essay on ill effects of poverty

What are the Health Effects of Poverty?

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There is a wealth of evidence to suggest that health is correlated to individuals’ socioeconomic status and lifestyle.

The relationship between socio-economic status and health has Been corroborated by several studies conducted across the world. All studies have confirmed a profound impact of socio-economic status on health; however, the mechanism behind this correlation has been a matter of debate.

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What is poverty?

Individuals, families, and communities within a population can be said to be living in poverty when they lack resources to obtain the type of diet, participate in lifestyle activities, and have the living conditions and resources which are customary to the majority of the society in which these individuals, families, and groups belong.

In the UK, receiving income-related welfare benefits has been used as a measure of poverty. This can be job seekers allowance, housing benefits, council tax benefits, or working tax credit and child tax credit.

Objective and subjective measures of material deprivation have also been used as poverty measures; these can include celebrations, clothes appropriate for all weather, the ability to go on holiday, and access to a car.

Poverty in the context of other health-affecting factors

In 2000, the 2013 to 2020 World Health Organisation (WHO) Global Action Plan for the Prevention And Control of Noncommunicable Diseases had targeted seven risk factors.

These include use of alcohol, insufficient physical activity, tobacco use, increased blood pressure, elevated salt or sodium intake, diabetes, and obesity. These are referred to as the 25 x 25 risk factors; through targeting these risk factors, the WHO hoped to reduce early death from non-communicable diseases by 25% by the year 2025.

The Global Burden Of Disease Collaboration, which is the largest study with monitoring health changes globally, has similarly found risk factors that are associated with the burden of disease and injury across 21 world regions.

Among them, poor socio-economic circumstances are one of the strongest predictors of morbidity and premature mortality across the world; However, poverty is not considered to be a modifiable risk factor across both of these important global health strategies.

According to a paper published in The Lancet and coordinated by Imperial College London, socioeconomic status has been found to produce the same impact on health as smoking or a sedentary lifestyle, being associated with a reduced life expectancy of 2.1 years, a figure comparable to being inactive (which is estimated to cause a reduction in life expectancy of 2.4 years).

Socio-economic status refers to the measure of an individual's or family’s economic and social position relative to others in a population. This is assessed on income, education, and occupation. Despite these factors being known to affect health already independently, early studies have not compared the impact of low socioeconomic status with other major risk factors on health. Indeed global health policies do not consider risk factors such as poverty and poor education when predicting health outcomes.

In the study, 1.7 million people across the United Kingdom, Switzerland, Portugal, Italy, The United States, and Australia were surveyed. They compared individuals' socioeconomic status against several risk factors, including tobacco use, unhealthy diet, physical inactivity, and alcohol abuse, as defined by the WHO. Overall, researchers determined that those of low socioeconomic status were 46% more likely to die early compared to wealthier counterparts.

The greatest risk factors as estimated by the number of years lost in expected life were compared to a range of other factors. The factors that contributed to the greatest number of years lost were smoking and diabetes, reducing life expectancy by 4.8 and 3.9 years, respectively. High blood pressure, obesity, and high alcohol consumption were associated with fewer years lost; 1.6, 0.7, and 0.5 years respectively.

The results of this study demonstrated that low socio-economic status should be targeted alongside the conventional health risk factors as part of global and National Health strategies to minimize the risk of premature mortality.

What are the effects of poverty?

Poverty can impact people's health at all stages of life in several ways and impacts overall life expectancy. In England, for example, between 2009 and 2013, the life expectancy for those in the most deprived areas compared to the least deprived areas was 7.9 years greater for men and 5.9 years greater for women.

Moreover, the Kings' Fund found that between 1999 and 2010, the majority of areas in England that showed low life expectancy also showed high proportions of people earning minimal or no wages.

Poverty in childhood

Poverty can impact children before birth. A survey by the Royal College of Pediatrics and Child Health and the Child Poverty Action Group demonstrated that 2/3 of doctors showed that poverty in low-income areas was a significant contributor to the ill-health of children that they worked with.

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On average, babies born in the most deprived areas in the UK weigh 200 g less than those born in more affluent areas, which may subsequently impact cognitive development.

Babies living in poverty are also more likely to die within the first year of birth and were more likely to be bottle-fed. Seventy-three percent of women in the most deprived areas were shown to initiate breastfeeding compared to 89% of women in the least deprived areas.

Children born into poverty are also more likely to suffer from chronic diseases such as asthma as well as diet-related problems such as tooth decay, malnutrition, diabetes, and obesity. A 2016 report by NHS digital found that children living in the most deprived areas of England are more than twice as likely to become obese compared to those living in the least deprived areas. By the age of 11, 26% of children living in the most deprived areas were obese compared with 11.7% in less deprived areas.

Alongside physical health, children living in low-income households are more than three times more likely to suffer from mental health issues compared to wealthier peers. Increased levels of child poverty have demonstrated direct negative effects on emotional, social, cognitive, and developmental outcomes.

As a result, poverty continues to have long-term implications on individuals' health as well as exacerbating this effect due to limited life chances. Those growing up in poverty are subsequently more likely to suffer poor mental and physical health into adulthood, risking life-limiting, severe, long-term illnesses.

Longitudinal studies have shown that children in poverty have a subsequent increased risk of death as adults. This includes all-cause mortality, including the risk of death from various cancers, cardiovascular diseases, and alcohol-related deaths.

Poverty and adult life

The prevalence of long-term conditions is greater in adults from lower socio-economic backgrounds. These conditions include diabetes, chronic obstructive pulmonary disease, arthritis, and hypertension. In England, for example, 40% of adults between the ages of 45 to 64 living with below-average income have long-term illnesses. This is double the rate of adults of the same age with above-average incomes.

The Mental Health Foundation has also found that 3/4 of people living in the lowest household income bracket have reported experience of poor mental health, compared to six in ten of those in the highest household income bracket. Moreover, poverty, unemployment, and social exclusion are correlated with increased incidents of schizophrenia, and rates of admission to specialist psychiatric care.

Overall, there is a strong need for systematic evidence-based interventions and policies to reduce health inequalities. a strategy that embeds lifestyle interventions in public health policies is one of several ways to improve the overall health of the population, particularly those in the most deprived areas living in poverty.

References:

• Wang J, Geng L. (2019) Effects of Socioeconomic Status on Physical and Psychological Health: Lifestyle as a Mediator. Int J Environ Res Public Health. doi:10.3390/ijerph16020281
• Murray S. (2006) Poverty and health. CMAJ . doi:0.1503/cmaj.060235.
• BMA. Health at a price. Reducing the impact of poverty. Available at: https://www.bma.org.uk/media/2084/health-at-a-price-2017.pdf . Last accessed: October 2021.
• Royal College of Paediatrics and Child Health & Child Poverty Action Group (2017) Poverty and children’s health: views from the frontline. Royal College of Paediatrics and Child Health & Child Poverty Action Group. Available at: https://cpag.org.uk/sites/default/files/files/policypost/pdf%20RCPCH_0.pdf . Last accessed: October 2021.
• NHS Digital (2016) Statistics on Obesity, Physical Activity and Diet – England, 2016. NHS Digital. Available at: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/statistics-on-obesity-physical-activity-and-diet-england-2016 . Last accessed: October 2021.

Further Reading

• All Mental Health Content
• World mental health support and the effect of stigma and discrimination
• A Guide to Coping with Change
• Managing and Reducing Stress
• Analyzing the Stigma Surrounding Mental Health

Last Updated: Dec 7, 2021

Hidaya Aliouche

Hidaya is a science communications enthusiast who has recently graduated and is embarking on a career in the science and medical copywriting. She has a B.Sc. in Biochemistry from The University of Manchester. She is passionate about writing and is particularly interested in microbiology, immunology, and biochemistry.

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Home — Essay Samples — Social Issues — Poverty in America — Causes And Effects Of Poverty

Causes and Effects of Poverty

• Categories: Child Poverty Poverty in America

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Published: Jun 13, 2024

Words: 736 | Pages: 2 | 4 min read

Table of contents

Underlying causes of poverty, effects on individuals and communities, breaking the cycle.

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How does poverty affect people’s mental and physical health?

Americans who are living in poverty report feelings of worry and anxiety at higher rates than average.

Published Wed, November 1, 2023 by the USAFacts Team

Poorer households spend a larger portion of their incomes on housing, food, and healthcare . But the challenges of poverty go beyond paying for necessities. People living in poverty are more prone to mental and physical health issues — 19.4% report regular anxiety, and a range of studies indicate an increased risk for chronic disease.

What is the federal poverty level?

As of January 2023, the federal poverty line is $29,960 for a family of four , or $14,891 for an individual. Households earning at or below these incomes are eligible for certain government programs, including Head Start, the Supplemental Nutrition Assistance Program (SNAP, sometimes referred to as food stamps), and other welfare benefits or temporary assistance .

The poverty rate was 11.5% in 2022 — nearly 38 million people. The share of people in poverty remains below the most recent peak of 15.1%, hit during the Great Recession. When the federal government established its standard poverty thresholds in 1963, the rate was 19.5% .

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How does poverty affect mental health?

The effects of poverty extend beyond the tangibles — food, shelter, transportation, medicine, and even education. Living in poverty is associated with poorer mental well-being .

People with incomes below the poverty line reported feelings of worry, nervousness, or anxiety at higher rates than average: 19.4% of people living below the poverty line, compared to 12.7% of Americans generally, according to 2022 data from the Centers for Disease Control and Prevention.

Children growing up in poverty are also vulnerable. Kids living in poverty are two to three times more likely to develop mental health conditions than those living in more economically stable households, according to a 2021 Surgeon General report .

How does poverty affect physical health?

The US Department of Health and Human Services has assembled a comprehensive list of research showing that living in poverty increases risks for chronic diseases such as heart disease, hypertension, and stroke . The studies it compiled also show associations between childhood poverty and developmental delays, toxic stress, and nutritional deficits.

See more data:

The poorest Americans pay a larger share of their incomes on food and housing.

How does the government help people living in poverty?

The government funds a variety of programs and initiatives aimed at helping people living in poverty improve their overall well-being. These programs address various aspects, including healthcare, nutrition, housing, and education. Here are a few:

Medicaid is a joint federal and state program that provides healthcare coverage to low-income individuals and families. Eligibility criteria vary by state .

Supplemental Nutrition Assistance Program

Supplemental Nutrition Assistance Program , formerly known as food stamps, gives low-income individuals and families funds) to buy groceries.

