By Jessica Schorr Saxe, M.D.
The Charlotte Observer, June 1, 2018
On Monday, The Poor People’s Campaign: A National Call for Moral Revival will hold rallies in Raleigh and other state capitals focusing on health care and ecological devastation.
You might wonder how poverty relates to health. Profoundly.
In medicine, when we talk about risk factors and “risk factor reduction,” we usually mean conditions such as high blood pressure, diabetes, or high cholesterol as, for example, risks for heart disease.
Low income and low wealth are associated with lower life expectancy; higher rates of heart disease, diabetes, and other chronic illnesses; increased infant mortality; and higher rates of childhood conditions including asthma, heart conditions, hearing problems, digestive disorders, and elevated blood lead levels. “Socioeconomic status is the most powerful predictor of disease, disorder, injury and mortality we have,” says Dr. Tom Boyce, chief of Developmental Medicine at University of California at San Francisco.
The links between poverty and poor health include lack of access to health services, inadequate and unsafe housing, lack of nutritious food, and inadequate physical activity. And science shows that the stress of poverty leads to depressed immune systems. Poor children are more likely to have Adverse Childhood Experiences (ACEs), such as abuse, neglect, or exposure to substance abuse or mental illness. ACEs have been shown to increase the risk of later heart disease, cancer, and other illnesses as well as alcoholism and other detrimental behaviors.
In medical practice, I saw the risks of poverty daily. I saw patients who missed appointments or medication doses because they didn’t have the necessary money. I saw patients who wanted to exercise but whose neighborhoods weren’t safe for walking, couldn’t afford the gym or didn’t have transportation. I saw children so burdened with ACEs that their future was bleak.
Addressing issues related to poverty, an underlying and arguably the most important risk factor for disease, can make a difference. High-quality early childhood programs that support parenting lead to increased educational achievement, higher incomes and better health. One study showed that increasing the minimum wage was associated with a decrease in low birth weight babies and infant mortality. Another study showed that raising the minimum wage in New York in 2008 would have prevented thousands of deaths over the next 5 years. “Mincome,” a guaranteed minimum income experiment in Canada that gave money to low-income residents, decreased hospitalization rates and mental health diagnoses.
What to do? Join us at the Poor People’s Campaign in Raleigh on Monday.
If you can’t attend, learn about it at https://www.poorpeoplescampaign.org and support the demands that include living wage laws; Medicaid expansion, protection of Medicare, and single-payer universal health care; access to mental health professionals and addiction and recovery programs; equal treatment for people with disabilities; and immediate attention to policies that would end child poverty.
Fifty years ago, Martin Luther King led the Poor People’s Campaign against the triple evils of poverty, racism and militarism. Rev. William Barber II, one of the co-leaders of the current campaign which has added environmental degradation as a fourth evil, notes that this is not a commemoration, but a reconsecration.
Join this reconsecration to bring justice and equity — and health — to all.
Jessica Schorr Saxe is a retired Charlotte physician who is chair of Health Care Justice—NC. Contact her at email@example.com.