Povertys Influence on the Health of America

Povertys Influences on the Health of America

Carla Stephens
Glen Allen High School

Povertys Influences on the Health of America

Povertys Influence on the Health of America

For decades, poverty has had a direct impact on the health of poor Americans. There are
several factors that have contributed to this including: the war on poverty, lack of education
and income, lack of resources to aid citizens with mental health and toxic stress issues,
ramifications of reciprocal two-generation poor health habits, and insufficient legislation and
programs to help close the gap between those that have and those that have not.
How the War on Poverty had an Impact on Poor Health:
The federal government started to measure poverty in 1959. During the 1960s, President
Lyndon B. Johnson declared a national war on poverty. He stated that the purpose was to
mobilize the human and financial resources of the nation (The Economic Opportunity Act,
1964, p.x.). The Economic Opportunity Act of 1964 attempted to promote the well-being and
prosperity of individuals who were in unbearable situations. In addition, the law attempted to
create agencies that were dedicated to helping communities. However, eventually the funds that
were dedicated to the war on poverty went to the war in Vietnam and thus the poverty issue
continued to grow in Americaleaving a nation under-protected and abandoned to fend for
itself.
Today, the United States Department of Health and Human Services (HHS) sets the
poverty guidelines for the country. They base their findings on a multitude of criteria such as the
poverty thresholds that are established by the United States Census Bureau each year.
Specifically, those that live below the line are classified as impoverished while those above the
line are classified as middle-class, or upper-class Americans. Those that are above the line
typically do not qualify for certain government benefits such as Medicaid and food stamps.
Those below the line do; however, the amount distributed is oftentimes not enough which has a
direct bearing on food choices, ultimately leading to poor health.

Povertys Influence on the Health of America

How Low Income, Lack of Education, and Food Selection has an Impact on Poor Health
In 2013 in the United States alone45.3 million people were in poverty according to
the US Census Bureau. This number is steadily increasing and as a result more people are living
in despairing environments, which generally speaking, has a direct impact on their physical
health, mental health (behavioral and social), and life expectancy in comparison to households
who live in more affluent areas. Poverty often prevents adults from obtaining better jobs that
provide decent wages in order to obtain more robust healthcare plans, which in essence
correlates to the health of children. Michelle Obamas Lets Move Initiative focuses in on
childhood obesity, which is more prevalent in lower income families because they are not able to
choose healthier foods which would ultimately lead to better health (letsmove.org). In addition,
healthier foods are typically more expensive than non-healthy foods so lower income families
have a tendency to select food items that are less nutritious leading to their families being
overweight, which in turn, leads to other health-related issues. According to www.letsmove.gov,
nearly one in three children in America are overweight or obese.
On the flip side, impoverished children can also suffer from starvation and malnutrition.
These children, whose parents are not able to provide healthy food for their children can cause
their children potential long-term consequences (Child Development, 2015). In 2012 alone
there were 15.8 million children that lived in households that were food-insecure (Child
Development, 2015). Food insecurity exists whenever the availability of nutritionally adequate
and safe foods or the ability to acquire acceptable foods in socially acceptable ways is limited or
uncertain (National Research Council, 2006). Sadly enough, since these children experience
food insecurity; they may be at higher risk for behavioral issues and social difficulties (Child
Development, 2015).

Povertys Influence on the Health of America

In 2008 alone, about 1 in 5 children experienced the effects of poverty according to

Center on the Developing Child at Harvard University (2015). This finding is not only
troublesome but also surprising since children are typically not the breadwinners in their family.
That means that about 20% of all children live in a neighborhoods that do not provide affluent
schools, great opportunities for obtaining jobs, and efficient healthcare centers. So not only are
the parents losing out on receiving better services for themselves because they live in
undeveloped areas but also their children are being raised in a community that has unsanitary
conditions and limited access to services. This issue has been growing for decades, and the time
is now to help more people gain knowledge about how to overcome the barriers of living in an
impoverished areas.
Since lack of education about healthy living is more prevalent in impoverished areas,
health professionals can continuously teach at-risk populations about maintaining better care
for themselves. Those that are in poverty obtain ill-health status because they are being
influenced by the education of the impending environment (World Health Organization,
n.d.). In the same way, many researchers show individuals in impoverished environments are
more likely to have a handicap of poverty which can be passed down from generation to
generation (Issues & controversies, 2015). Psychologist Martin E.P. Seligman stated that prior
learning can result in a drastic change in behavior making it difficult to explain why
individuals may accept and remain passive in negative situations even if they are harmful
(Nolen, 2015). Thus, the issue of poor health in impoverished areas will continue to reciprocate
if we do not do something about it now.
How Toxic Stress and Mental Health has an Impact on Poor Health:

Povertys Influence on the Health of America

One effect of poverty is toxic stress which can be caused by poor health and unsuitable
living conditions. Toxic stress is a term used by psychologists and developmental
neurobiologists to describe the kinds of experiences, particularly in childhood that can affect
brain architecture and brain chemistry (Toxic Stress, 2015). Low-income, environments that
have high rates of crime, and places that have poor education can cause individuals high levels
of stress (Duncan, Magnuson, Boyce, & Shonkoff, 2015.). Toxic stress could influence brain
development, and comprise community growth because these types of environments
inadequately [stimulate] cognition (Evans, 2002). The Risk-Stress Model has been proposed
that suggests that poverty and achievement can be broken if in fact law makers attempt to
address the likelihood of poverty associated with physical or psychological risks, if they can
understand the effects of such risks, and if they can find better ways of reaching achievement
rates with the poor. Many sources have attempted to find ways of approving the toxic stress level
among children because adolescents are more likely to be influenced by poor health and are
more likely to have measurable changes in brain structure (Evans, Brooks, & Klebanov, 2002).

Another effect of poverty is mental illness. Undeveloped environments, especially cities,

are havens for not stimulating individual growth and cognitive development which can cause

Povertys Influence on the Health of America

people to have higher risks for mood disorders, anxiety disorders, and schizophrenia
(Anakwenze & Zuberi, 2013). In addition, exposure to these environments can cause
psychological distress, hypertension, and hearing impairment[s] (Anakwenze & Zuberi, 2013).
Oftentimes, city dwellers are impacted by poor health and mental illness the most because they
lack the infrastructure to provide protection and services which increases the risks for
depression, substance use, delinquency, violence, maltreatment, and posttraumatic stress
disorder (Black & Krishnakumar, 1998). In addition, cities can also fume economic disparities,
joblessness, underemployment, and developmental obstacles.
Specifically, children suffer the most from these unsuitable environments. In a study,
where parents were asked to rate their childs health status; as excellent or very good health
only 68.0% of children with household incomes below the Federal poverty level were
reported to be in excellent or very good health, compared to 79.1% of children with higher
household incomes (U.S. Department of Health and Human Services). That is why many
scholars suggest that that there is a bidirectional relationship between poverty and mental
health because each influences the other, and causes serious implications on the child
(Anakwenze &Zuberi 2013).
There are some critics that believe that even if parents try to discourage certain behaviors
or try to protect their children from certain environments; that may not be enough to overcome
certain conditions because it would hinder children from establishing independence and
autonomy in their community (Anakwenze & Zuberi, 2013). In American Psycologist, Black
suggests that children may [also] be influenced by systems that impact them indirectly, rather
than directly so basically regardless if the child is actually possessing a mental illnessthe
socioeconomic characteristics could also have severe impacts on their well-being.

Povertys Influence on the Health of America

One of the most common chronic or mental health problems that children undergo is
asthma or anxiety. There are about 9.0% of children that have asthma followed by learning
disabilities [at] 7.8% (U.S. Department of Health and Human Services). In addition, the
psychological distress caused by trauma and violence can also cause individuals to experience
PSTD (Anakwenze & Zuberi, 2013). However, children that have these disorders and serious
conditions should have preventative care visits annually in order to monitor a childs growth
and developmentand to discuss important issues regarding nutrition and prevention but that is
far from what is happening (U.S. Department of Health and Human Services). Instead,
children are living in these clearly unsustainable environments, obtaining diseases, and not being
provided necessary care to treat these treatments. How then are these children going to improve
their condition if they were never given the chance to because their current situation has had
impending effects on their well-being? The only answer is providing these children the
opportunity to receive these benefits by creating legislation that is solely focused on children that
have mental illnesses because of their poor health condition.
How Poverty has an Impact on Two-Generation Poor Health:
As briefly stated earlier, parents do not only impact their own lives, but also their
childrens. So if parents health is affected by environmental factors, low-income, and poor
educationoftentimes the growth of their children, and the interactions [within] their families
will also be influenced (Black & Krishnakumar, 1998). The ways that these problems can be
fixed is by teaching these parents the importance of health in their personal lives. Instead of
providing with just government aid such as food stampsgive the opportunity to purchase
healthier foods. One point that the government is lacking is understanding that new beginnings
with these parents start right now because if parents are taught earlier about the risks that are