Temporary Assistance for Needy Families

Temporary Assistance for Needy Families provides temporary financial support and job training to low-income families with children.

Supplemental Security Income

Supplemental Security Income provides cash assistance to low-income individuals who are over 65, blind, or disabled.

Head Start and Early Head Start

Head Start and Early Head Start provide comprehensive early childhood education and parent involvement services to children from low-income families.

Section 8 Housing Choice Voucher Program

Section 8 Housing Choice Voucher Program helps low-income families afford rental housing by subsidizing a portion of their rent.

Low-Income Home Energy Assistance Program

Low-Income Home Energy Assistance Program helps low-income households with their energy bills, particularly during extreme weather conditions.

Children's Health Insurance Program

Children's Health Insurance Program provides health insurance coverage to children from low-income families.

Free and Reduced-Price School Meals

Free and Reduced-Price School Meals are available to students in public schools through the National School Lunch Program and the School Breakfast Program .

These are just a few examples of the programs aimed at supporting people living in poverty. The eligibility criteria and available services can vary based on need and availability.

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Poverty and Health

Poverty is a major cause of ill health and a barrier to accessing health care when needed. This relationship is financial: the poor cannot afford to purchase those things that are needed for good health, including sufficient quantities of quality food and health care. But, the relationship is also related to other factors related to poverty, such as lack of information on appropriate health-promoting practices or lack of voice needed to make social services work for them.

Ill health, in turn, is a major cause of poverty. This is partly due to the costs of seeking health care, which include not only out-of-pocket spending on care (such as consultations, tests and medicine), but also transportation costs and any informal payments to providers. It is also due to the considerable loss of income associated with illness in developing countries, both of the breadwinner, but also of family members who may be obliged to stop working or attending school to take care of an ill relative. In addition, poor families coping with illness might be forced to sell assets to cover medical expenses, borrow at high interest rates or become indebted to the community.

Strong  health systems  improve the health status of the whole population, but especially of the poor among whom ill health and poor access to health care tends to be concentrated, as well as protect households from the potentially catastrophic effects of out-of-pocket health care costs. In general, poor health is disproportionately concentrated among the poor.

The World Bank’s work in the area of health equity and financial protection is defined by the  2007 Health, Nutrition and Population Strategy . The strategy identifies “preventing poverty due to illness (by improving financial protection)” as one of its four strategic objectives and commits the Bank’s health team, both through its analytical work and its regional operations, to addressing vulnerability that arises from health shocks.

The strategy also stresses the importance of equity in health outcomes in a second strategic objective to "improve the level and distribution of key health, nutrition and population outcomes... particularly for the poor and the vulnerable".

The Bank supports governments to implement a variety of policies and programs to reduce inequalities in health outcomes and enhance financial protection. Generally, this involves mechanisms that help overcome geographic, social and psychological barriers to accessing care and reducing out-of-pocket cost of treatment. Examples include:

• Reducing the direct cost of care at the point of service, e.g. through reducing/abolishing user fees for the poor or expanding health insurance to the poor (including coverage, depth and breadth).
• Increasing efficiency of care to reduce total consumption of care, e.g. by limiting “irrational drug prescribing,” strengthening the referral system, or improving the quality of providers (especially at the lower level).
• Reducing inequalities in determinants of health status or health care utilization, such as reducing distance (through providing services closer to the poor), subsidizing travel costs, targeted health promotion, conditional cash transfers.
• Expanding access to care by using the private sector or public-private partnerships.

The Bank’s health team also promotes the monitoring of equity and financial protection by publishing global statistics on inequalities in health status, access to care and financial protection, as well as training government officials, policymakers and researchers in how to measure and monitor the same.

Examples of how World Bank projects have improved health coverage for the poor and reduced financial vulnerability include:

The  Rajasthan Health Systems Development Project resulted in improved access to care for vulnerable Indians. The share of below-poverty line Indians in the overall inpatient and outpatient load at secondary facilities more than doubled between 2006 and 2011, well exceeding targets. In the same period, the share of the vulnerable tribal populations in the overall patient composition tripled.

The  Georgia Health Sector Development Project  supported the government of Georgia in implementing the Medical Insurance Program for the Poor, effectively increasing the share of the government health expenditure earmarked for the poor from 4% in 2006 to 38% in 2011. It also increased the number of health care visits of both the general population and the poor, but by more for the poor (from 2 per capita per year to 2.6) than for the general population (from 2 to 2.3) over the same time period.

The  Mekong Regional Health Support Project  helped the government of Vietnam to increase access to (government) health insurance from 29% to 94% among the poor, as well as from 7% to 68% among the near-poor. Hospitalization and consultation rates, at government facilities, also increased among both the poor and near-poor.

Analyzing Health Equity Using Household Survey Data

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2.4 The Consequences of Poverty

Learning objectives.

• Describe the family and housing problems associated with poverty.
• Explain how poverty affects health and educational attainment.

Regardless of its causes, poverty has devastating consequences for the people who live in it. Much research conducted and/or analyzed by scholars, government agencies, and nonprofit organizations has documented the effects of poverty (and near poverty) on the lives of the poor (Lindsey, 2009; Moore, et. al., 2009; Ratcliffe & McKernan, 2010; Sanders, 2011). Many of these studies focus on childhood poverty, and these studies make it very clear that childhood poverty has lifelong consequences. In general, poor children are more likely to be poor as adults, more likely to drop out of high school, more likely to become a teenaged parent, and more likely to have employment problems. Although only 1 percent of children who are never poor end up being poor as young adults, 32 percent of poor children become poor as young adults (Ratcliffe & McKernan, 2010).

Poor children are more likely to have inadequate nutrition and to experience health, behavioral, and cognitive problems.

Kelly Short – Poverty: “Damaged Child,” Oklahoma City, OK, USA, 1936. (Colorized). – CC BY-SA 2.0.

A recent study used government data to follow children born between 1968 and 1975 until they were ages 30 to 37 (Duncan & Magnuson, 2011). The researchers compared individuals who lived in poverty in early childhood to those whose families had incomes at least twice the poverty line in early childhood. Compared to the latter group, adults who were poor in early childhood

• had completed two fewer years of schooling on the average;
• had incomes that were less than half of those earned by adults who had wealthier childhoods;
• received $826 more annually in food stamps on the average;
• were almost three times more likely to report being in poor health;
• were twice as likely to have been arrested (males only); and
• were five times as likely to have borne a child (females only).

We discuss some of the major specific consequences of poverty here and will return to them in later chapters.

Family Problems

The poor are at greater risk for family problems, including divorce and domestic violence. As Chapter 9 “Sexual Behavior” explains, a major reason for many of the problems families experience is stress. Even in families that are not poor, running a household can cause stress, children can cause stress, and paying the bills can cause stress. Families that are poor have more stress because of their poverty, and the ordinary stresses of family life become even more intense in poor families. The various kinds of family problems thus happen more commonly in poor families than in wealthier families. Compounding this situation, when these problems occur, poor families have fewer resources than wealthier families to deal with these problems.

Children and Our Future

Getting under Children’s Skin: The Biological Effects of Childhood Poverty

As the text discusses, childhood poverty often has lifelong consequences. Poor children are more likely to be poor when they become adults, and they are at greater risk for antisocial behavior when young, and for unemployment, criminal behavior, and other problems when they reach adolescence and young adulthood.

According to growing evidence, one reason poverty has these consequences is that it has certain neural effects on poor children that impair their cognitive abilities and thus their behavior and learning potential. As Greg J. Duncan and Katherine Magnuson (Duncan & Magnuson, 2011, p. 23) observe, “Emerging research in neuroscience and developmental psychology suggests that poverty early in a child’s life may be particularly harmful because the astonishingly rapid development of young children’s brains leaves them sensitive (and vulnerable) to environmental conditions.”

In short, poverty can change the way the brain develops in young children. The major reason for this effect is stress. Children growing up in poverty experience multiple stressful events: neighborhood crime and drug use; divorce, parental conflict, and other family problems, including abuse and neglect by their parents; parental financial problems and unemployment; physical and mental health problems of one or more family members; and so forth. Their great levels of stress in turn affect their bodies in certain harmful ways. As two poverty scholars note, “It’s not just that poverty-induced stress is mentally taxing. If it’s experienced early enough in childhood, it can in fact get ‘under the skin’ and change the way in which the body copes with the environment and the way in which the brain develops. These deep, enduring, and sometimes irreversible physiological changes are the very human price of running a high-poverty society” (Grusky & Wimer, 2011, p. 2).

One way poverty gets “under children’s skin” is as follows (Evans, et. al., 2011). Poor children’s high levels of stress produce unusually high levels of stress hormones such as cortisol and higher levels of blood pressure. Because these high levels impair their neural development, their memory and language development skills suffer. This result in turn affects their behavior and learning potential. For other physiological reasons, high levels of stress also affect the immune system, so that poor children are more likely to develop various illnesses during childhood and to have high blood pressure and other health problems when they grow older, and cause other biological changes that make poor children more likely to end up being obese and to have drug and alcohol problems.

The policy implications of the scientific research on childhood poverty are clear. As public health scholar Jack P. Shonkoff (Shonkoff, 2011) explains, “Viewing this scientific evidence within a biodevelopmental framework points to the particular importance of addressing the needs of our most disadvantaged children at the earliest ages.” Duncan and Magnuson (Duncan & Magnuson, 2011) agree that “greater policy attention should be given to remediating situations involving deep and persistent poverty occurring early in childhood.” To reduce poverty’s harmful physiological effects on children, Skonkoff advocates efforts to promote strong, stable relationships among all members of poor families; to improve the quality of the home and neighborhood physical environments in which poor children grow; and to improve the nutrition of poor children. Duncan and Magnuson call for more generous income transfers to poor families with young children and note that many European democracies provide many kinds of support to such families. The recent scientific evidence on early childhood poverty underscores the importance of doing everything possible to reduce the harmful effects of poverty during the first few years of life.

Health, Illness, and Medical Care

The poor are also more likely to have many kinds of health problems, including infant mortality, earlier adulthood mortality, and mental illness, and they are also more likely to receive inadequate medical care. Poor children are more likely to have inadequate nutrition and, partly for this reason, to suffer health, behavioral, and cognitive problems. These problems in turn impair their ability to do well in school and land stable employment as adults, helping to ensure that poverty will persist across generations. Many poor people are uninsured or underinsured, at least until the US health-care reform legislation of 2010 takes full effect a few years from now, and many have to visit health clinics that are overcrowded and understaffed.

