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The association of near poverty status with cancer incidence among black and white adults.

This cumulative incidence study was accomplished among adults in Upstate New York metropolitan areas (Buffalo, Rochester, Syracuse and Albany--1979-1986). It used a new ecological socioeconomic status measure--near poverty status (i.e., below 200% of the federally established poverty criterion, including the poor and near poor)--and observed its association with site-specific cancer incidence (lung, stomach, cervix uteri, prostate, colon, rectum and breast). Findings were: 1) near poverty status is directly associated with each cancer site's incidence and the strength of the associations are similar among blacks and whites for each one and 2) the prevalence of exposure, of living in high near impoverishment areas, is nearly seven-fold greater among blacks; prevalence ratio [PR] = 6.74 (95% confidence interval [CI]:5.07,8.99).

Adult↗

Neighborhood poverty, social capital, and the cognitive development of African American preschoolers.

In this investigation, we examine the impact of the ecological context of the residential neighborhood on the cognitive development of children by considering social processes not only at the family-level but also at the neighborhood-level. In a socioeconomically diverse sample of 200 African American children living in 39 neighborhoods in Baltimore, we found that neighborhood poverty was associated with poorer problem-solving skills over and above the influence of family economic resources and level of positive parent involvement. Sampson has theorized that neighborhood poverty affects child well-being by altering levels of neighborhood social capital as well as family social capital. Although we found that indicators of neighborhood and family social capital were associated with cognitive skills, these factors did not explain the association between neighborhood poverty and problem-solving ability. Implications for future research in the area of neighborhoods and child development are discussed.

Black or African American↗

Health and poverty: past, present and prospects for the future.

Periodically the results of class comparisons in mortality rates have been reported. These reports have permitted comparisons since the earlier part of this century to the present period. The data thus available enables us to make some tentative predictions about the likely magnitude of class inequalities in mortality in the future. We consequently argue that: the concept of class should be abandoned in favour of a more direct measure of economic inequality which emphasises those living in poverty. despite overall declines in mortality for all socioeconomic groups, in the most recent period there has been an increase in the relative mortality disadvantage in some countries. this increase in mortality disadvantage is paralleled by an increase in the proportion of people, particularly children, living in poverty. Five groups constitute the bulk of those living in poverty and, of these, three (single mothers, the aged and the disabled) are likely to increase in numbers in the future, producing a likely increase in class-related mortality inequalities. Reducing these inequalities will depend upon welfare and education initiatives more than on any changes likely to be produced by the health system.

Adult↗

Exposure to violence and parenting as mediators between poverty and psychological symptoms in urban African American adolescents.

The present study builds on past research that has found support for a conceptual model in which poverty is linked with adolescent psychological symptoms through economic stressors and impaired parenting. The present study examined this model in a sample of urban African American mothers and their adolescent children. In addition, an alternative hypothesis was examined: that exposure to community violence mediates the relation between poverty and psychological symptoms in urban youth. Limited support was found for a model in which poverty is linked with internalizing symptoms through exposure to community violence and with externalizing symptoms through economic stressors and inconsistent discipline. Interpretations, limitations, and directions for future research are outlined.

Adolescent↗

Poverty and child health.

Poverty is now more heavily concentrated in children than at any other time in U.S. history. Poverty's influence on child health is pervasive and creates a variety of clinical challenges. This discussion reviews the clinical expression of poverty in childhood and assesses our clinical and political capacity to reduce its tragic impact.

Child↗

Putting policy into practice? Poverty and people with serious mental illness.

This paper addresses the effects of chronic poverty on people with serious mental illness. More specifically, we are concerned with the extent to which welfare restructuring, by deepening the poverty facing people with serious mental illness, undermines the expressed intent of mental health policy to improve the quality of life (QOL) of this population. The province of Ontario in Canada forms the setting for the study. The paper first examines recent trends in mental health care and social assistance policy in Ontario. While income support is consistently recognized as a core element of mental health care, welfare restructuring has led to a significant decline in the real value of income supports received by people with serious mental illness. The paper then examines the implications of this trend for the QOL of residential care facility tenants in Hamilton, Ontario. Here, the case study is explicitly connected to QOL scholarship. In addition, the study is grounded in an analysis of the broader transformation of the welfare state in Ontario. Interview data suggest that tenants experience chronic poverty that has a deleterious impact on multiple life domains including basic needs, family, social relations, leisure and self-esteem. Implications for research and policy are discussed.

Adult↗

Mutual influences of health and poverty. Evidence from German panel data.

