Poverty and health in the United States

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U.S. Poverty Trends US poverty rate timeline.gif
U.S. Poverty Trends

Poverty and health are intertwined in the United States. [1] As of 2019, 10.5% of Americans were considered in poverty, according to the U.S. Government's official poverty measure. People who are beneath and at the poverty line have different health risks than citizens above it, as well as different health outcomes. The impoverished population grapples with a plethora of challenges in physical health, mental health, and access to healthcare. These challenges are often due to the population's geographic location and negative environmental effects. Examining the divergences in health between the impoverished and their non-impoverished counterparts provides insight into the living conditions of those who live in poverty.

Contents

A 2023 study published in The Journal of the American Medical Association found that cumulative poverty of 10+ years is the fourth leading risk factor for mortality in the United States, associated with almost 300,000 deaths per year. A single year of poverty was associated with 183,000 deaths in 2019, making it the seventh leading risk factor for mortality that year. [2] [3] [4] [5] [6]

Environmental Health Impacts

The environment of people in poverty impacts their health in many aspects. [7] High poverty areas experience problems associated with poor air quality, water pollution, hazardous and toxic waste, and noise pollution. [7] [8] According to Unhealthy Cities: Poverty, Race, and Place in America, poor air quality results in higher rates of children with asthma living in these areas, and nearly 2 million children with asthma live in areas that do not meet national ozone standards. [8] These children are also exposed to greater amounts of allergens that trigger their asthma. [7] Water pollution is also present impoverished cities due which results in unsanitary practices due to poor water supply and sanitation. [9] Impoverished communities are prone to be in proximity to hazardous waste facilities which result in toxic waste dumping, chemical runoff, and water pollution within the area. [8] Because many residents of low-income areas are desperate, they tend to not protest against incoming hazardous facilities. [8] Therefore, these facilities tend to seek out these communities to build in, and this results in more health costs for those in the area. [8] Low-income populations are also more exposed to pesticides, and a significantly higher amount of lead was found in African-American children living in inner-city areas. [7] Neglected Tropical Diseases (NTDs) are also more prevalent in areas of high poverty such as the South and inner-city areas though they often get overlooked by physicians for other diseases. [10]

Climate change also affects the health of those living in low-income communities. Climate change can result in a greater frequency of bad allergy days which results in weakened immune systems and increase asthma cases within the community. [11] From air pollution, respiratory and cardiovascular diseases can worsen due to the greater amounts of chemicals in the atmosphere and hotter temperatures. [11] The warmer temperatures also result in warmer surface water bodies which are better environments for tropical diseases to take root and spread. [11] Climate change also results in a higher frequency of storms, hurricanes, and floods which can result in greater damage to infrastructure resulting in more financial stress for people in low-income communities. [11]

Spatial

Health outcomes of those in poverty can also be determined by spatial, or geographic, location which is another aspect of the environment. Opportunities for healthcare, goods and services like food, and community are all based on geography. [12] Childhood/early adulthood settings highly influence behavior, education, and careers. [12] Those who are financially unstable can usually only find homes that are lower-priced in neighborhoods that are not invested in and are not managed well. [7] These homes are often lower quality, and the costs are higher than what can be managed. [7] According to The Link between Neighborhood Poverty and Wealth: Context or Composition?, Residents in a high-poverty neighborhood reports poor health 1.63 times more than a person in a low-poverty neighborhood, even when controlling for factors like education, marital status, and labor force status. [12] For those living in rural areas, health services are not as accessible, and impoverished people go to doctors fewer times than their counterparts. [1] The effect of spatial location is seen in both physical and mental health.

