Author: Adekola Taylor
It is no exaggeration saying disease, health and poverty are interrelated when it comes to the various causes of diseases and the approaches being adopted by various nations in tackling the menace of poverty and diseases. It is generally accepted that health is wealth. Living healthily is more economical than living unhealthily because a healthy individual does not need to worry about paying the exorbitant health bill for the treatment of diseases. It is believed that the diseases such as Tuberculosis, AIDS, Malaria and other tropical diseases are claiming thousand of lives every day. Many bread winners of various families especially in the developing countries have been killed by life-debilitating diseases which could have been prevented or treated successfully if there had been availability of drugs and vaccines in these developing and poor countries. Apart from the availability of drugs and vaccines many poor people hardly eat nutritious and balance diets which make them to be more susceptible to infections and diseases.
The context of poverty as related to disease and health is multi-dimensional; it may be political, social and economical when looking at it from the holistic point of view. Visionary leadership would produce good governance, economic buoyancy and a healthy nation but bad leadership characterized by corruption would make virtually all the sectors of the economy including the health sector to be in shambles. When the health sector is affected, there would be no access to standard healthcare facilities, availability of standard drugs and vaccines would be jeopardized and apart from the effects on the health sector also there would be no good water supply and majority of the populace would be living below poverty line. Therefore, it is crystal clear that improved health has profound effects on economic growth, household incomes and poverty reduction since health is considered as a form of human capital that enhances individual’s capabilities (Bloom & Canning).
Undoubtedly, poor people die younger and suffer worse conditions of health. Their lives are associated with higher than average maternal and child mortality, more limited access to healthcare and higher levels of disease. Good health is of course a good asset for the poor because when poor people get injured or ill, their insufficient incomes are spent on the healthcare bills. This may even hinder them from invest in the education and health of their children. Many children are dying on daily basis because of common malaria in poor countries all over the world and many have been disabled by some of the common tropical diseases. The international community is aware of these facts and recognizes the strong relationship between poverty and health that is why three of the eight Millennium Development Goals call for strategic health improvements by 2015: slowing the speed of HIV/AIDS, malaria and tuberculosis; reducing child mortality and reducing maternal mortality (Oecd.org). In achieving the Millennium Development Goals, health is considered fundamental to the eradication of extreme hunger and poverty.
The work of Alsan et al on the biosocial understandings of disease in Haiti and Rwanda reveals that apart from sustainable responses that make available the fruits of modern medicine—pharmaceuticals, diagnostic tools and trained clinicians, the consequences of deep poverty: limited transportation, poor housing, and food scarcity among others must be addressed to tackle the issues of disease, health and poverty. On the part of the government, good private- and public-sector services should be developed to take care of the health needs of poor people who are more susceptible to diseases such as malaria, tuberculosis and HIV/AIDS, reproductive health and communicable diseases because of poverty-infested environment they are dwelling. The public sector’s capacity should be empowered to exercise functions of regulator, policymaker, purchaser and provider of health services at reasonable and affordable costs. The vulnerable groups and the poor should be targeted and given access to standard healthcare facilities, the voices of the poor, civil society and the NGOs should be heard when planning and implementing a sustainable, viable and lasting health system.
Chronic Diseases and the Diseases of Poverty
The collective description of diseases, health conditions and disabilities that are more rampant among the poor than the rich is termed the diseases of poverty. It has been shown that in most cases poverty is the determinant or the leading risk factor for such diseases. There is a wide range of contributing factors linking these diseases to poverty. Environmental and social reasons, including inadequate sanitation, unhealthy working conditions, crowed living, and demoralising occupation like prostitution make the poor to be more exposed to infectious diseases. Moreover, stress, overwork, malnutrition, inaccessibility or non-existence of quality healthcare can prevent and worsen diseases among the poor population. In the poverty-ridden areas of the world, hunger and malnutrition are the major underlying causes of many diseases; due to exhaustion and weakness their susceptibility to infections is heightened.
