison (or relative deprivation) on financial satisfaction between the poor and the non-poor.

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 indicators.

Geographic poverty and racial/ethnic disparities in cervical cancer precursor rates in Connecticut, 2008-2009.

PubMed

Niccolai, Linda M; Julian, Pamela J; Bilinski, Alyssa; Mehta, Niti R; Meek, James I; Zelterman, Daniel; Hadler, James L; Sosa, Lynn

2013-01-01

We examined associations of geographic measures of poverty, race, ethnicity, and city status with rates of cervical intraepithelial neoplasia grade 2 or higher and adenocarcinoma in situ (CIN2+/AIS), known precursors to cervical cancer. We identified 3937 cases of CIN2+/AIS among women aged 20 to 39 years in statewide surveillance data from Connecticut for 2008 to 2009. We geocoded cases to census tracts and used census data to calculate overall and age-specific rates. Poisson regression determined whether rates differed by geographic measures. The average annual rate of CIN2+/AIS was 417.6 per 100,000 women. Overall, higher rates of CIN2+/AIS were associated with higher levels of poverty and higher proportions of Black residents. Poverty was the strongest and most consistently associated measure. However, among women aged 20 to 24 years, we observed inverse associations between poverty and CIN2+/AIS rates. Disparities in cervical cancer precursors exist for poverty and race, but these effects are age dependent. This information is necessary to monitor human papillomavirus vaccine impact and target vaccination strategies.

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.

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.

Child Poverty: The United Kingdom Experience.

PubMed

Mansour, Jane G; Curran, Megan A

2016-04-01

The United States has long struggled with high levels of child poverty. In 2014, 2 of 5 (42.9%) of all American children lived in economically insecure households and just over 1 in 5 children lived below the official absolute poverty line. These rates are high, but not intractable. Evidence from the US Census Bureau's Supplemental Poverty Measure, among other sources, shows the effect that public investments in cash and noncash transfers can have in reducing child poverty and improving child well-being. However, with significant disparities in services and supports for children across states and the projected decline of current federal spending on children, the United States is an international outlier in terms of public investments in children, particularly compared with other high-income nations. One such country, the United Kingdom (UK), faced similar child poverty challenges in recent decades. At the end of the 20th century, the British Prime Minister pledged to halve child poverty in a decade and eradicate it 'within a generation.' The Labour Government then set targets and dedicated resources in the form of income supplements, employment, child care, and education support. Child poverty levels nearly halved against an absolute measure by the end of the first decade. Subsequent changes in government and the economy slowed progress and have resulted in a very different approach. However, the UK child poverty target experience, 15 years in and spanning multiple changes in government, still offers a useful comparative example for US social policy moving forward. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Disability, Poverty, and Material Hardship since the Passage of the ADA

PubMed Central

Drew, Julia A. Rivera

2015-01-01

The past 25 years have seen an unprecedented expansion in formal civil rights for people with disabilities that, among other things, was predicted to improve their economic well-being. Studies of economic well-being among people with disabilities have traditionally focused on employment and earnings, despite the fact that a minority of people with disabilities are employed. More recent literature has expanded to include measures of income poverty and material hardship, but has not examined trends in these dimensions of economic well-being over time or across different groups of people with disabilities. The current study uses nationally representative data covering the 1993-2010 period to examine trends over time in cross-sectional and dynamic measures of income poverty, and multiple dimensions of material hardship. It also describes differences in time trends by education, sex, race/ethnicity, and employment status among people with disabilities in income poverty and any material hardship. Levels of both material hardship and income poverty are high across the entire period for all groups, but while material hardship remains at the same level between 1993 and 2010, income poverty declines. These findings show that there has been little improvement over the past two decades in the economic well-being of people with disabilities, and additional research is needed to understand the mechanisms that keep even groups that are relatively privileged – college graduates and full-time, full-year workers – at very low levels of economic well-being. PMID:27042381

The association of fitness and school absenteeism across gender and poverty: a prospective multilevel analysis in New York City middle schools.

