Poverty as a Disease: The Adverse Effects of Income Inequality on U.S. Health

Both sides of the political spectrum have come to acknowledge that the erosion of the middle class has become a problem in the United States, though their solutions vastly differ. What is generally left out of their discourse, however, are the moral concerns of poverty.

It should be a greater part of the national discourse, however, especially when you consider the impact that long-term poverty has on the lives of individuals, especially children.

Based on 2017 Census Bureau estimates, the poverty rate in the United States rests around 12.3 percent, meaning that those individuals and families are lacking the resources to meet the basic needs for healthy living; having insufficient income to provide the food, shelter and clothing needed to preserve and maintain good health for themselves and their families.

“Socioeconomic status is the most powerful predictor of disease, disorder, injury and mortality we have,” notes Tom Boyce, MD, chief of the University of California San Francisco’s Division of Developmental Medicine.

That is due, in part, because a person’s socioeconomic status affects nearly every aspect of their lives, from the places they live, the types of food they can afford, their ability to find a job, the education they receive, and their ability to save early for retirement.

Children in particular are drastically impacted by poverty, as the effects of income inequality starts early, and these kinds of stresses can cause lasting and sometimes permanent damage.

“If a child is exposed to constant stress in childhood, essentially their stress mechanism is never turned off,” Dr. James Duffee tells U.S. News. “So it resets at a higher level, a higher heart rate, higher blood pressure,” he continues. This manifests in a number of ways. As adults, those who have lived in poverty are much more likely to develop inflammatory diseases, with an increased risk for heart attack and stroke.  

“Many, many adult illnesses have their foundation in early childhood,” Duffee said. Many of those illnesses are linked to various symptoms of poverty and affect every aspect of their lives.

Food Insecurity Causes Health and Social Issues

According to Concordia University, one in five American students struggles with food insecurity, meaning that over 16 million students lack the basic necessity of food. Other studies from Feeding America suggest that nearly 69 percent of households had to choose between buying food and paying for utilities, 67 percent had to choose between food and transportation, and 66 percent have had to choose between food and medical care.

The same studies suggest that many compensate for their lack of funds by purchasing inexpensive or unhealthy food, and some even water down food and drinks to make their dollar stretch that much further.

There are a number of obvious ways that food and health are interconnected. Most agree that the effects of hunger can be life altering. For those who already struggle with chronic illnesses such as diabetes, the choice between food and paying for healthcare can lead to severe complications such as kidney disease, problems with vision, and nerve damage. Additionally, children who are at risk of hunger are more likely to have developmental and behavioral problems, struggle in school, and be in poor health.

Life Expectancy Declines

Poverty can have a drastic impact on your life expectancy. Recent reports by the University of Washington indicate that the average life expectancy in the United States varies by more than 20 years depending on the region in which you live.

America has a growing “life expectancy gap” that is predicted to grow much wider. As it stands now, researchers found that while affluent counties in central Colorado had the highest life expectancy at 87 years, people in several counties in North and South Dakota — many of which had Native American reservations — had life expectancies of only 66 years.

The figures shouldn’t be all that surprising, as geographic inequalities point to differences in socioeconomic factors as well as factors related to the race/ethnic makeup of an area and their access to quality healthcare and insurance.

Emotional Health Suffers

Almost half of all children in the U.S. who live in poverty have mothers with at least some symptoms of depression, due to the economic stress of raising a family in dire circumstances. This has consequences for both the parent’s emotional health, but it also affects their children.

“Mothers who are depressed interact with their children very differently,” Duffee notes. “Those interactions–the lack of stimulation and socio-emotional connections, what we call attachment–also have long-term effects, if not lifelong effects, on children.”  

Not only is a child with a depressed parent two to four times more likely to develop depression themselves, but it can also affect their social, emotional, and cognitive development. They can sometimes have trouble regulating their own moods, cooperating with requests from adults, and have a harder time with problem-solving skills. Naturally, this also affects their performance and interactions with others at school.

While many individuals suffer from depression and other mental health conditions who are not impoverished, socioeconomic struggles make it all the more difficult to get help. Depending on the area you live in, there might not even be help available.

Living in Areas With Suboptimal Infrastructure and Environmental Pollution

Recent findings from Yale University indicate that communities of color, those with low education, high poverty, and high rates of unemployment face a larger number of health risks due to environmental pollution present in the areas they live in.

The study is the first of its kind to reveal that there are major racial and economic differences when it comes to exposure of specific particles, which can lead to asthma, cardiovascular disease, and cancer. Those who live in industrial areas, such as Illinois, Texas, and California, are particularly at risk for developing serious health conditions.

The particles people breathe include a variety of metals and chemicals. Those living near refineries are exposed to higher concentrations of nickel and vanadium, while neighborhoods along busy roads have more nitrates from vehicle exhaust. Those who live near manufacturing centers are at risk of breathing in toxic levels of asbestos.

Boyle Heights in East Los Angeles is a prime example. The community is 90 percent Hispanic, and is one of the most impoverished places in the city. Boyle Heights is surrounded by freeways, many of which are used for shipping commercial goods. Four major rail yards emit diesel exhaust nearby.

This population was exposed to “more than 1.5 times the whites’ exposure to nickel, nitrate, silicon, vanadium – all linked in some studies to hospitalizations or deaths from cardiovascular and lung disease – and aluminum, which is associated with low birth weights,” writes Cheryl Katz for Scientific American.

Flint, Michigan is another example of environmental pollution. Flint has the nation’s highest poverty rate among U.S. cities with at least 65,000 residents, according to Census Bureau data. As it stands, over 41.2 percent of the city’s residents live under the poverty level. For years, Flint residents have been living with toxic levels of lead that have affected their water supply.  

Poor Access to Healthcare Including Dental and Vision

Those living in poverty often report that they will skip visits to the doctor because of cost, even if they have access to health insurance. This, in large part, is because they don’t have access to paid sick leave, and lose income when they take unplanned time off to go to the doctor.

Even if patients are insured, consultations can still cost hundreds of dollars, making it more economical to sometimes skip out on care altogether for the financial well-being of their family.

For many low-income Americans, choosing which symptoms to treat can also be a huge issue. This is especially true when it comes to dental and vision care.

“Do you want your teeth, or do you want your heart to continue beating,” one man posited to the Commonwealth Fund. “You’ve got to figure out which one and balance it out. Sometimes I’ve had to omit the eyes and the teeth.”

This is especially unfortunate, as dental and vision treatment, often viewed as being more “cosmetic”, can have a significant impact on your health and your ability to keep and maintain a job. In addition, early detection of diseases can prevent blindness, gum disease, and more.

The same is true for the healthcare sector as a whole. Many diseases experienced by those who experience poverty are easily preventable when detected early, or when patients are given information to help treat problems before they become exacerbated. Access to this kind of information and treatment remains to be a problem.

It’s clear that your socioeconomic status affects a number of areas in your life. For those living in poverty, the long-term effects of living without the means to take care of yourself and your family can have drastic consequences on your health and well-being.

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