While a large body of literature is concerned with the interplay of health and poverty in developing countries, comparable studies for developed countries are rare. Using data drawn from the German Socio-Economic Panel (GSOEP), this paper investigates the relationships between changes in relative income poverty, income changes and health-related quality of life in Germany, i.e. in an environment with nominally equal access to medical care, education and social security. A fundamental five-dimensional health concept is introduced and tested for its empirical performance. The background of the causal analysis is formed by two hypotheses, one regarding low income as a possible cause for poor health (prevention hypothesis) and the other assuming the opposite causal direction (deprivation hypothesis). By means of a descriptive analysis and a structural equations model, the existence of a more complex relational web between health and poverty is demonstrated.

Germany↗

Education, poverty, and stroke incidence in whites and blacks: the NHANES I Epidemiologic Follow-up Study.

The purpose of this study was to test the hypothesis that educational attainment and poverty index are inversely associated with incidence of stroke in blacks and in whites. The NHANES I Epidemiologic Follow-up Study data were analyzed. We analyzed 2953 women and 2661 men with no history of stroke before baseline (1971-1975), using the incidence of stroke through 1992, years of education, and poverty index at baseline. In white men aged 45 to 74, Cox regression models showed an inverse age-adjusted association with education that did not attain statistical significance. In white women, those with 12 or more years of education had significantly lower age-adjusted risk of stroke compared with those with less than 8 years. A test for linear trend was significant when adjusting for age (P = 0.0005). In blacks, stroke risk was significantly lower in those with 8 or more years of education than in those with <8 years in adjusted models. In each group, Cox regression models showed an inverse, graded, age-adjusted association with poverty index that attained statistical significance. After controlling for multiple confounders and risk mediators, the association was diminished and nonsignificant.

Black or African American↗

Developmental delay and poverty in the strabismus clinic.

BACKGROUND: Strabismus and poverty are more common among developmentally delayed children. Poverty is difficult to define, but qualification for Medicaid benefits has been used as an indicator in the past. METHODS: There was a retrospective review of 95 patients with strabismus younger than 7 years who were seen in the Department of Pediatric Ophthalmology at the Albany Medical Center for a 12-month period and were reviewed for the presence or absence of developmental delay. These patients were selected from 2 groups: one with Medicaid coverage and one without. RESULTS: Developmental delays were noted in 13 patients without Medicaid (27.0%) and in 26 patients with Medicaid (55.3%) (P = .0096). Patients with Medicaid were less likely to name Allen pictures by age 3 years (P = .0003). CONCLUSIONS: Poverty is more commonly associated with delays in patients with strabismus, and this should alert ophthalmologists who work with Medicaid patients to seek to identify the presence of developmental delay in managing the care of these patients.

Child↗

Women's social power, child nutrition and poverty in Mali.

While the macro-level association between poverty and child malnutrition is well-established, the concept of 'poverty' and its operationalization in terms of measures of socioeconomic status shed little or no light on the mechanisms through which malnutrition is created and/or prevented. This paper investigates a woman's social power, one such mechanism that may mediate the impact of poverty on childhood nutrition. This micro-level factor is examined using survey data on 402 children 5 years of age and younger and their 261 Fulbe mothers in rural Mali. A conceptual model of social power is developed and used to test the hypothesis that a mother's social power can predict her child's nutritional status.

Adolescent↗

Class mortality differentials, income distribution and trends in poverty 1921-1981.

The official figures which appear to show a widening of class differences in health in England and Wales during the post-war period have been controversial partly because they do not fit with common perceptions of what has happened to differences in the standard of living. As a result, a great deal of effort has gone into investigating suggested weaknesses in the decennial social class mortality data. Though initially plausible, the artifactual and selective explanations of the widening mortality differences which were put forward have not usually been borne out by closer investigations. The only fault in the broad picture presented by the official data which we do perhaps need to bear in mind is the tendency for a narrowing of mortality differentials among younger women to be masked by the widening among older women. This paper is an attempt to look at the other side of the coin--namely, to investigate trends in differences in the standard of living in relation to mortality differentials. It concludes that trends in mortality differences have not been related to trends in class differences in average earnings, but have been fairly clearly related to trends in relative poverty. Relative poverty and class differences in mortality declined before the war but have both increased, decade by decade, since the war. Younger women have perhaps been protected from the increase in relative poverty during much of the post-war period by their increased economic activity rates and the relative improvement in earnings of women in poorly paid manual occupations.

Adult↗

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

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

Aged↗

Attacking poverty and improving health: a report on the WHO/State of Maryland International Health Congress, Baltimore, September 1997.

