Are You Sick, or are You Just Poor? A Peer Into the Interconnectedness of Health and Poverty
Author: Rachel Downey
Upon arriving in Athens on July 6th,
one of the program coordinators, Tom, took myself and my fellow classmates on a
short tour of the immediate area of the city, called Plaka. On our way through
town, a frantic, greasy-haired woman scurried past us on the street, with her
breasts hanging free and a young child to her nipple. She was distressed, and
even began speaking to passerby in Greek, but we couldn’t understand. I didn’t
think too much of it, because the #FreeTheNipple movement has made it’s impact in
the states, but I also realize that we are in a different culture on the other
side of the world.
Shortly after this encounter, Tom
informs us of what is going on. These women panhandle, at these children’s
expense, exploited for their innocence by their own mothers and handed off to
beggars on the street. This experience got me thinking about the lengths people
will go, simply in order to live a comfortable life. In 2014, 14.8% of the U.S.
population was living below the poverty line, that is, making less than $24,008
a year for a family of four (Bernstein, 2018). The statistics in Greece are not
much different. In 2016, 13.6% of Greeks lived below the poverty line, rounding
out to just under 1.5 million (Chrysopoulos, 2017).
Regardless of geographical location,
poverty affects people of all ages, and manifests itself amongst various
levels. A journal article composed by Deepti Gupta (2017), focuses on the
effects of poverty, unemployment, and recession on youth’s mental health. The
youths are a pivotal population to study, because they have the highest chance
to emerge out of poverty between the ages of 18 and 22. Emergence is much less
likely to happen after one reaches post-college age, or doesn’t graduate high
school. Poverty can impact an individual’s mental and physical health within
various contexts. At an individual level, poverty can cause anxiety,
depression, and low self esteem. Physically, it can cause immense amounts of
stress, which can lead to high blood pressure, circulatory problems, and an
increased risk for sclerosis multiplex. It has even been known to manifest as
an immune system suppressant, causing an increased risk for infections as well
as a multitude of other physiological issues.
At the family level, poverty, recession, or
unemployment can lead to shame (from the providers of the family for not
fulfilling their duty), neglect, and harsher parenting practices, while marital
distress can lead to negative social and emotional outcomes for children. It
has been said that financial strain, particularly in the case of providing for
a family, is thought to be a better predictor of psychiatric morbidity than
both poverty and unemployment. In the case of parents, this frequently
manifests as chronic stress and feelings of hopelessness (Deepti, 2017).
At the community level, living in
poverty can mean poor educational facilities and resources, violent or
dangerous neighborhoods, behavioral problems at school such as difficulty
making friends, aggression, conduct disorder, and overall increased levels of
frustration due to lack of resources and feelings of helplessness. Growing up
in an unsafe neighborhood can lead to a number of different psychological
difficulties for children. Increased exposure to violence or gang related
behaviors has been known to predict violent behavior in the future, and puts
youth at a greater risk for injury, death, or ending up in the juvenile justice
system (Deepti, 2017).
One’s own perception of their
quality of life or poverty level can also impact their health. Anderson (1968),
proposes what he calls the Anderson Model to describe three telling factors of
health service use. These three factors include: predisposing characteristics,
enabling resources, and need. Predisposing characteristics includes sociodemographic
factors such as one’s age, sex, race/ethnicity, or marital status. Enabling
factors can be seen at both an individual level and community level, and these
include income, health insurance, and the availability of health resources and
facilities. Lastly, need refers to one’s perceived need for medical evaluation
and/or health services. In simpler terms, people living in poverty are less
likely to take advantage of health service facilities due to lack of income,
inadequate or nonexistent health insurance, and overall scarcity of resources.
Stigma also plays a role in access to healthcare, for the need to rely on
welfare or government assistance can have a negative perception in society.
What does this mean for people
struggling to make ends meet who are struggling with chronic illnesses? A study
(Ezzy, 1999) titled “Poverty, Disease Progression, and Employment Among People
Living with HIV/AIDS in Australia” may help shed some light on the effects of
having a chronic illness and dealing with poverty. Although the Australian
Health and Welfare system provides reasonable assistance with the costs of
medical bills, it can be assumed that the results of this study could be
amplified to mirror the healthcare systems in the U.S. (or lack thereof).
Ultimately, the study found that living with a chronic illness such as HIV/AIDS
has the potential to propell someone into poverty, since their health
progressively declines as the disease progresses, and psychosocial factors such
as anxiety, depression, and withdrawal can cause them to leave the workforce.
Likewise, infectious diseases have been a leading killer of the poor since the
beginning of society. The poor cannot afford the same treatments the wealthy
can, therefore risk of infection is higher and treatment is less likely
(Ngonghala, 2014).
Additionally, a study conducted by
Bernstein (2018) found that individuals that met the income levels up to three
thresholds higher than the federal poverty threshold had higher annual survival
rates than those living in poverty, or even near poverty. Since the official
federal poverty threshold is set so low, Bernstein considered people “near”
poverty in the study as well and found that they had lower life expectancies
than their more well-off counterparts. “Near poverty” is generally considered
as a family income of 101%- 134% of the federal poverty level, whereas
“poverty” is considered to be a family income of 0%-100% of the federal poverty
level (Kim, 2015).
