Abstract
Poverty is associated with both low education and adverse health outcomes for all demographic groups. This chapter examines the federal definition of poverty and recent statistics on the incidence of poverty rates within the United States. Section I of the chapter examines statistical evidence relevant to the causes, duration, and consequences of poverty. Section II examines the question: Why is it so difficult to achieve good outcomes for individuals with low income and low levels of education? The chapter concludes with a discussion of five pathways by which system-level issues constrain individual decisions and behaviors, as well as the implications of these constraints for professionals providing services to individuals and families with low levels of income and education.
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References
Aizer, A. (2007). Public health insurance program uptake and child health. The Review of Economics and Statistics, 89(3), 400–415.
American Academy of Pediatrics. (2013). U.S. must not neglect millions of children still living in poverty, says American Academy of Pediatrics. Retrieved from https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/US-Must-Not-Neglect-Millions-of-Children-Still-Living-in-Poverty-Says-American-Academy-of-Pediatrics.aspx
Aron, L. Dubay, L., Simon, S., Zimmerman, E. Chapman, D. & Woolf, S. H. (2015). Can income-related polices improve population health? The Urban Institute and Center on Society and Health
Balsa, A. I., & McGuire, T. G. (2003). Prejudice, clinical uncertainty and stereotyping as sources of health disparities. Journal of Health Economics, 22(1), 89–116. https://doi.org/10.1016/S0167-6296(02)00098-X
Becker, G., & Newsom, E. (2003). Socioeconomic status and dissatisfaction with health care among chronically ill African Americans. American Journal of Public Health, 93(5), 742–748.
Ben-Ishai, L. (2015). Volatile Job Schedules and Access to Public Benefits. September 16, 2015. CLASP. https://www.clasp.org/sites/default/files/public/resources-and-publications/publication-1/2015.09.16-Scheduling-Volatility-and-Benefits-FINAL.pdf
Bharadwaj, P., Gibson, M., Zivin, J. G., & Neilson, C. A. (2014). Gray matters: Fetal pollution exposure and human capital formation. (NBER Working Paper No. 20662). The National Bureau of Economic Research. Retrieved from http://www.nber.org/papers/w20662
Blackwell, D. L., Lucas, J. W., & Clarke, T. C. (2014). Summary health statistics for U. S. adults: National Health Interview Survey, 2012. Vital Health Statistics, 10(260), 1–157. Retrieved from http://www.cdc.gov/nchs/data/series/sr_10/sr10_260.pdf
Cabinet Office Behavioural Insights Team. Applying behavioural insight to health. (2010). https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/60524/403936_BehaviouralInsight_acc.pdf. Accessed July 7, 2015.
Cassel, C. (2014, March 27). Should provider performance measures be risk-adjusted for sociodemographic factors? (Web blog). Retrieved from http://healthaffairs.org/blog/2014/03/27/should-provider-performance-measures-be-risk-adjusted-for-sociodemographic-factors/
Cawley, J., & Ruhm, C. (2011). The economics of risky health behaviors. (Working Paper 17). The National Bureau of Economic Research. Retrieved from http://www.nber.org/papers/w17081
Centers for Disease Control and Prevention. (2013). Healthy People 2020. http://www.cdc.gov/nchs/healthy_people/hp2020.htm. Accessed 1 July 2015.
