Poverty and Health, When You’re Too Poor to be Healthy

 

All over the world we can look around and see inequality everywhere, a world unbalanced. In the Untied States we have a runaway obesity epidemic, as I mentioned in a previous post, but there are people all over the world who are starving. The wage gap between the wealthiest 1% and the rest of the world continues to grow. And Nestle continues to extract ground water from draught stricken California (CNBC), while people around the world have little to no access to clean drinking water. Education costs continue to go up, making something that was once a moderate struggle to achieve, has become nearly impossible for many today to go to college. There are children in developing countries who barely receive an elementary education, if any, and leave school with little knowledge of how to better themselves or how to take of their health.

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Living in poverty makes it extremely difficult to gain access to nutritious food, clean drinking water, and good healthcare in order to achieve optimum health. According to the World Health Organization (WHO), 21,000 children all over the world die everyday due to lack of health care, maternal mortality is much higher in developing countries than it is in industrialized countries, as well as life expectancies vary as much as 37 years in those same countries. Also, developing people who live in poverty are more prone to catching non-communicable diseases and have much higher rates of tuberculosis.

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The problem then is providing a way in which people living in poverty can gain access to better medical care. Theory of planned behavior says that we can actually change people’s behaviors by targeting their behavioral intentions (Lafreniere & Cramer). In other words one can be taught to make good behavioral decisions in advance of an activity. While this theory in no way addresses all of the issues with poverty and lack of healthcare, it can be an important piece. For example, one of the reasons for poverty is lack of education and by modeling good health choices in a classroom setting this would then start to remove one of the barriers to accessing healthcare. Perhaps a bigger piece of moving towards improving this problem would be to change policies and procedures in the healthcare world. According to Loignan et al, there are three major factors that cause healthcare to be inaccessible to the poor, and they are difficult living conditions for the poor, lack of communication between patients and providers, and finally the overwhelming complexity of the healthcare system.

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The goal is to improve access to healthcare for the poor. The way to do this is to simplify the healthcare system, and to provide programs that will model good healthcare choices and how to find services to support healthy choices. Legislation at the government level to reduce the amount of paperwork and information necessary to gain access to healthcare and simplifying and streamlining the whole process. Also put training programs in place starting in elementary school by having teachers model good health choices and how, where, and when to access resources to support the good choices they are learning to make. This should be a progressive training continuing to the college level and up to medical school, that way to better communication skills between providers and patients.

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Evaluating the success of these interventions will come in the form of improved access to healthcare for those living in poverty, reduced infant and maternal deaths, improved living conditions as health improves. Also, as communication improves between providers and patients, more people are going to feel more encouraged to seek out healthcare as they need it, thereby reducing their chances of getting sicker or dying from easily treatable illnesses.

 

Resources

http://www.cnbc.com/id/

http://www.who.int/features/factfiles/health_inequities/en/

Loignon, C., Hudon, C., Goulet, E.,  Boyer, S., De Laat, N., Fournier, N., Grabovschi, C., and Bush, P. Perceived barriers to healthcare for persons living in poverty in Quebec, Canada: the EQUIhealThY project. International Journal for Equity in Health 2015, 14:4  doi:10.1186/s12939-015-0135-5

 

 

2 comments

  1. Windy Williams Alonso

    Very interesting and pertinent topic! Socioeconomic status is a considerable determinant of health status. I am a little unsure of applying the theory of planned behavior in this context because although intending to live a healthier lifestyle is a great first step in the process of behavior change the poor and poverty stricken face extreme obstacles in implementing these changes. Recent evidence suggests that targeting “upstream” processes like the distribution of wealth and power may be more effective in eliminating health disparities (Freudenberg, et al., 2015). However, I do realize this would be quite the challenge given our propensity to blame poverty on personal attributes of individuals in a case of fundamental attribution error. Suggestions for “upstream” changes from Freudenberg and colleagues are broad in scope and range from providing a living wage to placing limits on the marketing of unhealthy foods, beverages and tobacco to the poor.

    Reference
    Freudenberg, N., Fanzosa, E., Chisholm, J. & Libman, K. (2015). New approaches for moving upstream: how state and local health departments can transform practice to reduce health inequalities. Health, Education and Behavior. 42(Suppl): 46S-56S.

  2. Anthony D Ferrono

    This was a very powerful post regarding health and economic stature. I would agree that in today’s society it has become increasingly difficult to obtain proper education regarding health. As you stated this is because the cost of education has dramatically increased, while poverty has also taken a turn for the worst. Children in developing countries do not have proper education or nutrition, resulting in catastrophic disease and poverty. A rising issue in our society as you mentioned is that poverty is very prevalent, not only in developing countries, but also in ours. With poverty comes decreased health, due to malnutrition and little to no healthcare. People are less likely to go to the doctors for a lump they found on their breast because they may not have healthcare, and cannot afford the large amount of money to go see a doctor. This directly affects socio economic health, as the poor get sicker without treatment. One a more positive notes, since Obama has taken office, his affordable healthcare act has done wonders for poverty stricken individuals, as healthcare has become cheaper and more obtainable. I would agree with your disposition of providing more healthcare programs, and perhaps more healthcare education, which is widely important because it could save, lives. “Poverty and ill-health are intertwined. Poor countries tend to have worse health outcomes than better-off countries. Within countries, poor people have worse health outcomes than better-off people. This association reflects causality running in both directions: poverty breeds ill-health, and ill-health keeps poor people poor (Wagstaff 2002)”.

    Wagstaff, Adam. (2002). Poverty and health sector inequalities. Bulletin of the World Health Organization, 80(2), 97-105. Retrieved April 01, 2015, from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0042-96862002000200004&lng=en&tlng=en. 10.1590/S0042-96862002000200004.

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