Question

ABOUT POVERTY AND HOMELESSNESS

The community of Finnytown has identified the need for a shelter to serve homeless women and children. Finnytown currently has a homeless shelter for men. Women and children can obtain health care services there but are not allowed to stay overnight. The Finnytown health care task force performed a community assessment that revealed that a higher number of homeless men than women reside in Finnytown, but the percentage of homeless women is steadily increasing. Results further showed that more women with children than men are living in poverty. The task force speculated that many women who are living in poverty are being overlooked and thus are becoming women without homes.

The task force and the community of Finnytown decide to open a homeless shelter for women and children. The new shelter will primarily serve women with children who are homeless or in poverty. Georgia B. is the community health nurse who is a member of the task force team. Nurse Georgia and other health care professionals are charged with planning health care services for women with children to be provided at the new homeless shelter.

Questions

1. What common health problems should Nurse Georgia and the task force be aware of when planning health services to be provided at the new shelter?

2. What effects of poverty on the health of children should Nurse Georgia and the task force be aware of when planning appropriate services?

3. After the shelter opens, Nurse Georgia becomes one of the nurses who works in the clinic. What strategies are important for Nurse Georgia to implement when working with this population?

Answer 1

1)Non-availability of health facilities and poor economic condition leaves poor in pathetic condition. Poverty not only pulls back families economically but it effects on their social condition. Families those are below poverty line face many problems. Poverty also has a bad impact on the education, health and basic services. Government is spending lot of money in providing health facilities to rural poor but still that efforts are not sufficient. Primary health centre are unable to reach poor families due to many reasons. Unawareness about the health and non-availability of facilities, many of rural families spend lot of money on the health. Addiction is also reason for the poor health of rural people.

Majority of the heads of the BPL families are educated up to secondary education.
It is clear from the above findings that low income, low education, dependency on daily wage, lack of livelihood sources, lack of agriculture land these families are having low social and economic status which
affects on the overall development of family members. Availability of toilets, availability of safe drinking water, facility for safe disposal
of the garbage are the important aspects of the health. But the BPL families are facing the problems regarding above requirement that creates the nasty situation for health. Addiction is present in each family which increase the expenses on addiction and increase the expenditure on health so it is causing two ways to the BPL families.

Though government taking efforts to provide the health services to BPL families but unawareness about the schemes and programmes, non positive approach towards Primary Health Services are the main reasons behind the keeping people away from the benefits.

• Extreme poverty is the strongest predictor of homelessness for families. These families are often forced to choose between housing and other necessities for their survival. At least 11% of American children living in poverty are homeless.

• Female-headed households (particularly by women with limited education and job skills) are also particularly vulnerable. The current economic climate has made the labor market even less hospitable as many of them do not have more than a high school diploma or GED.

• Teen parents are also particularly at risk of homelessness as they often lack the education and income of adults who become parents.

• Lack of affordable housing is also a risk factor for homelessness, particularly for families who devote more than 50% of household income to paying rent or those who experience a foreclosure. Foreclosures affect vulnerable tenants as well as homeowners who are delinquent in their mortgage payments.

• Substance abusing or physically violent parents and stepparents are the major drivers of homelessness in runaway youth, particularly for those who identify as GLBT.

What are the outcomes of homelessness for children and youth?

• Homelessness has particularly adverse effects on children and youth including hunger, poor physical and mental health, and missed educational opportunities.

• Homeless children lack stability in their lives with 97% having moved at least once on an annual basis, which leads to disruptions in schooling and negatively impacts academic achievement.

• Schooling for homeless children is often interrupted and delayed, with homeless children twice as likely to have a learning disability, repeat a grade or to be suspended from school.

• Homelessness and hunger are closely intertwined. Homeless children are twice as likely to experience hunger as their non-homeless peers. Hunger has negative effects on the physical, social, emotional and cognitive development of children.

• A quarter of homeless children have witnessed violence and 22% have been separated from their families. Exposure to violence can cause a number of psychosocial difficulties for children both emotionally (depression, anxiety, withdrawal) and behaviorally (aggression, acting out).

• Half of school age homeless children experience problems with depression and anxiety and one in five homeless preschoolers have emotional problems that require professional care.

• Homelessness is linked to poor physical health for children including low birth weight, malnutrition, ear infections, exposure to environmental toxins and chronic illness (e.g., asthma). Homeless children also are less likely to have adequate access to medical and dental care.

• Unaccompanied youth are often more likely to grapple with mental health (depression, anxiety and PTSD) and substance abuse problems.

• Many runaway youth engage in sexually risky behaviors (sometimes for their own survival), which places them at risk of HIV, other STDs and unintended pregnancies. Also, emerging research has shown that GLBT homeless youth are 7 times more likely to be victims of violent

2)

that living in poverty has a wide range of negative effects on the physical and mental health and well-being of our nation’s children. Poverty impacts children within their various contexts at home, in school, and in their neighborhoods and communities.

• Poverty is linked with negative conditions such as substandard housing, homelessness, inadequate nutrition and food insecurity, inadequate child care, lack of access to health care, unsafe neighborhoods, and underresourced schools which adversely impact our nation’s children.

• Poorer children and teens are also at greater risk for several negative outcomes such as poor academic achievement, school dropout, abuse and neglect, behavioral and socioemotional problems, physical health problems, and developmental delays.

Poverty is an

• These effects are compounded by the barriers children and their families encounter when trying to access physical and mental health care.

• Economists estimate that child poverty costs an estimated $500 billion a year to the U.S. economy; reduces productivity and economic output by 1.3 percent of GDP; raises crime and increases health expenditure (Holzer et al., 2008).

