Live Online Event: How does poverty affect health decisions?

Poverty affects every aspect of life and has particularly bad repercussions on human health. The stress of poverty has detrimental effects on the body — and especially the brain.

Two landmark studies are among the many to show poverty’s harsh impact. In the Whitehall Studies, researchers at the University College of London sought to understand how the health of men in the British Civil Service varied by rank. Published in 1978, the first study showed that men ranking lowest were nearly four times more likely to have their lives abruptly ended by heart disease than those at the top. More recently, economist Barry Bosworth at the Brookings Institute and Kathleen Burke of the Consumer Financial Protection Bureau published a study in April 2014 about the life expectancy of women in their mid-fifties with similarly morbid results. A woman at the top of the income scale could expect to live an entire decade longer than a woman of the same age at the lower end.

Obvious reasons exist for health problems among the poor. Physician shortages in low-income neighborhoods leave individuals in these areas with hard options. The closest primary care physician may be over an hour’s ride away on public transportation, which makes it financially taxing and time consuming to make prescribed visits. Beyond the health care system, individuals living below the poverty line are usually overworked, sleep deprived, not able to afford healthy food, and constantly exposed to less than adequate living conditions. The list goes on.

shutterstock_177309557Scientists have begun to discover that poverty takes its toll on health starting at an early age. A recent study published in Nature pointed to telomeres, which are the caps on the end of chromosomes. The research showed that children who grew up in low-income families had shorter telomeres than their peers from more wealthy families. While telomere length naturally reduces with aging, premature shortening of telomeres can lead to a shortened lifespan, as well as an increased risk of chronic disease.

Poverty May Affect Cognitive Function

This host of daily problems also causes toxic stress that doesn’t just target the immune system; it influences almost every aspect of the body, including the brain.
“Studies show chronic stress can change the chemical and physical structures of the brain,” Annie Gilbertson explains in her recent article, “Teaching Through Trauma.”
These changes can be linked to impairments in attention, concentration, memory, and cognition.

One haunting finding is that damage can be done before a child is even born. Psychological and physiological mechanisms activated in response to the stress of poverty send signals to a developing fetus about this environment. According to a 2012 study published in The Journal of American Academy of Pediatrics, stress-induced changes in brain architecture that occur in utero “have potentially permanent effects on a range of important functions, such as regulating stress physiology, learning new skills, and developing the capacity to make healthy adaptations to future adversity.”

With such cognitive disadvantages from the start, it’s no wonder that those in poverty don’t always make health conscious decisions. Johannes Haushofer and Ernst Fehr examined decision-making skills of individuals living below the poverty line in their recent research On the Psychology of Poverty. They found that individuals who are financially constrained favor short-term over long-term benefits when making decisions. This type of thinking is what drives a person with persistent chest pain to self-medicate in lieu of visiting a doctor, or to invest their paycheck in a tv instead of gym membership.


Intervening in the Cycle of Poverty

Does poverty automatically lead to a hopeless health outcome? A number of community-based interventions hope to turn the prognosis around. For example, some schools that serve low-income students have been looking for ways to support students and their families inside and outside of the classroom. These efforts include counseling for kids who have been through a traumatic experience or are battling a mental health issue, tutoring for students who are struggling with academics, and helping parents find healthcare providers. Other organizations cater to the needs of low-income areas by offering a one-stop-shop sort of clinic that not only offers basic medical care, but also groceries, eyeglasses, and clothing.

With more inclusive and accessible healthcare options, there is hope that some of the health problems caused by poverty will be abated.

Scientists are also making efforts to find the best way to help reverse or eradicate poverty’s health effects. Could education about basic health and nutrition for low-income populations help? Could cash transfers improve some of the health problems that result from poverty?

poverty hangout

To learn more about psychology of poverty and which interventions work best to thwart the cycle, join a live online event. Participants include:

Joe Rojas-Burke (moderator): Independent Journalist and Author of “The challenge of writing about people in poverty
James Redford: Director of Paper Tigers
Laura Gottlieb, MD, MPH: Center for Health and Community at UCSF
Johannes Haushofer: Postdoctorate at MIT’s Abdul Latif Jameel Poverty Action Lab
Teri Barila and Mark Brown: Children’s Resilience Initiative

By: Lydia Marks