Poverty and physical health

Poverty can affect health outcomes throughout a person's entire life. The affect may not always be expressed while an individual is impoverished. Mothers who are in poverty during their pregnancies may experience more health risks during their delivery, and their newborns may experience more health risks and markedly more behavioral problems during their development. [13]  Furthermore, children in poverty have worse health outcomes during adulthood. This effect is especially pronounced for specific ailments, such as heart disease and diabetes. The impact persists even if a youth escapes poverty by adulthood, suggesting that the stress of poverty encountered during childhood or adolescence has a lasting effect. [14] Previous research has identified the labor environments of the impoverished as more likely to contain risk factors for illness and disability relative to their non-impoverished counterparts. [15] The implication is that the unique stresses of life within an impoverished community contribute to poorer health outcomes, even if the resident does not engage in any specific behavior detrimental to their health. [16] Early into the COVID-19 pandemic in North America, being impoverished was associated with an increased likelihood of contracting COVID-19, as well as dying from it. [17]

Poor housing results in many health problems. Accidents, respiratory disease, and lead poisoning can be caused by poorly built housing. [7] There can also be a lack of safe drinking water, pests, and dampness in the house, and gonorrhea is associated with deteriorating houses. [7] Mothers who live in poverty areas have lower rates of prenatal care and higher rates of infant mortality and low birth weight. [18] Tuberculosis rates are also higher in high-poverty areas. [18] Obesity is associated with poverty due to lack of infrastructure that supports a healthy lifestyle. [19] Often, poverty-areas do not have places to walk or get healthy food nearby, and they are bombarded with unhealthy promotions like cigarettes, alcohol, and fast food. [19] High-poverty areas also had higher death rates than low-poverty areas. [18] [20]

The cost of housing is a huge detriment to physical health. Housing is what the poor pay the most for on a regular basis, and this results in lack of funds for other basic needs like food and health. [7] [19] [21] In a National Health Interview Survey, it was found that around 10% of American families did not receive needed medical care because of cost. [22] Food insecurity also increases due to being unable to buy food due to cost. [23]

According to a 2023 study published in JAMA , cumulative poverty of a decade or more is the fourth leading risk factor for death in the United States annually, being associated with 295,000 deaths. A single year of poverty was associated with 183,000 deaths in 2019, making it the seventh leading risk factor. [4] Up until the age of 40, poor people's survival rates were essentially comparable to those of more affluent people, according to UCR researchers, but after that point, they died at a rate that was noticeably higher. [5] [6]

Poverty and mental health

Poverty also has a complex relationship with mental health. Being in poverty may itself provoke a condition of elevated emotional stress, known as "poverty distress". [24]   Poverty is also a precursor or risk factor for mental illness, particularly mood disorders, such as depression and anxiety. Schizophrenia is also strongly associated with poverty, occurring most frequently in the poorest classes of people all over the world, especially in more unequal countries. [25]   In a sort of reciprocating relationship, having a mental illness is a major risk factor for being in poverty.  Having a mental illness may inhibit a person's ability to work or deter employees from hiring them.

A hypothesis known as "drift hypothesis", posits that for people with psychiatric disorders (primarily schizophrenia), they tend to fall further down the socioeconomic ladder as their condition reduces their functionality.  This hypothesis is an effort to establish that people with profoundly limiting psychiatric symptoms are more likely to descend economically, not that the financially challenged are more likely to present severe psychiatric disorders. People experiencing less severe symptoms are less likely to be affected by "drift". [24]  

Receiving treatment has shown positive effects for those struggling with mental illness and poverty. Psychotherapy.JPG
Receiving treatment has shown positive effects for those struggling with mental illness and poverty.

With those in poverty having a greater likelihood of suffering from mental illness, the benefit of access to clinical psychotherapy treatments has been explored. Despite numerous barriers to access to care for low-income individuals, there is evidence that those who do receive care respond with significant improvements. This research supports policy measures for improved outreach and access-to-care measures designed to benefit those with low-incomes and mental health disorders. [26]

Mental health is affected by location as well. Noisy housing impacts reading in children and promotes psychological stress. [7] Many poor families move more often and are residentially unstable. This results in children experiencing instability with relationships with peers. [7] They also experience more stressful life events which places strain on their mental state as the events cumulate. [7] [11] As both parents and children try to cope, they may cut themselves off from social interactions and healthy development. [7]