Povertys Influence on the Health of America

specific to their environmentthey will be able to improve their opportunities for resilience
and learn how to succeed in an impending environment (Black & Krishnakumar, 1998).
However, a key aspect to these programs are insuring that they are built on collaboration, and
trust because people need to not only be informed, but also need to be supported within the
process.
In my interview with Sheryl Garland, Vice-President of Health and Innovation at Virginia
Commonwealth University, I asked her the following question to support the notion that twogenerational behavior has an impact on poor health and this is what she said:
CS: Oftentimes parents impact on their children is very significant as many children imitate their
parents behaviors, health habits, and value system. From prior research conducted within
my capstone, many sources state that there should be more government programs that
help children and their families improve their opportunities for resilience and learn how
to succeed in an impending environment (Black & Krishnakumar, 1998). Do you believe
that children should be the focal point of government aid and if so why?
SG: Providing assistance to children to ensure their success should be a priority for our government.
The success of our nations economy and culture are totally dependent upon the ability
of the next generation to thrive and contribute to the society. Children who are not
afforded every opportunity to succeed will grow up to be adults who cannot contribute,
resulting in some who will require government assistance. The government should focus
on providing a level playing field for all children will prove to be a worthwhile
investment for the future (personal communication, April 29, 2014).
How Health Programs and Legislation has an Impact on Solutions for Poor Health

Povertys Influence on the Health of America

There are many sources that suggest that in order for the poverty level to decline, it is
essential for policy makers to create programs and legislation that protect disadvantaged groups.
There are a range of programs that have been created that attempt to foster the growth of
individuals, families, and child development. However, many of these sources suggest that these
programs are not as effective as they were set out to become (Glied, & Oellerich, n.d.). Many
programs have financing issues, are very narrow-focused and do not promote well-being of
families and children, and many people are not knowledgeable about these resources (Black &
Krishnakumar, 1998). Thus, many people are not receiving the benefits that many programs aim
to reach.
One program, Mental Health Services, is a program that is decided to parents and
children. It provides the resources and environment [to provide an] array of services and
support for families (U.S. Department of Health and Human Services). In addition the
program provides prevention and promotion activities [that] promote healthy development in
early childhood (U.S. Department of Health and Human Services).
Many sources agree that since there is such a poor health increase in America that it is necessary
to have policy, assistant programs, and outreach initiatives in the community to help foster the
growth and collaboration between individuals and healthcare systems. One source suggests that
the best way to start community initiatives is working with the community directly to see what
they believe are their needs, and try to enact policy based on their responses. Many programs
agree that it is necessary to focus on individual youth and try to stop the downward turmoil in
younger children in order to prevent behavioral and social problems during childhood (Black
& Krishnakumar, 1998). In addition, the American Psychologists suggest that policy makers
must work together not only as a medical community but also as a family entity in order to

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promote well-being among individuals. Many sources agree that the easiest and most affordable
way of enacting this practice is by creating school-based programs, creating plans that help
individuals find employment, and creating a support network between health systems. However,
sources do discuss the barriers that exist among people that live in poverty. Therefore, sources
suggest that in order to overcome [the] barriers between medical professionals and families;
that more social workers, educators, and volunteers are needed to fulfill the grave need of
disparity (Anakwenze & Zuberi, 2013).
In addition, more medical professionals could promote more education for students personal
growth by implementing more school-based health centers within poorer communities. School
based programs help students learn about their health at a sooner age, and also educates teachers
how to deal with certain risks within the classroom.
Finally, there are many sources that believe that the Affordable Care Act is a sufficient policy
that has been created, but more policy needs to be created when assisting healthy child
development (Duncan, Kalil & Ziol-Guest, n.d.). I asked Sheryl Garland her opinion about
whether or not America has the resources to improve impoverished Americans health care issue
and whether or not medical professionals collaborating with parents and families will help to
influence a more reliable healthcare system and this is what she said:
CS: Do you believe that America has the resources to fix and improve the poor health crisis in
America? Why or why not?
SG: I do believe that America has the resources to fix and improve the health care system, which
will ultimately address many of the health conditions that are faced by its citizens. It
should be noted, however, that this needs to be a collective strategy, not one that is solely
financed by the government. From that standpoint, I support many of the efforts that