PubMed

D'Agostino, Emily M; Day, Sophia E; Konty, Kevin J; Larkin, Michael; Saha, Subir; Wyka, Katarzyna

2018-03-01

One-fifth to one-third of students in high poverty, urban school districts do not attend school regularly (missing ≥6 days/year). Fitness is shown to be associated with absenteeism, although this relationship may differ across poverty and gender subgroups. Six cohorts of New York City public school students were followed up from grades 5 to 8 during 2006/2007-2012/2013 (n = 349,381). Stratified three-level longitudinal generalized linear mixed models were used to test the association between changes in fitness and 1-year lagged child-specific days absent across gender and poverty. In girls attending schools in high/very high poverty areas, greater improvements in fitness the prior year were associated with greater reductions in absenteeism (P = .034). Relative to the reference group (>20% decrease in fitness composite percentile scores from the prior year), girls with a large increase in fitness (>20%) demonstrated 10.3% fewer days absent (incidence rate ratio [IRR] 95% confidence interval [CI]: 0.834, 0.964), followed by those who had a 10%-20% increase in fitness (9.2%; IRR 95% CI: 0.835, 0.987), no change (5.4%; IRR 95% CI: 0.887, 1.007), and a 10%-20% decrease in fitness (3.8%; IRR 95% CI: 0.885, 1.045). In girls attending schools in low/mid poverty areas, fitness and absenteeism also had an inverse relationship, but no clear trend emerged. In boys, fitness and absenteeism had an inverse relationship but was not significant in either poverty group. Fitness improvements may be more important to reducing absenteeism in high/very high poverty girls compared with low/mid poverty girls and both high/very high and low/mid poverty boys. Expanding school-based physical activity programs for youth particularly in high poverty neighborhoods may increase student attendance. Copyright © 2018 Elsevier Inc. All rights reserved.

Understanding the socioeconomic heterogeneity in healthcare in US counties: the effect of population density, education and poverty on H1N1 pandemic mortality.

PubMed

Ponnambalam, L; Samavedham, L; Lee, H R; Ho, C S

2012-05-01

The recent outbreak of H1N1 has provided the scientific community with a sad but timely opportunity to understand the influence of socioeconomic determinants on H1N1 pandemic mortality. To this end, we have used data collected from 341 US counties to model H1N1 deaths/1000 using 12 socioeconomic predictors to discover why certain counties reported fewer H1N1 deaths compared to other counties. These predictors were then used to build a decision tree. The decision tree developed was then used to predict H1N1 mortality for the whole of the USA. Our estimate of 7667 H1N1 deaths are in accord with the lower bound of the CDC estimate of 8870 deaths. In addition to the H1N1 death estimates, we have listed possible counties to be targeted for health-related interventions. The respective state/county authorities can use these results as the basis to target and optimize the distribution of public health resources.

Association of Child Poverty, Brain Development, and Academic Achievement

PubMed Central

Hair, Nicole L.; Hanson, Jamie L.; Wolfe, Barbara L.; Pollak, Seth D.

