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PubMed2003

Depression and poverty among African American women at risk for type 2 diabetes.

Poverty is associated with negative health outcomes, including depression. Little is known about the specific elements of poverty that contribute to depression, particularly among African American women at risk for type 2 diabetes. This study examined the relationships of economic and social resources to depression among African American women at high risk for the development of type 2 diabetes (N = 181) using the Conservation of Resources theory as a conceptual framework. Women were assessed at 3 time points in conjunction with a dietary change intervention. At baseline, 40% of women reported clinically significant depression, and 43.3% were below the poverty line. Depressed women reported fewer economic assets and greater economic distress than nondepressed peers. Multivariate logistic regression analyses indicated that nonwork status, lack of home ownership, low appraisal of one's economic situation, low self-esteem, and increased life events were significantly associated with depression at baseline. Longitudinal multivariate logistic regression models indicated that income, home ownership, future economic appraisal, life events, and self-esteem predicted depression trajectories at Time 3. These results speak to the multifaceted sources of stress in the lives of poor African American women. Interventions that address the economic and social factors associated with depression are needed.

Adult↗

PubMed1987

Illness-engendered poverty among the elderly.

This paper presents an overview of the economic situation of elderly women in the United States. Its focus is on "illness-engendered poverty," a type of poverty that results from the inadequacies of Medicare coverage of long-term care and the subsequent need of many elderly to "spend down" into poverty in order to qualify for means-tested, publicly financed health and social programs. The consequences of Medicaid eligibility requirements and system incentives on the economic and social well-being of older women and their families are discussed.

Aged↗

PubMed2004

The potential of the SSI program to reduce poverty among the elderly.

Is it more effective to reduce poverty among the elderly by increasing the benefits paid by the Supplemental Security Income (SSI) program or by increasing eligibility for the program? This paper answers that question from a policymaker's perspective. At given program cost levels, we compare the potential reduction in poverty from increasing benefit levels to the potential reduction associated with a variety of policy proposals that would increase eligibility for the program. This paper employs a microsimulation model containing an eligibility and benefits calculator, a participation model, and an optimization algorithm. The data are from the Survey of Income and Program Participation supplemented by the administrative records of the SSI program. The results show that increasing eligibility by relaxing the restrictions of the means tests can be more effective in reducing poverty than raising benefit levels.

Actuarial Analysis↗

PubMed2005

Promising practices for meeting the multiple needs of low-income families in poverty neighborhoods.

This review of promising practices for meeting the multiple needs of low-income families in poverty neighborhoods reveals four main themes: (1) The challenges facing low-income families living in poverty neighborhoods are not discrete-but are multidimensional; (2) Integrated family and neighborhood strengthening practices, such as the Making Connections (MC) Initiative (funded by the Annie E. Casey Foundation), and the Harlem Children's Zone (HCZ), represent innovative strategies to address the multifaceted issues facing low-income families living in poverty neighborhoods; (3) The organizational structure, challenges and successes of the MC and HCZ provide insight into the nature of integrated family and neighborhood approaches; (4) A framework for the design of an integrated family and neighborhood program includes a focus on internal organizational processes, neighborhood processes, and external processes. This framework can assist social service agencies in moving their services toward a more integrated family and neighborhood approach.

Family↗

PubMed2005

Living in poverty in America today.

No statistician, social scientist or tarot card reader is needed to attest that the gap between the rich and poor in America is increasing. Further, most Americans don't care that much about it. There are also more rich people today living in the U.S. and there are more people living in poverty. Between 2000 and 2002, the number of Americans living in poverty increased by nearly 3 million to 34.6 million. Of these, 12% (or about one half a million persons) are living extreme poverty and many are children, with 16.7% likely to be poor (National Association of Social Workers, 2003).

Humans↗

PubMed2000

The influences of race, ethnicity, and poverty on the mental health of children.

