Child Poverty and Health

Study shows poor children face higher rates of asthma and ADHD, By David Templeton, February 13, 2017, Pittsburgh Post-Gazette: “Poverty takes a toll on human health and especially on children.   The American Academy of Pediatrics and Britain’s Child Poverty Action Group, among various groups and scientific studies, long have documented the higher risk of illness, chronic disease and disability among impoverished children, along with lower birth weights and an average life expectancy nearly a decade shorter than children from affluent families.  Now add asthma and attention deficit/hyperactivity disorder to the long list of physical and mental maladies, along with attendant conditions known as ‘comorbidities.’   These are the key findings of a Children’s Hospital of Pittsburgh of UPMC study published today in Pediatrics…”

Housing Conditions and Health

  • Philly study finds house calls could help asthma patients living in poverty, By Stacey Burling, January 3, 2017, Philadelphia Inquirer: “Tyra Bryant-Stephens, a doctor who is medical director of the Community Asthma Prevention Program at Children’s Hospital of Philadelphia, thinks doctors and researchers need to think more about an often unseen factor in patients’ asthma: their housing.  When doctors see poor patients in clinics, she said, they may not have time to ask about their living conditions.  Even if they did, patients might be too embarrassed to tell them…”
  • Seller-financed deals are putting poor people in lead-tainted homes, By Alexandra Stevenson and Matthew Goldstein, December 26, 2016, New York Times: “A year after Tiffany Bennett moved into a two-story red brick house at 524 Loudon Avenue here, she received alarming news.  Two children, both younger than 6, for whom Ms. Bennett was guardian, were found to have dangerous levels of lead in their blood. Lead paint throughout the nearly 100-year-old home had poisoned them.  Who was responsible for the dangerous conditions in the home?  Baltimore health officials say it was an out-of-state investment company that entered into a rent-to-own lease with the unemployed Ms. Bennett to take the home in 2014 ‘as is’ — chipping, peeling lead paint and all.  Ms. Bennett, 46, and the children moved out, but they should never have been in the house at all. City officials had declared the house ‘unfit for human habitation’ in 2013…”

State Medicaid Programs

  • New Mexico seeks copays from Medicaid patients, By Morgan Lee (AP), October 26, 2016, News Tribune: “New Mexico is pursuing federal authority to charge medical co-payments and some other costs to patients enrolled in Medicaid health care for the poor and disabled, the state Human Services Department secretary told lawmakers on Wednesday.  Secretary Brent Earnest said ‘nominal’ co-payments and other charges would provide a small economic incentive to steer patients away from wasteful expenses, such as the use of emergency room services for routine care…”
  • Medicaid expansion credited for getting record number of kids insurance in Ohio, By Catherine Candisky, October 27, 2016, Columbus Dispatch: “More than 95 percent of Ohio children have health coverage as the uninsured rate fell to historic lows in the wake of Obamacare.  A new report from the Georgetown University Center for Children and Families credits Medicaid expansion under the Affordable Care Act for the decline in uninsured children…”
  • In Maryland, diabetics cost Medicaid twice as much, study finds, By Andrea K. McDaniels and Meredith Cohn, October 27, 2016, Baltimore Sun: “People with diabetes cost the state’s Medicaid program twice as much as those without the chronic condition, a study commissioned by the society that represents Maryland’s doctors has found…”

Housing and Health

Zika could hit people in poverty hardest, By Liz Szabo, June 30, 2016, USA Today: “There’s no mystery about how the mosquitoes got into Shawanda Holmes’ former home. They flew through a gaping hole in the wall. One of the wooden boards on the side of the house is partly missing, covered only by a loose, blue plastic tarp that flows down the outside wall and crumples in a heap on the grass. Rainwater pools in its folds, providing an ideal site for mosquitoes to breed. Trash fills the backyard. Holmes’ home had no air conditioning, and she was afraid to plug in a fan, for fear that water had leaked into the electrical outlet. Mosquitoes repeatedly bit her children, ages 4, 6 and 14. ‘The mosquitoes were tearing us up, no matter what I did,’ said Holmes, 32, who lives in New Orleans’ Center City neighborhood.  If Zika spreads in the United States, Americans who live in substandard housing and neglected neighborhoods could face the greatest danger, particularly along the Gulf Coast – where steamy summers, high poverty rates and a dizzying array of mosquitoes could allow the virus to take hold, said Peter Hotez, dean of the National School of Tropical Medicine at Houston’s Baylor College of Medicine…”