2015-01-01

IMPORTANCE Children living in poverty generally perform poorly in school, with markedly lower standardized test scores and lower educational attainment. The longer children live in poverty, the greater their academic deficits. These patterns persist to adulthood, contributing to lifetime-reduced occupational attainment. OBJECTIVE To determine whether atypical patterns of structural brain development mediate the relationship between household poverty and impaired academic performance. DESIGN, SETTING, AND PARTICIPANTS Longitudinal cohort study analyzing 823 magnetic resonance imaging scans of 389 typically developing children and adolescents aged 4 to 22 years from the National Institutes of Health Magnetic Resonance Imaging Study of Normal Brain Development with complete sociodemographic and neuroimaging data. Data collection began in November 2001 and ended in August 2007. Participants were screened for a variety of factors suspected to adversely affect brain development, recruited at 6 data collection sites across the United States, assessed at baseline, and followed up at 24-month intervals for a total of 3 periods. Each study center used community-based sampling to reflect regional and overall US demographics of income, race, and ethnicity based on the US Department of Housing and Urban Development definitions of area income. One-quarter of sample households reported the total family income below 200% of the federal poverty level. Repeated observations were available for 301 participants. EXPOSURE Household poverty measured by family income and adjusted for family size as a percentage of the federal poverty level. MAIN OUTCOMES AND MEASURES Children’s scores on cognitive and academic achievement assessments and brain tissue, including gray matter of the total brain, frontal lobe, temporal lobe, and hippocampus. RESULTS Poverty is tied to structural differences in several areas of the brain associated with school readiness skills, with the largest influence observed among children from the poorest households. Regional gray matter volumes of children below 1.5 times the federal poverty level were 3 to 4 percentage points below the developmental norm (P < .05). A larger gap of 8 to 10 percentage points was observed for children below the federal poverty level (P < .05). These developmental differences had consequences for children’s academic achievement. On average, children from low-income households scored 4 to 7 points lower on standardized tests (P < .05). As much as 20% of the gap in test scores could be explained by maturational lags in the frontal and temporal lobes. CONCLUSIONS AND RELEVANCE The influence of poverty on children’s learning and achievement is mediated by structural brain development. To avoid long-term costs of impaired academic functioning, households below 150% of the federal poverty level should be targeted for additional resources aimed at remediating early childhood environments. PMID:26192216

Effectiveness of a poverty simulation in Second Life®: changing nursing student attitudes toward poor people.

PubMed

Menzel, Nancy; Willson, Laura Helen; Doolen, Jessica

2014-03-11

Social justice is a fundamental value of the nursing profession, challenging educators to instill this professional value when caring for the poor. This randomized controlled trial examined whether an interactive virtual poverty simulation created in Second Life® would improve nursing students' empathy with and attributions for people living in poverty, compared to a self-study module. We created a multi-user virtual environment populated with families and individual avatars that represented the demographics contributing to poverty and vulnerability. Participants (N = 51 baccalaureate nursing students) were randomly assigned to either Intervention or Control groups and completed the modified Attitudes toward Poverty Scale pre- and post-intervention. The 2.5-hour simulation was delivered three times over a 1-year period to students in successive community health nursing classes. The investigators conducted post-simulation debriefings following a script. While participants in the virtual poverty simulation developed significantly more favorable attitudes on five questions than the Control group, the total scores did not differ significantly. Whereas students readily learned how to navigate inside Second Life®, faculty facilitators required periodic coaching and guidance to be competent. While poverty simulations, whether virtual or face-to-face, have some ability to transform nursing student attitudes, faculty must incorporate social justice concepts throughout the curriculum to produce lasting change.

Incarceration and Relative Poverty in Cross-National Perspective: The Moderating Roles of Female Employment and the Welfare State

PubMed Central

Gottlieb, Aaron

2017-01-01

A growing body of scholarship explores how incarceration contributes to inequality. The majority of this scholarship focuses on individual-level outcomes or aggregate outcomes within the United States. Despite substantial cross-national variation in incarceration rates, we know little about whether these differences contribute to cross-national variation in inequality outcomes. Using data from the period 1971–2010 from 15 advanced democracies, this study begins to fill this gap by exploring whether cross-national differences in incarceration rates help to explain cross-national differences in relative poverty rates. Although this research finds no average association, this null association obscures the important moderating role of country context. The association between incarceration and relative poverty is contingent upon a country’s female employment rate and welfare state generosity. PMID:29104322

Place, Poverty, and Algebra: A Statewide Comparative Spatial Analysis of Variable Relationships

ERIC Educational Resources Information Center

Hogrebe, Mark C.; Tate, William F.