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were outlined in the Affordable Care Act to engage a variety of sectors of our society
(Pharmaceutical companies, hospitals, insurance companies, employers, etc.) to address
and finance health care programs for those who are uninsured. Investments in preventive
care will ultimately yield savings to the entire health care delivery system. However,
these may take years to realize. In the interim, there is a need to curb or reduce health
care costs which will require a wholesale commitment from all sectors of the health care
industry. As long as health care is viewed as a business and not a societal good, then I
think this will be difficult to achieve. Are the resources available? Yes. Is there a will to
fix the health care crisis? I would dare say there is not (personal communication,
April 29, 2014).
CS: Oftentimes social workers play a big role in helping medical professionals and collaborating
with parents and families. Do you think that there should be a better communication
system between medical professionals, health policy advocates, and educators so that a
better and more reliable healthcare system can reach an array of individuals?
SG: Improving communications across the continuum of care is a critical goal that needs to be
achieved to enhance the quality of care provided and improve safety and outcomes for
patients. The challenge is how to create a communications system that protects patient
confidentiality while providing the necessary information to those involved in the
delivery of care. Across the country, efforts are underway to create regional and
statewide health information networks that allow providers to communicate patient
information across sectors of the health care delivery system. The development of these
health information networks is fraught with issues due to the challenges and costs of
creating connectivity between disparate systems. Critical to the success of these systems

Povertys Influence on the Health of America

12

is also the ability to develop the infrastructure to communicate with patients (Sheryl
Garland, personal communication, April 29, 2014).
Conclusion
When asked what she believed to be the overall barriers for providing quality care to all
individuals and why, Sheryl Garland concluded:
SG: From a philosophical standpoint, I believe that in this era all health care providers strive to
provide quality care to all who are served. Some are more successful at achieving metrics that
have been established by regulatory groups and payers than others. That being said, one of the
barriers to providing quality care is limited access that some providers may have to resources
(financial, human, space, etc). Struggles with any of these items can result in the inability to
provide the desired level of services to a population. A second barrier is lack of coverage or
payment options for patients. This may limit the patients ability to access health care at the
appropriate time (when a condition is first noticed) or place (physicians office vs. Emergency
Department). A final barrier to providing quality is lack of access to care encountered by
patients. Whether this occurs due to lack of transportation, or lack of affordable care in close
proximity to patients (which may be especially true in rural areas), this issue can prove
problematic. I believe the greatest contributor to these issues is poverty, which is unfortunately
tied to lack of employment opportunities that pay at least a living wage rate. Often lack of
access to jobs is directly related to lack of preparedness either from a skill or knowledge base
from the public education system that is available for children who live in these neighborhoods.
From my perspective, the most promising opportunity is to work with community leaders to
strengthen the educational system to provide options for graduates to obtain post-secondary
educations or technical/job skills training. Finally, it is important to develop focused efforts to

Povertys Influence on the Health of America

connect graduates with employers in the region who are in need of individuals with the skills
they have developed (Sheryl Garland, personal communication, April 29, 2014).
It is clear that we have a long way to go with the war on poverty as it ties into the
overall impact on healthcare among the nations poorer citizens. We can continue to work on
educating the poor about affordable options to benefits as well as preventative measures
(healthier low-cost food choices, diet and exercise, low-risk behaviors) to help minimize the
crisis that they face when it comes to their health; but, if we do not stop the cycle of poverty
within the generation, in a country as wealthy as America, we will be still having this same
discussion for many more years to come.

Reference:

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