1. Consequences of healthcare expenditures on standard of living
2. Poverty is associated with higher rates of diseases
3. Poverty is associated with shorter life expectancy
4. Poverty, health and race
5. Poverty and road safety
Healthcare is expensive, and may push some people into poverty, and poor people will generally have less resources available for healthcare. Here’s a graph showing the poverty rates in the US before and after health expenses:
The share of people that fall below the poverty line rises if health expenses are taken into account (especially for the elderly, of course, since they spend more on health care). Since poor people are generally less well protected by health insurance (see data for the US in the graph below), their expenses will be relatively higher.
Hence it’s no surprise that the data on poverty and health indicators show strong correlations.
Living in poverty is associated with lower life expectancy, high infant mortality, poor reproductive health, higher rates of infectious diseases (notably tuberculosis and HIV infection), higher rates of substance use (tobacco, alcohol and illegal drugs), higher rates of non-communicable diseases, depression and suicide, and increased exposure to environmental risks. Poor children are more likely to die by the age of five years and to suffer from acute respiratory infections, diarrhea, congenital anomalies and chronic diseases. (source)
For example, rich men in their early 60s report similar health to poor men in their late 30s:
There’s also a correlation between poverty and depression, as this Gallup Poll points out. 30% of poor Americans have been diagnosed with depression, compared to the overall total of 17% of Americans:
From this it’s not clear if the burden of poverty causes depression, or if it’s more likely that the burden of depression causes poverty. Probably it’s a bit of both. In any case, this echoes the link between wealth and happiness.
The same is true for other diseases, such as asthma. Children with asthma are almost twice as likely as all children to be below the poverty line, and less than half as likely to live at 4-times the poverty line or higher:
The correlation between poverty rates on the one hand and rates of disease or health outcomes on the other has to do with the cost of healthcare. Poor people have less resources to buy healthcare, which translates into worse health outcomes. Here’s a graph showing the percentage of US adults aged 18-64 who did not get needed prescription drugs because of their cost, by poverty status:
Again, an important cause of this is inadequate health insurance.
Poverty kills, it seems. As if it’s not bad enough in itself. Although death is often multi-causal, one study has tried to estimate in how many cases poverty is a contributing factor:
For 2000, the study attributed 176,000 deaths to racial segregation and 133,000 to individual poverty. The numbers are substantial. For example, looking at direct causes of death, 119,000 people in the United States die from accidents each year, and 156,000 from lung cancer.
How does the causal chain operate? Poverty contributes to poor health, in different ways:
- poor people tend to have jobs or occupations that are physically hazardous
- they often live in environmentally unsound circumstances
- they can’t afford a healthy diet
- their lack of education makes it harder to take the right health decisions
- they may lack adequate health insurance and health screening
- substandard housing can cause health problems etc.
Life expectancy – an important indicator of health – in a poor neighborhood of Glasgow, U.K. , is on average 20 years shorter than in the richer parts of the same city:
Black males in the US, who are generally and relatively more at risk of being poor, have a life expectancy of 69, compared to 87 for Asian females.
Another example of the “poverty kills” principle: in low-income neighborhoods in NYC, children face a higher risk from traffic. The same is probably true in any other city, but I only have data for NYC:
Intersections near public housing appear to be particularly dangerous for children trying to cross the street. That is the case even after correction for a neighborhood’s population size. The design of roads, intersections and public housing complexes is probably one of the major causes of this, together with the fact that poor people and poor children in particular are more likely to use the roads as pedestrians (they have less entertainment alternatives and make less use of cars).
More on the link between poverty and health is here.