As Chapter 12 “Work and the Economy” discusses, it is unclear how much of poor people’s worse health stems from their lack of money and lack of good health care versus their own behavior such as smoking and eating unhealthy diets. Regardless of the exact reasons, however, the fact remains that poor health is a major consequence of poverty. According to recent research, this fact means that poverty is responsible for almost 150,000 deaths annually, a figure about equal to the number of deaths from lung cancer (Bakalar, 2011).

Poor children typically go to rundown schools with inadequate facilities where they receive inadequate schooling. They are much less likely than wealthier children to graduate from high school or to go to college. Their lack of education in turn restricts them and their own children to poverty, once again helping to ensure a vicious cycle of continuing poverty across generations. As Chapter 10 “The Changing Family” explains, scholars debate whether the poor school performance of poor children stems more from the inadequacy of their schools and schooling versus their own poverty. Regardless of exactly why poor children are more likely to do poorly in school and to have low educational attainment, these educational problems are another major consequence of poverty.

Housing and Homelessness

The poor are, not surprisingly, more likely to be homeless than the nonpoor but also more likely to live in dilapidated housing and unable to buy their own homes. Many poor families spend more than half their income on rent, and they tend to live in poor neighborhoods that lack job opportunities, good schools, and other features of modern life that wealthier people take for granted. The lack of adequate housing for the poor remains a major national problem. Even worse is outright homelessness. An estimated 1.6 million people, including more than 300,000 children, are homeless at least part of the year (Lee, et. al., 2010).

Crime and Victimization

As Chapter 7 “Alcohol and Other Drugs” discusses, poor (and near poor) people account for the bulk of our street crime (homicide, robbery, burglary, etc.), and they also account for the bulk of victims of street crime. That chapter will outline several reasons for this dual connection between poverty and street crime, but they include the deep frustration and stress of living in poverty and the fact that many poor people live in high-crime neighborhoods. In such neighborhoods, children are more likely to grow up under the influence of older peers who are already in gangs or otherwise committing crime, and people of any age are more likely to become crime victims. Moreover, because poor and near-poor people are more likely to commit street crime, they also comprise most of the people arrested for street crimes, convicted of street crime, and imprisoned for street crime. Most of the more than 2 million people now in the nation’s prisons and jails come from poor or near-poor backgrounds. Criminal behavior and criminal victimization, then, are other major consequences of poverty.

Lessons from Other Societies

Poverty and Poverty Policy in Other Western Democracies

To compare international poverty rates, scholars commonly use a measure of the percentage of households in a nation that receive less than half of the nation’s median household income after taxes and cash transfers from the government. In data from the late 2000s, 17.3 percent of US households lived in poverty as defined by this measure. By comparison, other Western democracies had the rates depicted in the figure that follows. The average poverty rate of the nations in the figure excluding the United States is 9.5 percent. The US rate is thus almost twice as high as the average for all the other democracies.

This graph illustrates the poverty rates in western democracies (i.e., the percentage of persons living with less than half of the median household income) as of the late 2000s

Source: Data from Organisation for Economic Co-operation and Development (OECD). (2011). Society at a glance 2011: OECD social indicators. Retrieved July 23, 2011, from http://www.oecd-ilibrary.org/sites/soc_glance-2011-en/06/02/index.html;jsessionid=erdqhbpb203ea.epsilon?contentType=&itemId=/content/chapter/soc_glance-2011-17-en&containerItemId=/content/se .

Why is there so much more poverty in the United States than in its Western counterparts? Several differences between the United States and the other nations stand out (Brady, 2009; Russell, 2011). First, other Western nations have higher minimum wages and stronger labor unions than the United States has, and these lead to incomes that help push people above poverty. Second, these other nations spend a much greater proportion of their gross domestic product on social expenditures (income support and social services such as child-care subsidies and housing allowances) than does the United States. As sociologist John Iceland (Iceland, 2006) notes, “Such countries often invest heavily in both universal benefits, such as maternity leave, child care, and medical care, and in promoting work among [poor] families…The United States, in comparison with other advanced nations, lacks national health insurance, provides less publicly supported housing, and spends less on job training and job creation.” Block and colleagues agree: “These other countries all take a more comprehensive government approach to combating poverty, and they assume that it is caused by economic and structural factors rather than bad behavior” (Block et, al., 2006).

The experience of the United Kingdom provides a striking contrast between the effectiveness of the expansive approach used in other wealthy democracies and the inadequacy of the American approach. In 1994, about 30 percent of British children lived in poverty; by 2009, that figure had fallen by more than half to 12 percent. Meanwhile, the US 2009 child poverty rate, was almost 21 percent.

Britain used three strategies to reduce its child poverty rate and to help poor children and their families in other ways. First, it induced more poor parents to work through a series of new measures, including a national minimum wage higher than its US counterpart and various tax savings for low-income workers. Because of these measures, the percentage of single parents who worked rose from 45 percent in 1997 to 57 percent in 2008. Second, Britain increased child welfare benefits regardless of whether a parent worked. Third, it increased paid maternity leave from four months to nine months, implemented two weeks of paid paternity leave, established universal preschool (which both helps children’s cognitive abilities and makes it easier for parents to afford to work), increased child-care aid, and made it possible for parents of young children to adjust their working hours to their parental responsibilities (Waldfogel, 2010). While the British child poverty rate fell dramatically because of these strategies, the US child poverty rate stagnated.

In short, the United States has so much more poverty than other democracies in part because it spends so much less than they do on helping the poor. The United States certainly has the wealth to follow their example, but it has chosen not to do so, and a high poverty rate is the unfortunate result. As the Nobel laureate economist Paul Krugman (2006, p. A25) summarizes this lesson, “Government truly can be a force for good. Decades of propaganda have conditioned many Americans to assume that government is always incompetent…But the [British experience has] shown that a government that seriously tries to reduce poverty can achieve a lot.”

Key Takeaways

• Poor people are more likely to have several kinds of family problems, including divorce and family conflict.
• Poor people are more likely to have several kinds of health problems.
• Children growing up in poverty are less likely to graduate high school or go to college, and they are more likely to commit street crime.

For Your Review

• Write a brief essay that summarizes the consequences of poverty.
• Why do you think poor children are more likely to develop health problems?

Bakalar, N. (2011, July 4). Researchers link deaths to social ills. New York Times , p. D5.

Block, F., Korteweg, A. C., & Woodward, K. (2006). The compassion gap in American poverty policy. Contexts, 5 (2), 14–20.

Brady, D. (2009). Rich democracies, poor people: How politics explain poverty . New York, NY: Oxford University Press.

Duncan, G. J., & Magnuson, K. (2011, winter). The long reach of early childhood poverty. Pathways: A Magazine on Poverty, Inequality, and Social Policy , 22–27.

Evans, G. W., Brooks-Gunn, J., & Klebanov, P. K. (2011, winter). Stressing out the poor: Chronic physiological stress and the income-achievement gap. Pathways: A Magazine on Poverty, Inequality, and Social Policy , 16–21.

Grusky, D., & Wimer, C.(Eds.). (2011, winter). Editors’ note. Pathways: A Magazine on Poverty, Inequality, and Social Policy , 2.

Iceland, J. (2006). Poverty in America: A handbook . Berkeley, CA: University of California Press.

Krugman, P. (Krugman, 2006). Helping the poor, the British way. New York Times , p. A25.

Lee, B., Tyler, K. A., & Wright, J. D. ( 2010). The new homelessness revisited. Annual Review of Sociology, 36 , 501–521.

Lindsey, D. (2009). Child poverty and inequality: Securing a better future for America’s children . New York, NY: Oxford University Press.

Moore, K. A., Redd, Z., Burkhauser, M., Mbawa, K., & Collins, A. (2009). Children in poverty: Trends, consequences, and policy options . Washington, DC: Child Trends. Retrieved from http://www.childtrends.org/Files//Child_Trends-2009_04_07_RB_ChildreninPoverty.pdf .

Ratcliffe, C., & McKernan, S.-M. (2010). Childhood poverty persistence: Facts and consequences . Washington, DC: Urban Institute Press.

Russell, J. W. ( 2011). Double standard: Social policy in Europe and the United States (2nd ed.). Lanham, MD: Rowman & Littlefield.

Sanders, L. (2011). Neuroscience exposes pernicious effects of poverty. Science News, 179 (3), 32.

Shonkoff, J. P. (2011, winter). Building a foundation for prosperity on the science of early childhood development. Pathways: A Magazine on Poverty, Inequality, and Social Policy , 10–14.

Waldfogel, J. (2010). Britain’s war on poverty . New York, NY: Russell Sage Foundation.

Social Problems Copyright © 2015 by University of Minnesota is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

Extreme poverty: How far have we come, and how far do we still have to go?

The world has made immense progress against extreme poverty, but it is still the reality for almost one in ten people worldwide..

Two centuries ago, the majority of the world population was extremely poor. Back then, it was widely believed that widespread poverty was inevitable. But this turned out to be wrong. Economic growth is possible, and poverty can decline. The world has made immense progress against extreme poverty.

But even after two centuries of progress, extreme poverty is still the reality for every tenth person in the world. This is what the ‘international poverty line’ highlights – this metric plays an important (and successful) role in focusing the world’s attention on the very poorest people in the world.

The poorest people today live in countries that have achieved no economic growth. This stagnation of the world’s poorest economies is one of the largest problems of our time. Unless this changes, hundreds of millions of people will continue to live in extreme poverty.

The state of poverty today

There are poor people in every country, people who live in poor housing and who struggle to afford basic goods and services like heating, transport, and healthy food for themselves and their families.

The definition of poverty differs from country to country, but in high-income countries, the poverty line is around $30 per day . 1

Even in the world’s richest countries, a substantial share of people – between every 10th and every 5th person – lives below this poverty line.

In the map below, and in all international poverty statistics on Our World in Data, the data is adjusted for inflation and cross-country differences in the price level. The expandable section below the map provides a more detailed explanation of how.

Basics of global poverty measurement

Throughout this article – and in global income and expenditure data generally – the statisticians who produce these figures are careful to make these numbers as comparable as possible.

Non-monetary sources of income are taken into account

Many poor people today and in the past rely on subsistence farming and do not have a monetary income. To take this into account and make a fair comparison of their living standards, the statisticians that produce these figures estimate the monetary value of their home production and add it to their income/expenditure.

