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"Culture" and the intergenerational transmission of poverty: the prevention paradox.

Many U.S. policymakers support changing the "culture" of poor parents to encourage marriage, work, and religion as a means to end the intergenerational transmission of poverty. In this article Jens Ludwig and Susan Mayer review and evaluate research on how parental work, marriage, and religion affect children's socioeconomic status as adults, as well as on the likelihood that changing these indicators of parental behavior will reduce poverty in the next generation. They conclude that even if policymakers were able to ensure that all children had married, working, and religious parents, the result would be a far smaller reduction in poverty among the children's generation than many people believe. The explanation for this "poverty-prevention paradox," say Ludwig and Mayer, is that the poverty rate in the children's generation depends not only on how many poor children grow up to be poor adults, but also on how many nonpoor children grow up to be poor adults. Reducing the chances that poor children become poor adults will dramatically lower future poverty rates only if most poor adults begin life as poor children. But most poor adults grow up as nonpoor children in the type of "pro-social" households that policymakers are pushing to attain. Moreover, little good evidence supports the idea that such parental behaviors as marriage, work, and religious adherence have strong causal effects on children's long-term economic success. The authors argue that encouraging positive social behaviors in the parents of poor children is a worthwhile goal in its own right. But they stress that policymakers should recognize the limits of this strategy for reducing poverty among future generations. There may be no substitute for a system of social insurance and income transfers for those children who do wind up poor as adults.

Achievement↗

Neighborhood poverty, mortality rates, and excess deaths among African Americans: Philadelphia 1999-2001.

We used vital statistics and census data to determine whether mortality rates in Philadelphia were associated with neighborhood poverty, and to what extent excess mortality among African Americans was associated with neighborhood poverty. Gender-specific, age-adjusted mortality rates for 1999-2001 were strongly associated with neighborhood poverty among both women and men overall, and among both African Americans and non-Hispanic whites. The actual number of deaths among African Americans was 5,305 higher than it would have been if African Americans had had the same gender- and age-specific mortality rates as the average for non-Hispanic whites in Philadelphia, and 1,944 higher than if African Americans had had the same gender- and age-specific rates as non-Hispanic whites in the same neighborhood poverty categories. The excess mortality associated with neighborhood poverty and the socioeconomic factors that force large numbers of African Americans into poverty and high-poverty neighborhoods appear to be major factors in excess mortality among African Americans.

Black or African American↗

Poverty and death in the United States.

The authors conducted a survival analysis to determine the effect of poverty on mortality in a national sample of blacks and whites, 25 to 74 years of age (the first National Health and Nutrition Examination Survey (NHANES-1) and NHANES-1 Epidemiologic Follow up Study). They estimated the proportion of mortality associated with poverty during 1971-1984 and in 1991 by calculating population attributable risk and assessed confounding by major known risk factors (e.g., smoking, cholesterol levels, and physical inactivity). In 1973, 6.0 percent of U.S. mortality among black and white persons 25 to 74 years of age was attributable to poverty; in 1991, the proportion was 5.9 percent. In 1991, rates of mortality attributable to poverty were lowest for white women, 2.2 times as high for white men, 8.6 times as high for black men, and 3.6 times as high for black women. Adjustment for all these potential confounders combined had little effect on the hazard ratio among men, but reduced the effect of poverty on mortality among women by 42 percent. The proportion of mortality attributable to poverty among U.S. black and white adults has changed only minimally in recent decades. The effect of poverty on mortality must be largely explained by conditions other than commonly recognized risk factors.

Adult↗

Poverty rates in Venezuela: getting the numbers right.

This article looks at household and individual poverty rates in Venezuela over the past seven years. For more than a year, the statement that poverty in Venezuela has increased under the government of President Hugo Chávez has appeared in scores of major newspapers, on major television and radio programs, and even in publications devoted to foreign policy. There are no data to support such statements, and in fact the available data show a decline in poverty for both individuals and households over the seven-year period: the percentage of people in poverty declined from 50 percent in the first quarter of 1999 to 43.7 percent in 2005. Further, there is no evidence to suggest any change in the methodology for measuring poverty during this period, as has been alleged in a number of reports. The article also examines briefly the impact of significant changes in non-cash benefits such as free health care, which are not taken into account in the measured poverty rate, on poor people in Venezuela. Finally, the authors look at how the mistakes in reporting on Venezuela's poverty rate were made; an appendix gives examples of mistakes in major media and foreign policy publications.

