Lifestyle

As income declines, so does health | Gustafson

The number of Americans living below the official poverty line has increased to 46.2 million, according to just released statistics by the Census Bureau. It is a record in the 52 years the bureau has surveyed poverty in the United States.

The median household income fell nationally last year back to the levels of 1997. It is the first time since the Great Depression that Americans earned less, adjusted for inflation, than they did more than a decade ago.

Predictably, minorities were hit the hardest, with poverty rates twice as high as those of non-Hispanic whites. Southern states had the highest amount of people falling below the poverty line – almost double the rate of the Northeast, Midwest and West.

The poverty threshold is an annual income of $22,314 for a family of four and $11,344 for a single person.

"This is truly a lost decade," said Lawrence Katz, an economics professor at Harvard University. "We think of America as a place where every generation is doing better, but we're looking at a period when the median family is in worse shape than it was in the late 1990s."

As income declined, the number of people without health insurance coverage rose. Nearly 50 million are now uninsured, almost a million more since 2009. For many working-age Americans, job loss and long-term unemployment lead to loss of employer-provided health insurance or affordable alternatives. And those who are working often struggle to maintain their coverage. In 2010, approximately 55 percent of working Americans were insured by their employers, a 10 percent decrease from 2000, according to the census report.

Studies on the causes of poverty have shown that there are three important components that hold together the social safety net for most people: Income, health and relationships. If one of these fails, the other two are usually still able to bridge the gap, at least for some time. However, if two out of three are diminished, the chances for falling into poverty and even homelessness rise sharply.

In other words, if you lose your job but are healthy and have a stable marriage or partnership (especially if there is a second income in a household), you are much better equipped to get through the ordeal of temporary unemployment than if you are sick and/or on your own. That may sound like a no-brainer, but it is exactly the kind of situation that most poor people are dealing with.

Youth affected

The harsh realities of poverty affect the youngest members of society even more. Twenty-two percent of children and adolescents under 18 are now considered poor. Hunger or what is called in bureaucratic terms, "food insecurity," affects 15 million kids in this country today. Considering the importance of healthy nutrition for normal physical and mental development at a young age, there is a whole generation that is being lost in front of our eyes.

Nutrition-related diseases, such as obesity, diabetes and high blood pressure, are most common among the poor. With healthy foods out of reach because of high prices and lack of outlets in low-income neighborhoods, poor families have little choice but to survive on junk food.

The New York City Department of Health and Mental Hygiene has recently published a report on "Health Disparities in Life Expectancy and Death," documenting current health disparities in New York City based on differences in race, ethnicity and economics. Other factors included in the study were social and physical environmental conditions, opportunities, stressors that impact health, access to primary and preventive health care and quality of health care received.

Trying to identify how poverty and health are interrelated, the researchers wrote: "Living in poverty makes it difficult to know about, find or access a variety of resources that promote health and prevent illness. For example, people living in poor neighborhoods may have access to fewer opportunities to exercise and buy healthy food. Living with limited resources also increases stress and anxiety, which can, in turn, lead to unhealthy habits, like smoking and drug use. In the other direction, poor health can prevent people from completing their education and obtaining well-paying jobs, which can lead to subsequent poverty."

In other words, the decline of income, social safety and health are all part of the same vicious cycle. To break it, the Health Department makes a number of recommendations, including setting up "health policies that benefit vulnerable populations," directing "resources to target communities disproportionately affected by illness and premature death," and implementing "policies that reduce economic and social disadvantages."

In the meantime, the White House and Congress continue debating how to cut hundreds of billions of dollars more from entitlements and aid programs. I guess the statistics are not scary enough just yet.

Timi Gustafson R.D. is a clinical dietitian and author of the book "The Healthy Diner – How to Eat Right and Still Have Fun"®, which is available on her blog, "Food and Health with Timi Gustafson R.D." (www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter (twitter.com/TimiGustafsonRD) and on Facebook.

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