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PubMed1998

Developmental screening scores among preschool-aged children: the roles of poverty and child health.

OBJECTIVES: To investigate, using a nationally representative sample of preschool-aged children, the relationship among poverty history, child health, and risk of an abnormal developmental screening score. METHODS: Data were derived from the 1988 National Maternal and Infant Health Survey and 1991 Longitudinal Follow-up. Family income in the child's prenatal year and at 2 years old defined a poverty history for each child. Multivariate logistic regression was used to estimate the effects of poverty history on risk of an abnormal screening score or delays in large-motor, personal-social, or language subscales. RESULTS: Poor and near-poor children were 1.6 to 2.0 times as likely as nonpoor children to be classified as abnormal, even when maternal and household characteristics and the child's health history were taken into account. Preterm birth, chronic illness, dearth of reading materials in the home, and maternal depression were also associated with elevated risks of abnormal scores. CONCLUSIONS: Poverty is the largest single predictor of an abnormal developmental screening score. The implications of inadequate medical care among poor children for the interpretation of individual screening scores and for amelioration of problems are also discussed.

Child Health Services↗
PubMed1996

Understanding the relationship between neighborhood poverty and specific types of child maltreatment.

In this paper we examined the relationship between neighborhood poverty and three different types of child maltreatment; neglect, physical abuse, and sexual abuse. We explore both rates of reporting and rates of substantiated reports across low, moderate, and high poverty areas. We use 1990 Census data and Child Protective Services (CPS) data to study this relationship. We find that neighborhood poverty is positively associated with all three forms of child maltreatment, but to different degrees. Of the three types of child maltreatment, child neglect is most powerfully associated with neighborhood poverty status.

Adolescent↗
PubMed1982

The neurology of poverty.

An intellectual deficit is known to exist in populations where extreme poverty is rife and is thus seen extensively in the lower socio-economic strata of underdeveloped nations. Poverty is a complex entity whose sociological and economic indicators often bear little relevance to the biological agents which can affect the central nervous system. An attempt is made to express poverty in terms of identifiable defects, physiological in nature. Thus adverse socio-economic factors are converted into specific biological entities which, though necessary for adequate development of the brain, are restricted where there is poverty. A number of causative deficiencies, including nutritional, visual, auditory, tactile, vestibular, affective, and other stimuli are postulated. These interact and potentiate one another. Each is capable of an independent action on the brain and examples are given of some sensory deprivations as well as malnutrition and their possible mechanism of action. If the various deficiencies can independently harm the brain, then a number of separate specific functions should be affected; examples are offered. The nature of this intellectual deficit is probably a non-fulfillment of genetic potential of certain specific functions of the brain, which may exhibit limited variations between one community and another, depending on cultural differences. The deleterious effect of this intellectual impairment is seen most clearly in figures of school desertion, for example in Latin America. Analogous data for adults is scarce.

Central Nervous System Diseases↗
PubMed1983

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

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

Africa↗
PubMed2004

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

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

Adult↗
PubMed2005

"The walls were so damp and cold" fuel poverty and ill health in Northern Ireland: results from a housing intervention.

This article reports the findings from an evaluation of a fuel poverty programme in the Armagh and Dungannon Health Action Zone in Northern Ireland. Focusing on a rural community, it adds to the debate surrounding the hidden nature of rural fuel poverty. As part of the programme, energy efficiency measures, including some central heating systems, were installed in 54 homes. Surveys were conducted both pre and post intervention and analysed to assess any changes. The programme demonstrated that energy efficiency intervention can lead to improvements in health and well being, increased comfort levels in the home and a reduction in the use of health services, therefore having potential cost savings for the NHS. Some households, however, remain in fuel poverty after having full central heating installed, reflecting the significant contribution of low income on the production of fuel poverty. The article concludes by suggesting that interventions in this area require commitment from multiple sectors of society, including health professionals and local communities.

Cold Temperature↗
PubMed2004

Poverty, food insecurity, and nutritional outcomes in children and adults.

Using data from the National Health and Nutrition Examination Survey, we examine the relationship between nutritional status, poverty, and food insecurity for household members of various ages. Our most striking result is that, while poverty is predictive of poor nutrition among preschool children, food insecurity does not provide any additional predictive power for this age group. Among school age children, neither poverty nor food insecurity is associated with nutritional outcomes, while among adults and the elderly, both food insecurity and poverty are predictive. These results suggest that researchers should be cautious about assuming connections between food insecurity and nutritional outcomes, particularly among children.

Adolescent↗
PubMed2006

Leishmaniasis and poverty.