Data Collection↗

Manifestations of poverty and birthrates among young teenagers in California zip code areas.

CONTEXT: Given that many communities are implementing community-wide initiatives to reduce teenage pregnancy or childbearing, it is important to understand the effects of a community's characteristics on adolescent birthrates. METHODOLOGY: Data from the 1990 census and from California birth certificates were obtained for zip codes in California. Regression analyses were conducted on data from zip code areas with at least 200 females aged 15-17 between 1991 and 1996, to predict the effects of race and ethnicity marital status, education, employment, income and poverty, and housing on birthrates among young teenagers. RESULTS: In bivariate analyses, the proportion of families living below poverty level within a zip code was highly related to the birthrate among young teenagers in that zip code (r=.80, p<.001). In multivariate analyses, which controlled for some of the correlates of family poverty level, the proportion of families living below poverty level remained by far the most important predictor of the birthrate among young teenagers (b=1.54), followed by the proportion of adults aged 25 or older who have a college education (b=-0.80). Race and ethnicity were only weakly related to birthrate. In all three racial and ethnic groups, poverty and education were significantly related to birthrate, but the effect of college education was greater among Hispanics (b=-2.98) than among either non-Hispanic whites (b=-0.53) or blacks (b=-1.12). Male employment and unemployment and female unemployment were highly related to the birthrate among young teenagers in some racial or ethnic groups, but not in others. CONCLUSIONS: Multiple manifestations of poverty, including poverty itself, low levels of education and employment, and high levels of unemployment, may have a large impact upon birthrates among young teenagers. Addressing some of these issues could substantially reduce childbearing among young adolescents.

Adolescent↗

An integration programme of poverty alleviation and development with family planning.

The State Council (the central government) recently issued a Circular for Speeding Up the Integration of Poverty Alleviation and Development with the Family Planning Programme during the Ninth Five-year Plan (1996-2000). The Circular was jointly submitted by the State Family Planning Commission and the Leading Group for Poverty Alleviation and Development. The document sets the two major tasks as solving the basic needs for food and clothing of the rural destitute and the control of over-rapid growth of China's population. Practice indicates that a close Integration Programme is the best way for impoverished farmers to alleviate poverty and become better-off. Overpopulation and low educational attainments and poor health quality of population in backward areas are the major factors retarding socioeconomic development. Therefore, it is inevitable to integrate poverty alleviation with family planning. It is a path with Chinese characteristics for a balanced population and sustainable socioeconomic development. The targets of the Integration Programme are as follows: The first is that preferential policies should be worked out to guarantee family planning acceptors, especially households with an only daughter or two daughters, are the first to be helped to eradicate poverty and become well-off. They should become good examples for other rural poor in practicing fewer but healthier births, and generating family income. The second target is that the population plans for the poor counties identified by the central government and provincial governments must be fulfilled. This should contribute to breaking the vicious circle of poverty leading to more children, in turn generating more poverty. The circular demands that more efforts should focus on the training of cadres for the Integrated Programme and on services for poor family planning acceptors.

Asia↗

Effect of child and family poverty on child health in the United States.

Poverty has been described as an economic state that does not allow for the provision of basic family and child needs, such as adequate food, clothing, and housing. However, the debate about the effects of poverty on the growth, development, and health of children is as much involved with the culture or general context of poverty as it is with the economics of poverty. This culture of poverty is in part mediated through environmental deprivations, such as failing schools, gangs, drugs, violence, and struggling families. Heclo(1) described this sociocultural and environmental dimension of poverty as "a condition of misery, hopelessness, and dependency." The subject of this article is to review the literature on the effects of poverty on US children as mediated through economic, ecologic, and family influences.

Adolescent↗

Short, thin, or obese? Comparing growth indexes of children from high- and low-poverty areas.

This study compared the growth indexes of first-grade, white children living in geographic areas of high poverty (n = 281) and low poverty (n = 442) in the state of Washington. Obesity was the most common growth deviance observed in these children. In the low-poverty area, 18% of children had a weight for height greater than the 90th percentile on the National Center for Health Statistics (NCHS) growth standards, whereas only 12% of children from the high-poverty area were in this category. Neither area had high numbers of children with reduced weight for height (less than the 10th percentile on the NCHS growth standards), but children from the high-poverty area were almost twice as likely to be short for their age; 9% of children from the high-poverty area and 5% of children from the low-poverty area had height-for-age values less than the 10th percentile on the NCHS growth standards. Criteria used to determine students' eligibility for financial support for school lunch did not accurately identify children who were thin or short. The prevalence of obesity in these first-grade children suggests that school-based growth screening as well as weight management and physical fitness programs are needed to identify and avert childhood obesity.