Sufficient evidence demonstrates that poverty has a negative effect on the psychological well-being of children, but most research has focused only on white populations. The purpose of this literature review is to gain a better understanding of the positive and negative influences of socioeconomic factors, cultural/ethnic characteristics, and racial differences on the mental health of children. A review of the literature on the influence of race, ethnicity, and poverty on the mental health of children found that (1) children whose parents are in poverty or who have experienced severe economic losses are more likely to report or be reported to have higher rates of depression, anxiety, and antisocial behaviors; and (2) after controlling for socioeconomic status, African Americans, Native Americans, and Hispanics are less likely to report or be reported to have such mental health problems. A theoretical construct for this protective effect is related to cultural factors, such as perceived social support, deep religiosity/spirituality, extended families, and maternal coping strategies as buffers against psychological distress.

Adolescent↗

PubMedDate not supplied

Access to care, unmet health needs, and poverty status among children with and without chronic conditions.

OBJECTIVES: To compare insurance coverage, access to care, and unmet health needs of children with and without chronic conditions in a national probability sample of the US population and to examine the role of poverty status in any demonstrated differences between the 2 groups. DESIGN: We analyzed parent-report data on children 0-17 years old from the 1994 National Health Interview Survey Disability Supplement (NHIS-D) and from the health insurance and access to care files of the 1994 Family Resources Supplement to the NHIS. In the NHIS-D, 4452 (14.8%) of the 30032 children were identified as having a chronic condition by a noncategorical method. We compared insurance coverage, access to care, and unmet needs of children with and without conditions overall and also compared them within 3 different income levels relative to the national poverty index: 1) below, 2) within 100%-200%, and 3) >200% above poverty level. RESULTS: In bivariate analyses, children with chronic conditions were more likely to be covered by some type of health insurance (odds ratio [OR], 1.3) and to have a usual provider both for medical ("sick") care (OR, 1.4) and for routine or preventive care (OR, 1.4). They also were more likely to have the same provider for medical care and routine or preventive care (OR, 1.2) and to have seen their health care provider in the last year (OR, 1.8) than children without chronic conditions (all P <.0001). Nonetheless, children with chronic conditions were twice as likely to have had at least 1 unmet need from a list of 4 services that included dental care, prescription medications, eyeglasses, and mental health services (OR, 2.0). They also were more likely to have more than 1 unmet need from the list (OR, 3.1), to have been unable to get needed medical care (OR, 3.1), and to have delayed obtaining medical care because of worry about its cost (OR, 1.8). Children with chronic conditions were at greater risk for unmet needs than were children without conditions across all income levels. The magnitude of the disparity between the groups increased with family income level. Differences persisted even after controlling for sociodemographic variables and insurance status. CONCLUSION: Despite higher levels of insurance coverage and greater access to regular providers of medical and routine care compared with healthy peers, children with chronic conditions are reported by their parents to be less likely than other children to receive the full range of needed health services. The magnitudes of the differences are small, yet the pattern of disadvantage in meeting health care needs among children with conditions compared with healthy peers is consistent across many different variables and it exists across income levels.

Child↗

PubMed1997

Alcohol-related problems among black, Hispanic and white men: the contribution of neighborhood poverty.

OBJECTIVE: We examined the cross-sectional relationships between race/ethnicity, neighborhood poverty and alcohol-related problems among black, Hispanic and white male drinkers. Test hypotheses were that black and Hispanic men living in more impoverished neighborhoods would report increased numbers of alcohol-related problems than comparable white men. METHOD: Study hypotheses were tested in a sample of 744 black, Hispanic and white men participating in the 1992 National Alcohol Follow-up Survey. Study hypotheses were analyzed using generalized linear model regression analysis. RESULTS: Neighborhood poverty had a greater effect on alcohol-related problems in black than in white men, partially supporting our hypothesis. Black men living in more impoverished neighborhoods reported greater numbers of alcohol-related problems than comparable white men; there were no race differences among more affluent men. Neighborhood poverty had little effect on alcohol-related problems in Hispanic men. CONCLUSIONS: Findings suggest that, giving unfavorable economic conditions, black men will report greater numbers of alcohol-related problems than comparable white men.