Race and health

Poverty and race both impact the health outcome of a person. [18] Of the residents in poverty-areas, well over half are people of color. [18] When compared to White Americans, all other races have lower outcomes of infant mortality, low birth weight, prenatal care, and deaths in cities. [18] People of Color have an 80% higher mortality rate than White people, and this includes deaths from cancer, accidents/homicides, and disease. [1] Those in severe poverty are more likely to be Black Americans and Latinx. [19] More than one-fourth of the Native American and Alaska Native population lives in poverty. [27] When adjusted for age, the death rate of Native Americans and Alaska Natives is 40% higher than the general population, and 39% of the children are obese or overweight. [27] Mental health is the number one problem in the Native American and Alaska Native population. [27] For Black Americans, racial segregation in neighborhoods are barriers for equitable health opportunities. [7] Most current neighborhoods that are predominantly Black have been institutionally disinvested and have fewer public services and more housing insecurity. [7] With these barriers, many Black Americans do not have the wealth of a family home passed down through generations. [7] Latinx and Asians may also have trouble with home ownership due to cultural and linguistic isolation. [7]

Homelessness and health

This section is an excerpt from Homelessness in the United States § Health.[ edit ]

Homelessness is a public welfare and health epidemic within the United States. Any period of homelessness is associated with adverse health consequences. [28] These adverse health consequences are associated with poor living conditions and a lack of access to treatment facilities. Due to living in extreme poverty it is unlikely for an individual or a family to have a healthcare plan. These healthcare plans are important in obtaining treatment for illnesses or injury from treatment facilities. Without it, individuals and families are left to deal with their ailments themselves or endure further financial burden by receiving treatments without a health insurance plan. Respiratory infections and outbreaks of tuberculosis and other aerosol transmitted infections have been reported. Homeless intravenous drug users are at an increased risk of contracting HIV, and hepatitis B and C infections.

[29] The close living spaces of areas such as Skid Row in California provide an environment in which infectious diseases can spread easily. These areas with a high concentration of homeless individuals are dirty environments with little resources for personal hygiene. It was estimated in a report to congress that 35% of homeless were in unsheltered locations not suitable for human habitation. [30]

There is a bidirectional relationship between homelessness and poor health. [31] Homelessness exacts a heavy toll on individuals and the longer individuals experience homelessness, the more likely they are to experience poor health and be at higher risk for premature death. [32] Health conditions, such as substance use and mental illness, can increase people's susceptibility to homelessness. Conversely, homelessness can further cause health issues as they come with constant exposure to environmental threat such as hazards of violence and communicable diseases. Homeless people have disproportionately high rates of poly substance use, mental illness, physical health problems and legal issues/barriers in attaining employment. [33]

Large number of homeless people work but few homeless people are able to generate significant earnings from employment alone. [34] Physical health problems also limit work or daily activities which are barriers to employment. Substance use is positively associated with lower work level but is negatively related to higher work level. [35] Those with physical health problems are substantially more likely than those with mental health problems to be in the more generous disability programs. Substance use disorders are also a barrier to participation in disability programs. Rates of participation in government programs are low, and people with major mental disorders have low participation rate in disability programs. [36]

Around the United States, homeless deaths surged 77% from 2016 to 2020. An analysis from The Guardian in February 2022 found that some 18,000 homeless people died on the streets and in encampments and shelters over a five year period, with 5,000 of these deaths occurring in 2020. The non-profit National Health Care for the Homeless Council places homeless deaths at between 17,000 and 40,000 annually, as many are never counted given the federal government does not track homeless deaths nationally. The top direct causes of death among the homeless population include "drug overdoses, violence, traffic deaths and premature lethality of treatable conditions like heart disease." Regarding drug deaths, methamphetamine is a significant killer, as people who are homeless use the stimulant drug to stay awake and alert in order to protect themselves from violence. The report also notes that, outside of direct medical causes of death, a major factor contributing to both the epidemic of homelessness and surge in deaths among the homeless population is the lack of affordable housing throughout much of the country. [37]

Homelessness among the elderly has been increasing. [38] The Los Angeles County Department of Public Health found that homeless persons die at greater rates than the general public from specific causes. [39] They are more likely to die by: 35 times from alcohol or drug overdoses, 16 times from auto accidents, 14 times from murder, 8 times from suicide, and 4 times from heart disease. [39] According to data from HUD in September 2023, the elderly are now the fastest growing demographic of the homeless population. [40]