Leishmaniasis, a neglected tropical disease, has strong but complex links with poverty. The burden of leishmaniasis falls disproportionately on the poorest segments of the global population. Within endemic areas, increased infection risk is mediated through poor housing conditions and environmental sanitation, lack of personal protective measures and economically driven migration and employment that bring nonimmune hosts into contact with infected sand flies. Poverty is associated with poor nutrition and other infectious diseases, which increase the risk that a person (once infected) will progress to the clinically manifested disease. Lack of healthcare access causes delays in appropriate diagnosis and treatment and accentuates leishmaniasis morbidity and mortality, particularly in women. Leishmaniasis diagnosis and treatment are expensive and families must sell assets and take loans to pay for care, leading to further impoverishment and reinforcement of the vicious cycle of disease and poverty. Public investment in treatment and control would decrease the leishmaniasis disease burden and help to alleviate poverty.

Animals↗
PubMed1985

The perception of poverty and wealth among teenagers.

This study is concerned with the perception of poverty and wealth among high-school teenagers. Over 300 teenagers completed a questionnaire which probed their perceptions of the attributions and consequences of poverty and wealth, and requested them to estimate the income for both a specified "poor" and "rich" man. The results indicate that all groups in this sample emphasized the significance of the family and downplayed the significance of luck when dealing with poverty and wealth. Further, the groups emphasized the economic consequences of poverty and wealth and they did not rate their psychological consequences as being of much importance. The results are discussed in terms of the small literature relevant to this topic.

Adolescent↗
PubMed1997

Population growth, poverty and health.

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

Adolescent↗
PubMed2005

Neighborhood poverty and public policy: a 5-year follow-up of children's educational outcomes in the New York City moving to opportunity demonstration.

Data from the Moving to Opportunity Program, a randomized mobility experiment in which a subset of low-income minority families living in public housing in high-poverty neighborhoods were given vouchers to move to low-poverty neighborhoods, were used to evaluate 1 policy approach for improving children's educational outcomes. Four hundred twenty-five New York City children were seen 2 1/2 and 5 years following relocation (mean age=14.64 years, SD=3.21 years). Analyses examining program effects on 5-year educational outcomes, accounting for 2 1/2-year outcomes, revealed that program effects on adolescent boys' achievement found at 2 1/2 years were not sustained at 5 years. Rather, male and female youths 14-20 years of age in low-poverty neighborhoods reported lower school grades and engagement relative to youths in high-poverty neighborhoods. From a policy standpoint, the complexity of enhancing low-income minority children's educational outcomes is underscored by the multiple dynamics involved--family, neighborhood, housing, and school.

Adolescent↗
PubMedDate not supplied

An examination of race and poverty for populations living near industrial sources of air pollution.

This study examines the sociodemographic characteristics of people living near industrial sources of air pollution in three areas of the United States: (1) the Kanawha Valley in West Virginia: (2) the Baton Rouge-New Orleans corridor in Louisiana: and (3) the greater Baltimore metropolitan area in Maryland. Using data from the 1990 Toxics Release Inventory (TRI) and the 1990 Census, we analyze relationships between variables assumed to be independent, such as location of single or multiple industrial emission sources, and the dependent variables of race (black/white) and poverty status (above/below poverty level). Results from all three study areas are consistent and indicate that African Americans and those living in households defined to be below the established poverty level are more likely, on average, to live closer to the nearest TRI facility and to live within 2 miles of multiple TRI facilities. Conversely, whites and those living in households above the poverty level are more likely, on average, to live farther from the nearest TRI facility and to live within 2 miles of fewer facilities, compared to African Americans and poor people.

Black or African American↗
PubMed2006

The association of poverty with the prevalence of albuminuria: data from the Third National Health and Nutrition Examination Survey (NHANES III).

BACKGROUND: Albuminuria is a major risk factor for the development and progression of chronic kidney disease (CKD) and cardiovascular disease. Socioeconomic factors also have been reported to modify CKD and cardiovascular risk factors and clinical outcomes. The extent to which poverty influences the prevalence of albuminuria, particularly among racial/ethnic minority populations, is not well established. The influence of poverty on the prevalence of albuminuria and the implication of this relationship for the racial and/or ethnic differences in the prevalence of albuminuria were examined. METHODS: We examined data from 6,850 male and 7,634 female adults from a national probability survey conducted between 1988 and 1994. RESULTS: In univariate analysis, poverty, defined as less than 200% federal poverty level (FPL), was associated with the presence of both microalbuminuria (odds ratio [OR], 1.35; 95% confidence interval, 1.22 to 1.49) and macroalbuminuria (OR, 1.78; 95% confidence interval, 1.40 to 2.26). The association of less than 200% FPL with microalbuminuria persisted in a multivariate model controlling for age, sex, race, education, obesity, hypertension, diabetes, reduced glomerular filtration rate, and medication use (OR, 1.18; 95% confidence interval, 1.05 to 1.33). FPL less than 200% was not associated with macroalbuminuria in the multivariate model. When multivariate analysis is stratified by FPL (<200% and > or =200%), differences in ORs for microalbuminuria and macroalbuminuria among racial/ethnic minority participants compared with whites were more apparent among the less affluent participants in the FPL-less-than-200% stratum. CONCLUSION: FPL less than 200% is associated with microalbuminuria, and differences in FPL levels may account for some of the observed differences in prevalence of albuminuria between racial/ethnic minority participants and their white counterparts.