Centers for Medicare and Medicaid Services. (2015). MIPCD: The states awarded. Retrieved from http://innovation.cms.gov/initiatives/MIPCD/MIPCD-the-states-awareded.html
Chaufan, C., Constantino, S., & Davis, M. (2012). ‘It’s a full time job being poor’: Understanding barriers to diabetes prevention in immigrant communities in the USA. Critical Public Health, 22(2), 147–158. https://doi.org/10.1080/-09581596.2011.630383
Cheung, P. T., Wiler, J. L., Lowe, R. A., & Ginde, A. A. (2012). National study of barriers to timely primary care and emergency department utilization among Medicaid beneficiaries. Annals of Emergency Medicine, 60(1), 4–10.e2. https://doi.org/10.1016/j.annemergmed.2012.01.03
Clawson, R. A., & Trice, R. (2000). Media portrayals of the poor. The Public Opinion Quarterly, 64(1), 53–64. http://www.jstor.org/stable/3078840
Currie, J., & Stabile, M. (2003). Socioeconomic status and child health: Why is the relationship stronger for older children? American Economic Review, 93(5), 1813–1823. Retrieved from http://search.proquest.com/openview/c9653e45be1ee9f6be9fbd4b93cd80c1/1?pq-origsite=gscholar
Cutler, D. M., & Meara, E. (1999). The technology of birth: Is it worth it? (NBER Working Paper No. 7390). National Bureau of Economic Research. Retrieved from http://core.ac.uk/download/pdf/6743264.pdf
Cutler, D. M. & Lleras-Muney, A. (2006). Education and health: Evaluating theories and evidence. (Working Paper 12352). National Bureau of Economic Research. Retrieved from http://www.nber.org/papers/w12352
Cutler, D. M., Rosen, A. B., & Vijan, S. (2006). The value of medical spending in the United States, 1960–2000. The New England Journal of Medicine, 355, 920–927. https://doi.org/10.1056/NEJMsa054744
Federal Reserve Community Development Resources, FedCommunities.org. (2018). https://www.fedcommunities.org/policy-and-practice/healthy-communities
Figlio, D., Guryan, J., Karbownik, K., & Roth, J. (2014). The effects of poor neonatal health on children’s cognitive development. American Economic Review, 104(12), 3921–3955.
Galewitz, P. (2014). Michigan to offer better Medicaid to enrollees for getting healthier. Retrieved from http://www.governing.com/news/headlines/michigan-to-reward-medicaid.html
Galewitz, P. (2015). Why not just pay Medicaid enrollees to get healthier? Kaiser Health News. 5/5/2015.
Gany, F., Lee, T., Ramirez, J., Massie, D., Moran, A., Crist, M. . . . Leng, J. C. F. (2014). Do our patients have enough to eat? Food insecurity among urban low-income cancer patients. Journal of Health Care for the Poor and Underserved, 25(3), 1153–1168. doi: https://doi.org/10.1353/hpu.2014.0145.
Gelberg, L., Gallagher, T. C., Andersen, R. M., & Koegel, P. (1997). Competing priorities as a barrier to medical care among homeless adults in Los Angeles. American Journal of Public Health, 87(2), 217–220. https://doi.org/10.2105/AJPH.87.2.217
Goldman, D., & Smith, J. P. (2011). The increasing value of education to health. Social Science & Medicine, 72(10), 1728–1737. https://doi.org/10.1016/j.socscimed.2011.02.047
Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy., 80(2), 223–255.
Heckman, J. J. (2006). Skill formation and the economics of investing in disadvantaged children. Science, 312, 1900. https://doi.org/10.1126/science.1128898
Hoynes, H., Schanzenbach, D. W., & Almond, D. (2016). Long-Run impacts of childhood access to the safety net. American Economic Review, 106(4), 903–934. https://doi.org/10.1257/aer.20130375
Johnson, R. C. (2011). Health dynamics and the evolution of health inequality over the life course: The importance of neighborhood and family background. The B. E. Journal of Economic Analysis & Policy Advances, 11(3). https://doi.org/10.1515/1935-1682.2823
Johnson, R. C., & Schoeni, R. F. (2007). The influence of early-life events on human capital, health status and labor market outcomes over the life course. (Population Studies Center Research Report 07–616).