Judge Milan Smith Jr., an American jurist claimed that homelessness is "presently the defining public health and safety crisis in the western United States." [41] According to the Lahsa data, on average six unhoused people are dying each day. the causes reported of death are Overdoses, heart disease, traffic accidents, homicides, hypothermia, and heat exhaustion.Va Lecia Adams Kellum, Lahsa's CEO, believes "The primary causes of homelessness are economic." [42]

Health care policy

Between 1987 and 2005, the number of people without health insurance in the United States rose from just over 30 million, to 46.6 million. [43]  Insurance tends to increase the price of services, [9] and at that time, 8.5% of people belonging to households that made over $75,000 annually were uninsured. For families earning $25,000 or less, that percentage rose to 24.4% uninsured. [43] This figure exhibits how lack of access to care via health insurance disproportionately affects those in poverty.

Graph from U.S. Census Bureau on rates of uninsuredGraph showing Percentage of People Without Health Insurance Coverage from 2013 to 2021.pdf
Graph from U.S. Census Bureau on rates of uninsuredGraph showing

Despite the cost of healthcare being an obstacle for those with relatively low incomes, research suggests that insurance coverage will not dramatically change outcomes related to physical health.  Access to Medicaid for low-income adults aided in the diagnosis of metabolic disease, saw a reduction in diagnosis of mental health disorders, and reduced incurrence of "catastrophic medical costs" by patients dramatically. While these positive effects were observed, outcomes for heart disease, diabetes, and other physical health characteristics were not meaningfully improved. It has been posited that one year, the duration of the study, is an insufficient length to fully observe the divergent health outcomes that would be characteristic of an experiment with a lengthier time-table. [44] Also, minorities have an excess amount of deaths due to diseases like cancer and cardiovascular disease compared to whites. [1]

The medical-industrial complex also contributes to the difficulties of patients paying for medications and healthcare costs. [45]

Actions taken by the government

The United States governmen t has passed acts to make healthcare more accessible. [46] Though it does not have universal health coverage, the country has two forms of public insurance, Medicare and Medicaid. Medicare is insurance for those who are over 65 or have long-term disabilities or end-stage renal disease. [46] Medicaid allows for federal funding to match health care services and allow low-income families, low-income pregnant women, low-income children up to 18 years old, the blind, and those with disabilities to have these services. [46] Medicaid is administered by states, so states have the right to set the criteria for eligibility. According to The Commonwealth Fund website, Medicaid now covers 17.9% of Americans. The Children's Health Insurance Program (CHIP) provides insurance to children in low-income families and covers 9.6 million children, according to The Commonwealth Fund. [46] The Affordable Care Act was passed in 2010, and it expanded Medicaid eligibility and provided funding for federally qualified health centers. These centers take patients regardless of ability to pay and provides free vaccines to uninsured and underinsured children. [46] Community mental health services are also funded by the federal government through grants provided to states by the Substance Abuse and Mental Health Services Administration. [46]

Recommendations to further improve healthcare access

One recommendation to address the inequity of healthcare for the poor is to take community-based action. [1] [47] One example of this is county health councils in Tennessee. These are volunteer groups from the community who assess health inequities within their county and decide what policies to implement. [47] Another idea is to implement community-oriented primary care where physicians consider the environment and culture of the patient to further their health. [1] To improve housing, weatherization programs are recommended to refurbish poor housing to be more health-friendly. [21]

Policy wise, it is recommended to continue investing in the health of the poor by creating an amendment or law and increasing affordable housing. [11] [48] The amendment would ensure that adequate housing is a right to be enjoyed by everyone, and if that could not happen, then a law could be passed for a better housing policy. [11] Affordable housing can be increased by increasing subsidies through housing vouchers for households or reduced interest loans for developers.

Related Research Articles

<span class="mw-page-title-main">Homelessness in the United States</span>

In the United States, the number of homeless people on a given night in January 2023 was more than 650,000 according to the Department of Housing and Urban Development. Homelessness has increased in recent years, in large part due to an increasingly severe housing shortage and rising home prices in the United States.

<span class="mw-page-title-main">Diseases of affluence</span> Health conditions thought to be a result of increasing wealth in society

Diseases of affluence, previously called diseases of rich people, is a term sometimes given to selected diseases and other health conditions which are commonly thought to be a result of increasing wealth in a society. Also referred to as the "Western disease" paradigm, these diseases are in contrast to "diseases of poverty", which largely result from and contribute to human impoverishment. These diseases of affluence have vastly increased in prevalence since the end of World War II.