Income and Childhood Cancer Relapse

Childhood leukemia patients from low-income areas relapse earlier, study finds, By Ellen Brait, February 23, 2016, The Guardian: “Children who live in high-poverty areas with acute lymphoblastic leukemia (ALL) – the most common pediatric cancer – tend to relapse earlier than patients from low-poverty areas even if they are receiving the same treatment, a new study found. The research, published on Tuesday in the journal Pediatric Blood and Cancer, is one of very few on the subject, as ‘investigation of the impact of poverty on outcomes in childhood leukemia has been limited’, according to the study. It looked at the medical results from 575 children from 2000 to 2010 who were treated at major academic medical centers across the United States. The children were all newly diagnosed and between the ages one and 18…”

Hospitals and Food Insecurity

Some hospitals prescribe food, take other steps to fight food insecurity, By Christopher J. Gearon, December 8, 2015, US News and World Report: “At Boston Medical Center, physicians write prescriptions for food when patients don’t have enough to eat. Doctors in the center’s emergency department and more than 20 clinics screen all patients for hunger, writing those who struggle to feed themselves a script to the on-site Preventive Food Pantry. They write a lot of food prescriptions – enough to keep the food pharmacy serving 7,000 people each month…”

SNAP Benefits and Health

What happens when a family runs out of food stamps, By Emily Badger, December 9, 2015, Washington Post: “Toward the end of every month, hospitals in California see a curious uptick in admissions for hypoglycemia, the kind of low blood sugar that can affect diabetics. The pattern, detected in a recent study by researchers at the University of California, San Francisco, is almost entirely driven by low-income patients. The non-poor don’t show much change in admissions at all.  The researchers suspect this trend may point to an underlying challenge for the poor: Food stamps, given out in a lump sum at the start of each month,run out for many families before they reach the end of it. Grocery stores in poor neighborhoods often report a rise in business when food stamps are electronically debited, and hospitals may see the result when they run out…”

Medicaid and Preventive Care – Kentucky

Preventive care rises among Kentucky Medicaid patients, By Laura Ungar, August 5, 2015, Louisville Courier-Journal: “Kentuckians on Medicaid were far more likely to get cancer screenings, physicals and dental check-ups after the state expanded the government program for the poor and disabled through the Affordable Care Act, new state data shows…”

Child Poverty and Health

  • How to cut the cost of child poverty, to the health of kids and the community, By Brie Zeltner, June 16, 2015, Cleveland Plain Dealer: “Cleveland is awash in poor, sick kids. Poverty and poor health go hand in hand, and they’re costly — to the children and the rest of the community.  Cleveland’s child poverty rate is 54 percent, second in the U.S. only to Detroit’s.  Poor kids face assaults to their health that begin in the womb, and can last a lifetime. Many never make it past their first year; in some East Side neighborhoods the infant mortality rate exceeds Third World levels.  They are more likely to be born premature; to die young; to be poisoned by lead, to suffer from asthma, diabetes and obesity…”
  • Cost-effective way to prevent chronic asthma in kids has Cleveland roots, By Brie Zeltner, June 17, 2015, Cleveland Plain Dealer: “For decades, some of Cleveland’s most vulnerable children — those with severe, chronic asthma — have been caught in an expensive cycle of fear and frustration.  They live in substandard housing surrounded by mold, cockroaches, dust, lead and secondhand smoke. They have expensive inhalers, drugs and breathing machines, but still they suffer potentially lethal asthma attacks…”
  • Home visits clean up triggers for kids with chronic asthma, By Brie Zeltner, June 17, 2015, Cleveland Plain Dealer: “It’s a cold day in mid-December, and Akbar Tyler stands in the kitchen of a two-story colonial in the West Side Brooklyn Centre neighborhood. He points to a line of white powder along the counter and floorboards.  Roach poison. The oven is on, its door hanging open, in an attempt to heat the drafty room. ‘This is a problem,’ he says. Tyler is the healthy housing manager at Environmental Health Watch, a nonprofit environmental advocacy group based in Cleveland. For the past 15 years, he and a team from Case Western Reserve University and University Hospitals, as well as local housing officials have used federal funding to help clean up breathing hazards in Cleveland homes…”