2012-01-01

Place matters in moderating variable relationships between algebra performance and educational variables because there are differences on the socioeconomic (SES) poverty-affluence continuum that shape local contexts. This article examines relationships between variables for school district demographic composition, teaching and financial contexts,…

The Feminization of Poverty: Women, Work, and Welfare

ERIC Educational Resources Information Center

Pearce, Diane

1978-01-01

Statistics are presented which show that women are accounting for an increasingly large proportion of the economically disadvantaged. Different sources of income (earned, public, and private transfer income) and the welfare system are discussed in terms of their roles in the perpetuation of female poverty. (Author/GC)

Effectiveness of an NGO primary health care programme in rural Bangladesh: evidence from the management information system.

PubMed

Mercer, Alec; Khan, Mobarak Hossain; Daulatuzzaman, Muhammad; Reid, Joanna

2004-07-01

This paper considers evidence of the effectiveness of a non-governmental organization (NGO) primary health care programme in rural Bangladesh. It is based on data from the programme's management information system reported by 27 partner NGOs from 1996-2002. The data indicate relatively high coverage has been achieved for reproductive and child health services, as well as lower infant and child mortality. On the basis of a crude indicator of socio-economic status, the programme is poverty-focused. There is good service coverage among the poorest one-third and others, and the infant and child mortality differential has been eliminated over recent years. A rapid decline in infant mortality among the poorest from 1999-2002 reflects a reduction in neonatal mortality of about 50%. Allowing for some under-reporting and possible misclassification of deaths to the stillbirths category, neonatal mortality is relatively low in the NGO areas. The lower child and maternal mortality for the NGO areas combined, compared with estimates for Bangladesh in recent years, may at least in part be due to high coverage of reproductive and child health services. Other development programmes implemented by many of the NGOs could also have contributed. Despite the limited resources available, and the lower infant and child mortality already achieved, there appears to be scope for further prevention of deaths, particularly those due to birth asphyxia, acute respiratory infection, diarrhoeal disease and accidents. Maternal mortality in the NGO areas was lower in 2000-02 than the most recent estimate for Bangladesh. Further reduction is likely to depend on improved access to qualified community midwives and essential obstetric care at government referral facilities.

REGIONAL VARIATIONS IN INFANT AND CHILD MORTALITY IN NIGERIA: A MULTILEVEL ANALYSIS.

PubMed

Adedini, Sunday A; Odimegwu, Clifford; Imasiku, Eunice N S; Ononokpono, Dorothy N; Ibisomi, Latifat

2015-03-01

There are substantial regional disparities in under-five mortality in Nigeria, and evidence suggests that both individual- and community-level characteristics have an influence on health outcomes. Using 2008 Nigeria Demographic and Health Survey data, this study (1) examines the effects of individual- and community-level characteristics on infant/child mortality in Nigeria and (2) determines the extent to which characteristics at these levels influence regional variations in infant/child mortality in the country. Multilevel Cox proportional hazard analysis was performed on a nationally representative sample of 28,647 children nested within 18,028 mothers of reproductive age, who were also nested within 886 communities. The results indicate that community-level variables (such as region, place of residence, community infrastructure, community hospital delivery and community poverty level) and individual-level factors (including child's sex, birth order, birth interval, maternal education, maternal age and wealth index) are important determinants of infant/child mortality in Nigeria. For instance, the results show a lower risk of death in infancy for children of mothers residing in communities with a high proportion of hospital delivery (HR: 0.70, p < 0.05) and for children whose mothers had secondary or higher education (HR: 0.84, p < 0.05). Although community factors appear to influence the association between individual-level factors and death during infancy and childhood, the findings consistently indicate that community-level characteristics are more important in explaining regional variations in child mortality, while individual-level factors are more important for regional variations in infant mortality. The results of this study underscore the need to look beyond the influence of individual-level factors in addressing regional variations in infant and child mortality in Nigeria.