Anthropometry↗

Chronic poverty and childhood asthma in the Maritimes versus the rest of Canada.

OBJECTIVE: To examine the role of higher long-term poverty rates in the Maritimes as an explanation for higher rates of asthma among children 2-7 years of age. METHODS: Using longitudinal data from the National Longitudinal Survey of Children and Youth (NLSCY), logistic regressions examine associations between poverty duration and the probability of a child having been diagnosed with asthma, having a current asthma attack or experiencing wheezing in the past 12 months, controlling for other known determinants. RESULTS: NLSCY data indicate that 15.9% of Maritime children have been diagnosed with asthma, 8.7% have recently had an attack and 24.1% experienced wheezing, statistically higher levels than in the rest of Canada. Children in chronic poverty show rates that are over 30% higher than the Canadian averages. Although 19.9% of Maritime children have been chronically poor compared to 11.7% elsewhere, and although poverty is associated with a higher probability of asthma/wheezing, controlling for poverty status does not eliminate the regional difference in asthma rates. Including other controls with poverty status again does not fully explain the difference. CONCLUSION: While these findings do not completely explain why asthma prevalence rates are higher for Maritime children, they do indicate important pathways from poverty to childhood asthma. For example, chronically poor children are more likely to have had low birthweights and are less likely to have been breastfed, both of which are correlates of asthma. Such information can be useful for policy-makers. Pollutants and other environmental factors associated with asthma not included in the study may help further explain regional differences.

Adult↗

The role of Hispanic race/ethnicity and poverty in breast cancer survival.

The association of Hispanic race/ethnicity and poverty with general survival time and breast cancer survival time was examined for a total of 14,896 breast cancer patients (14,035 White and 861 Hispanic) included in the National Cancer Institute Surveillance Epidemiology and End Results (NCI SEER) program in New Mexico and San Francisco between 1975 and 1984. Variables examined included: age, marital status, stage at diagnosis, tumor histology, delay, treatment, period of diagnosis (1975-79 vs. 1980-84), and poverty. Univariate analysis of 14,896 patients indicated that a greater proportion of Hispanics (vs. Whites) with breast cancer were: younger than age 50, married, diagnosed at a later stage, diagnosed in New Mexico, lived in greater poverty, were diagnosed between 1980-84, and died from breast cancer. Univariate Cox Proportion Hazards analysis indicated that poverty was a significant predictor for reduced general survival time. Being diagnosed in the 1980-84 period was a predictor for improved general survival time. Poverty and Hispanic race/ethnicity were significant predictors of reduced breast cancer survival time. Multivariate Cox Proportional Hazards models indicated that Hispanic race/ethnicity was a significant risk factor for breast cancer survival time for women aged 50 and older. For White women: state, marital status, poverty, surgery, radiation/hormonal treatments, and histology were significant risk factors for breast cancer survival time. For Hispanic women: stage, surgery, hormonal treatment and period of diagnosis were significant risk factors for breast cancer survival time. For White breast cancer patients, period of diagnosis was not a significant risk factor for reduced breast cancer survival time; but for Hispanics, it was a significant risk factor. In the age and race/ethnicity-stratified models of breast cancer survival time, similar risk factors emerged for both Whites and Hispanics. For both younger and older Hispanics, being diagnosed in the early 1980's (vs. the late 1970's) was associated with reduced breast cancer survival time--vs. Whites, who experienced no significant change in breast cancer survival time in the same time period. Poverty was not a predictor for Hispanic survival time in any of the models; however, it was a predictor for younger Whites for breast cancer survival time. These results fueled discussion in three areas targeting breast cancer in underserved women: the development of racial/ethnic-specific cancer control guidelines, the development of a breast cancer integrated delivery system, and population management.

Adult↗

Poverty and death in the United States--1973 and 1991.

