Poverty In The United States Research Articles

Intergenerational persistence of poverty in five high-income countries.

Childhood poverty increases the likelihood of adult poverty. However, past research offers conflicting accounts of cross-national variation in the strength of-and mechanisms underpinning-the intergenerational persistence of poverty. Here the authors investigate differences in intergenerational poverty in the United States, Australia, Denmark, Germany and the United Kingdom using administrative- and survey-based panel datasets. Intergenerational poverty is decomposed into family background effects, mediation effects, tax and transfer insurance effects and a residual poverty penalty. The intergenerational persistence of poverty is 0.43 in the United States (95% confidence interval (CI) = 0.40-0.46; P < 0.001), compared with 0.16 in the United Kingdom (95% CI = 0.07-0.25; P < 0.001) and 0.08 in Denmark (95% CI = 0.08-0.08; P < 0.001). The US disadvantage is not channelled through family background, mediators, neighbourhood effects or racial or ethnic discrimination. Instead, the United States has comparatively weak tax and transfer insurance effects and a more severe residual poverty penalty. If the United States were to adopt the tax and transfer insurance effects of its peer countries, its intergenerational poverty persistence could decrease by more than one-third.

Mass Beliefs about the Working Poor and Support for Redistributive Policies

Abstract Past research demonstrates that the working poor are politically relevant, yet little is known about public opinion toward this group. This research note explores public beliefs about working poverty in the United States. The results suggest that most Americans are aware of the working poor and view working poverty as problematic and due to structural factors. Like many political attitudes, beliefs about the working poor are linked to Americans’ personal experiences—namely, their level of local exposure to low-income people. However, consistent with research on the role of race in shaping the politics of poverty and inequality, the linkage between local low-income populations and beliefs about the working poor is conditioned by the race of the local poor. Finally, the political relevance of beliefs about the working poor is illustrated by their substantively large relationships to preferences over spending on the poor and taxing the rich.

Spatiotemporal Trends of Poverty in the United States, 2006–2021

Spatiotemporal Trends of Poverty in the United States, 2006–2021

Self-Regulation Interventions for Children in Living Poverty in the United States: A Systematic Review

Self-Regulation Interventions for Children in Living Poverty in the United States: A Systematic Review

Intrahousehold Resource Allocation and Child Food Poverty in the United States

Intrahousehold Resource Allocation and Child Food Poverty in the United States

When user error calls for a product redesign: Poverty in the United States

When user error calls for a product redesign: Poverty in the United States

Racial-Ethnic Poverty Gaps in Later Life: A Role for Late Career Employment Quality?

Abstract Racial-ethnic disparities in poverty are an important form of inequality in older age. Recent scholarship on racial-ethnic poverty gaps demonstrates that, beyond individual characteristics and behaviors, racialized structural factors like employment contribute to such gaps. Yet surprisingly little is known about the role of employment quality, despite observed racial-ethnic disparities in employment quality and the role of employment history in shaping later life well-being. Using data from the 2002–2018 waves of the Health and Retirement Study (HRS) and three poverty measures, we decompose the proportions of the Black-white and Hispanic-white poverty gaps among households led by 65-year-olds that are attributable to disparities in late career employment quality. We find that racial-ethnic disparities in late career employment quality account for 17–28 percent of the observed Black-white and 18–32 percent of the observed Hispanic-white poverty gaps, thus explaining a greater proportion of such gaps than many common individual or behavioral explanations. Disaggregating employment quality into its component measures, we find racial-ethnic disparities in access to employer-provided health insurance and hourly wages account for the largest proportion of racial-ethnic poverty gaps. Our findings suggest that employment quality captures important racialized dimensions of labor market context that help account for racial-ethnic inequalities in later life poverty in the United States.