Trends and determinants of infant and under-five childhood mortality in Vietnam, 1986-2011.

PubMed

Lee, Hwa-Young; Van Do, Dung; Choi, Sugy; Trinh, Oanh Thi Hoang; To, Kien Gia

2016-01-01

Although Vietnam has taken great efforts to reduce child mortality in recent years, a large number of children still die at early age. Only a few studies have been conducted to identify at-risk groups in order to provide baseline information for effective interventions. The study estimated the overall trends in infant mortality rate (IMR) and under-five mortality rate (U5MR) during 1986-2011 and identified demographic and socioeconomic determinants of child mortality. Data from the Vietnam Multiple Indicator Cluster Surveys (MICSs) in 2000 (MICS2), 2006 (MICS3) and 2011 (MICS4) were analysed. The IMR and U5MR were calculated using the indirect method developed by William Brass. Unadjusted and adjusted odds ratios were estimated to assess the association between child death and demographic and socioeconomic variables. Region-stratified stepwise logistic regression was conducted to test the sensitivity of the results. The IMR and U5MR significantly decreased for both male and female children between 1986 and 2010. Male children had higher IMR and U5MR compared with females in all 3 years. Women who were living in the Northern Midlands and Mountain areas were more likely to experience child deaths compared with women who were living in the Red River Delta. Women who were from minor ethnic groups, had low education, living in urban areas, and had multiple children were more likely to have experienced child deaths. Baby boys require more healthcare attention during the first year of their life. Comprehensive strategies are necessary for tackling child mortality problems in Vietnam. This study shows that child mortality is not just a problem of poverty but involves many other factors. Further studies are needed to investigate pathways underlying associations between demographic and socioeconomic conditions and childhood mortality.

Reducing out-of-pocket expenditures to reduce poverty: a disaggregated analysis at rural-urban and state level in India.

PubMed

Garg, Charu C; Karan, Anup K

2009-03-01

Out-of-pocket (OOP) expenditure on health care has significant implications for poverty in many developing countries. This paper aims to assess the differential impact of OOP expenditure and its components, such as expenditure on inpatient care, outpatient care and on drugs, across different income quintiles, between developed and less developed regions in India. It also attempts to measure poverty at disaggregated rural-urban and state levels. Based on Consumer Expenditure Survey (CES) data from the National Sample Survey (NSS), conducted in 1999-2000, the share of households' expenditure on health services and drugs was calculated. The number of individuals below the state-specific rural and urban poverty line in 17 major states, with and without netting out OOP expenditure, was determined. This also enabled the calculation of the poverty gap or poverty deepening in each region. Estimates show that OOP expenditure is about 5% of total household expenditure (ranging from about 2% in Assam to almost 7% in Kerala) with a higher proportion being recorded in rural areas and affluent states. Purchase of drugs constitutes 70% of the total OOP expenditure. Approximately 32.5 million persons fell below the poverty line in 1999-2000 through OOP payments, implying that the overall poverty increase after accounting for OOP expenditure is 3.2% (as against a rise of 2.2% shown in earlier literature). Also, the poverty headcount increase and poverty deepening is much higher in poorer states and rural areas compared with affluent states and urban areas, except in the case of Maharashtra. High OOP payment share in total health expenditures did not always imply a high poverty headcount; state-specific economic and social factors played a role. The paper argues for better methods of capturing drugs expenditure in household surveys and recommends that special attention be paid to expenditures on drugs, in particular for the poor. Targeted policies in just five poor states to reduce OOP expenditure could help to prevent almost 60% of the poverty headcount increase through OOP payments.

Neighborhoods, Schools, and Academic Achievement: A Formal Mediation Analysis of Contextual Effects on Reading and Mathematics Abilities.

