INTRODUCTION
The topic of this paper is the impact of poverty on the health outcomes of low-income people in society. Poverty is a complex determinant of health due to systematic factors that persist in a family. Poverty may have an intense impact on health and health consequences starting from birth to the entire life of a person. Primary care doctors and public health specialists continue to work in collaboration to improve healthcare systems. As private and tertiary healthcare centres get more integrated, the unique goal becomes more significant, obvious, and focused. In this new era, success implies enlightening outcomes through revolutionizing health care to avoid hurdles associated with social, community, and environmental determinants of health like poverty. Since people treat families and follow patients through multiple life phases, family doctors uniquely perceive the local community’s health concerns. This paper aims to analyze the key social determinant risk factors associated with poverty, explore the significance and prevalence of poverty as a practice problem, and propose an evidence-based intervention and evaluation plan to improve the health outcomes of low-income individuals in the community. This paper will examine subtopics, the population, the problem, epidemiology, goal and objectives, evidence-based population intervention, and evaluation.
Population
This paper is selected, and the suitable population is low-income individuals living in a given society. The three social determinant risk factors connected with this population are poverty, inadequate healthcare facilities, and limited access to healthy food options.
Practice Problem
The National Practice Problem that affects the population of low-income individuals in society is poverty. Poverty occurs when a family or individual lacks ways to meet their needs, like water, food, clothing, and shelter. It also includes a shortage of resources such as education and health care. This has been associated with an increased risk of diabetes, heart disease, and poor health outcomes (Arif & Adeyemi, 2020). These impacts are mediated via systems at the community and personal levels. Poverty inhibits people’s capacity to lessen dangers and engage in healthy practices. For example, in 2020, the federal poverty threshold for a person under the age of 65 was $12,760, and the federal poverty line for a family of four was $26,200.In 2019, around 10.5% of the people living in the US lived below the poverty level. While poverty rates have been dropping in recent years, SDoH reports that inequities like ethnicity, racism, educational achievement, and disability continue to rise instantly. The significance of poverty as a practice problem at the local, regional, or national level is that it disproportionately affects certain populations, including low-income individuals and communities of colour, and can lead to health disparities. The prevalence of poverty in the community is high, with a significant portion of the population living below the poverty line.
Epidemiology measures
Various epidemiology measures and principles can be used to address the issue of poverty. The measures include; asset-based measures, consumption expenditure, education, income, and occupation measures.
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Asset-based measures
Theoretical basis
These measures include the wealth index, which arose in the attempt to solve for measurement of household surveys in low and middle-class income communities. Much, but not all, of the asset index’s theoretical and methodological development has revolved around Demographic and Health Surveys. DHS does not include economic indicators such as consumption expenditure or income. However, they gather data on ownership of various durable products, housing characteristics, and access to basic services. These categories were first entailed in the surveys due to their possible direct effects on health; for example, owning a television was interesting to recognize homes hearing health messaging.
Measurement
When generating an asset from various variables, a choice concerning the weights to apply to each indication must be made. The easiest technique could be to add up the indicators owned by each home. This is arbitrary; because each indication has a similar weight, they are implicitly assigned a similar value in terms of socioeconomic position. Another alternative is to utilize asset indicator regressions on other SEP measures in one data and then use the regression constants as weights to build an asset in a given data from a similar nation.
Interpretation
Asset indexes try to quantify the material dimensions of living situations by measuring SEP at the domestic level. Because the index assesses SEP at the domestic level, its interpretation depends on the individual’s relationship with the household. It might be the parent’s socioeconomic position for young adults and kids still living in the family house or the spousal domestic socioeconomic position for married ladies.
Strengths
The index is a quick and easy way to acquire SEP data, needing questionnaire space and minimum interview time. While the basic concepts of exploration with PCA are sophisticated, their utilization in various statistical tools is straightforward.
Limitations
When employed as a complex score, the asset index measures relative instead of absolute socioeconomic position. It determines SEP ranking within an order across a given population. The ranking contrasts with measurements like consumer spending, which have an ‘absolute’ rate. Thus be compared across and within populations with some adjustment.
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Consumption expenditure
Theoretical basis
This measure aims to quantify the scope to which a household can fulfil its demands by tracking how salary is spent—what items and services are purchased.
Measurement
The idea is most commonly utilized in national account analysis, which usually amounts to a considerable share of GDP. It is known as personal expenses on products and services and excludes capital expenditure, tax payments, business expenditures, and interest payments on mortgages or loans.
Interpretation
It should ideally measure socioeconomic position due to consumption pressing in response to income variations. It is controversial whether health costs should be included in a summary metric. Large expenditures on health care may show bad health, but it also indicates the capacity to pay for health care (Howe et al., 2012). Spending on preventative health interventions shows a willingness to pay for the intervention but does not reflect existing illness.
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Education
Theoretical basis
Education is normally proportional to the health status of a person. For instance, someone educated has experience with the impacts and effects of certain diseases and is, therefore, able to control them.
Measurement
Education is quantified in terms of the years spent pursuing school, qualifications attained, and literacy. Using a constant measure of completed years of education suggests that every year used up in education contributes equally to socioeconomic position. Many circumstances, particularly the health result under investigation, will determine whether this assumption is likely correct.
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Income
Measurement
However, income in low-income nations is more problematic to quantify due to a larger dependence on the informal sector, seasonal activities, and self-employment. Depending on the context, informal and periodic work may be more widespread than official employment, but several occupations and home businesses may be common. Homes may have several ways of generating income, revenue may differ significantly between centuries, and revenue may be commodities.