Differences in purchasing power and inflation are taken into account

The data is expressed in international dollars . This is a hypothetical currency that results from price adjustments across time and place. 2  An international dollar is defined as having the same purchasing power as one US-$ in the US . This means no matter where in the world a person is living on int.-$30, they can buy the goods and services that cost $30 in the US. None of these adjustments are ever going to be perfect, but in a world where price differences are large, it is important to attempt to account for these differences as well as possible, and this is what these adjustments do. 3

Throughout this text, I’m always adjusting incomes for price changes over time and price differences between countries in this way. All dollar values discussed here are presented in int.-$; the UN does the same for the $2.15 poverty line. Sometimes I leave out ‘international’ as it is awkward to repeat it all the time; but every time I mention any $ amount in this text, I’m referring to international-$ and not US-$. 4

Global data is a mix of income and expenditure data

There is no global survey of incomes: researchers need to rely on the available national surveys. Such surveys are designed with cross-country comparability in mind, but because they reflect the circumstances and priorities of individual countries, there are some important differences across countries. In most high-income countries, the surveys capture people’s incomes, while in poorer countries, these surveys tend to capture people’s consumption.

The two concepts are closely related: the income of a household equals their consumption plus any saving (or minus any borrowing). When speaking about these statistics, it would therefore be accurate to speak about ‘the income of people in richer countries and the monetary value of consumption in poorer countries’. But since it’d be a bit much to repeat this every time, researchers simply speak of ‘living standards’ or ‘income’ instead. I do the same in this text.

We can apply this $30-a-day-poverty-line to the global income distribution to see the share in poverty as judged by the definition of poverty in high-income countries. 5

The latest global data tells us that the huge majority – 84% of the world population – live on less than $30 per day. That means 6.7 billion people.

Why is an extremely low poverty line necessary?

Extreme poverty is defined by the UN as living on less than $2.15 a day. Why do we need a poverty line that is so extremely low?

It is not enough to measure global poverty solely by a higher poverty line because a large number of people are living in extreme poverty. Without an extremely low poverty line, we would not be able to see that a large share of the world lives in such deep poverty.

If we’d only rely on the poverty line from high-income countries, we would hide the differences between people with very different living standards. Whether someone was living on almost $30 a day or on thirty times less would not matter – they would all be considered ‘poor’.

It is however a good idea to add additional poverty lines. As the following chart shows, this can draw attention to the large income differences between people and highlights how many live on extremely low incomes. 6

The $2.15 poverty line, set by the UN, shows that globally close to one in ten people live in extreme poverty. In all these statistics, the researchers are not only taking people’s monetary income into account, but also their non-monetary income and home production. One reason why this is important is because many poor people are small-scale farmers who produce their own food. 7

The UN’s global poverty line is valuable because it has been successful in drawing attention to the terrible depths of extreme poverty of the poorest people in the world. 8

In a related essay , I focus on global poverty as defined by a higher poverty line.

The big lesson of the last 200 years: Economic growth is possible, poverty is not inevitable

What needs explanation is not poverty, but prosperity. Deep poverty was the condition that the majority of humanity has always lived in. In the pre-modern days, hunger was widespread , and every second child died no matter where in the world it was born.

Historian Michail Moatsos has recently produced a new global dataset that goes back two centuries. The chart shows his data. According to his research three-quarters of the world lived in extreme poverty in 1820. This means they "could not afford a tiny space to live, some minimum heating capacity, and food that would not induce malnutrition.” 9

The chart looks simple, but it would be a mistake to think that it was simple to produce this data. Underlying it is a wealth of careful historical research that Moatsos made use of. Historians gathered data for people around the world over two centuries to reconstruct how many of them were able to afford a set of very basic goods and services and aggregated this detailed information into this final picture. You find more information on the methodology in the footnote. 10

Economic growth made it possible to leave poverty behind

Economic growth made it possible to leave the widespread extreme poverty of the past behind. It made the difference between a society in which the majority were lacking even the most basic goods and services – food, decent housing and clothes, healthcare, public infrastructure and transport – and a society in which these products are widely available.

Growth means that a society produces an increasing quantity and quality of economic goods and services. The key to economic growth is the development of technology that makes it possible to increase productivity by which these goods and services are produced.

Because the total production in an economy equals the total income in that country – as everyone’s spending is someone else’s income – incomes grow at the same rate as production increases.

The 9 charts show the data for different regions in the world. On the horizontal axis of each chart, you find the average income (GDP per capita) and on the vertical axis you see the share living in extreme poverty. The starting point of each trajectory shows the data for 1820 and it tells us that two centuries ago the majority of people lived in extreme poverty, no matter where in the world they were at home. 11 Since then, all world regions achieved growth – the production of goods and services increased – and the share living in poverty declined.

[See also my related article: 'What is Economic Growth? ]

Most extremely poor people today are living in Africa

How far do we still have to go?

The previous chart showed that Sub-Saharan Africa is the poorest region. Almost 40% of the population lives in extreme poverty.

Not all African countries are struggling. In fact, most African countries have achieved good growth after the end of the oppressive colonial regimes that hindered the growth of African economies. But in a number of countries, the situation is bad. These countries remain as poor as they were in the past. Since the economy is stagnant, poverty is too.

In the chart below, you see that mean incomes have actually fallen in some of the world’s poorest countries. 12

To see the consequences of this, let’s first focus on one country that achieved large growth and then contrast it with a country that did not.

A country that achieved large growth is the UK: the orange distribution on the left shows incomes in the UK two centuries ago; the majority lived in extreme poverty. The green distribution shows how the distribution of incomes has changed since then. Two centuries of economic growth lifted the majority of people out of the deep poverty of the past. 13

The next chart shows the income distribution of the UK in 2019 in green – just as in the previous chart – and in red the income distribution of Madagascar, a country that did not achieve growth.

The majority of people in Madagascar still live in extreme poverty. Very similar to the global situation two centuries ago, three-quarters of Madagascar’s population are living in extreme poverty.

Not just economic growth, but also the distribution of that growth matters. If the inequality of income increases, the poorest can be left behind.

But without economic growth, there is no chance at all to leave poverty behind. The data from Madagascar makes clear that a reduction of inequality cannot end extreme poverty in a poor country. If inequality in Madagascar would be entirely eradicated, then everyone would live on the average income. In Madagascar, this is $1.60 a day. For poor countries, the only way to end poverty is an increase in incomes – economic growth.

The majority of the world is making good progress against poverty, but not all: some of the very poorest economies are stagnating

The history of extreme poverty is, at the same time, one of humanity’s greatest achievements and failures.

The majority of the world left extreme poverty behind. To me, this ranks among the most impressive and most important achievements in humanity’s history.

But, as we’ve seen, the fight against extreme poverty is far from over. Almost one in ten people still live in extreme poverty right now.

The worry with extreme poverty today is that some of the world’s poorest countries are not growing. Unless this changes, hundreds of millions of people will continue to live in extreme poverty.

Crucially this was true before the pandemic hit – even before COVID, researchers expected that half a billion people would remain in extreme poverty by 2030. The global recession that followed the pandemic exacerbated this further.

When it comes to the consequences of climate change , this is what I am most worried about. Richer people will be able to adapt in many ways. It is the extremely poor population that will be hardest hit.

The economic stagnation of some of the world's poorest countries is not as widely known as it should be. I think it deserves more attention. If the stagnation of the very poorest economies persists, we will see a growing divide at the lowest end of the global income distribution. While the living standards of the majority of the world are rising, some of the world’s very poorest people remain in extreme poverty.

Whether or not the poorest countries achieve growth is among the most important questions for the coming years. It will decide whether humanity wins its long fight against extreme poverty or not.

Last updated in 2023

This article was first published on November 22, 2021. It was last updated in August 2023.

For the moment, it is important to note that this $30 per day poverty line is defined in international-$ and therefore comparable with the ‘International Poverty Line’ discussed in the following section. More details about how to compare incomes across countries, the income concept here, and the definition of this poverty line follow further below in this text.

This is possible by relying on the work of the International Comparison Project , which monitors the prices of goods and services around the world.

Angus Deaton and Alan Heston (2010) discuss the methods behind such price adjustments and many of the difficulties and limitations involved.

Deaton, A., and Heston, A. 2010. “Understanding PPPs and PPP-Based National Accounts.” American Economic Journal: Macroeconomics 2 (4): 1–35. A working paper version is available online here .

Keep in mind that in the special case of the US, the US-$ equals the international-$.

Remember that these statistics take the cost of living into account – a person who lives on less than int-$30 is a person who cannot afford the goods and services that cost US-$30 in the US .

If you want to explore this data for any world region or any individual country, you can do so here .

See also the previous box on poverty measurement. This is, of course, also true of the historical research.

Indeed, there is an argument for using an even lower poverty line. To understand what is happening to the very poorest in the world, we need to look even lower than $2.15. This is because one of the biggest failures of development is that over the last decades, the incomes of the very poorest people have not risen. A big part of the reason for why this issue doesn’t get discussed enough is that the International Poverty Line we rely on is too high to see this fact.

Michail Moatsos (2021) – Global extreme poverty: Present and past since 1820. Published in OECD (2021), How Was Life? Volume II: New Perspectives on Well-being and Global Inequality since 1820 , OECD Publishing, Paris, https://doi.org/10.1787/3d96efc5-en .

The sources for the measures shown in this chart and the following chart are:

Jutta Bolt and Jan Luiten van Zanden (2021) – The GDP data in the chart is taken from The long view on economic growth: New estimates of GDP, How Was Life? Volume II: New Perspectives on Well-being and Global Inequality since 1820 , OECD Publishing, Paris, https://doi.org/10.1787/3d96efc5-en .

The latest datapoint for the poverty data refers to 2018, while the latest datapoint for GDP per capita in the chart below refers to 2016. In that chart, I have chosen the middle year (2017) as the reference year.

The historical poverty research was done by economic historian Michail Moatsos and is based on the ‘cost of basic needs’-approach as suggested by Robert Allen (2017) and recommended by the late Tony Atkinson.

The ‘cost of basic needs’-approach was recommended by the ‘World Bank Commission on Global Poverty’, headed by Tony Atkinson, as a complementary method in measuring poverty. The report for the ‘World Bank Commission on Global Poverty’ can be found here .

Tony Atkinson – and after his death, his colleagues – turned this report into a book that was published as Anthony B. Atkinson (2019) – Measuring Poverty around the World. You find more information on Atkinson’s website .