The cost of doing nothing: Preventable premature births for at-risk women

Background: The effects of poverty in the United States are growing, and the impacts are most severe for the already vulnerable populations. This analysis looks at the cost of doing nothing for at-risk pregnant women in one county in NE Ohio. Most of these women are living at or below the poverty level, lack safe, affordable, and stable housing, and often do not receive recommended levels of prenatal care. This examination uses data from Mahoning County, Ohio, where one program has provided wrap-around support for any at-risk pregnant mother since 2016. Objective: Examine the cost/savings of providing wrap-around support services to at-risk pregnant women. Methods: Data was provided by the Mahoning County Pathway HUB (MCPH) regarding all births since its 2016 inception. Data was extracted from the Ohio Department of Health, the CDC, and other sources regarding the cost of births and specifically premature births. These sources of data were analyzed using causal-comparative methods, in order to understand the frequency of premature births, with, and without the support services provided by the MCPH. Conclusion: The results of these causal-comparative analyses suggest that the cost of doing nothing for at-risk pregnant women is substantial for all stakeholders. Results demonstrate a savings of 2.45 million dollars for the five years included in the analysis. Because most of the services provided by the MCPH are billable to public health insurance, this model of supporting pregnant mothers who are at risk is important. The cost of doing nothing can lead to a lifetime of avoidable suffering and financial hardship for the women and infants who are born premature. The results from the MCPH suggest that this model of support and service delivery is making a difference, based on the lower-than-expected pre-term births over their tenure of operation.

Corrections to “Managing the ‘hot spots’: Health care, policing, and the governance of poverty in the US”

Corrections to “Managing the ‘hot spots’: Health care, policing, and the governance of poverty in the US”

Design and rationale of the cardiometabolic health program linked with community health workers and mobile health telemonitoring to reduce health disparities (LINKED-HEARTS) program

Hypertension and diabetes are major risk factors for cardiovascular diseases, stroke, and chronic kidney disease (CKD). Disparities in hypertension control persist among Black and Hispanic adults and persons living in poverty in the United States. The "LINKED-HEARTS Program" (a Cardiometabolic Health Program LINKED with Community Health WorkErs and Mobile HeAlth TelemonitoRing To reduce Health DisparitieS"), is a multi-level intervention that includes home blood pressure (BP) monitoring (HBPM), blood glucose telemonitoring, and team-based care. This study aims to examine the effect of the LINKED-HEARTS Program intervention in improving BP control compared to enhanced usual care (EUC) and to evaluate the reach, adoption, sustainability, and cost-effectiveness of the program. Using a hybrid type I effectiveness-implementation design, 428 adults with uncontrolled hypertension (systolic BP ≥ 140 mm Hg) and diabetes or CKD will be recruited from 18 primary care practices, including community health centers, in Maryland. Using a cluster-randomized trial design, practices are randomly assigned to the LINKED-HEARTS intervention arm or EUC arm. Participants in the LINKED-HEARTS intervention arm receive training on HBPM, BP and glucose telemonitoring, and community health worker and pharmacist telehealth visits on lifestyle modification and medication management over 12 months. The primary outcome is the proportion of participants with controlled BP (<140/90 mm Hg) at 12 months. The study tests a multi-level intervention to control multiple chronic diseases. Findings from the study may be leveraged to reduce disparities in the management and control of chronic diseases and make primary care more responsive to the needs of underserved populations. ClinicalTrials.gov. Identifier: NCT05321368.

Renal Oxidative Stress May Explain Sex Differences in Blood Pressure in Adult Offspring Exposed to an Impoverished Environment