We conducted a survival analysis to determine the effect of poverty on mortality in a national sample of blacks and whites 25-74 years of age (in the First National Health and Nutrition Examination Survey and National Health Examination Follow-up Survey). We estimated the proportion of mortality associated with poverty from 1973 through 1984 and in 1991 by calculating the population attributable risk. We assessed confounding by major known risk factors, such as smoking, serum total cholesterol, and inactivity. In 1973, 16.1% of U.S. mortality among black and white persons 25-74 years of age was attributable to poverty; in 1991, the proportion increased to 17.7%. In 1991, the population attributable risk of poverty on mortality was lowest for white women, 1.7 times higher for white men, 2.6 times higher for black women, and 3.6 times higher for black men. Potential confounders explained 40% of the effect of poverty on mortality among women. The proportion of mortality attributable to poverty among U.S. black and white adults has increased in recent decades and is comparable to that attributable to cigarette smoking. The effect of poverty on mortality must be explained by conditions other than commonly recognized risk factors.

Adult↗

Child poverty can be reduced.

Child poverty can be reduced by policies that help families earn more and supplement earned income with other sources of cash. A comprehensive antipoverty strategy could use a combination of these approaches. This article reviews recent U.S. experience with these broad approaches to reducing child poverty and discusses lessons from abroad for U.S. policymakers. The evidence reviewed suggests that, although policies to increase earned incomes among low-wage workers can help, these earnings gains will not be sufficient to reduce child poverty substantially. Government income support programs, tax policy, and child support payments from absent parents can be used to supplement earned incomes of poor families with children. Until recently, Aid to Families with Dependent Children (AFDC) was the main government assistance program for low-income families with children. Temporary Assistance for Needy Families (TANF) has recently replaced AFDC. This article explains why TANF benefits are likely to be less than AFDC benefits. The article also examines the effects of Social Security and Supplemental Security Income on child poverty. The most encouraging recent development in antipoverty policy has been the decline in the federal tax burden on poor families, primarily as a result of the expansion of the Earned Income Tax Credit (EITC), now the largest cash assistance program for families with children. In 1995, government transfer programs (including the value of cash, food, housing, medical care, and taxes) decreased child poverty by 38% (from 24.2% to 14.2% of children under 18). Child poverty may also be reduced by policies that increase contributions from absent single parents to support their children. Overall, evidence from the United States and other developed countries suggests that a variety of approaches to reducing child poverty are feasible. Implementation of effective programs will depend, however, on the nation's political willingness to devote more resources to this end.

Child↗

Institutionalism and schizophrenia 30 years on. Clinical poverty and the social environment in three British mental hospitals in 1960 compared with a fourth in 1990.

In their comparison of chronic schizophrenic patients in three British mental hospitals in 1960, Wing and Brown found a strong association between the poverty of the social environment and the severity of 'clinical poverty' (blunted affect, poverty of speech, and social withdrawal). Between 1960 and 1968 the social environments of all three hospitals improved and a weak causal relationship between social poverty and clinical poverty was reported in a proportion of patients. Using the same assessment instruments as Wing and Brown, the present study re-examined the relationship between social and clinical poverty in the long-stay schizophrenic population of a fourth British mental hospital in 1990. The association found between social and clinical poverty was much weaker than in 1960. Reluctance on the part of patients to be discharged from the institution was unrelated to length of stay. There was no significant difference in severity of illness between the patients in the present study and those in the earlier study. However, patients in the former group spent more time doing nothing than those in the hospital with the most understimulating environment three decades before, with four-fifths doing nothing for over five hours a day, despite a greatly increased ratio of nurses to patients.

Attitude to Health↗

Human resources development and poverty alleviation: a study of 23 poor counties in China.

"In recent years, poverty has become a serious issue in the socioeconomic development of China. One of the most important features of poverty is 'poor population quality', a factor that also causes poverty. Human resources development (HRD) strategies have been used as a weapon against poverty in many developing countries; some have proven to be quite effective. This article, which researches the relationship between HRD indicators and poverty status, finds that enhancement of education levels, improvement of health status, the gaining of skills and experience, increasing time away from home and choosing suitable occupations, all can contribute greatly to the reduction and alleviation of poverty."

Asia↗

Trends in the association of poverty with overweight among US adolescents, 1971-2004.

