Key Facts: Poverty and Poor Health | Health Poverty Action
DAC Guidelines and Reference Series: Poverty and Health . the OECD Health Project which aims to analyse, measure and improve the developing countries is another example of the fruitful collaboration between our two institutions relationship with partner countries to achieve sustainable health improvements that. What other links are there between poverty and poor health? corporate tax evasion, are central to what is needed from the global community. Poverty creates ill-health because it forces people to live in environments that make them sick, without decent shelter, clean water or adequate sanitation.
There is a social gradient in health. This social gradient in health runs from top to bottom of the socioeconomic spectrum. If you were to look at, for example, cardiovascular disease mortality according to income group in Canadamortality is highest among those in the poorest income group and, as income increases, mortality rate decreases.
Poverty and Health
Poverty in childhood is associated with a number of health conditions in adulthood. Children who live in poverty are more likely to have low birth weights, asthma, type 2 diabetes, poorer oral health and suffer from malnutrition.
- Key Facts: Poverty and Poor Health
But also children who grow up in poverty are, as adults, more likely to experience addictions, mental health difficulties, physical disabilities and premature death.
Children who experience poverty are also less likely to graduate from high school and more likely to live in poverty as adults.
Poverty and Health
People living in poverty face more barriers to access and care. It has been found that Canadians experiencing low-income are more likely to report that they have not received needed health care in the past 12 months. Individuals in low income are also twice as likely as those in the highest income group to visit the emergency department for treatment. Deaths were attributed to central nervous system infection 11malaria 3urinary tract infection 2gastrointestinal infection 1 and undifferentiated sepsis 1.
Both poor and non-poor households relied predominantly upon the often informal private sector for medical advice before reaching the referral hospital, but MPI poor participants were less likely to have consulted a qualified doctor. We conclude that multidimensional poverty is associated with greater pre-hospital delays and expenditure in this setting.
Closer links between health and development agendas could address these consequences of poverty and streamline access to adequate healthcare. Introduction Bangladesh, in common with most rapidly developing countries, is subject to profound inequities of wealth and health [ 1 — 4 ]. Poverty—the state of multidimensional deprivation in which basic needs cannot be met—is inextricably linked with disease. This relationship is complex and bi-directional: The goals of alleviating poverty and improving global health have become a converging focus of development and public health initiatives nationally and internationally [ 6 — 9 ].
Reducing inequities of wealth and healthcare has an essential role in addressing the burden of many diseases, and quantifying these inequities is a fundamental prerequisite [ 7 ].
Acute febrile illness AFI accounts for the majority of illness episodes in the Chittagong Division, and for much of the excess burden of disease associated with poverty [ 1011 ]. In most cases, the aetiology of AFI is unknown at the time of admission to the referral hospital; once hospitalized, characterization of the disease usually remains limited by available diagnostics and cost to clinical impression from symptoms, signs, basic microbiology, and malaria diagnostics.
This aetiologic uncertainty is a major challenge to effective clinical care and public health, and necessitates the pragmatic approach of a broad case definition when considering healthcare-seeking behaviour [ 12 ]. Prompt and effective treatment of malaria, meningitis, enteric fever, sepsis, and other causes of serious AFI in this setting can save lives and reduce morbidity [ 13 — 17 ].
Hence, identifying and addressing barriers to care is essential. However, there is limited understanding of the socioeconomic risk factors and consequences of AFI. Most reports on the correlation between AFI and poverty have come from community-based surveys, where the majority of illnesses encountered are self-limiting and minimally investigated [ 1018 ]. In contrast, patients with the most burdensome and best-characterized infections converge upon the in-patient hospital setting, where reports of morbidity and mortality are frequently compiled, but rarely disaggregated by socioeconomic status.
The multidimensional poverty index MPI was developed by the Oxford Poverty and Human Development Initiative OPHI with the aim of providing a validated, easily administered, and internationally applicable metric for assessing household deprivation, and steer recommendations to reduce poverty [ 20 ]. This index identifies household living standards, education, and chronic health status defined by nutritional status and exposure to child mortality as co-existing dimensions of poverty, and links its assessment parameters directly to the priorities of the Millennium Development Goals.
The United Nations Development Programme has recently adopted MPI as an international standard for assessment, tracking, and planning of progress in the global fight against poverty [ 21 ]. This investigation seeks to complement previous, community-based studies of the socioeconomic background of people with AFI in Bangladesh, by characterizing the subset of patients admitted for acute medical management [ 101122 — 24 ].
We report a survey of patients with AFI attending a large referral hospital in Bangladesh, and describe the relationship between poverty and pre-hospital delays.
These Government Health Complexes GHC are intended to provide a broad range of out-patient services, and have very limited diagnostic facilities such as rapid diagnostic tests, RDTs ; most also support 30—50 in-patient beds under the supervision of a small medical and nursing team.
Secondary level services are provided by District Hospitals, with out-patient facilities, 50 to in-patient beds, and limited laboratory and radiographic capabilities.
Within the public sector, consultations with healthcare workers are free of charge, but fees for provision of medication and investigations, as well as inpatient care, vary. Health Complexes and District Hospitals both make direct referrals to tertiary referral hospitals such as Chittagong Medical College Hospital CMCHwhere this investigation was undertaken [ 2627 ].
The true catchment population of CMCH is difficult to define. In addition to formal referrals from public and private secondary level services, a large number of patients are admitted via the Emergency Department after attending on the informal advice of practitioners or by self-referral.
Alongside public sector health facilities, the private sector delivers a large proportion of medical care at all levels, where payment for consultations, investigations, and treatment is usually out-of-pocket.
Shops and pharmacies sell over-the-counter and prescription medication, and many shopkeepers and pharmacists give informal medical advice.
We define Allopathic Practitioners as those who provide allopathic healthcare advice in a private chamber, but who lack MBBS, LMF, or higher qualification or whose qualification is unknown. Alongside Allopathic Practitioners, healers from homoeopathic, herbalist, Ayurvedic, and spiritual backgrounds also provide health advice and treatment within the private sector, and are here defined separately, as Traditional Healers [ 1022 ].
In-patient services are also present in the private sector, with numerous private hospitals, concentrated in urban centers. Participants were recruited continuously from September to September Patients were recruited from the three adult general medical wards and one general pediatric ward.
Over the study period, a total of 39, patients were admitted to the adult medical wards, and 15, to the pediatric ward with all clinical presentations; the total number of patients presenting with AFI was not available.
Screening and recruitment procedures Informed, written consent was obtained from patients or legally acceptable representatives in all cases.
For adults with capacity to give consent to participate, informed, written consent was obtained from the patient directly.
For children and adults without capacity to give consent, informed, written consent was obtained on behalf of the patient from the next of kin, caretakers, or guardians.
A team of six medical and pediatric resident junior doctors acted as interviewers for this survey. All interviewers were fluent speakers of Bengali and Chittagonian.