PubMed

Wodtke, Geoffrey T; Parbst, Matthew

2017-10-01

Although evidence indicates that neighborhoods affect educational outcomes, relatively little research has explored the mechanisms thought to mediate these effects. This study investigates whether school poverty mediates the effect of neighborhood context on academic achievement. Specifically, it uses longitudinal data from the Panel Study of Income Dynamics, counterfactual methods, and a value-added modeling strategy to estimate the total, natural direct, and natural indirect effects of exposure to an advantaged rather than disadvantaged neighborhood on reading and mathematics abilities during childhood and adolescence. Contrary to expectations, results indicate that school poverty is not a significant mediator of neighborhood effects during either developmental period. Although moving from a disadvantaged neighborhood to an advantaged neighborhood is estimated to substantially reduce subsequent exposure to school poverty and improve academic achievement, school poverty does not play an important mediating role because even the large differences in school composition linked to differences in neighborhood context appear to have no appreciable effect on achievement. An extensive battery of sensitivity analyses indicates that these results are highly robust to unobserved confounding, alternative model specifications, alternative measures of school context, and measurement error, which suggests that neighborhood effects on academic achievement are largely due to mediating factors unrelated to school poverty.

Grandfather caregivers: race and ethnic differences in poverty.

PubMed

Keene, Jennifer R; Prokos, Anastasia H; Held, Barbara

2012-01-01

We use data from the 2006 American Community Survey to examine race and ethnic differences in the effects of marital status and co-residence of the middle generation on the likelihood of poverty among grandfathers who have primary responsibility for co-resident grandchildren (N = 3,379). Logistic regression results indicate that race/ethnicity and household composition are significant predictors of poverty for grandfather caregivers: non-Hispanic white grandfathers, those who are married, and those with a co-resident middle generation are the least likely to be poor. The effects of race/ethnicity, marital status, and the presence of a middle generation are, however, contingent upon one another. Specifically, the negative effect of being married is lower among grandfathers who are Hispanic, African American, non-Hispanic, and non-Hispanics of other race/ethnic groups compared to whites. In addition, having a middle generation in the home has a larger negative effect on poverty for race/ethnic minority grandfathers than for non-Hispanic whites. Finally, the combined effects of marriage and a middle generation vary across race/ethnic group and are associated with lower chances of poverty among some groups compared with others. We use the theory of cumulative disadvantage to interpret these findings and suggest that race/ethnicity and household composition are synergistically related to economic resources for grandfather caregivers.

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.

Socioeconomic determinants of infant mortality: a worldwide study of 152 low-, middle-, and high-income countries.

PubMed

Schell, Carl Otto; Reilly, Marie; Rosling, Hans; Peterson, Stefan; Ekström, Anna Mia

2007-01-01

To reach the Millennium Development Goals for health, influential international bodies advocate for more resources to be directed to the health sector, in particular medical treatment. Yet, health has many determinants beyond the health sector that are less evident than proximate predictors. To assess the relative importance of major socioeconomic determinants of population health, measured as infant mortality rate (IMR), at country level. National-level data from 152 countries based on World Development Indicators 2003 were used for multivariate linear regression analyses of five socioeconomic predictors of IMR: public spending on health, GNI/capita, poverty rate, income equality (Gini index), and young female illiteracy rate. Analyses were performed on a global level and stratified for low-, middle-, and high-income countries. In order of importance, GNI/capita, young female illiteracy, and income equality predicted 92% of the variation in national IMR whereas public spending on health and poverty rate were non-significant determinants when adjusted for confounding. In low-income countries, female illiteracy was more important than GNI/capita. Income equality (Gini index) was an independent predictor of IMR in middle-income countries only. In high-income countries none of these predictors was significant. The relative importance of major health determinants varies between income levels, thus extrapolating health policies from high- to low-income countries is problematic. Since the size, per se, of public health spending does not independently predict health outcomes, functioning health systems are necessary to make health investments efficient. Potential health gains from improved female education and economic growth should be considered in low- and middle-income countries.