Interpretation
Income can be calculated for a person or a household as a whole. In general, the explanation of income measurements attempts to quantify the material components of SEP. The bidirectional link between health and income may be especially crucial in LMICs, where inadequate security systems in most locations can lead to illness, which has a particularly detrimental influence on income (Howe et al., 2012).
Analytical epidemiology
The association between poverty and health outcomes may be investigated using analytical epidemiology. Researchers can use this form of epidemiology to determine causation and identify specific variables that contribute to poverty-related health inequalities (Moss et al., 2020). Observational studies, such as case-control or cohort studies, are one method of analytic epidemiology that may be utilized to address poverty’s influence on health. These studies can uncover particular risk factors for poor health among poor people, such as a lack of healthcare, bad housing conditions, or poor access to good food.
Surveillance
Epidemiological monitoring is the basis of all preventative and control efforts. Surveillance is organized analysis, collection, explanation, and distribution of data concerning a health-related occurrence; for performing actions”. It is also an essential component of health practice. It also involves observing the spread of disease to recognize the patterns of movement, thereby getting the control measures to evade the spread of the disease (Ibrahim, 2020). Real-time epidemiological data analyses are urgently needed to raise awareness of the problem and prompt solutions.
Ethical concerns
Data confidentiality was promised among the participants. The surveillance data questions were distributed directly to the participating population to preserve anonymity. The concerns related to the use of the data are privacy concerns and the potential for stigmatization of specific people.
Goals and objectives
One Healthy People 2030 goal addressing poverty’s challenge is to “eliminate poverty and improve the economic well-being of families. In the United States, 1 in 100 individuals lives in poverty, where they cannot afford healthy living, healthy eating, and even healthcare facilities like clinics and hospitals. One healthy People 2030 goal focuses on helping people achieve economic stability. Several people who have secure jobs need more funds to buy the goods they need to be healthy. Career coaching, employment initiatives, and quality childcare options can aid more individuals in retaining and acquiring employment. Moreover, measures that help people pay for clothing, food, healthcare, rent, and education can lessen poverty while cultivating well-being and health.
A measurable objective using the SMART format to help achieve this goal is to “eradicate the poverty rate in the community by 20% within the next eight years. Several measures can be put in place to eradicate poverty among low-income societies. Some measures include implementing programs to educate people on significant ways to earn their daily living and offering education through billboards and posters on the importance of financial literacy.
Evidence-Based Population Intervention
One intervention from the research study is a community-based program to provide relevant education concerning various ways to solve financial poverty. The program also provides job training and financial literacy education for low-income people. This intervention falls under the “system, policy, and environmental change” on the Minnesota Public Health Wheel. This intervention aims to address the underlying causes of poverty by providing low-income people with the resources and skills they need to enhance their economic well-being.
Evaluation
Combined qualitative and quantitative methods can be used to evaluate if the intervention is equitable, efficient, and effective. Quantitative approaches employ statistical analysis and numerical data to quantify and comprehend phenomena. In the context of poverty and health outcomes, quantitative approaches may be used to quantify changes in poverty rates in a community and changes in low-income people’s health outcomes (Zimmerman et al., 2021). Measuring changes in poverty rates in a community may entail gathering information on the people and families living below the poverty line, as well as the proportion of the population that falls into this group. Measuring changes in low-income persons’ health outcomes include gathering data on various health indicators such as chronic illness prevalence, newborn mortality, and life expectancy.
In addition, interviews and focus groups with program participants to get feedback on their experience with the program and its influence on their lives are examples of qualitative methods.
Conclusion
The challenge of poverty significantly impacts the health outcomes of people in low-income societies. Poverty is a complex determinant of health due to systematic factors that persist for generations in a family. Poverty may have an intense impact on health and health consequences starting from birth to the entire life of a person. Primary care doctors and public health specialists continue to work in collaboration to improve healthcare systems. Poverty may have an insightful impact on health and health consequences starting from the birth of a child and throughout their entire life. Several qualitative and quantitative methods can be used to evaluate the impacts of poverty on health outcomes and thereby help eradicate poverty in low-income communities. The evidence-based intervention that is a community-based program is a proper way to address the challenge of poverty in low-income society. Services like job training and education also help improve people’s economic stability.
References
Arif, A. A., & Adeyemi, O. (2020). The prevalence of chronic diseases among current and ex-miners in the United States. Journal of Occupational & Environmental Medicine, 62(3), 227-231. https://doi.org/10.1097/jom.0000000000001809
Howe, L. D., Galobardes, B., Matijasevich, A., Gordon, D., Johnston, D., Onwujekwe, O., Patel, R., Webb, E. A., Lawlor, D. A., & Hargreaves, J. R. (2012). Measuring socioeconomic position for epidemiological studies in low-and middle-income countries: A methods of measurement in epidemiology paper. International Journal of Epidemiology, 41(3), 871–886. https://doi.org/10.1093/ije/dys037
Ibrahim, N. K. (2020). Epidemiologic surveillance for controlling Covid-19 pandemic: types, challenges, and implications. Journal of Infection and Public Health, 13(11), 1630–1638. https://doi.org/10.1016/j.jiph.2020.07.019
Moss, J. L., Pinto, C. N., Srinivasan, S., Cronin, K. A., & Croyle, R. T. (2020). Persistent poverty and cancer mortality rates: An analysis of county-level poverty designations. Cancer Epidemiology, Biomarkers & Prevention, 29(10), 1949-1954.
Zimmerman, A., Garman, E., Avendano-Pabon, M., Araya, R., Evans-Lacko, S., McDaid, D., … & Lund, C. (2021). The impact of cash transfers on mental health in children and young people in low-income and middle-income countries: a systematic review and meta-analysis. BMJ global health, 6(4), e004661.
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