Medicaid Expansion and Diabetes Diagnosis

  • With expansion of Medicaid, some states are identifying more new diabetes cases, By Sabrina Tavernise, March 23, 2015, New York Times: “The number of new diabetes cases identified among poor Americans has surged in states that have embraced the Affordable Care Act, but not in those that have not, a new study has found, suggesting that the health care law may be helping thousands of people get earlier treatment for one of this country’s costliest medical conditions.  One in 10 Americans have diabetes, and nearly a third of cases have not been diagnosed. The disease takes a toll if it is caught too late, eventually causing heart attacks, blindness, kidney failure and leg and foot amputations. The Centers for Disease Control and Prevention estimates that the disease accounts for $176 billion in medical costs annually. The poor and minorities are disproportionately affected…”
  • Diabetes study shows benefits of expanded Medicaid under Obamacare, By Noam N. Levey, March 23, 2015, Los Angeles Times: “Low-income patients with diabetes are getting better access to medical care in states that have expanded Medicaid coverage through the Affordable Care Act, suggests a new study that provides one of the first indications of the sweeping law’s health effects.  Residents of other states are at risk of being left behind.  The number of Medicaid patients with newly identified diabetes surged 23% in states that expanded their programs, an option provided by the law, but there was virtually no increase in states that declined to expand coverage, researchers found…”

Food Insecurity and Diabetes Management

When doctors aren’t enough to help patients keep diabetes in check, By Karen Kaplan, December 29, 2014, Los Angeles Times: “Patients with diabetes need access to doctors and medicines to help them keep their disease under control. But they also need food in their pantries and enough money in their pockets to pay for necessities like rent and heat, a new study shows. Among a group of 411 patients being treated for Type 2 diabetes in the Boston area, those who suffered from food insecurity and those who tried to save money by skimping on their meds were only half as likely as their more financially secure counterparts to be managing their disease. This disparity turned up despite the fact that in Massachusetts, nearly everyone has medical insurance and prescription coverage thanks to the state’s universal healthcare law…”

Childhood Poverty and Health Outcomes

Improved parenting may fortify low-income kids against poverty effects, By Melissa Healy, August 1, 2014, Los Angeles Times: “For children growing up in poverty, the seeds of poor health in adulthood appear to be sown early. But a nurturing parent may be able to foster a child’s resilience to such conditions as allergies, diabetes, heart disease and some cancers, says a new study. To gauge the lasting health effects of good parenting, the latest research returned to rural Georgia eight years after researchers completed their first clinical trial of a seven-week program called the Strong African American Families Project. Of the 667 African American mothers and their children who participated in that trial, researchers returned to 272 of the child subjects, who were by now 19 to 20 years old. They collected blood samples and measured those samples for signs of systemic inflammation…”

SNAP Cuts and Health Risks

  • Study ties diabetic crises to dip in food budgets, By Sabrina Tavernise, January 6, 2014, New York Times: “Poor people with diabetes are significantly more likely to go to the hospital for dangerously low blood sugar at the end of the month when food budgets are tight than at the beginning of the month, a new study has found. Researchers found no increase in such hospitalizations among higher-income people for the condition known as hypoglycemia, suggesting that poverty and exhausted food budgets may be a reason for the increased health risk…”
  • Doctors say cutting food stamps could backfire, By Lauran Neergaard (AP), January 9, 2014, Philadelphia Inquirer: “Doctors are warning that if Congress cuts food stamps, the federal government could be socked with bigger health bills. Maybe not immediately, they say, but over time if the poor wind up in doctors’ offices or hospitals as a result. Among the health risks of hunger are spiked rates of diabetes and developmental problems for young children down the road. The doctors’ lobbying effort comes as Congress is working on a compromise farm bill that’s certain to include food stamp cuts. Republicans want heftier reductions than do Democrats in yet another partisan battle over the government’s role in helping poor Americans…”

Poverty and Disease

Study links disease, poverty and biodiversity, By Kenneth R. Weiss, December 26, 2012, Los Angeles Times: “Poverty and disease often come together. That much is well understood. But how much does poverty foster disease? Or, how much can disease perpetuate poverty? And what’s the role of nature, given that so many infectious diseases are spread by mosquitoes or spend part of their life cycle outside of the human body? A new study finds that certain types of infectious and parasitic diseases have a significant influence on economic development across the world and accounts for some of the differences in per-capita income between those who live in countries in the tropics or those in temperate latitudes…”

