Leigh Foran, Staples High School, Westport, Connecticut, USA
HIV/AIDS, tuberculosis (TB), and malaria are considered the “big three” infectious diseases in global health. These illnesses alone account for nearly 3 million deaths every year, ravaging communities and countries around the world (National Center for Biotechnology Information, 2021). While this number alone is staggering, it is even more notable to observe exactly who is getting sick from these diseases. 95% of all AIDS victims, 98% of the world’s TB cases, and over 90% of the deaths from Malaria occurred in developing countries (National Center for Biotechnology Information, 2021).
These statistics display the tragic truth: the connection between poverty and sickness continues to plague the world like a rampant infection. If the fight for equitable global health is to succeed, this devastating correlation must be addressed.
Economic prosperity and wealth provide individuals with an environment that is conducive to health and safety. Because of this, studies consistently show that higher incomes correlate to better health outcomes. Those living in low-income neighborhoods have limited access to healthy foods, shelter, safe housing, clean air and water, and utilities, increasing their likelihood of experiencing health issues (American Academy of Family Physicians, 2021).
One of the ways poverty poisons health equity is by cultivating unequal educational opportunities. Children from low-income families lack access to quality schools and academic experiences, which can negatively impact their health in the future (ChildFund, 2021). For instance, the children of women with no education are 40% less likely to survive than the children of women with 5 years or more of primary school enrollment (Murray, 2006). Education plays a large role in overall health, but poverty decreases the chances of accessing this education in the first place.
The link between cortisol levels and low incomes makes the connection between poverty and sickness increasingly clear. Elevated quantities of this stress hormone can heighten the risk of memory and concentration impairment, heart disease, anxiety, and depression (Mayo Clinic, 2019). Researchers from Dartmouth College studied poor farmers in the Kianaga district of Kenya alongside non-farmers living in the surrounding urban areas. They found that negative events, such as extreme weather concerns, increased the farmers’ cortisol at a greater margin than non-farmers in the city. This revealed that people living in poverty are at a higher risk of increased stress and are more likely to experience negative health effects (Haushofer et al., 2012). Living in poverty brings additional stressors regarding finance, safety, and livelihood, which can all increase levels of cortisol (American Academy of Family Physicians, 2021). Consequently, another symptom rooted in the inequitable connection between sickness and poverty becomes clear: low-income individuals have increased risk of contracting serious medical disorders as a biological result of the stress they experience.
In response to widespread health inequities, multiple nongovernmental organizations (NGOs), such as the Clinton Foundation and the Bill and Melinda Gates Foundation, have provided significant aid to developing countries (American Public Health Association, 2008). Despite this increase in resources, philanthropic efforts alone are not a long-term solution for these nations.
In fact, NGOs can have negative consequences. They encourage health departments to depend on these programs and respond to short-term goals instead of strengthening the overall health systems (American Public Health Association, 2008). NGOs also divert health workers from the public sector, creating separate organizations that isolate communities from governmental health institutions. In this way, they accelerate the weakening of national health systems (Farmer, 2013). Instead of solely relying on international organizations, governmental institutions must provide permanent and effective national health care in order to limit the inequities stemming from poverty.
Stronger public healthcare is necessary to achieve equity and social justice to ensure that everyone has equal access to quality health services (Narain, 2019). Greater investment in these systems will develop the quality and quantity of the institutions, resources, and caregivers present in high-poverty areas, promoting a lasting solution for the disparities present today.
Today, poverty is synonymous with lesser health. Like any disease, it attacks its host and slowly makes life harder to live, breaking down system after system until there is nothing left that can help the host survive. But in this case, there is a tangible cure. By understanding and addressing how millions are trapped in a cycle of poverty and sickness and by strengthening healthcare systems, global health can be made more equitable to sustain a healthier world.
References
Addressing Continuous Threats: HIV/AIDS, Tuberculosis, and Malaria. (2017, May 15). National Center for Biotechnology Information. Retrieved July 2, 2021, from https://www.ncbi.nlm.nih.gov/books/NBK458475/
Chronic stress puts your health at risk. (2019, March 19). Mayo Clinic. Retrieved July 2, 2021, from https://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress/art-20046037
Farmer, P. (2013, September 11). Challenging orthodoxies: The road ahead for health and human rights. Health and Human Rights Journal. Retrieved July 21, 2021, from http://hhrjournal.org/2013/09/challenging-orthodoxies-the-road-ahead-for-health-and-human-rights/
Haushofer, J., de Laat, J., & Chemin, M. (2012, October 21). Poverty Raises Levels of the Stress Hormone Cortisol: Evidence from Weather Shocks in Kenya. Dartmouth College. Retrieved July 2, 2021, from https://www.dartmouth.edu/neudc2012/docs/paper_195.pdf
Murray, S. (2006, March 28). Poverty and health. National Institutes of Health. Retrieved July 2, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1405857/
Narain, J. P. (2019, July). Why Investing in Public Health is So Critical. National Institutes of Health. Retrieved July 21, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6776932/
Poverty and Education. (n.d.). ChildFund. Retrieved July 2, 2021, from https://www.childfund.org/poverty-and-education/
Poverty and Health - The Family Medicine Perspective. (2021). American Academy of Family Physicians. Retrieved July 2, 2021, from https://www.aafp.org/about/policies/all/poverty-health.html
Singh, A. R., & Singh, S. A. (2008, January). Diseases of Poverty and Lifestyle, Well-Being and Human Development. National Institutes of Health. Retrieved July 2, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190550/#CIT115
Strengthening Health Systems in Developing Countries. (2008, October 28). American Public Health Association. Retrieved July 21, 2021, from https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2014/07/23/09/09/strengthening-health-systems-in-developing-countries
Talbot, B. (2006, January 29). The Greatest Poverty [Photograph]. https://www.flickr.com/photos/68634595@N00/92918576