Kangovi, S., Barg, F. K., Carter, T., Long, J. A., Shannon, R., & Grande, D. (2013). Understanding why patients of low socioeconomic status prefer hospitals over ambulatory care. Health Affairs, 32(7), 1196–1203. https://doi.org/10.13377/hitaff.2012.0825
Kazdin, A. E. (2008). Society’s grand challenges: Insights from Psychological Science – Health disparities. Retrieved from http://www.apa.org/research/action/gc-health-disparities.pdf
Konnikova, M. (2014). No money, no time. Opinionator-New York Times. Retrieved from http://opinionator.blogs.nytimes.com/2014/06/13/no-clocking-out/
Kushel, M. B., Gupta, R., Gee, L., & Haas, J. S. (2005). Housing instability and food insecurity as barriers to health care among low-income Americans. Journal of General Internal Medicine, 21, 71–77. https://doi.org/10.1111/j.1525-1497.2005.00287.x
Land, T., Warner, D., Paskowsky, M., Cammaerts, Al, Wetherell, L., Kaufman, R. … Keithly, L. (2010). Medicaid coverage for tobacco dependence treatments in Massachusetts and associated decreases in smoking prevalence. Plos One, 5(3), 1–6. https://doi.org/10.1371/journal.pone.0009770
Lakoff, G. (1987). Women, fire, and dangerous things: What categories reveal about the mind. Chicago: The University of Chicago Press.
Lee, Y.-Y., & Lin, J. (2009). The effects of trust in physician on self-efficacy, adherence and diabetes outcomes. Social Science Medicine, 68, 1060–1068. https://doi.org/10.1016/j.socscimed.2008.12.033
Lega, F., & Mengoni, A. (2008). Why non-urgent patients choose emergency over primary care services? Empirical evidence and managerial implications. Health Policy, 88(2–3), 326–380. https://doi.org/10.1016/j.healthpol.2008.04.005
Lyles, C. R., Schafer, A. L., & Seligman, H. K. (2014). Income, food insecurity, and osteoporosis among older adults in the 2007–2008 National Health and Nutrition Examination Survey (NHANES). Journal of Health Care for the Poor and Underserved, 25(4), 1530–1541. Retrieved from http://muse.jhu.edu/journals/journal_of_health_care_for_the_poor_and_underserved/v025/25.4.lyles.html
Macabasco-O’Connell, A., Crawford, M. H., Stotts, N., Stewart, A., & Froelicher, E. S. (2008). Self-care behaviors in indigent patients with heart failure. Journal of Cardiovascular Nursing, 23(3), 223–230. https://doi.org/10.1097/01.JCN.0000317427.21716.5f
Macartney, S., Bishaw, A., & Fontenot, K. (2013). Poverty rates for selected detailed race and Hispanic groups by state and place: 2007–2011. Washington, DC: U.S. Census Bureau, Economics and Statistics Administration (census.gov).
Madrian, B. C., & Shea, D. F. (2001). The power of suggestion: Inertia in 401(k) participation and savings behavior. The Quarterly Journal of Economics, 116(4), 1149–1187.
Mallinson, R. K., Rajabiun, S., & Coleman, S. (2007). The provider role in client engagement in HIV care. AIDS Patient Care and STDs, 21(Suppl 1), S77–S84.
Mani, A., Mullainathan, S., Shafir, E., & Zhao, J. (2013). Poverty impedes cognitive function. Science, 341(6149), 976–980. https://doi.org/10.1126/science.1238041
McGinnis, J. M., Williams-Russo, P., & Knickman, J. R. (2002). The case for more active policy attention to health promotion. Health Affairs, 21(2), 78–93. https://doi.org/10.1377/hithaff.21.2.78
Mickle, T. (2015). Secondhand exposure falls, unevenly. U. S. News, p. A2.
Mojtabai, R., & Olfson, M. (2003). Medication costs, adherence, and health outcomes among Medicare beneficiaries. Health Affairs, 22(4), 220–229. https://doi.org/10.1377/hlthaff.22.4.220
National Institute on Minority Health and Health Disparities at NIH. http://www.nimhd.nih.gov/about/nimhdHistory.html. Accessed 1 July 2015.
Pear, R. (2014, April 27). Health Law’s Pay Policy is skewed, panel finds. New York Times. http://www.nytimes.com/2014/04/28/us/politics/health-laws-pay-policy-is-skewed-panel-finds.html?_r=0. Accessed 7 July 2015.