The CBN-approach Moatsos’ work is based on was suggested by Allen in Robert Allen (2017) – Absolute poverty: When necessity displaces desire. In American Economic Review, Vol. 107/12, pp. 3690-3721, https://doi.org/10.1257/aer.20161080

Moatsos describes the methodology as follows: “In this approach, poverty lines are calculated for every year and country separately, rather than using a single global line. The second step is to gather the necessary data to operationalize this approach, alongside imputation methods in cases where not all the necessary data are available. The third step is to devise a method for aggregating countries’ poverty estimates on a global scale to account for countries that lack some of the relevant data.” In his publication – linked above – you find much more detail on all of the shown poverty data.

The speed at which extreme poverty declined increased over time, as the chart shows. Moatsos writes, “It took 136 years from 1820 for our global poverty rate to fall under 50%, then another 45 years to cut this rate in half again by 2001. In the early 21st century, global poverty reduction accelerated, and in 13 years, our global measure of extreme poverty was halved again by 2014.”

Parts of Western Europe and the US had already achieved some growth in the decades before this chart begins so that the share in poverty had already fallen, but even in 1820 the majority was still living in extreme poverty there

In the centuries and millennia before, no region in the world had achieved sustained economic growth (see, for example, my post on the Malthusian Trap and links therein). The chart here focuses on the very exceptional two last centuries when economic growth reduced widespread poverty.

You can explore related data in detail in this chart for growth measured as GDP per capita and in our Poverty Data Explorer .

The data shown in the small plots of the income distribution in the UK and Madagascar is again taken from PovcalNet – the predecessor to the World Bank's Poverty and Inequality Platform – Gapminder, and Michail Moatsos 2021.

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Long-Term Impact of Poverty on Children: Health and Education

Childhood poverty is a widespread issue in the United States with one in five children living in need . Poverty has both immediate and lasting consequences that can follow a child into adulthood. Here are just ten ways poverty can impact the health and education of a child.

There are identifiable side-effects of poverty such as hunger, but there are also long-term side-effects that can go unnoticed and follow a child into adulthood.

1. Brain Development : Conditions that correspond with poverty (noise, substandard housing, family turmoil, etc.) can be toxic to a developing brain.

2. Self Confidence : A healthy self-esteem is crucial to a child’s health. Without strong levels of confidence, children may be susceptible to various other health problems or unhealthy habits. And since self-esteem tends to form in childhood and continue through adulthood, it’s even more important to help kids feel good about themselves.

3. Heart Disease : Studies have shown that growing up in poverty (less access to healthy meals, lack of proper attire, and insufficient health coverage) might put children at risk for heart disease in adulthood.

4. “Learned Helplessness” : Children feel as if they have no power to control their circumstances. This is a behavioral pattern that can be a result of prolonged poverty.

5. Toxic Stress: Toxic stress is the prolonged activation of stress response systems in the body/brain. This can occur when a child experiences strong, frequent, and/or prolonged adversity—such as emotional abuse or the accumulated burdens of family economic hardship—without adequate adult support. 

Poverty can also impact a child’s ability to succeed in school. Here are two shocking statistics from a study by the Urban Institute:

• Children who are poor from birth to age 2 are 30 percent less likely to complete high school than children who are poor for the first time later in their life.
• Nearly 30 percent of poor children do not complete high school, which limits future economic success and potential employability, leading to poverty as an adult.

6. School Preparation : Students living above the poverty line are entering kindergarten more prepared than those below it. Higher income families are able to put more money towards their children’s cognitive development than those living in poverty. Parents with low incomes, on average, have less time to read to their children, no-funds for pre-school, and less stable home environments. The difference in preparation tends to persist through elementary and high school.

7. School Attendance : Chronic absenteeism (missing more than 10 percent of school a year) occurs at rates three to four times higher in high-poverty areas. An overwhelming majority of chronically absent kids are impoverished, dealing with such daily stresses as caring for siblings, high rates of disease, violence in the community, and frequent familial moves to find employment.

8. Educational Attainment : Early childhood poverty is related to lower educational achievement.

9. Bullying : A study by the American Journal of Public Health found that kids and teens from poor families are more likely to be bullied than others and also concluded that schools with the largest economic inequality (or a big difference between how wealthy some families are and how poor other families are) had the highest rates of bullying.

10. School Behavior: Strong, secure relationships help stabilize children's behavior and provide the core guidance needed to build lifelong social skills. Children who grow up with such relationships learn healthy, appropriate emotional responses to everyday situations. But children raised in poor households often fail to learn these responses, to the detriment of their school performance.

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Mental health effects of poverty, hunger, and homelessness on children and teens

Rising inflation and an uncertain economy are deeply affecting the lives of millions of Americans, particularly those living in low-income communities. It may seem impossible for a family of four to survive on just over $27,000 per year or a single person on just over $15,000, but that’s what millions of people do everyday in the United States. Approximately 37.9 million Americans, or just under 12%, now live in poverty, according to the U.S. Census Bureau .

Additional data from the Bureau show that children are more likely to experience poverty than people over the age of 18. Approximately one in six kids, 16% of all children, live in families with incomes below the official poverty line.

Those who are poor face challenges beyond a lack of resources. They also experience mental and physical issues at a much higher rate than those living above the poverty line. Read on for a summary of the myriad effects of poverty, homelessness, and hunger on children and youth. And for more information on APA’s work on issues surrounding socioeconomic status, please see the Office of Socioeconomic Status .

Who is most affected?

Poverty rates are disproportionately higher among most non-White populations. Compared to 8.2% of White Americans living in poverty, 26.8% of American Indian and Alaska Natives, 19.5% of Blacks, 17% of Hispanics and 8.1% of Asians are currently living in poverty.

Similarly, Black, Hispanic, and Indigenous children are overrepresented among children living below the poverty line. More specifically, 35.5% of Black people living in poverty in the U.S. are below the age of 18. In addition, 40.7% of Hispanic people living below the poverty line in the U.S. are younger than age 18, and 29.1% of American Indian and Native American children lived in poverty in 2018. In contrast, approximately 21% of White people living in poverty in the U.S. are less than 18 years old.

Furthermore, families with a female head of household are more than twice as likely to live in poverty compared to families with a male head of household. Twenty-three percent of female-headed households live in poverty compared to 11.4% of male-headed households, according to the U.S. Census Bureau .

What are the effects of poverty on children and teens?

The impact of poverty on young children is significant and long lasting. Poverty is associated with substandard housing, hunger, homelessness, inadequate childcare, unsafe neighborhoods, and under-resourced schools. In addition, low-income children are at greater risk than higher-income children for a range of cognitive, emotional, and health-related problems, including detrimental effects on executive functioning, below average academic achievement, poor social emotional functioning, developmental delays, behavioral problems, asthma, inadequate nutrition, low birth weight, and higher rates of pneumonia.

Psychological research also shows that living in poverty is associated with differences in structural and functional brain development in children and adolescents in areas related to cognitive processes that are critical for learning, communication, and academic achievement, including social emotional processing, memory, language, and executive functioning.

Children and families living in poverty often attend under-resourced, overcrowded schools that lack educational opportunities, books, supplies, and appropriate technology due to local funding policies. In addition, families living below the poverty line often live in school districts without adequate equal learning experiences for both gifted and special needs students with learning differences and where high school dropout rates are high .

What are the effects of hunger on children and teens?

One in eight U.S. households with children, approximately 12.5%, could not buy enough food for their families in 2021 , considerably higher than the rate for households without children (9.4%). Black (19.8%) and Latinx (16.25%) households are disproportionately impacted by food insecurity, with food insecurity rates in 2021 triple and double the rate of White households (7%), respectively.

Research has found that hunger and undernutrition can have a host of negative effects on child development. For example, maternal undernutrition during pregnancy increases the risk of negative birth outcomes, including premature birth, low birth weight, smaller head size, and lower brain weight. In addition, children experiencing hunger are at least twice as likely to report being in fair or poor health and at least 1.4 times more likely to have asthma, compared to food-secure children.

The first three years of a child’s life are a period of rapid brain development. Too little energy, protein and nutrients during this sensitive period can lead to lasting deficits in cognitive, social and emotional development . School-age children who experience severe hunger are at increased risk for poor mental health and lower academic performance , and often lag behind their peers in social and emotional skills .

What are the effects of homelessness on children and teens?

Approximately 1.2 million public school students experienced homelessness during the 2019-2020 school year, according to the National Center for Homeless Education (PDF, 1.4MB) . The report also found that students of color experienced homelessness at higher proportions than expected based on the overall number of students. Hispanic and Latino students accounted for 28% of the overall student body but 38% of students experiencing homelessness, while Black students accounted for 15% of the overall student body but 27% of students experiencing homelessness. While White students accounted for 46% of all students enrolled in public schools, they represented 26% of students experiencing homelessness.

Homelessness can have a tremendous impact on children, from their education, physical and mental health, sense of safety, and overall development. Children experiencing homelessness frequently need to worry about where they will live, their pets, their belongings, and other family members. In addition, homeless children are less likely to have adequate access to medical and dental care, and may be affected by a variety of health challenges due to inadequate nutrition and access to food, education interruptions, trauma, and disruption in family dynamics.

In terms of academic achievement, students experiencing homelessness are more than twice as likely to be chronically absent than non-homeless students , with greater rates among Black and Native American or Alaska Native students. They are also more likely to change schools multiple times and to be suspended—especially students of color.

Further, research shows that students reporting homelessness have higher rates of victimization, including increased odds of being sexually and physically victimized, and bullied. Student homelessness correlates with other problems, even when controlling for other risks. They experienced significantly greater odds of suicidality, substance abuse, alcohol abuse, risky sexual behavior, and poor grades in school.

What can you do to help children and families experiencing poverty, hunger, and homelessness?

There are many ways that you can help fight poverty in America. You can:

• Volunteer your time with charities and organizations that provide assistance to low-income and homeless children and families.
• Donate money, food, and clothing to homeless shelters and other charities in your community.
• Donate school supplies and books to underresourced schools in your area.
• Improve access to physical, mental, and behavioral health care for low-income Americans by eliminating barriers such as limitations in health care coverage.
• Create a “safety net” for children and families that provides real protection against the harmful effects of economic insecurity.
• Increase the minimum wage, affordable housing and job skills training for low-income and homeless Americans.
• Intervene in early childhood to support the health and educational development of low-income children.
• Provide support for low-income and food insecure children such as Head Start , the National School Lunch Program , and Temporary Assistance for Needy Families (TANF) .
• Increase resources for public education and access to higher education.
• Support research on poverty and its relationship to health, education, and well-being.
• Resolution on Poverty and SES
• Pathways for addressing deep poverty
• APA Deep Poverty Initiative

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• v.1(3); 2009 Aug

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

Paul andrew bourne.