Background: Nearly 40 million people experience poverty in the United States. Poverty is linked to adverse childhood experiences (ACEs) which affects about 64% of adults in the U.S. Previous studies indicate that those who experience ACEs are at a higher risk of developing hypertension (HTN) and cardiovascular diseases (CVDs) later in life, with a greater severity and earlier onset in males. The mechanisms behind the ACEs-attributed development of sex differences in HTN later in life is unknown. One plausible mechanism for this sex difference is increased oxidative stress. One rodent model to mimic poverty as an ACE is the limited bed and nesting (LBN) model. This model simulates an impoverished and low resource environment, as observed in poverty, in which the nesting material during weaning is reduced. We hypothesize that male offspring exposed to LBN will have elevated blood pressure and oxidative stress, while females will have no change in blood pressure and reduced oxidative stress. Methods: Pregnant Sprague Dawley rats gave birth naturally and weaned their offspring for 3 weeks. During the weaning period, on Days 2-9, the dams and their respective pups were divided into 2 groups: LBN and control (CON). After LBN treatment, all rats received normal bedding. After weaning, offspring were divided by sex and experimental status: LBN male (n=5), LBN female (n=5), CON male (n=6), and CON female (n=6). At 16-17 weeks, mean arterial pressure (MAP) was measured via carotid catheterization and the kidneys, brain, heart, and plasma were collected to measure antioxidant capacity via colorimetric biochemical assays. Results: LBN males had a significant increase (18 mmHg) in MAP compared to CON males (128.17±3.93 vs 110.72± 3.93 mmHg, P&gt;0.001), while female LBN and CON rodents displayed no differences. In males, there were no changes in antioxidant capacity in the brain, heart, and plasma. However, there was a significant 2-fold decrease in renal antioxidant capacity (233±14.0 vs 442±12.3 mM Trolox/mg protein, p&gt;0.0001). In females, there were no changes in the kidneys, heart, and brain antioxidant capacity. Conversely, LBN females showed a trending increase in plasma antioxidant capacity compared to CON (3.33±0.16 vs 2.53±0.35 mM Trolox/mg protein, p=0.053). Conclusion: Only males exposed to an impoverished environment during weaning have elevated blood pressure, while females do not. This difference in blood pressure may be explained by decreases in renal antioxidant capacity in males only. On the other hand, females may be protected from elevated blood pressure because they experience a slight increase in systemic antioxidant capacity. Future studies will examine the role of antioxidants in blood pressure regulation in the kidneys. This study is clinically relevant because ACEs affect a large percentage of the American population with about 17% of adults experiencing 4 or more ACEs, with minorities at a greater risk. Understanding the mechanisms on how ACEs contribute to HTN may alleviate some of the racial and ethnic disparities, along with the financial burden on the healthcare system to care for people with HTN and CVDs. Perhaps, organ and sex-specific antioxidant therapies may be used to alter, prevent, or reduce the development of HTN in adults that were exposed to ACEs, such as poverty during nursing and early childhood. This research was supported by start-up funds and the American Heart Association Early Career Development Award [AHA 18CDA34110264 (Cunningham)]. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Medical expenditures and the measurement of poverty in the United States

Using data from the Medical Expenditure Panel Survey (MEPS) we estimate the fraction of the US population that is health poor. A person is health poor if their income prior to paying health insurance premiums and out-of-pocket healthcare costs is above the poverty line, but their income net-of-premiums and out-of-pocket healthcare costs is below the poverty line. Because resources used to finance health insurance premiums and out-of-pocket costs are (A) lexicographically preferred and (B) cannot be used to maintain an individual’s standard of living, they should be excluded from official poverty estimates. Approximately 1% to 2% of the US population is health poor. Elderly individuals, individuals in ill health, and low-income individuals are more likely to be health poor than other groups. We use our estimates of the health poor to evaluate alternative healthcare reform policies. The Affordable Care Act reduced the proportion of individuals near-poverty that are health poor from 23% to 18% and reduced the proportion of all individuals that are health poor from 1.5% to 1.1%. In contrast, counterfactual simulations of a Medicare for All plan similar to Saez and Zucman’s (2019b) suggest that Medicare for All would all but eliminate health poverty.

The Influence of Family-Based Social Assistance Programs and Parenting on Child Development: A Conceptual Framework for Research with U.S. Families in Poverty.