Adult↗
PubMed2003

A life-course perspective on social exclusion and poverty.

This article assesses whether it is possible to reconceptualize the traditional research approaches to the relationship between poverty and the life cycle on the basis of different sociological perspectives on the life course found in the literature. While the family-cycle approach, which was originally formulated by Seebohm Rowntree (1902), is criticized for being static, descriptive, normative and inflexible, dynamic poverty research is mostly confined to the quantitative analysis of income trajectories, and thus offers only a partial solution to our problem. However, the life-course perspective allows us to combine the best elements of these traditional approaches and to reconceptualize them into a general framework for the study of social exclusion and poverty. To this end, three sociological perspectives on the life course are considered: the traditional North-American life-course perspective formulated by Elder (1974), the Continental institutional approach, and a combined approach which we label the 'political economy of the life course'. Drawing from these three perspectives, we propose a general framework of analysis and formulate hypotheses regarding the phenomena of social exclusion and poverty over the life course which can subsequently be empirically validated.

Cultural Deprivation↗
PubMed2005

Self-reported heart symptoms are strongly linked to past and present poverty in Russia: evidence from the 1998 Taganrog interview survey.

BACKGROUND: In this Russian-Swedish collaborative study the question of how symptoms of heart disease are linked to poverty in Russia was addressed. METHOD: A random sample household survey was conducted in Taganrog, southern Russia. It covered questions about living circumstances, poverty and health. Health questions included both symptoms of heart problems, such as chest pain and high blood pressure, psychological problems such as depression and anxiety, as well as health-related behaviours such as alcohol drinking. Answers from 1972 women and men aged 18-70 are analysed here. RESULTS: The poorest fifth of the population were more than twice as likely as others to report heart symptoms. Problems in affording vegetables, meat or fish, clothes and footwear were linked to heart symptoms more closely than other economic indicators, such as car ownership or ownership of consumer durables. Psychological symptoms, sleeping problems and alcohol drinking were all related to self-reported heart symptoms, but explained little of the excess risks attributable to present poverty. Childhood poverty was also linked to present heart symptoms. CONCLUSION: Life-time accumulated experience of economic hardship contributes to present levels of heart disease symptomology in Russia.

Adolescent↗
PubMed2003

Poverty among elderly women: assessing SSI options to strengthen Social Security reform.

OBJECTIVES: We explore the potential of the Supplemental Security Income (SSI) program to reduce poverty among elderly women. We develop a methodological framework that compares how well various reform proposals are targeted to reducing poverty among elderly women. METHODS: Using a microsimulation model and survey data matched to SSI administrative records, we model the effects of eight alternative policies on current and potential SSI recipients. We develop an evaluation methodology that systematically compares poverty outcomes, using multiple measures of effectiveness, at given levels of program expansion. RESULTS: All but two of the SSI reforms are clearly more target efficient at various degrees of simulated program expansion than popular proposals to reform Social Security. For a given cost increase, modifying the SSI asset test is the most effective option for reducing severe poverty among elderly women, but several reforms of the SSI income test are also highly effective. DISCUSSION: The SSI program is target efficient in providing a broad safety net to economically vulnerable elderly women. The relationship between SSI and Social Security and the relationship between the SSI asset and income tests have to be reevaluated to make the program more effective and appropriate to changing household structure and work patterns among the elderly population.

Aged↗
PubMed1991

Poverty dynamics in widowhood.

Data from a national sample of widows of all ages were used to examine links between poverty and widowhood. We found that widowhood drops living standards by 18 percent, on average, and pushes 10 percent of women whose incomes were above the poverty line prior to widowhood into poverty after it. Not surprisingly, economic status prior to widowhood is the strongest predictor of status during widowhood. Striking in the data is the instability of family income during widowhood, producing substantial numbers of exits from poverty.

Age Factors↗
PubMed2000

Work history and U.S. elders' transitions into poverty.

Poverty risks among elders are shaped in critical ways by their work history, demographic characteristics, current marital status, and residential context. Using 25 years of data from the Panel Study of Income Dynamics, we combined past occupation and work history of elders and their spouses with information on current marital status and residence to estimate discrete time event history models of first transitions into poverty after reaching age 55. Education, work history, and preretirement wages contributed to men's and some women's probability of becoming poor. Work history remained an important predictor of transitions into poverty, even after controlling for preretirement wages and human capital. Metropolitan residence was associated with a lower probability of making transitions into poverty. This residential difference was not appreciably attenuated in three of four elderly subgroups after measures of work history, preretirement wages, current life events, and demographic characteristics of the elders were included in the models.

Aged↗