CONTEXT: Prevalence of adolescent overweight in the United States has increased substantially during the past 3 decades. Whether socioeconomic disparities in adolescent overweight increased, decreased, or remained constant during this period is not known. OBJECTIVE: To examine trends in adolescent overweight from 1971 to 2004 by family poverty status, as well as trends in potentially relevant eating and physical activity behaviors. DESIGN, SETTING, AND PARTICIPANTS: Four cross-sectional, nationally representative surveys (US National Health and Nutrition Examination Surveys [NHANES] of 1971-1974, 1976-1980, 1988-1994, and 1999-2004) were examined for trends in the prevalence of overweight among adolescents aged 12 to 17 years by family poverty status. MAIN OUTCOME MEASURES: Prevalence of adolescent overweight, defined as body mass index at or above the 95th percentile for age and sex in the 2000 Centers for Disease Control and Prevention growth charts. Intermediate outcomes were physical inactivity in the past 30 days, proportion of caloric intake from sweetened beverages (24-hour recall), and whether respondent skipped breakfast (24-hour recall). RESULTS: Trends in the association of adolescent overweight with family poverty differed by age stratum (P = .01). In 12- to 14-year-old adolescents, prevalence did not significantly differ by family poverty status in any of the surveys; however, among non-Hispanic black adolescents, overweight prevalence increased faster in nonpoor vs poor families. In contrast, a widening disparity that disfavored adolescents from poor families was present in the 15- to 17-year-old adolescents. This trend was similar among male, female, non-Hispanic white, and non-Hispanic black adolescents, resulting in an overall prevalence of overweight in 1999-2004 more than 50% higher among adolescents in poor vs nonpoor families (23.3% vs 14.4%, respectively; P<.001). Additional analyses suggest that physical inactivity, sweetened beverage consumption, and skipping breakfast may contribute to these disparities. CONCLUSIONS: Trends of increasing overweight showed a greater impact in families living below the poverty line vs not living below the poverty line among older (15-17 years) but not younger (12-14 years) adolescents. Furthermore, physical inactivity, high consumption of sweetened beverages, and breakfast skipping may be candidate targets for prevention programs aimed at reducing this recently emerged disparity.

Adolescent↗

Poverty, social exclusion and health in Portugal.

People in Portugal have never been so healthy. Nevertheless, there are great differences in health status between social groups and regions. In 1994, Portugal was the country with the second worst level of inequality in terms of income distribution and with the highest level of poverty in the European Union (EU). Poverty in Portugal affects mainly the elderly and women (especially in single parent families). Beyond these groups, there are the children, the ethnic minorities and the homeless. Substance abusers, the unemployed, and ex-prisoners are also strongly affected by situations of social exclusion and poverty. Although poverty has been an important issue on the political agenda in Portugal, it shows a worrying tendency to resist traditional Social Security interventions. In the late 1990s, however, welfare coverage rates appear to have risen. To what extent can poverty cause a worsening of health status? Is there any sustainable positive association between welfare and improved health status? How, to whom and when should actions to improve the health status of the disadvantaged be addressed, without subverting the health status of the rest of the population. It is also necessary to reveal the consequences of poor health to individuals, families and communities in terms of income, social empowerment and the ability to fulfil other needs. Finally, reflection on the role and effectiveness of traditional social security models is necessary, in order to improve the impact and adequacy of its interventions. The goal of this paper is to contribute to the knowledge about disadvantage, the current health situation of the most vulnerable groups in Portuguese society-those affected by poverty, deprivation and social exclusion-and to detect the constraints on access to health and health care.

Adolescent↗

Exploring the relationships between multicultural training, racial attitudes, and attributions of poverty among graduate counseling trainees.

Increased attention to multiculturalism and social justice in psychology has been accompanied by assertions that there is a need for more acknowledgment of system-level oppression. Multicultural training (MCT) may help increase counselors' awareness of structural forces in the lives of clients facing poverty by examining structural influences in racial discrimination. This study examined the relationship between multicultural counseling training, attitudes about race, and attributions of poverty. Data from 158 African American and White American graduate counseling students were examined to determine the extent to which MCT and cognitive and affective racial attitudes predicted tendencies to attribute poverty to structural barriers or to individuals facing poverty. Regression analyses indicated that more MCT and more sensitive cognitive racial attitudes predicted a greater tendency to endorse structural explanations of poverty. Fewer multicultural workshops and less sensitive cognitive racial attitudes predicted a greater tendency to endorse individual explanations of poverty. Implications for training, practice, and research are discussed. ((c) 2005 APA, all rights reserved).

Adult↗

Global notes: counting the world's poor--how do we define poverty?

Health professionals are in constant interaction with parents and infants who are victims of poverty and poor socioeconomic status. But an important question remains: do we know how to define poverty? Defining poverty accurately is important as the definition is the basis of policy development. The definition of poverty has changed during the last quarter century. In addition to economic considerations, it is broadened to include other dimensions of life such as literacy, health and longevity. This article attempts to provide national and international definitions of poverty, the magnitude and effects of poverty.

Food↗