Poverty is a problem for all of us…and it reaches across the generations.

The health effects of poverty begin in early childhood and persist through a person’s lifetime. Poor children have a higher rate of asthma and lower rates of cognitive development. By middle age, diabetes and heart disease hit the poor harder than more affluent Americans. Among older Americans, those living below the poverty line are far more likely to have three or more chronic conditions than those whose incomes are four times greater than the poverty line.

Poverty costs not only the poor, but the overall U.S. economy as well. Based on a subset of the potential quantifiable consequences of poverty, the economic costs of sustained childhood poverty alone amount to $500 billion per year — nearly 4% of the U.S. GDP of the U.S.

A new study from the Robert Wood Johnson Foundation, The Poor Pay More: Poverty’s High Cost to Health, by Dr. George Kaplan of the University of Michigan School of Public Health (my alma mater).

Poor environments in childhood set the stage for ill health later in life. Environmental factors that negatively impact kids’ health include exposure to hazardous waste and bad air, as well as crime and disorder. Furthermore, lack of access to healthy foods – fresh fruit and vegetables – leads to higher incidence of obesity and heart un-healthy food habits. The report cites the impactful statistic that within walking distance of schools in lower income neighborhoods there are one-third more fast food restaurants and 50% percent more convenience stores than near schools in higher income neighborhoods. Citing a 2008 study by Zenk and Powell, curbing the obesity epidemic among adolescents requires addressing the food environment surrounding schools.

Because poorer Americans often lack health insurance benefits from employers, many poor and near-poor families don’t have adequate access to health care. This translates into less access to preventive care, diagnostic services and treatment. Of over 53 million people without health insurance some time in 2007, nearly two-thirds of 18 to 64 year old almost two-thirds of poor 18 to 64 year olds had no health insurance.38

Health Populi’s Hot Points: How to break the cycle of poverty and ill health in the United States? The diagram illustrates five strategic pillars that, together, would ameliorate the underlying negative forces that shape poor health among the poor. These challenges are:

  • To raise the economic status of the poor
  • To reinforce the safety net
  • To provide affordable health care
  • To improve where the poor live
  • To invest in early childhood and in education.

All five of these areas are, in fact, investments in the future health of Americans. Beyond the health of the individuals who would directly benefit in this investment strategy is the larger nation and its citizens. If we break the poverty cycle in early childhood, the lifelong benefits of healthy, hard-working taxpayers would accrue to the macroeconomy. And, wouldn’t it be nice for the health status of America to be raised from the position at #37 in the World Health Organization’s rankings of health systems.