Nearly three decades since the passage of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, federal cash assistance to families in poverty in the United States has entered political discourse once more with the Biden Administration's introduction of the American Families Plan. At the heart of this discussion are theories of change that derive from the family and developmental sciences. As a result, scientists in these fields have a duty to understand the history of the last reform and the consequences it has since had for children in poverty. In this paper, I review the history of perspectives toward government social assistance programs, as well as extant research demonstrating the mechanisms through which maternal employment and federal cash assistance impact child wellbeing. Lastly, I propose a conceptual framework for understanding the influence of family-based social assistance programs and parenting on child wellbeing to guide future research.

Impact of the COVID-19 Pandemic on Blood Lead Testing in Children in the United States.

The study objective was to evaluate the impact of the coronavirus disease (COVID-19) pandemic on pediatric blood lead testing in the United States. Clinical laboratory pediatric (ages <6 years) blood lead level (BLL) tests performed by Quest Diagnostics, January 2019-March 2022, were analyzed. Patients were categorized by age, by sex, and, through matching by ZIP code with US Census data, for race, ethnicity, pre-1950 housing, and poverty estimates. Over 2.8 million results from children (<6 years old) from all 50 states and the District of Columbia were included. Compared to March-May 2019, BLL testing was lower by 53.6% in March-May 2020 and lower by 14.6% in March-May 2021. Testing rebounded more for children in predominantly White non-Hispanic communities and among children living in communities, based on ZIP codes, with the least pre-1950 housing stock and lowest poverty rates. The proportion of children with BLL at or above the United States Centers for Disease Control and Prevention reference values of 3.5 and 5.0 µg/dL fell by 19% and 24%, respectively, in 2021 versus 2019. In conclusion, pediatric BLL testing has rebounded from sharp declines during the early pandemic period but unevenly. Declines in the proportion of children with elevated BLL should be interpreted with caution, as testing rebounds were less robust among communities with the highest risk of lead poisoning, notably communities with the oldest housing stock and higher poverty rates. More public health efforts are needed to address lead toxicity throughout the United States, especially in communities that did not experience a full rebound subsequent to the early COVID-19 pandemic period.

Covering the Distant Other: Discursive Construction of the Makoko Community in Nigeria as “Venice of Africa”

ABSTRACT Journalistic texts are sites for the construction of meaning. Through their work, journalists construct, enact, and sustain identities and social realities. In particular, journalistic representations of poverty have implications for how poverty is perceived and addressed, and although extensive research has examined media representations of domestic poverty in the United States, very little is known about how American news organizations represent poverty in other contexts. Nonetheless, Western media have been criticized for presenting a homogenizing and totalizing image of Africa as the “dark continent.” This study explores CNN’s representation of Makoko, a low-income community in Nigeria, as the “Venice of Africa.” Critical discourse analysis of CNN stories about Makoko published between 2012 and 2023 reveals a complicated practice. CNN constructed different identities for Makoko, such as victim, achiever, and spectacle, thereby challenging notions of stereotypical representations of countries in Africa by Western media. However, a predominant focus on success, and the discursive strategy of transforming suffering into artistic spectacle, suggests an exclusive ideology, which contributes to a public ambivalence toward addressing the structural issues faced by this community.

Youth Perspectives and Experiences With Menstruation and Period Poverty

PurposePeriod poverty is the lack of accessible menstrual education or menstrual tools. Millions of women and girls around the world experience period poverty, which can contribute to disparities in school and work performance, as well as overall quality of life. However, not much is known about youth experiences and perceptions of period poverty. This study aims to understand the personal experiences and opinions of American youth regarding knowledge about menstruation and period poverty, as well as to gauge youth attitudes of existing and future period poverty initiatives. MethodsThe MyVoice nationwide text message poll was used to ask five open-ended questions to over 1,000 youth across the United States aged 14–24 years. Responses were analyzed using content analysis by two independent researchers, and differences in coding were reviewed and resolved by discussion. ResultsOverall, 963 youth (80%) responded, and the sample was 54.7% self-reported male with an average age of 20.1 years (standard deviation = 2.3). Three main themes emerged: 1. Most youth, regardless of self-reported gender, have had conversations about periods but comfort discussing the topic varies, 2. Youths' knowledge of menstruation varies with personal experience, or lack thereof, and 3. Some youth have experience with period poverty, and most are overwhelmingly supportive of policies to improve access to period products. DiscussionThese findings suggest that normalization of discussions of menstruation, increasing awareness of the prevalence and impacts of period poverty, and greater implementation of programs to mitigate period poverty are supported by youth, and may reduce period poverty in the United States.

