contact for referral to care are basic principles necessary to address determinants of health. Case management can be done by nursing care coordinators, social workers, and elderly or child service case workers (Centers for Medicare and Medicaid Services [CMS], 2023).
Self-Assessment Quiz Question #1 Housing instability and low-quality housing can impact the health of children in which of the following ways? a. Decreasing the risk of respiratory diseases. b. Increasing the risk of developmental disorders.
c. Decreasing the risk of preterm birth. d. Increasing the risk of high birth weight.
ECONOMIC STABILITY
People living in low-income areas are at a higher risk of chronic disease, mental illness, and shorter life expectancy regardless of age. The largest age group of people experiencing poverty is children. Poverty in childhood is associated with several medical issues, including developmental delays, nutritional deficiencies, and chronic illness. Lasting effects of childhood poverty extend into adulthood, leading to adverse health effects caused by chronic stress, smoking, substance use, and obesity (Office of Disease Prevention and Health Promotion, 2024). Approximately 18.5% of the U.S. population does not have health insurance, and nearly 70% of noninsured individuals are poor or near-poor (Institute for Research on Poverty, n.d.). People without insurance tend to avoid preventative care and are more likely to wait until an illness becomes severe before they seek medical care. In addition, low- income individuals tend to access healthcare in different ways than their wealthier counterparts. Instead of utilizing primary care and specialists, people with low incomes more frequently rely on community health centers, urgent care facilities, and hospital clinics, which are less likely to provide the level of care needed to adequately treat chronic diseases (O’Neill Hayes & Gillian, 2020). their peers. Food insecure school-age populations are at risk for these social and behavior problems, and they are more likely to suffer physical effects from the intake of unhealthy foods (Edwards & Shipman, 2018; Thomas et al., 2019). A grocery store visit will show the significant price difference in heavily processed foods and healthier choices such as fresh fruits and vegetables. Intake of cheaper foods that are packed with carbohydrates and processed ingredients provides empty calories and less nutritional value. Families may opt for canned soups, vegetables, and pasta instead of healthier, but more expensive, options such as fresh protein, fruits, and vegetables. Edwards and Shipman (2018) suggested focusing on eliminating food insecurity in order to address overweight and obesity in adolescents. Additionally, Bahadur and colleagues (2018) found higher rates of anemia and hypercholesterolemia among children living in food insecure and economically disadvantaged households. These findings support addressing the root problem of food insecurity as a first step in creating an overall healthier lifestyle, which, in turn, can help prevent overweight, obesity, and the subsequent health problems that follow. Other populations that are at risk for health problems related to food insecurity include the elderly, pregnant women, and young adults. Food insecurity in pregnant women correlates with low infant birth weights (Edwards & Shipman, 2018). Among the elderly, it was revealed that food insecurity was significantly associated with falls (Mosen et al., 2019). Lack of adequate food intake is also associated with poorer mental health and inadequate sleep health in young adulthood. Healthcare providers should
Nearly 38 million Americans were living in poverty in the U.S. in 2022 (approximately 11.5% of the population; U.S. Census Bureau, 2024). Poverty commonly occurs in concentrated areas and can endure for generations. Some populations are at a higher risk of poverty, such as people with disabilities, those living in rural communities, and people belonging to marginalized races or ethnic groups. These factors often extend beyond the control of individuals, making it difficult to break free from the cycle of poverty. The relationship between socioeconomic status and health has been studied in many countries, and inequalities have continued to grow despite medical advances. It has been found that those with higher socioeconomic status consistently lead healthier lives. One study showed that men in the top 1% of income were expected to live 14.6 years longer than men in the bottom 1% of income (Office of Disease Prevention and Health Promotion, 2024). People with low incomes have reduced access to the resources they need to stay healthy, such as healthcare, exercise, and healthy foods. In addition, low incomes are associated with lower wage employment, which can be physically demanding and has limited opportunity for professional growth, reducing the individual’s ability to accumulate wealth (O’Neill Hayes & Gillian, 2020). Food insecurity Food insecurity can have serious implications for the physical well-being of vulnerable populations such as children and older adults. Food insecurity can be defined as households being uncertain of having, or being unable to acquire, enough food to meet the needs of all their members because of insufficient money or other resources for food (U.S. Department of Agriculture [USDA], 2023). No assumptions should be made that food insecurity does not exist in the U.S. According to the USDA (2023), 12.8% (17 million), U.S. households were food insecure at some time in 2022. Healthcare providers should consider these data and incorporate assessment of food security as part of a holistic approach to examining the needs of individuals and families encountered in any setting and in any geographic region. It is imperative to understand how not having enough food to meet one’s needs can have implications on a wide variety of outcomes, ranging from low birth weight in infants to behavior problems in school-age children (Edwards & Shipman, 2018; Thomas et al., 2019). Household food insecurity has been linked to significantly worse general health, acute and chronic health problems, and access to healthcare. Additionally, Thomas and colleagues (2019) reported that food insecurity can be connected to delays in seeking healthcare treatment and an increase in the use of emergency department resources. The effects of food insecurity can be seen across age groups and among populations in the community. For example, in the school setting, children who lack access to adequate amounts of or quality food may suffer academically, socially, and physically. Food insecure children demonstrate lower academic achievement and more behavioral difficulties than
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