Adult↗

PubMed1996

Poverty levels and children's health status: study of risk factors in an urban population of low socioeconomic level.

To test the hypothesis that the low socioeconomic population living in shanty towns in Porto Alegre presents different levels of poverty which are reflected on its health status, a cross-sectional study was designed involving 477 families living in Vila Grande Cruzeiro, Porto Alegre, Brazil. The poverty level of the families was measured by using an instrument specifically designed for poor urban populations. Children from families living in extreme poverty (poorest quartile) were found to have higher infant mortality rate, lower birth weights, more hospitalizations, and higher malnutrition rates, in addition to belonging to more numerous families. Thus, the shanty town population of Porto Alegre is not homogeneous, and priority should be given to the more vulnerable subgroups.

Birth Weight↗

PubMed2005

"Without money you're nothing": poverty and health in Mexico from women's perspective.

The objective of this qualitative study was to get to know poor Mexican women's experience of poverty in relation to health care. Forty-nine interviews were carried out with poor adult women in Mexico (between 35 and 65 years old). Three central elements were detected in relation to the women's experience of poverty and health care: their socio-economic dependence on their family; the notion of social belonging in their experience with health care rights, reflected in the idea and acceptance that, due to their poverty, they can only be attended at philanthropic institutions; and the existence of survival mechanisms when facing an illness. In recovering the experience of poor women in relation to their health care, we identified that there is a clear idea that, if women had had economic resources, their health problem would have been solved differently. They are also convinced that, due to being poor, they have to content themselves with bad-quality medical care. This conformity finally makes them resign to the fact of either loosing a part of their own body, or even just waiting for death.

Adult↗

PubMed1988

Poverty, race, and hospitalization for childhood asthma.

This study uses Maryland hospital discharge data for the period 1979-82 to determine whether Black children are more likely to be hospitalized for asthma and whether this difference persists after adjustment for poverty. The average annual asthma discharge rate was 1.95/1000 children aged 1-19; 3.75/1000 for Black children, and 1.25/1000 for White. Medicaid-enrolled children of both races had increased discharge rates for asthma compared to those whose care was paid for by other sources: 5.68/1000 vs 2.99/1000 for Blacks, and 3.10/1000 vs 1.11/1000 for Whites. When ecologic analyses were performed, populations of Black and White children had nearly equal asthma discharge rates after adjustment for poverty. The statewide adjusted rate was 2.70/1000 (95% CL = 1.93, 3.78) for Black children and 2.10/1000 (1.66, 2.66) for White children. Among Maryland counties and health planning districts, variation in asthma discharge rates was not associated with the supply of hospital beds or the population to primary-care physician ratio. We conclude that Black children are at increased risk of hospitalization for asthma, but that some or all of this increase is related to poverty rather than to race.

Adolescent↗

PubMed1998

Poverty area residence and changes in physical activity level: evidence from the Alameda County Study.

OBJECTIVES: Evidence from the Alameda County Study indicated that residential area has an independent effect on mortality risk. The current research examined the effect of poverty area residence on change in physical activity (n = 1737). METHODS: Data were from a longitudinal population-based cohort. Multiple linear regression analyses were used. RESULTS: Age- and sex-adjusted change scores between 1965 and 1974 for physical activity were 0.67 units lower for people living in poverty areas (P = .0001). Independent of individual income, education, smoking status, body mass index, and alcohol consumption, poverty area residence remained associated with physical activity change. CONCLUSION: These results further support the hypothesis that place affects health behaviors.

Age Distribution↗

PubMed2000

The effect of poverty, social inequity, and maternal education on infant mortality in Nicaragua, 1988-1993.