Abstract TP255: Racism, Resilience, and Quality of Life in Black Stroke Survivors

Introduction: Stroke impairs stroke survivor (SS) quality of life (QoL). Black SS in the US also endure stress from structural, cultural, and interpersonal racism. Resilience is a dynamic process of maintaining stable functioning after an event such as stroke. This observational study aimed to assess the effects of racism and resilience on Black SS QoL. Methods: Participants were community-dwelling SS (age ≥ 18) who identified as African American or Black and experienced a stroke within 8 weeks. Baseline data collection included exposure (discrimination, vigilance, resilience), demographic, clinical, and psychosocial variables. Outcome data for QoL was gathered after 6 months. The effects of exposure variables and covariates on QoL were analyzed with multiple linear regression. Results: Participants (n=74) had a mean age of 56.2, 32% were in marital or partner relationships, and 58% were female. Most participants (84%) had ischemic stroke, with no more than mild disability (mRS 0-2 for 80%). Over half of participants had some college (32%) or a college degree (20%). The remaining 46% had a high school education or less. Work status included 32% currently working, 15% not working, 28% retired, and 24% disabled. Half reported an annual household income of &lt; $25,000, with 63% living at ≤ 200% above the US poverty level. Participants reported moderate (64%) to high (8%) perceived stress, and 14% had moderate to moderately severe anxiety. Resilience was correlated with stress (r=-.59, p&lt;.001) and anxiety (r=-.66, p&lt;.01). At 6-month follow-up (n=44), QoL domains were very low for social relations ( M =36.83, SD=17.76) and environment ( M= 35.04, SD=14.57), and moderately low for physical ( M =46.49, SD=19.22) and psychological ( M =54.39, SD=17.23). Higher vigilance and higher disability explained 23.3% of the variance in social relations QoL (F=7.545, p=.002). Higher resilience and higher socioeconomic status explained 25.7% of the variance in psychological QoL (F=5.524, p=.009). Conclusions: This sample had significant baseline socioeconomic disadvantage and increased psychosocial stress at baseline, and diminished QoL 6 months post-stroke. Future research with larger samples is warranted.

Abstract HUP11: Racism, Resilience, and Quality of Life in Black Stroke Survivors

Introduction: Stroke impairs stroke survivor (SS) quality of life (QoL). Black SS in the US also endure stress from structural, cultural, and interpersonal racism. Resilience is a dynamic process of maintaining stable functioning after an event such as stroke. This observational study aimed to assess the effects of racism and resilience on Black SS QoL. Methods: Participants were community-dwelling SS (age ≥ 18) who identified as African American or Black and experienced a stroke within 8 weeks. Baseline data collection included exposure (discrimination, vigilance, resilience), demographic, clinical, and psychosocial variables. Outcome data for QoL was gathered after 6 months. The effects of exposure variables and covariates on QoL were analyzed with multiple linear regression. Results: Participants (n=74) had a mean age of 56.2, 32% were in marital or partner relationships, and 58% were female. Most participants (84%) had ischemic stroke, with no more than mild disability (mRS 0-2 for 80%). Over half of participants had some college (32%) or a college degree (20%). The remaining 46% had a high school education or less. Work status included 32% currently working, 15% not working, 28% retired, and 24% disabled. Half reported an annual household income of &lt; $25,000, with 63% living at ≤ 200% above the US poverty level. Participants reported moderate (64%) to high (8%) perceived stress, and 14% had moderate to moderately severe anxiety. Resilience was correlated with stress (r=-.59, p&lt;.001) and anxiety (r=-.66, p&lt;.01). At 6-month follow-up (n=44), QoL domains were very low for social relations ( M =36.83, SD=17.76) and environment ( M= 35.04, SD=14.57), and moderately low for physical ( M =46.49, SD=19.22) and psychological ( M =54.39, SD=17.23). Higher vigilance and higher disability explained 23.3% of the variance in social relations QoL (F=7.545, p=.002). Higher resilience and higher socioeconomic status explained 25.7% of the variance in psychological QoL (F=5.524, p=.009). Conclusions: This sample had significant baseline socioeconomic disadvantage and increased psychosocial stress at baseline, and diminished QoL 6 months post-stroke. Future research with larger samples is warranted.