It is evident that malnutrition, infectious diseases and immune system are interconnected; the harmful effects of infectious diseases on nutritional status can reduce the strength of the immune system therefore reducing the ability of the body defence mechanism to resist infection. Lack of access to safe and clean drinking water and inadequate sanitation play a very vital role in the spread of poverty-related diseases. For instance, diseases of poverty such as malaria and schistosomiasis are basically caused by poor sanitation and contaminated water. Poor sanitation would provide an avenue for the breeding of mosquitoes and many people would come in contact with disease causing pathogens through contaminated water while eating food, bathing or washing (Mintz et al). Of all these diseases of poverty tuberculosis, HIV/AIDS and malaria are the basic poverty-related diseases that are prevalent and claiming lives of people in the world’s poorest nations. However, there are other diseases that are also related to poverty such diseases are pneumonia, measles, and diarrheal diseases etc.
Chronic diseases cannot be separated from poverty. In fact there is a vicious cycle connecting them together. This may be the main reason while the poorest people are at a great risk of developing chronic diseases and leading to premature death. Moreover, poverty as well as social exclusion increases the risk for the development of a chronic disease. It is evident that as a nation develops politically and economically, the rich would have highest concentration of chronic diseases but in the progress of time the highest concentration would be recorded among the poor. This has been attributed to the widening gap in health inequalities between the rich and the poor. When poor person is confronted with a chronic disease like diabetes, he is likely to die quickly. Most of these chronic diseases require placing the patients on lifetime drugs and the poor may not be able to face the economic demand attached to the disease. This may even make the middle class people and their families fall into poverty and impoverishment.
The vulnerability of the poor people to chronic diseases is high due to lack of access to healthcare service, material deprivation, unhealthy living conditions and increased exposure to risks. Apart from the negative consequences of chronic diseases on the individuals and families, chronic diseases may also prevent macroeconomic development of many nations. Huge amount that supposed to be channelled to developmental projects may be needed to be spent on the life-ravaging chronic diseases to sustain life and productivity. More importantly, investment on the prevention of chronic diseases is pertinent to reduction of poverty among the low and middle income earners.
Health and Poverty
Poverty may be divided into three levels as follows: the extreme poverty characterized by inability to meet basic needs for survival, moderate poverty associated by inability to barely meet basic needs and relative poverty in which household income is less than a proportion of average national income. All these levels of poverty adversely affect accessibility and affordability of quality healthcare. As a matter of fact, in every country poverty is found but extreme poverty is associated with low income countries. Indisputably, wealth empowers people to have access to standard healthcare and to avoid most of the risks of developing diseases while poverty makes people to have no or limited access to healthcare and reduces the ability to prevent most of the risks of developing diseases. It is crystal clear that people with poor health tend to fall into poverty and poor health is more associated with the poor. In respect to health, poverty includes social exclusion, low education, low income and environmental degeneration.Three areas of health are affected by the socioeconomic status and they are: environmental exposure, healthcare and health behaviour. In Ghana and other developing countries, poverty cause more illness and death than pestilence, faming and plague (Adjei & Buor). The poor population of both the developing and developed countries would definitely face the problems of lack of information about healthcare options, limited or no access to healthcare and predisposition to poverty related diseases due to bad living conditions. In a study to investigate the relative impact of social class and race on the incident of excess low birth weight in offspring of a national cohort of women, it was found out that the risk of low birth weight among poor black women is the same as that of the poor white women and the overall risk of low birth weight for the black infants is more than twice that of the whites (Starfield). This is a pointer to the fact that poverty is a very potent risk factor to health status.
Inadvertently, it is a well-known fact that poverty has a general effect on the health of children. Children that are more likely to become ill are children from poor home, and when they develop illness they tend to get sicker and die at greater rates than children from rich home. Some relationship between poverty and ill-health are as follows: firstly, ill-health is often associated with substantial healthcare costs, secondly, poor countries and poor people within countries, suffer from the multiplicity of deprivations that translate into high levels of ill-health, thirdly, low income and poverty also can cause ill-health and fourthly, poor people unfortunately found themselves in a vicious cycle: poverty breeds ill-health and ill-health maintains poverty (Wagstaff). It is obvious that characteristics of the poor are linked to poor health outcomes and diminished income. Poor health outcomes are associated with malnutrition, ill-health and high fertility and also diminished income is connected to loss of wages, costs of healthcare and higher vulnerability to catastrophic illness. The major characteristics of the poor are inadequate service utilization, unhealthy dietary and sanitary practices and these are mainly caused by lack of income knowledge, poor health provision, poverty in community social norm, weak institution and infrastructure, bad environment and exclusion from health finance system (Wagstaff).