<span class="mw-page-title-main">Homeless women in the United States</span>

Out of 10,000 female individuals 13 are homeless. Although studies reflect that there are many differences among women suffering homelessness and there is no universal experience, the average homeless woman is 35 years old, has children, is a member of a minority community, and has experienced homelessness more than once in their lifetime.

The social determinants of health (SDOH) are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one's living and working conditions, rather than individual risk factors that influence the risk or vulnerability for a disease or injury. The distribution of social determinants is often shaped by public policies that reflect prevailing political ideologies of the area.

Diseases of poverty are diseases that are more prevalent in low-income populations. They include infectious diseases, as well as diseases related to malnutrition and poor health behaviour. Poverty is one of the major social determinants of health. The World Health Report (2002) states that diseases of poverty account for 45% of the disease burden in the countries with high poverty rate which are preventable or treatable with existing interventions. Diseases of poverty are often co-morbid and ubiquitous with malnutrition. Poverty increases the chances of having these diseases as the deprivation of shelter, safe drinking water, nutritious food, sanitation, and access to health services contributes towards poor health behaviour. At the same time, these diseases act as a barrier for economic growth to affected people and families caring for them which in turn results into increased poverty in the community. These diseases produced in part by poverty are in contrast to diseases of affluence, which are diseases thought to be a result of increasing wealth in a society.

<span class="mw-page-title-main">Hispanic paradox</span> Epidemiological finding

The Hispanic paradox is an epidemiological finding that Hispanic Americans tend to have health outcomes that "paradoxically" are comparable to, or in some cases better than, those of their U.S. non-Hispanic White counterparts, even though Hispanics have lower average income and education, higher rates of disability, as well as a higher incidence of various cardiovascular risk factors and metabolic diseases.

<span class="mw-page-title-main">Patient dumping</span> Inappropriately releasing homeless or indigent patients

Patient dumping or homeless dumping is the practice of hospitals and emergency services inappropriately releasing homeless or indigent patients to public hospitals or on the streets instead of placing them with a homeless shelter or retaining them, especially when they may require expensive medical care with minimal government reimbursement from Medicaid or Medicare. The term homeless dumping has been used since the late 19th century and resurfaced throughout the 20th century alongside legislation and policy changes aimed at addressing the issue. Studies of the issue have indicated mixed results from the United States' policy interventions and have proposed varying ideas to remedy the problem.

Social epidemiology focuses on the patterns in morbidity and mortality rates that emerge as a result of social characteristics. While an individual's lifestyle choices or family history may place him or her at an increased risk for developing certain illnesses, there are social inequalities in health that cannot be explained by individual factors. Variations in health outcomes in the United States are attributed to several social characteristics, such as gender, race, socioeconomic status, the environment, and educational attainment. Inequalities in any or all of these social categories can contribute to health disparities, with some groups placed at an increased risk for acquiring chronic diseases than others.

<span class="mw-page-title-main">Health insurance coverage in the United States</span>

In the United States, health insurance coverage is provided by several public and private sources. During 2019, the U.S. population overall was approximately 330 million, with 59 million people 65 years of age and over covered by the federal Medicare program. The 273 million non-institutionalized persons under age 65 either obtained their coverage from employer-based or non-employer based sources, or were uninsured. During the year 2019, 89% of the non-institutionalized population had health insurance coverage. Separately, approximately 12 million military personnel received coverage through the Veteran's Administration and Military Health System.

<span class="mw-page-title-main">Poverty in the United States</span>

In the United States, poverty has both social and political implications. In 2020, there were 37.2 million people in poverty. Some of the many causes include income inequality, inflation, unemployment, debt traps and poor education. The majority of adults living in poverty are employed and have at least a high school education. Although the US is a relatively wealthy country by international standards, it has a persistently high poverty rate compared to other developed countries due in part to a less generous welfare system.