An international meeting, 'Investment Strategies for Healthy Urban Communities', in Baltimore in September 1997 called on the the business community, city authorities and the health professions to reduce poverty and its adverse health consequences, especially in urban areas, in both the industrialized and developing world. In addition to issuing the Baltimore Charter on partnership for a healthy urban future, the meeting had two main outcomes: the innovative concept of Business for Health, championed by progressive business leaders from Australia, Europe and the United States, to promote business principles to reduce poverty, create enterprises and improve people's health, especially in developing countries; and the establishment by health professionals of an information network between cities and countries on poverty and ill-health. Two follow-up meetings in London in December 1997 resulted in an action plan to create networks of health professional groups and representatives of the business community.

Baltimore↗

Poverty, underdevelopment and infant mental health.

Very great advances have occurred in disciplinary and professional knowledge of infant development and its influence on subsequent development. This expertise includes the ways in which early experiences affect the capacity of mature individuals for social adjustment and productive competence, and promising methods of intervention to promote infant mental health and prevent adverse sequelae of risk conditions. However, very little of this knowledge has been applied in work among infants and children living in conditions of poverty and underdevelopment. This lack of application continues despite the enormous threats to the well-being of infants and young children brought about by the combined effects of poverty and the AIDS pandemic, especially in southern Africa. Protein-energy malnutrition, maternal depression, and institutional care of infants and small children are cited as illustrative of areas in which interventions, and their evaluation, are desperately needed in resource-poor countries. An argument is made for the critical importance of considering and addressing psychological factors in care givers and children in conditions of extreme material need. An example is provided of a simple intervention model based on sound developmental principles that can be implemented by trained non-professionals in conditions of poverty and underdevelopment.

Adult↗

[Poverty and deficits in basis social supplies among inpatient psychiatric patients].

OBJECTIVE: People with psychiatric diseases are often afflicted by processes of social disintegration and social problems are of great importance for the treatment of the mentally ill. METHODS: Two departments of psychiatry and psychotherapy with obligatory service for their area - one in an inner city area of a large town with disadvantageous social structure, one in a small town with more favourable economic data - collected data during a two-months-period in 1998 according to the social situation of their patients. RESULTS: 38,0 % resp. 31,9 % of the patients were living under conditions of poverty; 12,2 % resp. 11,5 % had acute housing problems, only 17,3 % resp. 31,7 % had some kind of payed occupation. Poverty was defined either as being dependent on public assistance or having an income below 50 % of the average. Patients with schizophrenic psychosis and patients with substance abuse related disorders formed in both departments the main groups and were at the same time those with the lowest income. Patients with substance abuse, mainly alcoholics, were more afflicted by social disintegration in the inner city area than in the small town sample. Concerning schizophrenic disorders, regional differences were not as prominent. CONCLUSIONS: The high risk of poverty among the mentally ill has to be taken in account in the development of community services, hospital staff and social legislation.

Adult↗

Intraregional income distribution and poverty: some investigations for the Netherlands, 1960-81.

"This paper is addressed to intraregional income inequalities in the Netherlands. Various concepts are used to measure the degree of regional poverty. In addition, dissimilarity between intraregional income distributions is studied. At the provincial level, relatively small and decreasing dissimilarities are observed. However, at lower spatial levels (especially within metropolitan areas) much larger dissimilarities in mean income and income distribution occur. In the Netherlands, urban poverty has become a more intense and widespread phenomenon than rural poverty."

Demography↗

Religious affiliation and social commitment as determinants of moral attitudes in the prevention of AIDS or the fight against poverty.

The present study is an analysis of the effect of religious affiliation and social commitment on moral attitudes in the fight against acquired immunodeficiency syndrome (AIDS) or the fight against poverty. French citizens (N = 284) who either belonged to the Roman Catholic church or were without religious affiliation, who were committed to the prevention of AIDS or to the fight against poverty, completed a 9-item scale drawn from R. C. Katz, J. Santman, and P. Lonero's (1994) Morally Debatable Behaviors Scale-Revised. Results indicated that the responses were significantly affected by the religious affiliation and beliefs of respondents: Roman Catholics expressed less moral tolerance than nonreligious respondents. An interaction between commitment and religious belief showed that Roman Catholics committed to the fight against AIDS were less tolerant of illegal conduct than those committed to the fight against poverty, whereas no difference appeared between nonreligious respondents. No gender effect appeared.

Acquired Immunodeficiency Syndrome↗

Poverty, disease progression and employment among people living with HIV/AIDS in Australia.

A national survey of 925 people living with HIV/AIDS (PLWHA) in Australia is used to examine the relationship between disease progression, employment status, poverty and economic hardship. While disease progression has some impact on economic hardship, employment status is found to be the strongest determinant of both poverty and economic hardship. The most commonly cited reasons for leaving work were psychosocial (71%), with declining health cited by half of respondents. It is therefore argued that psychosocial issues are at least as important as changes in health in causing unemployment and therefore poverty and economic hardship among PLWHA in Australia.

Acquired Immunodeficiency Syndrome↗