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Social Determinants of Health

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From:
Dennis Raphael <[log in to unmask]>
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Social Determinants of Health <[log in to unmask]>
Date:
Sat, 30 Sep 2006 15:46:41 -0400
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http://www.cnn.com/2006/HEALTH/08/29/poverty.health

  Poverty and poor health are intertwined, experts say
By Sabriya Rice CNN

Poverty in the United States increased 20 percent between 2000 and 2004,
census numbers show. And although the trend stalled in 2005, researchers
worry poverty will have profound effects on public health in this country.

Poverty and its effects are a chief issue for former President Bill
Clinton's Global Initiative. Clinton is bringing together a non-partisan
group of world leaders on September 20 in New York to try to match
innovative problem-solving with resources.

"More possibility for growth and more possibility for prosperity for
Americans is a very inexpensive thing to do, if you do it well," the former
president said.

Risk all around
New research indicates that it's not just the poor who are getting poorer.
An analysis of poverty rates and health published in the September issue of
The American Journal of Preventive Medicine found that people living in
extreme poverty tend to have more chronic illnesses, more frequent and
severe disease complications and make greater demands on the health care
system.

"When we talk about poverty, there is the tendency to feel it affects a
small percentage of the population and the rest of us are doing better,"
said Steven Woolf, a professor at Virginia Commonwealth University and
author of the study. But in this situation, he said, "we're all doing a
little bit worse."

A Census Bureau report released Tuesday said that U.S. salaries across the
board increased minimally, about $500 a year between 2004 and 2005. It's
also the first year that the poverty rate has not worsened since before
President Bush took office.

The modest salary increase is not enough to counter what Woolf's study
calls a "sinkhole effect" on income, a disparity shifting middle- and
upper-class families closer to the poverty level.

Fewer people can claim "poverty doesn't affect me" as more individuals face
layoffs and cutbacks, and are unable to afford health insurance, Woolf
said. According to the National Coalition on Health Care, the average
family pays about $2,700 a year for health insurance, not including
out-of-pocket expenses for co-payments and prescription drugs. That number
is expected to rise to $3,200 by the end of 2006.

As financially strapped families struggle to cover basic needs such as
food, shelter and the increasing cost of energy, health insurance often
takes a back seat on the list of priorities. A National Health Survey
conducted by the U.S. Centers for Disease Control and Prevention found more
than 40 million people of all ages went without insurance at some point in
2005.

More than half remained uninsured specifically because they simply couldn't
afford it, the CDC said. Research consistently highlights the negative link
between reduced income and worsening health -- as salaries drop,
individuals tend to be more stressed, and generally lead less-healthy
lifestyles.

"These people are going to develop diseases at a higher rate and the health
care system is going to feel the brunt of it," Woolf said.

Poverty's impact is felt most by the nation's children. Children under the
age of 5 are more likely to live in extreme poverty. Uninsured children are
at greater risk of experiencing health problems such as obesity, heart
disease and asthma that continue to affect them later in adulthood. The
prevalence of these illnesses does not bode well for future generations,
Woolf said.

"If we amplify the scale by the results of poverty left to run loose, the
economic consequence to everybody, to all Americans and all taxpayers, will
be substantial," Woolf said. The prevailing thought is that the problem
needs to be addressed, and quickly, he said.

By making the public more aware of the direction the economy is taking,
researchers say they hope policies can be put into place that will keep
Americans from living under such difficult conditions in the wealthiest
country in the world.

Sabriya Rice is an associate producer with the CNN Medical Unit.








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