The link of poverty & health

The link between health, income and community prosperity

Valerie graduated in 2005 with a degree in early childhood education and about $32,000 in debt.  She got her first job in children’s services and worked at an entry level for several years before budget tightening squeezed her out.

No problem right? Unemployment is low, and sure enough, Valerie landed something — after a search that lasted long enough to absorb what little reserves she had.  not surprisingly, it wasn’t in her chosen profession.  Those jobs continued to be fewer and farther between.  She does get to work with kids, though — as the janitor at her child’s school.  Her school loans are swelling in deferred status, and by the third week of every month, she’s making hard choices about utility bills and food.  The prospect of a medical bill, any medical bill, looms on the horizon like an iceberg over the bow of the Titanic.

Wait a minute, you say. Valerie has a college education.  The economy has been dancing in the streets for years now.  And everyone knows the poor are poor because of the choices they make, education they didn’t get, character they lack, right?

The truth goes viral

Actually about 4.5% of the nation’s college graduates live at or below the federal poverty line,  more than 22,000 of them live in Kansas.  A recent study from the Federal Reserve Bank found that 43% of our degree-holding citizens are underemployed, and college graduates make up nearly half of the working poor in the American workforce.  Given that 9 out of 10 new jobs are going to degreed candidates, the prospects are even worse for those less educated than Valerie.

At this writing, the coronavirus, alias COVID-19, is painting the world map red.  We are discovering on a global scale just how true it is that good health is a commodity we should all have access to — or eventually, we all suffer.

But access, wherever we live on that map, is too often complicated by economic status.  So much so that being poor deprives us of much more than a good car or the Christmas we all want for our kids.  It has a cause-and-effect relationship to not only the health of those who live in it but everyone who doesn’t and the communities we all share.

Poverty as a health risk

It turns out that not having health insurance is just the start of a cascading set of problems.  The next step is, of course, not going to see your doctor.  That eliminates virtually any preventive care.  If you are pregnant, a lack of prenatal care can lead to babies with low birth weights, not to mention the risk to maternal health.

As your health declines, you miss more work (and most likely income) which does wonders for your stress level, leading to things like high blood pressure, heart disease, and diabetes.  Of course, you’re likely eating on the run and on the cheap, so your diet is helping to advance those conditions and more. There’s even data to suggest that it’s more dangerous to be poor because you’re more likely to be injured or worse from an accident.

There’s a legacy aspect to this, too.  Your kids are living that same unhealthy lifestyle right along with you.  You would never willingly neglect their visits to the doctor when they are sick, but you always have to gauge their need for an appointment because of the cost in time away from work and the fees you can’t afford.

Illness and worries from home follow kids to school like puppies and their shadows.  Studies have shown a clear connection between how well a child does academically and how healthy, mentally and physically, she is in the classroom.  Like poverty, poor performance in school is hard for students to escape, setting them up to underachieve and fail to get the education that will lead to their success.

Staying with the children a moment more, there are factors like food insecurity, crime-prone neighborhoods and having to relocate frequently in pursuit of the ever-elusive better life.  All of these contribute to a child’s anxieties and can lead to depression, withdrawal, and stunted development.

Rochelle Bryant

“The more you look at it, ” said Rochelle Bryant, GraceMed’s Director of Community Care, “being poor is like having a kind of malignant cancer.  It spreads into every corner of your life.  you get sicker, owe more money, borrow more money, and pay more interest.  you can’t afford for anything to go wrong but everything always does.  And the hole just keeps getting deeper.

More recently, the chronic, seemingly inescapable nature of poverty has contributed to the rise of the addiction epidemic.  “The addiction crisis followed the recession that began in 2008, and there’s a reason for that,” noted GraceMed Director of Behavioral Health, Rita Zeller.  “The despair and depression that is often associated with long-term poverty can lead to a decision to self-medicate. And once the addiction starts, recovery tends to be harder to achieve for those in lower socioeconomic status.”

The bigger picture

So the vicious cycle that being poor can generate captures both parent and child and acts like a virus compounding itself, not just in their lives but in their health.  Is that were the impact ends? Or does the gaping chasm of inequality of income now entrenched in our social structure also carve a deficit in the lives of those on the other side of the gap?

The answer is, of course, it does.  We are only as healthy as the least healthy among us.  Prior to the dramatic reversal of fortunes currently being triggered by COVID-19, 40% of us were already left behind by the recovery, mired in shrinking incomes, and underemployment.  What that means for the health of the community at large is that a broad, growing swath of us can’t afford to stay healthy.  So sick days rise and the workforce is less productive.  It also means a decline in dependable income, so the economy lags as do tax revenues.

And then there’s the impact on healthcare resources.  In 2018, the number of uninsured Americans rose by about 3%, the first such increase since the Affordable Care Act began decreasing that number in 2013.  When the uninsured need medical care, they often go to emergency rooms.  The bill for a visit to the ER can be expensive, of course, and a lot of these visits go unreimbursed. The cost of that care then has to be absorbed in the rates charged to insured patients.  This inflationary influence on the cost of insured care is then reflected in the rising cost of premiums which have grown by 71% over the past 10 years.

So being poor costs a lot of money, and not just for those who don’t make much of it.  But we all pay another kind of price as well, one that is expressed in the loss of human potential.  Think again about all the Valeries whose skills and training we are not benefitting from, and all the children of those Valeries who likely will not fulfill their promise.

There is no bottom line to this.  Like cancer, chronic poverty is a disease state that is as destructive as neglect will allow it to be.  But it is also beatable as so many cancers now are.  The cures are as simple as a living wage, full and affordable access to education, and, of course, a willingness to accord everyone the right and resources to live a healthy life.`

This post originated in our State of Grace quarterly news magazine. If you would like to receive the magazine, please visit this link and give us your information. Thanks!