Why is poverty bad

Neglected tropical diseases affect over one billion people, almost all in the poorest and most marginalised communities. You may not have heard of diseases such as leprosy, lymphatic filariasis, onchocerciasis, schistosomiasis, soil-transmitted helminths and trachoma, but they can cause severe pain and life-long disabilities — and mean enormous productivity losses. However, efforts to tackle them have usually taken a back seat to the bigger killers.

The biggest non-communicable killers are maternal and newborn deaths and deaths related to poor nutrition, cardiovascular disease and non-communicable respiratory diseases.

World leaders and international organisations have slowly woken up to the impact of the most prevalent infectious diseases. However, as well as tackling specific diseases, it is crucial that leaders also address the underlying causes. It is widely accepted that the key reason for the increase in life expectancy in wealthy countries in the late 19th and early 20th century was less to do with the leaps forward in medical science, and more to do with the arrival of better nutrition, clean water and sanitation.

Reducing poverty, improving nutrition and making sure people have access to safe water and sanitation, as well as strengthening national health systems, is of the utmost importance. Otherwise tackling one particular threat simply leaves people open to another deadly disease soon afterward. Tackling the structural causes of poverty and poor health, for example calling for measures to tackle inequality and injustices such as corporate tax evasion, are central to what is needed from the global community.

Sign up to be a part of our global movement for health justice, including how you can get involved in our work through campaigning and fundraising. SDoH are the conditions under which people are born, grow, live, work, and age, and include factors such as socioeconomic status, education, employment, social support networks, and neighborhood characteristics.

Economic prosperity can provide individuals access to resources to avoid or buffer exposure to health risks. Individuals who live in low-income or high-poverty neighborhoods are likely to experience poor health due to a combination of these factors. Violence is also more prevalent in areas with greater poverty.

From to , individuals in households at or below the poverty level experienced more than double the rate of violent victimization than individuals in high-income households.

Because they intersect with so many SDoH, poverty and low-income status dramatically affects life expectancy. These have powerful associations with life expectancy for both sexes and all races at all ages.

Students from families with low income are five times more likely to drop out of high school than students from families with high income. Poverty affects individuals insidiously in other ways that we are just beginning to understand. Mental illness, chronic health conditions, and substance use disorders are all more prevalent in populations with low income.

These effects, which can influence cognitive development and chronic disease development, are dose-dependent i.

However, the effects of poverty are not predictably uniform. Longitudinal studies of health behavior describe positive e. However, there is a socioeconomic gradient in health improvement. In other words, populations with lower socioeconomic status lag behind populations with higher socioeconomic status in positive gains from health behavior trends.

Health behaviors are important in that they account for differences in mortality. Poverty affects health in many different ways through complex mechanisms that we are just beginning to understand and describe. Living in poverty does not necessarily predetermine poor health. Instead, poverty affects both the likelihood that an individual will have risk factors for disease and its ability and opportunity to prevent and manage disease.

Behavioral science at the crossroads in public health: extending horizons, envisioning the future. Soc Sci Med. Thinking of poverty as a risk regulator rather than a rigid determinant of health allows family physicians to relinquish the feeling of helplessness when providing medical care to families and individuals with low income. Family physicians are uniquely positioned to devise solutions to mitigate the development of risk factors that lead to disease and the conditions unique to populations with low income that interfere with effective disease prevention and management.

Strong primary care teams are critical in the care of patients with low income. These populations often have higher rates of chronic disease and difficulty navigating health care systems. They benefit from care coordination and team-based care that addresses medical and socioeconomic needs. In the United States, there is a move toward increased payment from government and commercial payers to offset the cost of providing coordinated and team-based care.

Some payment models provide shared savings or care coordination payments in addition to traditional fee-for-service reimbursement. The practice transformations from COPC and payment models based on targets and meaningful use alter how we approach patient panels and communities.

By recognizing and treating disease earlier — and actively partnering with local public health services like health educators, community health workers, and outreach services — family physicians can help prevent costly, avoidable complications and reduce the total cost of care. Care team members can positively affect the health of patients with low income by creating a welcoming, nonjudgmental environment that supports a long-standing therapeutic relationship built on trust.

For example, a patient with low income may arrive 15 minutes late to an appointment because they have to rely on someone else for transportation. A patient may not take prescribed medication because it is too expensive. A patient may not get tests done because their employer will not allow time off from work. A patient may not understand printed care instructions because of low-literacy skills. Such patients may be turned away by staff because their tardiness disrupts the schedule, or they may even be dismissed from the practice altogether because of repeated noncompliance.

Physicians and care team members should learn why the patient was noncompliant and promote an atmosphere of tolerance and adaptation. Patients with low socioeconomic status and other marginalized populations rarely respond well to dictation from health care professionals. Instead, interventions that rely on peer-to-peer storytelling or coaching are more effective in overcoming cognitive resistance to positive health behavior changes. Such activities are typically hosted by local hospitals, faith-based organizations, health departments, or senior centers.

Family physicians regularly screen for risk factors for disease. Once socioeconomic challenges are identified, physicians and their care teams can work with patients to design achievable, sustainable treatment plans.

For example, crowding, infestations, and lack of utilities are all risk factors for disease. Knowing that a patient is homeless or has poor, inadequate housing will help guide care. Family physicians direct the therapeutic process by working with the patient and care team to identify priorities so treatment goals are clear and achievable. It is likely that a patient with low income will not have the resources e. For example, for a patient with limited means and multiple chronic conditions — including hypertension and diabetes — start by addressing these conditions.

Colon cancer screening or a discussion about beginning statin therapy can come later. It may be easier for this patient to adhere to an insulin regimen involving vials and syringes instead of insulin pens, which are much more expensive. Celebrate success with each small step that takes a patient closer to disease control and improved self-management.

One World Bank estimates that climate change has the power to push more than million people into poverty over the next decade. They often have only just enough food and assets to last through the next season, and not enough reserves to fall back on in the event of a poor harvest.

Not every person without an education is living in extreme poverty. But education is often referred to as the great equalizer, because it can open the door to jobs and other resources and skills that a family needs to not just survive, but thrive.

UNESCO estimates that million people could be lifted out of extreme poverty if they left school with basic reading skills. Poverty threatens education, but education can also help end poverty. Imagine that you have to go to work, but there are no roads to get you there. Or heavy rains have flooded your route and made it impossible to travel. A lack of infrastructure — from roads, bridges, and wells, to cables for light, cell phones, and internet — can isolate communities living in rural areas.

Living off the grid often means living without the ability to go to school, work, or the market to buy and sell goods. Traveling further distances to access basic services not only takes time, it costs money, keeping families in poverty. Isolation limits opportunity. We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

Copyright The Health Foundation Registered charity number Unfortunately, your browser is too old to work on this website. Please upgrade your browser. Jo Bibby. Social determinants of health. Further reading Infographic.

Poverty and health Infographic. Read more. Long read.