Peterson, B. S., Rauh, V. A., & Bansal, R. (2015). Effects of prenatal exposure to air pollutants (polycyclic aromatic hydrocarbons) on the development of brain white matter, cognition, and behavior in later childhood. Journal of American Medical Association Psychiatry, 72(6), 531–540. https://doi.org/10.1001/amapsychiatry.2015.57
Sabaté, E. (Ed). (2003). Adherence to Long-Term Therapies: Evidence for action. World Health Organization. http://www.who.int/chp/knowledge/publications/adherence_full_report.pdf?ua=1.
Schwartz, M. B., Chambliss, H. O., Brownell, K. D., Blair, S. N., & Billington, C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11(9), 1033–1039.
Sheppard, V. B., Zambrana, R. E., & O’Malley, A. S. (2004). Providing health care to low-income women: A matter of trust. Family Practice, 21(5), 484–491. https://doi.org/10.1093/fampra/cmh503
Shonkoff, J. P., Boyce, W. T., & McEwen, B. S. (2009). Neuroscience, molecular biology, and the childhood roots of health disparities: Building a new framework for health promotion and disease prevention. Journal of the American Medical Association, 301(21), 2252–2259. https://doi.org/10.1377/hlthaff.21.2.48
Siminoff, L. A., Graham, G. C., & Gordon, N. H. (2006). Cancer communication patterns and the influence of patient characteristics: disparities in information-giving and affective behaviors. Patient Education and Counseling, 62(3), 355–360. https://doi.org/10.1016/j.pec.2006.06.011
Skinner, J., & Zhou, W. (2004). The measurement and evolution of health inequality: Evidence from the U. S. Medicare population. (NBER Working Paper No. 10842). Retrieved from http://www.nber.org/papers/w10842
Smith, J. (2007). Diabetes and the rise of the SES health gradient. (NBER Working Paper No. 112). The National Bureau of Economic Research. Retrieved from http://www.nber.org/papers/w12905
Spears, D. (2011). Economic decision-making in poverty depletes behavioral control. The B.E. Journal of Economic Analysis & Policy, 2(1). Available at http://www.bepress.com/bejeap/Volii/iss1/art72
Street Jr., R. L., Gordon, H., & Haidet, P. (2007). Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor. Social Science and Medicine, 65, 586–598. https://doi.org/10.1016/j.socscimed.2007.03.036
Thomas, E. J., Burstin, H. R., O’Neil, A. C., Orav, E. J., & Brennan, T. A. (1996). Patient non-compliance with medical advice after the emergency department visit. Annuals of Emergency Medicine, 27(1), 49–55.
Waldron, H. (2007). Trends in mortality differentials and life expectancy for male social security-covered workers, by socioeconomic status. Social Security Bulletin, 67(3). Retrieved from http://www.ssa.gov/policy/docs/ssb/v67n3/v67n3p1.html
Wimer, C., Wright, R., & Fong, K. (2013). The cost of free assistance: Studying nonuse of food assistance in San Francisco. (IRP Discussion Paper No. 1408-13). University of Wisconsin-Madison: Institute for Research on Poverty. Retrieved from http://web.stanford.edu/group/scspi-dev/cgi-bin/sites/default/files/wimer-wright-fong_cost-free-assist.pdf
Zonderman, A. B., Mode, N. A., & Ejiogu, N., Evans, M. K. (2016). Race and poverty status as a risk for overall mortality in community-dwelling middle-aged adults [published online July 18, 2016]. JAMA Internal Medicine. doi: https://doi.org/10.1001/jamainternmed.2016.3649.
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Svare, G.M., Wendel, J. (2018). Poverty: Implications and Strategic Options for Applied Psychologists, Clinicians, and Service Providers. In: Frisby, C., O'Donohue, W. (eds) Cultural Competence in Applied Psychology. Springer, Cham. https://doi.org/10.1007/978-3-319-78997-2_15
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