Federal Minimum Wage and Poverty Alleviation

In 2022, 37.9 million people in the United States lived in poverty creating a poverty rate of 11.5 percent (US Census Bureau 2024). There are many efforts across the country to decrease poverty, one of them being increasing the minimum wage to $15 an hour. This paper examines the history of the minimum wage in the United States, its erosion over the years, and its impact on poverty alleviation. Ultimately, increasing the minimum wage to $15 an hour will not decrease poverty in the United States due to average wage rates and insufficient targeting efforts. Reference: US Census Bureau. 2024. “National Poverty in America Awareness Month: January 2024.” Census.gov, January 4, 2024. https://www.census.gov/newsroom/stories/poverty-awareness-month.html.

Community-level social determinants of health and pregestational and gestational diabetes

Individual adverse social determinants of health are associated with increased risk of diabetes in pregnancy, but the relative influence of neighborhood or community-level social determinants of health is unknown. This study aimed to determine whether living in neighborhoods with greater socioeconomic disadvantage, food deserts, or less walkability was associated with having pregestational diabetes and developing gestational diabetes. We conducted a secondary analysis of the prospective Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be. Home addresses in the first trimester were geocoded at the census tract level. The exposures (modeled separately) were the following 3 neighborhood-level measures of adverse social determinants of health: (1) socioeconomic disadvantage, defined by the Area Deprivation Index and measured in tertiles from the lowest tertile (ie, least disadvantage [T1]) to the highest (ie, most disadvantage [T3]); (2) food desert, defined by the United States Department of Agriculture Food Access Research Atlas (yes/no by low income and low access criteria); and (3) less walkability, defined by the Environmental Protection Agency National Walkability Index (most walkable score [15.26-20.0] vs less walkable score [<15.26]). Multinomial logistic regression was used to model the odds of gestational diabetes or pregestational diabetes relative to no diabetes as the reference, adjusted for age at delivery, chronic hypertension, Medicaid insurance status, and low household income (<130% of the US poverty level). Among the 9155 assessed individuals, the mean Area Deprivation Index score was 39.0 (interquartile range, 19.0-71.0), 37.0% lived in a food desert, and 41.0% lived in a less walkable neighborhood. The frequency of pregestational and gestational diabetes diagnosis was 1.5% and 4.2%, respectively. Individuals living in a community in the highest tertile of socioeconomic disadvantage had increased odds of entering pregnancy with pregestational diabetes compared with those in the lowest tertile (T3 vs T1: 2.6% vs 0.8%; adjusted odds ratio, 2.52; 95% confidence interval, 1.41-4.48). Individuals living in a food desert (4.8% vs 4.0%; adjusted odds ratio, 1.37; 95% confidence interval, 1.06-1.77) and in a less walkable neighborhood (4.4% vs 3.8%; adjusted odds ratio, 1.33; 95% confidence interval, 1.04-1.71) had increased odds of gestational diabetes. There was no significant association between living in a food desert or a less walkable neighborhood and pregestational diabetes, or between socioeconomic disadvantage and gestational diabetes. Nulliparous individuals living in a neighborhood with higher socioeconomic disadvantage were at increased odds of entering pregnancy with pregestational diabetes, and those living in a food desert or a less walkable neighborhood were at increased odds of developing gestational diabetes, after controlling for known covariates.