Department of Community Health and Psychiatry, Faculty of Medial Sciences, The University of the West Indies, Andrew, Jamaica WI.

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.

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.

Introduction

Health (medical) care-seeking behaviour of people is not only an indicator of their willingness to preserve life but it is crucial to personal, societal and national development. The health of an individual affects all area of his/her life and extends to the family, community, society and the nation. The cost of ill-health is not only borne by the individual; but the entire society. Ill-health means less time on the job; lowered production and productivity; reduced Gross Domestic Product and savings; high health care expenditure; switching of expenditure from education and other social development to health care; and this can further increase poverty for an individual or his/her family. Health therefore holds a key to social and economic development. Hence, long life must be supported by a healthy individual or population. It is this interrelationship among health, life expectancy, social and economic development that account for a demand in health care services.

Life expectancy is computed from mortality data, and so healthy life expectancy means the delaying of mortality. Mortality statistics provides an insight into morbidity patterns as well as the health of a person or a population. It also provides a basis upon which we can estimate the burden of premature deaths[ 1 , 2 ]; lifestyle practices; and health care-seeking behaviour[ 3 ]. The Caribbean is experiencing health transition which accounts for reduction in fertility and mortality, and the changing pattern of diseases from communicable to non-communicable disease as the leading cause of death[ 2 , 4 ]. The Caribbean is not atypical in regards to aforementioned pattern as the[ 1 ] argued that 80% of chronic disease deaths occur in low-to-middle income countries, and that this has a serious influence on the causes of premature mortality.

Statistics from the Planning Institute of Jamaica and the Statistical Institute of Jamaica published in the Jamaica Survey of Living Conditions[ 5 ] revealed that in 2007, 15.5% of Jamaicans reported an illness/injury compared 9.7% in 1997. Of the 15.5% of Jamaicans who reported health conditions, 66% of them sought medical care. Of those who sought health care, 40.5% went to public facilities compared to 51.9% who attended private health care facilities. Interestingly the typologies of diseases were asthma (8.7%); diabetes mellitus (12%); hypertension (22.4%); and arthritis (8.8%). Concomitantly, 33.9% of Jamaicans who did not seek care reported that they were unable to afford it; 30.2% mentioned that they preferred home remedy and 6.0% remarked that they had no time. According to Fraser[ 6 ], the prevalence of hypertension in the Caribbean was 28% and 55% for those over 25 years and 40 years respectively. This explains Fraser's call for an aggressive management drive to address the prevention of those health conditions, which was equally echoed by other scholars[ 7 , 8 ].

Morrison[ 9 ] titled an article ‘Diabetes and hypertension: Twin Trouble’ in which he established that diabetes mellitus and hypertension have now become two problems for Jamaicans and in the wider Caribbean. This situation was equally collaborated by Callender[ 10 ] at the 6 th International Diabetes and Hypertension Conference, which was held in Jamaica in March 2000. They found that there is a positive association between diabetic and hypertensive patients - 50% of individuals with diabetes had a history of hypertension[ 10 ]. Prior to those scholars’ work, Eldemire[ 11 ] finds that 34.8% of new cases of diabetes and 39.6% of hypertension were associated to senior citizens (i.e. ages 60 and over). A national study of 958 Jamaicans found that 18% of women had hypertension compared to 8% of men; 4.8% of women with diabetes compared to 3.3% of men[ 4 ]; and an earlier study by Forrester et al[ 8 ] had found that 19.3% of African-Jamaican females reported hypertension compared to 13.0% of African-Jamaican males.

When the WHO[ 1 ] argued that some deaths are premature, a part of this answer lies in health care-seeking behaviour; time of treatment; identification of illness; poverty; inaccessibility; unhealthy lifestyle practices; and physical inactivity. According to WHO[ 1 ], one-half of all chronic diseases occur prematurely in people who are below the age of 70 years compared to one quarter of those younger than 60 years. The organization also reported that 80% of premature heart disease, stroke and diabetes mellitus could have been prevented from happening. Can premature deaths be prevented from happening?

Embedded in WHO publication is the relationship between poverty and illness, poverty and chronic diseases and poverty and premature death. Marmot[ 12 ] explained that income is positively associated with better health, and that poverty means poor nutrition; inadequate physical milieu, and poor water and food supply which account for increased ill-health in this cohort. Like Marmot[ 12 ], Sen[ 13 , 14 ] argued that poverty denotes reduced capability as this retard choices; freedom; educational access; proper nutrition; and therefore justifies not only chronic diseases but also employability; health insurance coverage; and medical care-seeking behaviour. Statistics from the Planning Institute of Jamaica and the Statistical Institute of Jamaica[ 5 ] revealed that those below the poverty line sought the least medical care: 51.7% for those below the poverty line; 52.7% for those just above the poverty line; 61.2% for those in the middle income categorization; 61.8% in the wealthy income category and 67.6% of those in the wealthiest income cohort. Concomitantly, the poorest income category had the highest reported illness (85.4%) compared to 85.1%; 79.6%: 67.5%; and 74.3% for poor, middle class, wealth and wealthiest income category respectively[ 5 ].

The poor not only seek less medical care; and this offers some more explanation for their increased probability of contracting chronic illness and other mortality causing morbidities; but they are least likely to purchase health insurance coverage. Poverty means in measurable terms inaffordability from material and other social resources, which explains the low likeliness to purchase food and other vital non-food items. In 2007, statistics on Jamaica revealed that 2.2% of those below the poverty line had health insurance coverage compared to 10.1% of those just above the poverty line; 15.9% of the middle class; 20.9% of the wealthy and 37.7% of the wealthiest income category[ 5 ]. This finding highlights the reality of the poor; that in order for them to access health care, this is substantially an out of pocket payment or that it has to state funded. With the probability that they are least likely to find out of pocket money to utilize on health care, premature mortality indeed will be greater for this cohort than other income cohorts.

Poverty therefore erodes good health status of a populace and further deepens individual and national poverty while creating a public health concern for the society. Inflation is a persistent upward movement in prices. It erodes the socio-economic choices of people within a society. Inflation increases the prices of goods and services and a part of this consequence is the cost of health care. In 2007, the annual rate of inflation on food and non-alcoholic beverages was 24.7% compared to 3.4% on health care cost ( Table 1 ), while it was 16.8% for the nation. The rate of the increase of inflation for 2007 over 2006 was 194.7%. With increases in food prices comes the upward price movement in other goods and services prices and such reality removes the willingness of people from seeking medical care as their priority would be to spend on food rather choosing to spend on medical care. The information above highlights the interconnectedness between poverty, unemployment, ill-health; not seeking medical care; health insurance coverage and mortality. In spite of this reality, extensive review of the literature has not found a study that has examined the aforementioned variables in a single research. 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.

Annual Inflation in Food and Non-Alcoholic beverages and Health Care Cost, 2003-2007

Using two decades of data (1988-2007), the current work will examine 10 hypotheses and provide an extensive account for mortality; not seeking medical care; illness; health insurance coverage and unemployment patterns in Jamaica in an attempt to provide research literature for future public health planning and a better understanding of mortality and premature mortality in Jamaica. The hypotheses are 1) there is a statistical correlation between not seeking medical care and poverty; 2) there is a statistical association between not seeking medical care and unemployment; 3) there is a statistical association between poverty and unemployment; 4) there is a statistical relationship between poverty and inflation; 5) there is a statistical association between not seeking medical care and illness; 6) there is a statistical association between not seeking medical care and health insurance coverage; 7) there is a statistical association between mortality and poverty; 8) there is a statistical relationship between mortality and unemployment, 9) there is a statistical relationship between mortality and not seeking medical care, and 10) there is a significant statistical association between not seeking medical care and inflation.

The aim of this study was to examine the impact of poverty, not seeking medical care, unemployment, inflation, self-reported illness, health insurance coverage on mortality in Jamaica in order to provide public health practitioners and health promotion specialists with research findings on those matters in Jamaica.

The currents findings revealed significant statistical correlation between not seeking medical-care and 1) prevalence of poverty(r = 0.759, p< 0.05); 2) unemployment; 3) inflation (r = 0.752); 4) illness; 5) health insurance coverage; and mortality. There is a positive correlation between prevalence of poverty and unemployment (r = 0.69), with 48% of poverty able to be explained by unemployment. A strong positive statistical correlation was found between poverty and inflation (r = 0.856), as 73.2% of poverty can be explained by inflation. A strong negative statistical correlation was found between mortality and prevalence of poverty (r=0.717), with 51.4% of the variance in mortality can be explained by poverty. The relationship between mortality and unemployment was an unsure one, with there being no clear linear or non-linear correlation. Linear associations were found between most of the aforementioned variable; however, non linear correlations were found between 1) mortality and not seeking-medical care; 2) mortality and unemployment; 3) not seeking medical-care and health insurance coverage; not seeking medical-care and illness; and 4) not seeking-medical care and unemployment.

Materials and Methods

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). The years selected for this paper is due to the availability of data on health care seeking behaviour; and illness.

Health care-seeking behaviour, poverty and illness data were taken from the Jamaica Survey of Living Conditions. The Jamaica Survey of Living Conditions (JSLC) is conducted jointly by the Planning Institute of Jamaica and the Statistical Institute of Jamaica. Its purpose is to collect data on living standards of Jamaicans. The JSLC used a detailed questionnaire to collect data from respondents between April and October each year. A self-administered questionnaire was used to collect the data which were stored and analyzed using SPSS for Windows 16.0 (SPSS Inc; Chicago, IL, USA). The questionnaire was modelled from the World Bank's Living Standards Measurement Study (LSMS) household survey. There are some modifications to the LSMS, as JSLC is more focused on policy impacts. The questionnaire covered areas such as socio-demographic, economic and health variables. The non-response rate for the survey was 26.2%.

The survey was drawn using stratified random sampling. This design was a two-stage stratified random sampling design where there was a Primary Sampling Unit (PSU) and a selection of dwellings from the primary units. The PSU is an Enumeration District (ED), which constitutes of a minimum of 100 dwellings in rural areas and 150 in urban areas. An ED is an independent geographic unit that shares a common boundary. This means that the country was grouped into strata of equal size based on dwellings (EDs). Based on the PSUs, a listing of all the dwellings was made, and this became the sampling frame from which a Master Sample of dwelling was compiled, which in turn provided the sampling frame for the labour force. One third of the Labour Force Survey (i.e. LFS) was selected for the survey. The sample was weighted to reflect the population of the nation. Furthermore, the instrument is posted on the World Bank's site to provide information on the typologies of question ( http://www.worldbank.org/html/prdph/lsms/country/jm/docs/JAM04.pdf ).

