Poverty and Health Health Article

POVERTY AND HEALTH

People with low incomes, particularly those who live in poverty, face particular challenges in maintaining their health. They are more likely than those with higher incomes to become ill, and to die at younger ages. They are also more likely to live in poor environmental situations with limited health care resources—factors that can compromise health status and access to care. Public programs play a vital role in helping to reduce disparities in health by income by supporting health initiatives targeted at those with low incomes and maintaining a safety net of health and social services for the poor.

POVERTY IN THE UNITED STATES

The United States is one of the wealthiest nations in the world, yet a significant portion of the population still lives in poverty. Though the poverty rate declined during the 1990s due to a strong economy, 11.8 percent of Americans—over 32 million people—lived below the poverty level in 1999. Calculated to assess the cost of food and basic expenses by family size, the federal poverty level was a little over $17,000 a year for a family of four in 1999. Many of America's poor are living far below the poverty level on incomes that barely exceed $10,000. In addition to the poor, another 50 million people are "near poor" and have incomes between poverty and twice the poverty level.

The problem of poverty in America is even more alarming when looking at particularly vulnerable populations (see Figure 1). According to the Census Bureau, in 1999:

• 16.9 percent of all children and 18 percent of children under age six lived in poverty, versus 10 percent of adults.

Figure 1

• Minority racial and ethnic groups are much more likely to live in poverty—23.6 percent of blacks and 22.8 percent of Hispanics lived below the poverty level, versus 7.7 percent of whites.
• Female-headed households (with no husband present) are much more likely than married couple families to live in poverty (27.8% versus 4.8%), with black and Hispanic female-headed households having the highest poverty rates (39.3% and 38.8%, respectively).

Public assistance helps many of the lowest-income families and individuals meet their most basic financial and health needs. Social Security, for example, provides financial assistance to workers and their families in retirement, as well as to some disabled individuals, enabling those who are no longer working to maintain an income. Since its enactment in 1935, this program has helped reduce poverty among the elderly and disabled, and today less than 10 percent of the elderly live in poverty. Many low-income families have also been helped by cash assistance (also called "welfare"), formerly under the Aid to Families with Dependent Children (AFDC) program and, since 1996, under the Temporary Assistance for Needy Families (TANF) program. While this assistance is an essential source of support for millions of families, the populations that are the targets for such assistance—mainly children and single-headed households—still have some of the highest poverty rates in the nation. Poverty persists in these groups for many reasons, including low benefit levels in welfare and restrictive eligibility levels that leave most workers, even those working at minimum wage jobs, ineligible for assistance.

While the poverty statistics for the United States are alarming, the problem of poverty around the world is even more dire. According to the World Bank, the average income in the world's wealthiest countries (which includes the United States) is thirty-seven times that in the poorest nations. This differential exists because poverty in developing nations is not only more prevalent, it is also significantly deeper—2.8 billion people in the world live on less than $2 a day, and 1.2 billion live on less than $1 a day. Poverty touches all areas of the world, though the most impoverished conditions are found in South Asia, sub-Saharan Africa, and East Asia and the Pacific regions. People living in the world's poorest nations are faced not only with trying to afford food, shelter, and clothing, but also with severe malnutrition, living without basic sanitation or clean water, and a lack of access to basic education.