<span class="mw-page-title-main">Social programs in the United States</span> Overview of social programs in the United States of America

The United States spends approximately $2.3 trillion on federal and state social programs include cash assistance, health insurance, food assistance, housing subsidies, energy and utilities subsidies, and education and childcare assistance. Similar benefits are sometimes provided by the private sector either through policy mandates or on a voluntary basis. Employer-sponsored health insurance is an example of this.

Housing quality and health outcomes in the United States are inextricably linked. As a matter of U.S. public health, substandard housing is associated with outcomes such as injury, respiratory infections, heavy metal poisoning and asthma. It may also be associated with mental disability and with obesity and its related morbidities.

The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. These conditions are also shaped by political, social, and economic structures. The majority of people around the globe do not meet their potential best health because of a "toxic combination of bad policies, economics, and politics". Daily living conditions work together with these structural drivers to result in the social determinants of health.

<span class="mw-page-title-main">Homelessness and mental health</span>

In a study in Western societies, homeless people have a higher prevalence of mental illness when compared to the general population. They also are more likely to suffer from alcoholism and drug dependency. It is estimated that 20–25% of homeless people, compared with 6% of the non-homeless, have severe mental illness. Others estimate that up to one-third of the homeless have a mental illness. In January 2015, the most extensive survey ever undertaken found 564,708 people were homeless on a given night in the United States. Depending on the age group in question and how homelessness is defined, the consensus estimate as of 2014 was that, at minimum, 25% of the American homeless—140,000 individuals—were seriously mentally ill at any given point in time. 45% percent of the homeless—250,000 individuals—had any mental illness. More would be labeled homeless if these were annual counts rather than point-in-time counts. Being chronically homeless also means that people with mental illnesses are more likely to experience catastrophic health crises requiring medical intervention or resulting in institutionalization within the criminal justice system. Majority of the homeless population do not have a mental illness. Although there is no correlation between homelessness and mental health, those who are dealing with homelessness are struggling with psychological and emotional distress. The Substance Abuse and Mental Health Services Administration conducted a study and found that in 2010, 26.2 percent of sheltered homeless people had a severe mental illness.

A large proportion of children in the United States experience poverty. As of 1992, children were the largest age group living below the poverty line, and around 1 in 5 children were affected as of 2016. Child poverty is measured using absolute and relative methods. It is caused by many factors, including race, education, and family structure, but ultimately race correlates with these factors. There are multiple effects due to this. Effects on health and development cause lifelong problems and lower educational outcomes, and food insecurity can also be caused by child poverty. The United States government has put in place programs using tax credits and transfers. There are also community programs that have impacted specific communities that have high child poverty rates. For future policies, research suggests that greater investment directed to children and families in poverty and connections between healthcare providers and financial services can lower the child poverty rate. In 2022, the child poverty rate climbed to 12.4% from 5.2% in 2021, largely as a result of the end of pandemic aid in late 2021.

Homelessness and aging is a largely neglected topic in the literature. There is a widespread assumption that aged homeless people are rare, but this is not true. Japan, Australia and the United Kingdom show increases in their populations of aging homelessness. Increased Elderly adults who straddle the poverty line are at greater risk of falling into pathways of homelessness. When a homeless person enters their later years, or becomes homeless for the first time in older age, health issues can become difficult to address and compound as age progresses.

<span class="mw-page-title-main">Housing insecurity in the United States</span>

Housing insecurity is the lack of security in an individual shelter that is the result of high housing costs relative to income, poor housing quality, unstable neighborhoods, overcrowding, and, but may not include, homelessness.

<span class="mw-page-title-main">Eviction in the United States</span> Landlord removals of rental housing tenants in the North American country

Eviction in the United States refers to the pattern of tenant removal by landlords in the United States. In an eviction process, landlords forcibly remove tenants from their place of residence and reclaim the property. Landlords may decide to evict tenants who have failed to pay rent, violated lease terms, or possess an expired lease. Landlords may also choose not to renew a tenant's lease, however, this does not constitute an eviction. In the United States, eviction procedures, landlord rights, and tenant protections vary by state and locality. Historically, the United States has seen changes in domestic eviction rates during periods of major socio-political and economic turmoil—including the Great Depression, the 2008 Recession, and the COVID-19 pandemic. High eviction rates are driven by affordable housing shortages and rising housing costs. Across the United States, low-income and disadvantaged neighborhoods have disproportionately higher eviction rates. Certain demographics—including low income renters, Black and Hispanic renters, women, and people with children—are also at a greater risk of eviction. Additionally, eviction filings remain on renters' public records. This can make it more difficult for renters to access future housing, since most landlords will not rent to a tenant with a history of eviction. Eviction and housing instability are also linked to many negative health and life outcomes, including homelessness, poverty, and poor mental and physical health.