Unemployment data were taken from the publication of the Labour Force Survey of Jamaica (conducted by the STATIN).

Mortality data were taken from the publication of the demographic statistics. Although a medical certificate of death is used to indicate mortality, data from the Registrar General Department (RGD) were cleaned, modified and validated by the Statistical Institute of Jamaica[ 15 ]. Using a study that was conducted in 1999 which showed that there was under-registration of deaths in RGD's figures, the STATIN developed a methodology that accounted for complete mortality.

For the period 1998-2001, STATIN subtracted the number of deaths as reported by the police (deaths from external causes) from the RGD's record on external deaths. The difference was added to the mortality data set. Secondly, on investigation of the infant mortality (ages below 1 year), STATIN found that 80.25 percent of the deaths occurs in the year in question and 19.75 years in the previous year. This was taken into consideration with the RGD's figures in order to account for all deaths occurring in the year in question. For a more detailed explanation of this methodology, readers can consult Demographic Statistics[ 15 ].

Inflation data were taken from Economic Statistics (published by the Bank of Jamaica).

Information is not available on those who are ill but not seeking medical care. As a result this information was computed by subtracting the percentage reported seeking medical care from 100 each year.

The aforementioned data will be used to provide background information on the study. Descriptive statistics and percentage will be presented on mortality; seeking medical care for the population, and males and females.

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. Four hypotheses will be tested in this study: (1) there is a statistical correlation between not seeking medical care and poverty; (2) there is a statistical association between not seeking medical care and unemployment; (3) there is a statistical association between poverty and unemployment; (4) there is a statistical relationship between poverty and inflation; (5) there is a statistical association between not seeking medical care and illness; (6) there is a statistical association between not seeking medical care and health insurance coverage; (7) there is a statistical association between mortality and poverty; (8) there is a statistical relationship between mortality and unemployment, (9) there is a statistical relationship between mortality and not seeking medical care, and (10) there is a significant statistical association between not seeking medical care and inflation.

Inflation: This is measured as the per cent increase in prices from December to December of each year.

Not seeking medical care: This variable is the difference between those who reported seeking medical care owing to illness/injury which is expressed as a percent and 100 percent.

Medical care-seeking behaviour: This is the total number of people who reported seeking medical care (i.e. health care practitioner; healer; pharmacist; nurse) (expressed in percent).

Poverty is categorized in two major headings: (1) absolute and (2) relative poverty[ 13 ]. Absolute poverty denotes the lack of particular social necessities that is caused by ‘limited material resource’ in which to function – affordability of meeting basic needs, such as adequate nutrition, clothing and housing. Relative poverty, on the other hand, speaks to the individuals’ low financial resources (money or income) or other material resources relative to other people. The Senate says that “relative poverty is defined not in terms of a lack of sufficient resources to meet basic needs, but rather as lacking the resources required to participate in the lifestyle and consumption patterns enjoyed by others in the society”[ 16 ].

The Senate Community Affairs Reference Committee (SCARC) ascribes Professor Ronald Henderson the developer of the ‘poverty line’. “…he developed his ‘poverty line’ which was originally set equal to the minimum wage plus child endowment in Melbourne in 1966”[ 16 ]. Within this measurement approach, poverty becomes a relative phenomenon instead of an absolutism technique. The SCARC[ 16 ] says that, “the aggregate money value of the poverty gap indicates the minimum financial cost of raising all poor families to the poverty line”[ 16 ]. The concept of the poverty line is used in Jamaica to evaluate poverty. In 2007, the poverty line for a household of five was $302,696.07 compared to $281,009.93 in 2006[ 5 ].

On average over the period, the percent of Jamaicans not seeking medical care was 41.9%. The number of Jamaicans not seeking medical care has been steadily declining, which indicates that health care-seekers have been increasing over the past 2 decades ( Figure 1 ; Table 2 ). 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.

Not seeking medical care (%) by Year. There is a linear pattern in percent of Jamaicans not seeking medical care.

Inflation, Public-Private Health Care Service Utilization, Incidence of Poverty, Illness and Prevalence of Population with Health

Figure 1 showed that not seeking medical care (which is derived by subtracting medical care-seeking behaviour from 100%) can be fitted with a straight line. Furthermore, not seeking medical care has been steadily declining. However, mortality is best fitted with a non-linear curve. It was found that mortality was falling up to 1990 then it reached the minimum then began rising at an increasing rate up to 2002, then an ever- growing declining set in post 2005 ( Fig. 2 ).

Annual Mortality in Years. The annual number of Jamaicans who die is best fitted with a non-linear diagram.

Based on findings ( Table 2 ), Jamaicans have a preference for private health care utilization. During the 1990s (1994-1995), the disparity between private and public health care utilization was approximately 40%; which continues to narrow post that period. In 2007, the disparity was 11%, which represents a 28% narrowing of the gap between both utilizations.

Concomitantly, during the latter part of the 1980s to early 1990s, inflation began mounting so much so that it peaked at 80.2% in 1991 ( Table 2 ). While inflation was rising, there were fluctuations between poverty and self-reported illness/injury. Continuing, when inflation was at it highest (80.2%), poverty was also at its peak (44.6%), unemployment was close to the peak (15.3%) ( Table 3 ) and so was the percent of not seeking medical care (52.3%). Inflation increased by 194% in 2007 over 2006 and during that period, health insurance coverage was at its highest (21.2%); medical care-seeking behaviour fell by 4% and self-reported illness increased by 3% (to 15.5%) and 4% more Jamaicans did not seek medical care.

Seeking medical care, self-reported illness, and gender composition of those who report illness and seek medical care in Jamaica (in percentage), 1988-2007.

Table 3 revealed that average mortality over the 2 decade period was 15,966 people, which in 1999; the figure was 18,200 people and a low of 13,200 people in 1992. Correspondingly, over the 2 decades it was on one occasion that men sought more medical care than women (2006), with the general trend in the data that men are less likely to report illness/injury. In 2007, the findings revealed that the mean number of days spent in medical care by men was marginally more (10.6 days) compared to women (9.3 days); but that generally the difference is minimal ( Table 3 ).

Not seeking medical-care

There is a significant statistical correlation between not seeking medical-care and prevalence of poverty (r=0.759, p<0.05). The association therefore is a strong positive one, with 57.6% of the variance in not seeking medical care can be explained by 1% change poverty ( Fig. 3 ).

Not Seeking Medical Care (%) by Prevalence of poverty rate (in %). There is a linear association between not seeking medical care (%) and prevalence of poverty (%) in Jamaica ( Fig. 3 ). Furthermore, 58% of the variability in not seeking medical care (%) can be explained by a 1% change in prevalence of poverty (%).

There is a statistical correlation between not seeking medical care and unemployment; but the association is a non-linear one ( Fig. 4 ). The findings revealed that there is a direct correlation between not seeking medical care and unemployment between 7.5% and 15% after which it begins to fall. At 15% of unemployment (not clear) not seeking medical care is at its maximum; then post that rate, the rate of not seeking medical care precipitously fall.

Not Seeking Medical Care (%) by Unemployment rate (%). The statistical correlation between not seeking medical care (%) and unemployment rate (%) is not a linear one. Based on Figure 4 , it is best fitted with a non-linear cure.

The findings revealed that there is a strong direct association between not seeking medical care and inflation rate (r=0.752). Continuing, 56.5% of the variance in not seeking medical care can be explained by a 1% change in inflation rate.

There is a non-linear statistical association between not seeking medical care and illness/injury ( Fig. 5 ). The findings revealed that when the rate of illness/injury is more than 9% and less than 14%, the rate of not seeking medical care falls at a decreasing rate and after 15% the rate rises significantly.

Not Seeking Medical Care (%) by Illness/Injury (%). Statistical correlation between not seeking medical care (%) and illness/injury (%) is a non-linear one.

Figure 6 revealed a statistical association between not seeking medical care and health insurance coverage; but that the relationship is a non-linear one. It was found that between 8 to 18%, the correlation is an inverse one and after 18% it becomes a direct one. Hence, the more people have health insurance coverage; the less likely that they will not seek medical care and this correlation reverses beyond 18% of coverage.

Mortality (No of people) by Not Seeking Medical Care (%). The association between mortality (number of people that died) and not seeking medical care (%) can be best fitted with a non-linear curve.

There is a statistical relationship between mortality and not seeking medical care. Based on Figure 6 , the correlation is best fitted with a non-linear curve than a linear one. Hence, the association does not have the same gradient throughout the curve. It follows that after 35% of not seeking medical care, the rate of change in mortality was decreasing and after 55% of not seeking medical care, the rate begins to mounting at an increasing rate.

Poverty, Unemployment, Inflation and Mortality

There is a positive correlation between prevalence of poverty and unemployment (r=0.69), with 48% of poverty able to be explained by unemployment ( Fig. 7 ).

Prevalence of poverty rate (%) and unemployment rate (%).

A strong positive statistical correlation was found between poverty and inflation (r=0.856), as 73.2% of poverty can be explained by inflation ( Fig. 8 ).

Not Seeking Medical Care (%) by Health Insurance Coverage (%). A non-linear relationship existed between not seeking medical care (%) and health insurance coverage (%).

Mortality (No. of people) by Prevalence of Poverty (%). Mortality (annual number of deaths) and prevalence of poverty (%) is a linear one.

A strong negative statistical correlation was found between mortality and prevalence of poverty (r=0.717), with 51.4% of the variance in mortality can be explained by poverty.

The relationship between mortality and unemployment was an unsure one, with there being no clear linear or non-linear correlation ( Fig. 10 ).

Mortality by unemployment rate (in%). There is no clear pattern between mortality (number of people who die, annual) and unemployment rate (%) in Jamaica.