Poverty and Tropical Diseases

Tropical diseases: The new plague of poverty, By Peter J. Hotez, August 18, 2012, New York Times: “In the United States, 2.8 million children are living in households with incomes of less than $2 per person per day, a benchmark more often applied to developing countries. An additional 20 million Americans live in extreme poverty. In the Gulf Coast states of Louisiana, Mississippi and Alabama, poverty rates are near 20 percent. In some of the poorer counties of Texas, where I live, rates often approach 30 percent. In these places, the Gini coefficient, a measure of inequality, ranks as high as in some sub-Saharan African countries. Poverty takes many tolls, but in the United States, one of the most tragic has been its tight link with a group of infections known as the neglected tropical diseases, which we ordinarily think of as confined to developing countries…”

Poverty and Child Asthma Rates – New York City

Poor children drive city’s asthma rate, By Sumathi Reddy and Jie Jenny Zou, July 17, 2012, Wall Street Journal: “One in eight New York City children has been diagnosed with asthma, with poor children nearly twice as likely to suffer from the respiratory disease, according to a report to be posted by the city health officials on Wednesday. The report was based on a 2009 survey and is the first time the city Department of Health and Mental Hygiene has estimated the number of children with asthma. The survey of parents found that 177,000 children 12 years and younger-or 13% of children in that age group-had received an asthma diagnosis at some point in their lives…”

Medicaid Experiment – Oregon

Oregon’s Medicaid experiment represents a ‘defining moment’, By Kristian Foden-Vencil, May 30, 2012, National Public Radio: “The things that Amy Vance does for James Prasad are pretty simple: She calls doctors with him, organizes his meds, and helps him keep tabs on his blood pressure, blood sugar and weight. These simple things – and the relationship between a health coach like Vance and a chronically ill Medicaid patient like Prasad – are a big part of a $2 billion health care experiment in Oregon. Gov. John Kitzhaber, a Democrat and a former emergency room doctor, has convinced the federal government that he has a way to make Medicaid treatment better, and cheaper, by completely changing the way the sickest people in Oregon get health care…”

CDC US Health Report 2011

  • CDC: Higher income and education levels linked to better health, By Alexandra Sifferlin, May 16, 2012, Time: “More educated people who make more money have lower rates of several chronic diseases, including obesity, compared to people with lower education and income levels, according to Health, United States, 2011, a new Centers for Disease Control and Prevention (CDC) report. In the government’s 35th annual comprehensive health report from the CDC’s National Center for Health Statistics (NCHS), data from nearly 60 major data sources within the federal government and in the private sector provide a health-related snapshot of life in the U.S. The NCHS looks at data from the start of the study in 1975 through 2010. ‘We like to highlight different things we find interesting for readers,’ says Amy Bernstein, a health services researcher at NCHS…”
  • Higher education linked to longer life, CDC report shows, By Nanci Hellmich, May 16, 2012, USA Today: “Education may not only improve a person’s finances, it is also linked to better health habits and a longer life. For instance, people who have a bachelor’s degree or higher live about nine years longer than those who don’t graduate from high school, according to an annual report, out today, from the Centers for Disease Control and Prevention’s National Center for Health Statistics. Some of the health data reached back a decade or more…”

Medicare/Medicaid Dual Eligibility and Managed Care – California

State takes step to shift some of poorest, sickest to managed care, By Anna Gorman, April 5, 2012, Los Angeles Times: “California is beginning the process of shifting 1.1 million of the state’s sickest and poorest patients into managed care, which healthcare officials say will cut costs and improve treatment. The move is part of a broader state plan to continue moving residents with publicly funded health coverage into managed care, prompting concerns among critics who fear that patients could lose their current doctors. State officials announced Wednesday that Los Angeles, Orange, San Diego and San Mateo will be the first counties to provide managed care to the patients, who are enrolled in both the federally run Medicare and the state-federal Medi-Cal program…”

Poor Children and Dental Disease

‘Silent epidemic’ of dental disease threatens poor kids’ health, By Renée C. Lee, March 4, 2012, Houston Chronicle: “Every time Dr. Martee Engel treats a young patient whose teeth have brown or white chalky spots, she’s reminded of an acute problem affecting children – particularly poor children. Engel sees more than her share of early childhood tooth decay as dental director at Denver Harbor Clinic in northeast Houston. The clinic treats mostly poor children who are twice as likely as more affluent children to have untreated tooth decay, studies show. While overall oral health care for adults and children has improved, tooth decay continues to be the most common chronic disease among children. It can have serious social and health consequences when untreated and, in rare cases, can be fatal…”