OBJECTIVES: This study assessed the effect of poverty and social inequity on infant mortality risks in Nicaragua from 1988 to 1993 and the preventive role of maternal education. METHODS: A cohort analysis of infant survival, based on reproductive histories of a representative sample of 10,867 women aged 15 to 49 years in León, Nicaragua, was conducted. A total of 7073 infants were studied; 342 deaths occurred during 6394 infant-years of follow-up. Outcome measures were infant mortality rate (IMR) and relative mortality risks for different groups. RESULTS: IMR was 50 per 1000 live births. Poverty, expressed as unsatisfied basic needs (UBN) of the household, increased the risk of infant death (adjusted relative risk [RR] = 1.49; 95% confidence interval [CI] = 1.15, 1.92). Social inequity, expressed as the contrast between the household UBN and the predominant UBN of the neighborhood, further increased the risk (adjusted RR = 1.74; 95% CI = 1.12, 2.71). A protective effect of the mother's educational level was seen only in poor households. CONCLUSIONS: Apart from absolute level of poverty, social inequity may be an independent risk factor for infant mortality in a low-income country. In poor households, female education may contribute to preventing infant mortality.

Adolescent↗

PubMed2006

Child poverty in rich countries, 2005, Part II.

Protecting children from the sharpest edges of poverty during their years of growth and formation is both the mark of a civilized society and a means of addressing some of the evident problems that affect the quality of life in the economically developed nations. The proportion of children living in poverty has risen in a majority of the world's developed economies over the past decade. This report asks what is driving poverty rates upwards and why some OECD countries are doing a much better job than others in protecting children at risk.

Adolescent↗

PubMed2006

Child poverty in rich countries, 2005, part I.

Child↗

PubMed1991

Poverty crisis in the Third World: the contradictions of World Bank policy.

Politicians, the mainstream media, and orthodox social science have all been telling us of a final victory of capitalism over socialism, suggesting that capitalism is the only viable option for solving the world's problems. Yet, the global capitalist system is itself entering the third decade of a profound structural crisis, the costs of which have been borne largely by the exploited and oppressed peoples of the underdeveloped periphery. While the World Bank's latest World Development Report recognizes the current poverty crisis in the third world, its "two-part strategy" for alleviating poverty is based on an inadequate analysis of how peripheral capitalist development marginalizes the basic needs of the third world poor. Hence, the World Bank's assertion that free-market policies are consistent with effective antipoverty programs does not confront the class structures and global capitalist interests bound up with the reproduction of mass poverty in the third world. The World Bank's subordination of the basic needs of the poor to free-market adjustments and reforms in fact suggests that the real purpose of its "two-part strategy" is to ensure continued extraction of surplus from third world countries by maintaining the basic structure of imperialist underdevelopment.

Developing Countries↗

PubMedDate not supplied

Families who live in chronic poverty: meeting the challenge of family-centered services.

Family-centered occupational therapy services are based on a collaborative relationship that does not always come easily. Role performance in parenting a child with special needs and being a consumer of occupational therapy services can be partially understood in terms of environmental context. Although occupational therapists recognize the need to adjust services to the cultural and economic backgrounds of families, most of the available literature has examined the contribution of ethnic differences. A particular challenge for occupational therapists may be treating clients and their families who live in chronic poverty. This article examines chronic poverty as it shapes parenting the child with special needs and subsequently the caregiver's participation in occupational therapy services. A framework for understanding cultural differences is used to suggest contrasting value orientations between families who live with persistent poverty and occupational therapists. A family-centered approach challenges the professional to understand varied influences on caregiving. Suggestions are offered to enhance communication between therapists and caregivers.

Caregivers↗

PubMedDate not supplied

Examining external and internal poverty as antecedents of teen pregnancy.

OBJECTIVES: To identify antecedents of teen pregnancy. METHODS: Data from the National Education Longitudinal Study were analyzed. This data set allowed us to identify eighth-grade antecedents of teen pregnancy/childbearing. RESULTS: The variables that were found to be most predictive of later pregnancy were reflective of internal poverty (locus of control, subject's educational expectations, and confidence in graduating from high school) and external poverty (parents' highest education). CONCLUSIONS: Prevention programs must begin before the eighth grade, instill an internal locus of control, promote academic achievement by enriching children's perception of personal life options for which an education is needed, empower children and their familial models, and prevent internal poverty.

Adolescent↗