Murray[ 18 ] found that there is a clear interrelation between poverty and health. She noted that financial inadequacy prevents an individual from accessing – food and good nutrition, potable water, proper sanitation, medicinal care, preventative care, adequate housing, knowledge of health practices - and attendance at particular educational institutions among other things, which was in agreement to Marmot and Sen's perspectives. Marmot[ 12 ] opined that poverty reduced an individual's socio-economic and political choices and like Sen[ 13 ], he saw this phenomenon as a retardation of human capabilities. They believed that poverty accounted for much of the low educational outcome of those that are therein as well as the poor nutrition, low water quality; poor physical environment and that this is not surprising when the poor experience increased health conditions. Marmot[ 12 ] argued that money can buy health as those who have it are able to afford medical care treatment; purchase particular goods; create a good physical milieu and by extension experience a better health status than the poor. This argument is not entirely correct as income cannot buy health, as health is not a commodity that can be purchased. However, income can buy the treatment which is a precursor to better health status; and this is what the wealthy has over the poor and not necessarily better health status. Easterlin[ 17 ] argued that material resources have the capacity to improve ones choices, comfort level, state of happiness and leisure; and not that money can buy health or happiness.

Poverty undoubtedly incapacitates those that are therein, which explains why the WHO[ 1 ] argued that some of the mortality in this group will be prematurely caused death. The current study found that there is a strong direct correlation between not seeking medical care and poverty. With 57% of reasons Jamaicans do not seek medical care being accounted for by poverty, it follows that some of the morbidities that require medical care will be attended to with home remedy and non-medical healers, and by extension will result in premature deaths. This is concurring with Murray's work which showed that poverty also leads to increased dangers to health: working environments of poorer people often hold more environmental risks for illness and disability; other environmental factors, such as lack of access to clean water, disproportionately affect poor families[ 18 ].

The studies clearly show a relationship between persistent and elongated poverty and health and even mortality[ 18 – 20 ]. If poverty is an undisputable a primary cause of malnutrition[ 21 ], then access to money plays a pivotal role in the well-being. In order to grasp the severity of the issue of money, we need to be brought into the recognition of poverty and health status. According to Bloom and Canning[ 22 ], ‘ill-health’ significantly affects poor people. This postulate further goes on to explain the higher probability (5 times) of mortality of the poor than the rich[ 23 ].

A survey conducted by Diener, Sandvik, Seidlitz and Diener[ 24 ], stated that correlation between income and subjective well-being was small in most countries. According to Diener[ 25 ], “…, there is a mixed pattern of evidence regarding the effects of income on SWB [subjective well-being]”. Benzeval, Judge and Shouls[ 26 ] study concurred with Diener that income is associated with health status. Benzeval et al went further as their research revealed that a strong negative correlation exists between increasing income and poor health. Furthermore, from a study, it was found that people from the bottom 25 percent of the income distribution self-reported poorer subjective health by 2.4 times than people in the to fifth quintile[ 26 ].

The poor like the wealthy or middle class also want long life and a life full of satisfaction; but the reality is, in order for them to spend on education and health care, they must first cover food and non-alcoholic beverage costs. In 2007, inflation on non-alcoholic beverages was 24.7% which means that the poor must now face the addition cost of survivalability before venturing into health care treatment. In 2003 and 2006, health care cost was close to double digits and in the latter year, the price increase was greater than that for food and non-alcoholic beverages. With the poor experiencing material and income inadequacies, inflation does not only create an economic hardship but a treatment care hindrance. This study revealed that there is a strong positive statistical relationship between not seeking medical care and inflation, which means that when inflation increased by 194% in 2007 over 2006, many poor Jamaicans delayed medical care treatment to their very detriment. It should be noted here that during the aforementioned period, the percentage of Jamaicans reporting health conditions increased to 15.5% (from 12.2% in 2006), suggesting that many poor people were not being treated for some of the chronic diseases that they were experiencing on a daily basis.

One of the ways that is used by many people to afford health care is health insurance coverage. Health insurance coverage reduces out of pocket payment, and makes medical care more affordable for countless non-wealthy people. To address the exponential increase in prices that took place in 2007 over 2006, many Jamaicans purchased health insurance as percentage of people holding health insurance coverage stood at 21.2%, the highest in the nation's 20 year history. Concomitantly, only 2.2% of those in the poorest income categorization were holders of health insurance coverage and 10.1% of those just above the poverty line, suggesting that health care treatment would be an out-of pocket payment for those individuals. With the typologies of diseases reported by Jamaicans being hypertension; diabetes mellitus; asthma; and arthritis; health insurance coverage increases the probability of medical care utilization and non-out of pocket expenditure on medication and health care treatment. The current research revealed that health insurance coverage is positively correlated with not seeking medical care. However, the association is not a linear one and so, beyond 18% of Jamaicans holding health insurance coverage, more of them see it as switching to not seeking medical care. Embedded in this finding is the fact that buying more health insurance coverage does not indicate a willingness to seek medical care treatment as beyond a certain percentage health insurance ownership does not encourage more health care-seeking behaviour.

The WHO[ 1 ] opined that poverty is associated with increased chronic diseases and premature death, and this is cemented by this work. The findings herein revealed that poverty is positively correlated with lowered medical care seeking behaviour; and it was also found that there is a negative relationship between mortality and poverty. This denotes that more poverty does not equate to increased death; instead the converse is true. The study showed that when mortality is high, poverty is less than 18% and that when poverty increased beyond 20%, mortality begins to decline and that it reaches it least when poverty is in excess of 40%. If poverty is not directly correlated with mortality, then is it possible that there are premature deaths of the poor?

Studies on morality have shown that there is a high correlation between patterns of death and health and/or life expectancy[ 27 , 28 ], indicating that not unattended health conditions could cause death. According to Kimmel[ 29 ], 80% of deaths post 65 years is attributed to cardiovascular diseases, blindness, hearing impairment, diabetes, heart conditions, high blood pressure, arthritis, and rheumatism. While this study was on Jamaicans and not of a particular age cohort, the poor reported the greatest percentage of health conditions and within the context of their inaffordability and low response to seek medical treatment compared to the other social classes, there should be some cases of premature mortality associated with low health care-seeking behaviour.

An interesting finding of the current study was observed as an association was found between mortality and not seeking medical care and that it was a non-linear one. Hence, when not seeking medical care is less than 35%, as not seeking medical care increase to this point the association between the two phenomena was positive and after it passes this threshold, increases in not seeking medical care begins to fall to approximately 55%. Beyond 55%, the association between the two variables was a positive one. It was found that an exponential increase in mortality was found when not seeking medical care surpassed 55%, suggesting that when people avoidance of health care is less than 45%, a case of premature mortality must be occurring to cause this increase in deaths. There is a direct correlation between poverty and not seeking medical care and so is not seeking medical care and inflation, which accounts for not only increased diseases; but a case of premature mortality. It is not just of premature deaths as the findings revealed that men sought less health care than women, and this account for more mortality of this group and a part of this would be premature deaths. Statistics for Jamaica in 2005 showed that there was 117 males to every 100 females that died, and this increased from 115 males to every 100 females in 1998 (Statistical Institute of Jamaica, 2008:56). Embedded in those mortality data are the fact that marginal disparity in figures could not be justifying that the drastic mortality increase could be premature deaths for only males.

Conclusions

Not seeking medical care is influenced by inflation, poverty and unemployment. With the low probability that the impoverished is likely to be holders of health insurance coverage in Jamaica, their out of pocket payment for health care treatment will be higher and therefore the high likeliness of medical care visits will be to the detriment of their health. 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.

Acknowledgement

The author would like to extend sincere gratitude to Ms. Neva South-Bourne who offered invaluable assistance in editing the final draft of this manuscript.

Poverty Essay for Students and Children

500+ words essay on poverty essay.

“Poverty is the worst form of violence”. – Mahatma Gandhi.

How Poverty is Measured?

For measuring poverty United nations have devised two measures of poverty – Absolute & relative poverty.  Absolute poverty is used to measure poverty in developing countries like India. Relative poverty is used to measure poverty in developed countries like the USA. In absolute poverty, a line based on the minimum level of income has been created & is called a poverty line.  If per day income of a family is below this level, then it is poor or below the poverty line. If per day income of a family is above this level, then it is non-poor or above the poverty line. In India, the new poverty line is  Rs 32 in rural areas and Rs 47 in urban areas.

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Causes of Poverty

According to the Noble prize winner South African leader, Nelson Mandela – “Poverty is not natural, it is manmade”. The above statement is true as the causes of poverty are generally man-made. There are various causes of poverty but the most important is population. Rising population is putting the burden on the resources & budget of countries. Governments are finding difficult to provide food, shelter & employment to the rising population.

The other causes are- lack of education, war, natural disaster, lack of employment, lack of infrastructure, political instability, etc. For instance- lack of employment opportunities makes a person jobless & he is not able to earn enough to fulfill the basic necessities of his family & becomes poor. Lack of education compels a person for less paying jobs & it makes him poorer. Lack of infrastructure means there are no industries, banks, etc. in a country resulting in lack of employment opportunities. Natural disasters like flood, earthquake also contribute to poverty.

In some countries, especially African countries like Somalia, a long period of civil war has made poverty widespread. This is because all the resources & money is being spent in war instead of public welfare. Countries like India, Pakistan, Bangladesh, etc. are prone to natural disasters like cyclone, etc. These disasters occur every year causing poverty to rise.

Ill Effects of Poverty

Poverty affects the life of a poor family. A poor person is not able to take proper food & nutrition &his capacity to work reduces. Reduced capacity to work further reduces his income, making him poorer. Children from poor family never get proper schooling & proper nutrition. They have to work to support their family & this destroys their childhood. Some of them may also involve in crimes like theft, murder, robbery, etc. A poor person remains uneducated & is forced to live under unhygienic conditions in slums. There are no proper sanitation & drinking water facility in slums & he falls ill often &  his health deteriorates. A poor person generally dies an early death. So, all social evils are related to poverty.

Government Schemes to Remove Poverty

The government of India also took several measures to eradicate poverty from India. Some of them are – creating employment opportunities , controlling population, etc. In India, about 60% of the population is still dependent on agriculture for its livelihood. Government has taken certain measures to promote agriculture in India. The government constructed certain dams & canals in our country to provide easy availability of water for irrigation. Government has also taken steps for the cheap availability of seeds & farming equipment to promote agriculture. Government is also promoting farming of cash crops like cotton, instead of food crops. In cities, the government is promoting industrialization to create more jobs. Government has also opened  ‘Ration shops’. Other measures include providing free & compulsory education for children up to 14 years of age, scholarship to deserving students from a poor background, providing subsidized houses to poor people, etc.

Poverty is a social evil, we can also contribute to control it. For example- we can simply donate old clothes to poor people, we can also sponsor the education of a poor child or we can utilize our free time by teaching poor students. Remember before wasting food, somebody is still sleeping hungry.

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