Poverty and academic achievement

• Poverty has a particularly adverse effect on the academic outcomes of children, especially during early childhood.

• Chronic stress associated with living in poverty has been shown to adversely affect children’s concentration and memory which may impact their ability to learn.

• The National Center for Education Statistics reports that in 2008, the dropout rate of students living in low-income families was about four and one-half times greater than the rate of children from higher-income families (8.7 percent versus 2.0 percent).

• The academic achievement gap for poorer youth is particularly pronounced for low-income African American and Hispanic children compared with their more affluent White peers.

• Underresourced schools in poorer communities struggle to meet the learning needs of their students and aid them in fulfilling their potential.

• Inadequate education contributes to the cycle of poverty by making it more difficult for low-income children to lift themselves and future generations out of poverty.

Poverty and psychosocial outcomes

• Children living in poverty are at greater risk of behavioral and emotional problems.

• Some behavioral problems may include impulsiveness, difficulty getting along with peers, aggression, attention-deficit/hyperactivity disorder (ADHD) and conduct disorder.

• Some emotional problems may include feelings of anxiety, depression and low self-esteem.

• Poverty and economic hardship is particularly difficult for parents who may experience chronic stress, depression, marital distress and exhibit harsher parenting behaviors. These are all linked to poor social and emotional outcomes for children.

• Unsafe neighborhoods may expose low-income children to violence which can cause a number of psychosocial difficulties. Violence exposure can also predict future violent behavior in youth which places them at greater risk of injury and mortality and entry into the juvenile justice system.

Poverty and physical health

Children and teens living in poorer communities are at increased risk for a wide range of physical health problems:

• Low birth weight

• Poor nutrition which is manifested in the following ways:

  1. Inadequate food which can lead to food insecurity/hunger

  2. Lack of access to healthy foods and areas for play or sports which can lead to childhood overweight or obesity

• Chronic conditions such as asthma, anemia and pneumonia

• Risky behaviors such as smoking or engaging in early sexual activity

• Exposure to environmental contaminants, e.g., lead paint and toxic waste dumps

• Exposure to violence in their communities which can lead to trauma, injury, disability and mortality

social determinant of health and contributes to child health disparities. Children who experience poverty, particularly during early life or for an extended period, are at risk of a host of adverse health and developmental outcomes through their life course.1 Poverty has a profound effect on specific circumstances, such as birth weight, infant mortality, language development, chronic illness, environmental exposure, nutrition, and injury. Child poverty also influences genomic function and brain development by exposure to toxic stress,2 a condition characterized by excessive or prolonged activation of the physiologic stress response systems in the absence of the buffering protection afforded by stable, responsive relationships.Children living in poverty are at increased risk of difficulties with self-regulation and executive function, such as inattention, impulsivity, defiance, and poor peer relationships. Poverty can make parenting difficult, especially in the context of concerns about inadequate food, energy, transportation, and housing.Child poverty is associated with lifelong hardship. Poor developmental and psychosocial outcomes are accompanied by a significant financial burden, not just for the children and families who experience them but also for the rest of society. Children who do not complete high school, for example, are more likely to become teenage parents, to be unemployed, and to be incarcerated, all of which exact heavy social and economic costs.A growing body of research shows that child poverty is associated with neuroendocrine dysregulation that may alter brain function and may contribute to the development of chronic cardiovascular, immune, and psychiatric disorders. The economic cost of child poverty to society can be estimated by anticipating future lost productivity and increased social expenditure.

Socioeconomic status is a term that often includes measurements of income, education, and job prestige – individually or in combination. The predictive power of income alone is perhaps most obvious when considering life expectancy. Impoverished adults live seven to eight years less than those who have incomes four or more times the federal poverty level.

Socioeconomic status is the most powerful predictor of disease, disorder, injury and mortality we have.It is especially important to understand that finding neurobiological differences among children from disadvantaged communities does not imply that the differences are genetic in origin. Rather, many or even most such socioeconomic disparities in brain structure and function are the direct consequences of early rearing in impoverished, chaotic and stressful conditions.

Chronic disease – which accounts for 70 percent of deaths in this country – is also deeply rooted in poverty.Diet and exercise play a big role in determining a person's health status; however, research shows that health behaviors like these are largely driven by the context of where people live. Poor neighborhoods are more likely to have higher crime rates, lower-performing schools, and little access to healthy foods. Transportation and time also factor into health behaviors. A person who has strung together three jobs to make ends meet for his or her family, and who must travel by bus to each job, likely does not have the luxury of time for exercise.

In fact, the sheer stress and adversity of poverty itself is perhaps its most toxic component, impacting multiple systems in the body. We know that kids growing up in poverty are more exposed to toxins, noise, turmoil and violence.These exposures damage the capacity of the brain to develop optimally.

• 3)Volunteer your time with charities and organizations that provide assistance to low-income and homeless children and families.

• Donate money, food, and clothing to homeless shelters and other charities in your community.

• Donate school supplies and books to underresourced schools in your area.

• Make your voice heard! Support public policy initiatives that seek to:

  1. Improve access to physical, mental, and behavioral health care for low-income people  by eliminating barriers such as limitations in health care coverage.

  2. Create a “safety net” for children and families that provides real protection against the harmful effects of economic insecurity.

  3. Increase the minimum wage, affordable housing and job skills training for low-income and homeless Americans.

  4. Intervene in early childhood to support the health and educational development of low-income children.

  5. Provide support for low-income and food insecure children such as Head Start, the National School Lunch Program, and the Temporary Assistance for Needy Families (TANF) authorization.

  6. Increase resources for public education and access to higher education.

  7. Support research on poverty and its relationship to health, education, and well-being.