<span class="mw-page-title-main">Impact of the COVID-19 pandemic on African diaspora</span>

The COVID-19 pandemic has revealed race-based health care disparities in many countries, including the United States, United Kingdom, Norway, Sweden, Canada, and Singapore. These disparities are believed to originate from structural racism in these countries which pre-dates the pandemic; a commentary in The BMJ noted that "ethnoracialised differences in health outcomes have become the new normal across the world" as a result of ethnic and racial disparities in COVID-19 healthcare, determined by social factors. Data from the United States and elsewhere shows that minorities, especially black people, have been infected and killed at a disproportionate rate to white people.

The COVID-19 pandemic has had an unequal impact on different racial and ethnic groups in the United States, resulting in new disparities of health outcomes as well as exacerbating existing health and economic disparities.

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  29. ↑ Roy, L.; Crocker, A. G.; Nicholls, T. L (2014). "Criminal Behavior and Victimization Among Homeless". Psychiatr Serv. 65 (6): 739–50. doi:10.1176/appi.ps.201200515. PMID   24535245. S2CID   26616742.
  30. ↑ Henry, M.; Morrill, T. "The 2018 Annual Homeless Assessment Report (AHAR) to Congress" (PDF). HUD Exchange. Archived (PDF) from the original on March 30, 2020. Retrieved May 30, 2019.
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  33. ↑ Fitzpatrick, Kevin Michael (2013). Poverty and Health: A Crisis Among America's Most Vulnerable [2 volumes]: A Crisis among America's Most Vulnerable. ABC-CLIO. p. 165. ISBN   978-1-4408-0264-5. Archived from the original on February 22, 2023. Retrieved February 8, 2019.
  34. ↑ Zuvekas, Samuel H.; Hill, Steven C. (2000). "Income and employment among homeless people: the role of mental health, health and substance abuse". The Journal of Mental Health Policy and Economics. 3 (3): 153–163. CiteSeerX   10.1.1.490.6983 . doi:10.1002/mhp.94. PMID   11967451.
  35. ↑ "Baggett, Travis P, and Darlene M Jenkins. "Chapter 6." Poverty and Health: A Crisis among America's Most Vulnerable, vol. 1, ABC-CLIO, LLC" (PDF). Archived (PDF) from the original on October 6, 2017. Retrieved October 5, 2017.
  36. ↑ "Affordable housing, homelessness, and mental health: What health care policy needs to address. - Free Online Library". thefreelibrary.com. Archived from the original on September 7, 2018. Retrieved September 6, 2018.
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  38. ↑ Grabenstein, Hannah (March 3, 2023). "More seniors are becoming homeless, and experts say the trend is likely to worsen". PBS. Retrieved June 16, 2023. There's no single reason for the rise in the older homeless population. Weak social safety nets, mass incarceration policies and an insufficient supply of affordable housing are among the many factors
  39. 1 2 Fuller, Thomas (April 18, 2022). "A Rising Tally of Lonely Deaths on the Streets". The New York Times . A study by the Los Angeles County Department of Public Health found that homeless people are 35 times as likely as the general population to die of a drug or alcohol overdose. They are also four times as likely to die of heart disease, 16 times as likely to die in a car crash, 14 times as likely to be murdered and eight times as likely to die of suicide.
  40. ↑ Louis, Serah (September 23, 2023). "'Unconscionable': Baby boomers are becoming homeless at a rate 'not seen since the Great Depression' — here's what's driving this terrible trend". Yahoo! Finance . Retrieved September 23, 2023. Thanks in part to a series of recessions, high housing costs and a shortage of affordable housing, older adults are now the fastest-growing segment of America's homeless population, according to a report in the Wall Street Journal, based on data from the Department of Housing and Urban Development.
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