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Social Medicine: Prescribing Information to Bridge the Gap between Poverty and Health

Any good healthcare provider will tell you that there is no one single cause to diseases or illnesses. While there are a host of variables and conditions that contribute to poor health, poverty is usually a common cofactor. Globally, 1.2 billion people live in extreme poverty, while one in eight Americans live under the poverty line [1,2]. Poor people living in poor neighborhoods often lack basic needs and resources and are vulnerable to bad health. Although social service organizations and other government programs provide communities with some resources, they are sometimes difficult to access. Much of this difficulty can be attributed to little knowledge of their existence. Lack of information on resource needs is thus a significant contributing factor to the poor health of low income communities and one that can be remedied by social medicine. Social medicine organizations are however few and located only in select cities, so more work is needed to breach the information gap.

A significant number of people in need of social service help do not get it because they lack the information needed to obtain it. While it is regrettable to see people suffer the lack of a resource because of their economic woes, it is even more unfortunate if they are eligible to receive the help they need but yet do not receive it. One can ascribe this failure to unawareness of the existence of the resource, ignorance of eligibility, and/or inability to properly complete whatever is required to obtain the resource. All of these factors ultimately point back to insufficient information or the lack of it altogether. This phenomenon is widespread and is often a great hazard to providing resources to basic needs. Over 17 million Americans eligible for food stamps do not obtain them [3]. At least 6 million tenants who are 50% below the area median income do not receive rental assistance from the Housing and Urban Development (HUD) despite their eligibility for this benefit [4]. 70% of uninsured children in America eligible to enroll in SCHIP (State Child Health Insurance Program) [5] remain uninsured.

The basic needs and resources low income families go without due to lack of information eventually results in poor health. Food insecurities among expectant mothers can lead to low birth weight in newly born children [6].  Children who experience difficulty in accessing food may end up with poor health and have a greater incidence of chronic illnesses such as hypertension, hyperlipidemia,and diabetes [7]. Families with energy problems are at risk of exposing children to a greater risk of hospitalization [8]. Inadequate housing among low income families is also a huge health hazard to both adults and children. Poor living and housing conditions are often associated with malnutrition, especially in children [9]. Household members are also at greater risk of mold exposure, lead poisoning, and asthma attacks.

Social medicine, the provision of non-medical help geared toward improving an individual’s health, is an efficient means of combating the aforementioned lack of information. Organizations such as Project HEALTH (PH) [10], LIFT [11], and Single Stop USA [12] are examples of the few not-for-profit organizations that provide information on social services, community resources, government programs and financial education to help combat the effects of poverty and promote better health. PH operates from Family Help Desks in local hospitals and community clinics staffed by a trained college volunteer workforce in six cities in United States. PH provides clients with information on resources for food, housing and employment. LIFT is a similar program aimed at combating poverty and improving the health and lives of its clients. Single Stop USA advises its clients on relevant financial issues and provides information on how to access previously unknown resources in order to better their life and health. All of these organizations work to eliminate the lack of information that has plagued most low income communities.

Social medicine organizations are few in number with a limited scope of influence and thus there still remains a huge void to fill in the provision of information to those who need it. These organizations are usually located in major cities such as Boston, Chicago, New York City, and Washington, D.C. The magnitude of their impacts underscores the need for their presence in more cities. In 2009, Single Stop USA helped over 120,000 low income families access over $300 million dollars in benefits [13]. An average of around 52% of families that visit the Project HEALTH Family Help Desk obtain at least one of the resources they need in the first three months with the rest receiving follow-ups until they obtain their resource [14].While some social medicine organizations have plans to open up more sites, a bulk of these new sites will be in locations they already have a presence in. That said, the quest to dispense social medicine continues and with organizations like Project HEALTH finding other ways to expand their influence such as working more closely with doctors and social workers – 30% of their clients have been referred by care providers [15] – we can make significant headway in bridging the gap between poverty and health.

References

  1. World Health Organization. Poverty and Health. July 19, 2010.
  2. DeNavas-Walt Carmen. Bernadette D. Proctor. Jessica C. Smith. Income, Poverty, and Health Insurance Coverage in the United States 2007. August 2008 U.S. Census Bureau.
  3. Food Research and Action Center. State of the States: 2007. A Profile of Food & Nutrition Programs Across the Nation. June 2007.
  4. HUD. Affordable housing needs report to congress 2005. May 2007.
  5. Kaiser Commission on Medicaid and the Uninsured/Urban Institute. Health Insurance Coverage of the Nonelderly by Poverty Level, 2007. March 2008.
  6. Borders, Ann E. Bryant MD, MSc; Grobman, William A. MD, MBA; Amsden, Laura B. MSW MPH; Holl, Jane L. MD, MPH.  “Chronic Stress and low birth weight neonates in a low income population of women”. Obstetrics & Gynecology:February 2007 – Volume 109 – Issue 2, Part 1 – pp 331-338.
  7. 7. Hilary K. Seligman, Barbara A. Laraia and Margot B. Kushel. Food Insecurity Is Associated with Chronic Disease among Low-Income NHANES Participants. Journal of Nutrition Vol. 140, No. 2, 304-310, February 2010.
  8. Cook, John T. Deborah A. Frank, Patrick H. Casey, Ruth Rose-Jacobs, Maureen M. Black, Mariana Chilton, Stephanie Ettinger deCuba, Danielle Appugliese, Sharon Coleman, MS, Timothy Heeren, Carol Berkowitz, Diana B. Cutts. “A Brief Indicator of Household Energy Security: Associations with Food Security, Child Health, and Child Development in US Infants and Toddlers”. Pediatrics Vol. 122 No. 4 October 2008, pp. e867-e875.
  9. Myers Alan, Diana Cutts, Deborah A. Frank, Suzette Levenson, Anne Skalicky, Timothy Heeren, John Cook, Carol Berkowitz, Maureen Black, Patrick Casey, Nieves Zaldivar.“Subsidized housing and children’s nutritional status”. Archives of Pediatric and Adolescent Medicine Vol. 159 No. 6, June 2005; 159:551-556.
  10. 10.  Project HEALTH. http://www.projecthealth.org/.
  11. 11.  LIFT. http://www.liftcommunities.org/.
  12. 12.  Single Stop USA. http://www.singlestopusa.org/.
  13. 13.  Single Stop USA. 2009 Results. http://www.singlestopusa.org/2009results.html. [Accessed August 17, 2010].
  14. 14.  Project HEALTH. Our Impact on Families. http://www.projecthealth.org/impact-families. [Accessed August 17, 2010].
  15. 15.  Project HEALTH. Our Impact on Clinics. http://www.projecthealth.org/impact-clinics [Accessed August 17, 2010].

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  • thanks for posting.. Nice shared%D%A

  • Emmanuel Aryee

    You are welcome. Thanks for reading. It is important for people to know the consequences of the lack of information in our society and what other are doing to remedy it.