As national attention turns increasingly toward the growing financial divide between the rich and the poor, APA's Public Interest Directorate continues its efforts to better understand and reduce socioeconomic health disparities. Identifying the causes of and ways to reduce health disparities is a major APA strategic initiative housed within the directorate.
Evidence has shown the critical role of socioeconomic factors in understanding health disparities. For example, low socioeconomic status is linked to such negative health outcomes as low birth weight, diabetes, depression, life expectancy, heart attacks and lower self-rated health.
APA's Public Interest Office on Socioeconomic Status explores the intersection between health disparities and poverty in its latest annotated bibliography series, Examining the Complexities Between Health Disparities and Poverty. This compilation uses a psychosocial framework with a social justice lens in its exploration of physical and psychological factors to include social and environmental forces that shape health.
Socioeconomic status and race and ethnicity are very much intertwined, and both must be considered if we are to fully understand health disparities. We know that higher proportions of blacks and Hispanics are poor and more likely than their white counterparts to live in neighborhoods with higher concentrations of poverty, even when family incomes are similar. Americans who are socioeconomically disadvantaged, ethnic-minority or have little formal education experience significantly worse health outcomes than those who are white, more affluent or better educated.
A 2013 report from the Robert Wood Johnson Foundation, Overcoming Obstacles to Health, describes the association between socioeconomic status and health status. For example, the authors found that 25-year-old college graduates can expect to live eight to nine years longer than those who have not completed high school, and two to four years longer than those who have attended but not graduated from college. They also found that life expectancy gaps are even greater when race and education are considered. Between 2008 and 2010, white college graduates could expect to live 10 to 14 years longer than blacks who had not finished high school.
Failure to address socioeconomic factors continues to be a major barrier to improving health outcomes for underserved, poorer populations. Poor people face multiple barriers to good health, in addition to those related to access. These include chronic stress, unsafe housing, crime and violence, poor schools, inadequate transportation, limited availability of healthy food choices, and inadequate places to play and exercise. I should note that one of the APA Health Disparities Initiative working groups is Stress and Health Disparities.
Psychology has a long history of commitment to underserved populations, and psychologists are recognized for competencies and leadership in research and practice in the health arena. Therefore, we have a substantial role to play in the work that must be done to reduce poverty and socioeconomic health disparities. Through our committees, offices and initiatives, the Public Interest Directorate is working with psychologists in doing just that.
Keita, G. P. (2014, March 1). Improving the health of low income populations. Monitor on Psychology, 45(3). https://www.apa.org/monitor/2014/03/itpi
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In addition to lasting effects of childhood poverty, adults living in poverty are at a higher risk of adverse health effects from obesity, smoking, substance use, and chronic stress.
Middle-class Americans are healthier than those living in or near poverty, but they are less healthy than the upper class. Even wealthy Americans are less healthy than those Americans with higher incomes. Income is a driving force behind the striking health disparities that many minorities experience.
3The Root Causes of Health Inequity. Health inequity, categories and examples of which were discussed in the previous chapter, arises from social, economic, environmental, and structural disparities that contribute to intergroup differences in health outcomes both within and between societies.
Residents in low-income and minority communities are more likely to suffer from diseases such as cancer and diabetes, more likely to be obese, less likely to access preventative health measures, and less likely to have access to healthy food.
Social determinants of health such as poverty, unequal access to health care, lack of education, stigma, and racism are underlying, contributing factors of health inequities. The Centers for Disease Control and Prevention (CDC) is committed to achieving improvements in people's lives by reducing health inequities.
The health of people with low incomes often suffers because they can't afford adequate housing, food, or child care. Such living conditions, and the stress they cause, can lead to higher rates of tobacco and alcohol use and increase the risk of health problems developing or worsening over time.
Poverty affects health by limiting access to proper nutrition and healthy foods; shelter; safe neighborhoods to learn, live, and work; clean air and water; utilities; and other elements that define an individual's standard of living.
Several decades of observational research have generally found that people with lower incomes are more likely to experience a greater burden of illness and premature death. In addition to having a lower life expectancy,6 adults at each higher category of household income have decreased prevalence of many diseases.
Raising awareness through education can help address health equity. Improving resource coordination can also help populations most harmed by health disparities. For example, health care organizations can help reduce ethnic health disparities by offering cultural competency training to health care providers.
Key actions • Introduce a minimum income for healthy living. Ensure the welfare system provides sufficient income for healthy living and reduces stigma for recipients through universal provision in proportion to need (proportionate universalism). A more progressive individual and corporate taxation.
Summary. People living in poverty are less likely to have access to health care, healthy food, stable housing, and opportunities for physical activity. These disparities mean people living in poverty are more likely to die from preventable diseases.
Economically disadvantaged individuals tend to experience the highest rate of mental health issues alongside poorer overall health, reduced mobility, reduced access to health care, and economic limitations that affect access to goods and services that can help with the negative effects of climate change.
Rather, low-income countries must manage such problems as infectious disease, high infant mortality rates, scarce medical personnel, and inadequate water and sewer systems. Such issues, which high-income countries rarely even think about, are central to the lives of most people in low-income nations.
Those with low incomes are more likely than Californians with higher incomes to say their community does not have enough primary care doctors (41 percent versus 31 percent), specialists (42 percent versus 24 percent), and hospitals (34 percent versus 22 percent) (Figure 7).
Individuals with lower incomes are more likely to experience adverse psychosocial factors that can induce a physiological stress response, resulting in higher circulating levels of catecholamines, higher cortisol levels, and increased blood pressure, which are all risk factors for CVD.
Introduction: My name is Msgr. Refugio Daniel, I am a fine, precious, encouraging, calm, glamorous, vivacious, friendly person who loves writing and wants to share my knowledge and understanding with you.
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