Overall, there are striking ties
between income disparities, unemployment, and health qualities of the poor.
Poverty has been shown to impact people of all ages, at various levels, and the
effects can be mental, emotional, and in extreme cases, physical. In order to
prevent poverty from affecting the health of the poor disproportionately, there
should be an improved healthcare system implemented in the United States,
providing better assistance to the poor, and making healthcare more accessible.
Hopefully with the help of the scientific community, infectious diseases will
become more easily combatable, and vaccines will be more accessible and
accepted in the public eye.
Resources:
Bernstein, Shayna Fae. (2018). “Poverty dynamics, poverty thresholds, and mortality: and age-stage Markovian model” PloS ONE. 13 (5). P. 1-12.
Resources:
Bernstein, Shayna Fae. (2018). “Poverty dynamics, poverty thresholds, and mortality: and age-stage Markovian model” PloS ONE. 13 (5). P. 1-12.
Chrysopoulos, Phillip. (2017). “Almos 1.5 million Greeks
live in extreme poverty” Greek Reporter:
Ezzy, Douglas. (1999). “Poverty, disease progression, and
employment among people living with HIV/AIDS in Australia” AIDS Care. 4 (11). P. 405-414.
Gupta, Deepti. (2017). “Unemployment, poverty, and recession
impact on youth’s mental health”. Indian Journal of Health and Well-being. 8 (8). P. 911-914.
Kim, Jim. (2015). “Poverty, health insurance status, and
health service utilization among the elderly” Journal of Poverty. (19). P. 424-444.
Ngonghala, Calistus N. (2014). “Poverty, disease, and the
ecology of complex systems” PloS Biol. 12 (4). P. 1-7.
Rachel,
ReplyDeleteYou have some very compelling and comprehensive findings regarding income inequality, unemployment and health. I find it fascinating, yet unsurprising, that poverty has such widespread effects on both in individual and society. In regards to limited access to healthcare, the poor are not the only one's who experience both sigma and limited insurance. Other minority groups such as transgender individuals, also face the same issues. I will be addressing this issue in a few days in my blog post. Thank you for your insight on this issue!
Rachel, I liked the connection you made between health disparities and low income. It seems to be this never ending cycle in the US. Our healthcare in the US is not easily accessed and isn't always affordable or with minimal coverage. If an individual is unemployed or already has sever health issues, then the proper healthcare can be even more hard to access in the US. Studies show that there is a relationship between living in poverty and suffering from health issues, but no real solution for someone to get off this cycle. Your health relies on your access, and your access relies on ones connections or income; so when a person doesn't have these resources it makes it hard to strive since our healthcare has a certain favoritism.
ReplyDeleteThese (Lily and Emilia's) comments are good. And Rachel lays out a number of consequences of poverty in this domain.
ReplyDeleteHere's the thing, though: We (as a field) have finally done pretty well in identifying and describing these disparities and their consequences. Now, the challenge becomes what to do about it? How can these disparities be reduced?
People will suggest that society somehow offer "more education!" and/or "more coverage", etc. But how do we provide these things? That is, who pays for it?
And in deciding who or how to pay for it, people will need to consider their priorities. What do "we" want to support?
We know from research on the psychology of inequality that in highly unequal contexts, people are typically motivated to preserve their status. And just in terms of rational, purely economic decision-making, middle- and upper-class persons would be expected to support, say, tax cuts (so they earn more and preserve their status) at the expense of services to the poor.
So of course, the solution to reducing disparities becomes a political question. Ultimately, "we" must decide what we value. As we've covered in class, what is "enough"? By extension, what is the "minimum"? And how do we have that conversation and arrive at a feasible, substantive solution?
Theoretically, I think the best way to rid the disparities would be to create a minimum and a maximum wage (and in a way, standard of living). Of course you can't control how much luxuries a wealthy person is going to indulge in, but we could try to create an income level that caps off at a certain amount, successfully abolishing the "1%". The minimum wage would more so apply to standard of living for the poorest people. While now their is a minimum wage, it is not a livable wage and people are still in poverty with this type of income. In a perfect society, the minimum would provide a standard of living that is comfortable and where families do not have to struggle to make ends meet.
DeleteThe issues in today's society are very deep and systemic. It would take many years or decades to reach an ideal society within America.
Rachel,
ReplyDeleteI really enjoyed your blog post! You made a plethora of important connections regarding inequality, poverty, unemployment, illness, etc. As Lily pointed out in her comment, these consequences may be much worse for someone in a minority group, such as, transgender individuals. However, I also think we could connect this topic to those with mental disabilities as well! As we discussed in class, there are certain stereotypes and social stigmas placed on persons with mental disorders. If someone is already facing inequalities based on metal health, struggling against poverty and physical health issues as well could further the stigma already placed on them by society.