Improvement in Health and Poverty
Undoubtedly, investment in health would bring about quick economic development. For the developing countries to break out of the cycle of poverty a considerable improved health outcome is a must. Good health contributes to eradication of poverty and development in a number of ways as stated by Organisation for Economic Co-operation and Development (OECD). Firstly, good health leads to higher labour productivity that is to say healthier workers are more productive, miss fewer days of work, and earn higher wages. This would increase agricultural production and enterprise profitability. Secondly, good health leads to higher rate of domestic and foreign investment. In other words, increment in labour productivity would in turn create incentives for investment, increase growth opportunities and reduce health risks. Thirdly, good health leads to improved human capital that is to say as health improves there would be growth in the human-capital base. Fourthly, good health leads to higher rates of national savings because healthier people have more resources to commit to savings and these savings would later provide funds for capital investment. And lastly, good health leads to demographic changes. That is to say, improvements in both health and education would contribute to reduction of the rates of mortality and fertility because demographic dividend so to say has been shown to be a significant source of growth in per capita income for low-income countries.
It is crystal clear that the context of poverty as related to disease and health is multi-dimensional. In order to demystify the socioeconomic mystics surrounding the context of poverty as related to diseases and health, strategic policies must be formulated and implemented. The biosocial understanding of disease in Haiti and Rwanda as discussed earlier throws more light on the importance of tackling poverty to achieve a healthy people. Policies must be aimed at preventing health sector inequalities. The inequalities in the quality and availability of health services must be reduced or even eradicated and also the equalities income, improved accessibility of health services, accessibility of health-related knowledge, availability of safe drinking water and proper sanitation must be improved.
It is obvious that poverty propagates ill-health and ill-health maintains poverty because of this particular fact. Moreover, the underlying causes of poverty in any country or communities should be identified and sensibly addressed and also standard, accessible and affordable healthcare services should be made available for all social classes in any country because a healthy people would bring about a viable, productive and economic buoyant country. Lastly, for any of the developing or world’s poorest countries to achieve the Millennium Development Goals, eradication of poverty and all its related diseases must be upheld and the healthcare services must be accessible and affordable for all.
Adjei, P., & Buor, D. 2012. “From Poverty to Poor Health: Analysis of Socio-Economic
pathways influencing health status in rural households of Ghana”. Health
Sociology Review 21(2), 232-241.
(Adjei 2012, 232-241)
Alsan, Marcella M., Westerhaus Micheal, Herce Micheal, Nakashima Koji and Famer Paul E.
2011. “Poverty, Global Health and Infectious Disease: Lessons from Haiti and
Rwanda”. Infect Dis Clin North Am 25(3):611-622 http://www.ncbi.nlm.nih.gov/
(Alsan 2011, 611-622)
Bloom David & Canning David. 2003. “The Health and Poverty of Nations: From Theory to
Practice”. Journal of Human Development 4(1):47-71http://www.tandfonline.com/d
(Bloom 2003, 47)
Mintz, E., Reiff, F., & Tauxe, R. 1995. “Safe Water Treatment and Storage in the Home. A
Practical New Strategy to Prevent Waterborne Disease”. The Journal Of The
American Medical Association 273(12), 948-953 http:// www.uvm.edu/~bwilcke/
(Mintz 1995, 948-953)
Oecd.com. 2003. “Poverty and Health in Developing Countries: Key Actions”.
Organization for Economic Co-operation and Development http://www.oecd.
(Oecd.com. 2003, 1-7)
Starfield, Barbara. 1992. “Effects of Poverty on Health Status”. Bull. N.Y Acad. Med.
68(1):17- 24 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1809870/pdf/bu
(Starfield 1992, 20)
Wagstaff, Adam. 2002. “Poverty and Health Sector Inequalities”. Bulletin of the World
Health Organization, 80:97-105 http://www.scielosp.org/pdf/bwho/v80n2/a04v
(Wagstaff 2002, 97-105)
Worrall, Eve., Basu, Suprotik. and Hanson, Kara. 2005. “Is Malaria a Disease of Poverty? A
Review of the Literature”. Tropical Medicine & International Health 10(10): 1047–
1059 http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156. 2005.01476.x/full
(Worrall 2005, 1047-1059)
Who.int. 2002. World Health Report 2002: Reducing Risks Promoting
Healthy Life. World Health Organization, Geneva.http:// www.who.int/whr/2002/
(Who.int 2002, 1)
Other related articles from the same Author