Poverty Stigma Research Articles

Testing the associations between poverty stigma and mental health: The role of received stigma and perceived structural stigma

Background: Previous research has documented how people living on low incomes in the United Kingdom (UK) and internationally experience various forms of poverty stigma. The purpose of this study was to quantitatively examine how experiences of poverty stigma are associated with mental health outcomes. Methods: An online, cross-sectional survey was conducted with 1,000 adults living in predominantly low- and middle-income households in the UK. The survey included a questionnaire designed to measure participants’ experiences of different forms of poverty stigma, as well as measures of anxiety, depression and mental well-being. Findings: Exploratory and confirmatory factor analyses of the poverty stigma questionnaire supported a two-factor solution. One factor reflected participants’ experiences of being mistreated and judged unfairly by other people because they live on low income (received stigma) and the other factor reflected participants’ perceptions of how people living in poverty are treated by media outlets, public services and politicians (perceived structural stigma). Both received and perceived structural stigma were independently associated with anxiety, depression and mental well-being and these relationships persisted after controlling for socioeconomic indicators. There was also evidence that received stigma and perceived structural stigma partially mediated the relationships between financial hardship and mental health outcomes. Discussion: Experiences of received and perceived structural poverty stigma are both associated with mental health and well-being. This suggests that addressing interpersonal and structural forms of poverty stigma may help to narrow socioeconomic inequalities in mental health.

Internalized poverty-related stigma and interpersonal violence among women living with HIV in the US

Background: Interpersonal violence (IPV) affects half of women living with HIV (WLHIV) in the US and has important consequences for mental health and HIV outcomes. While different types of stigmas (e.g., HIV- or sexual identity-related) are associated with increased risk of IPV, the relationship between poverty-related stigma and IPV is unclear, even though poverty frequently co-occurs with IPV. Methods: Data from up to four annual visits (2016-2020) were collected from 374 WLHIV enrolled in a sub-study of the Women’s Interagency HIV Study (WIHS; now known as MACS/WIHS Combined Cohort Study) at four sites across the US. A validated measure of the perceived stigma of poverty was used, along with questions on recent experiences of IPV. We used a mixed-effects model to assess the association between internalized poverty stigma and IPV. Results: The unadjusted model with internalized poverty-stigma and recent IPV as independent and dependent variables, respectively, suggested that the two were associated (prevalence ratio 1.29 [95% CI 1.02-1.62, p=0.033]). After adjusting for income and education, we found an independent association between internalized poverty-related stigma and recent IPV, with a prevalence ratio of 1.35 (95% CI 1.07-1.71, p=0.011). Conclusion: Our findings suggest that reducing the psychological consequences of poverty may better situate WLHIV to escape or avoid IPV. The usefulness of screening WLHIV who may be experiencing poverty-related stigma for IPV should be investigated. Interventions that address internalized poverty-related stigma may provide an avenue for reducing the harms caused by IPV in addition to interventions aiming to reduce violence itself.

Poverty Stigma: Assessing the Surveillance of and Psychological Reframing by WIC Recipients

ABSTRACT The current study examines the poverty stigma experienced by Women, Infants, and Children program recipients during grocery store transactions. Through in-person interviews with 32 WIC recipients in metro Detroit, the study examines perceptions of the social context, strategies to manage stigma, and the social psychological consequences. The findings highlight the resilience of interviewees and the need for public assistance programs to address not just practical needs but also the social psychological well-being of recipients. This research contributes significantly to understanding poverty stigma, especially within the context of WIC food assistance. Policy implications are discussed.

The impact of poverty stigma on computer and information literacy among China's rural students

Rural middle school students often experience significant educational disparities compared to their urban peers, particularly in developing computer skills and computer and information literacy (CIL). However, there has been insufficient research on the impact of poverty stigma on their CIL development. To address this literature gap, this research examines the influence of poverty stigma and self-efficacy on CIL performance among rural eighth graders in two studies. Guided by the social cognitive theory and labeling theory, Study 1 (n1 = 2783) analyzes the mediating effects of family socioeconomic status and self-efficacy on CIL, while Study 2 (n2 = 2153) investigates the mediating effects of perceived poverty stigma at the dimensions of social stigma and self-stigma on CIL. The results suggest that poverty, family socioeconomic status, and computer use at school positively affect CIL, with self-efficacy mediating the relationship between them. While students from low-resourced families do not perceive social stigma as directly impacting their CIL, self-stigma plays a mediating role between perceived social stigma and CIL. These findings have significant implications for educators seeking to improve CIL in the digital age, emphasizing the importance of increasing computer access at school for better educational outcomes.

How Does Poverty Stigma Affect Depression Symptoms for Women Living with HIV? Longitudinal Mediating and Moderating Mechanisms

How Does Poverty Stigma Affect Depression Symptoms for Women Living with HIV? Longitudinal Mediating and Moderating Mechanisms

Diversity and utilization of indigenous wild edible plants and their contribution to food security in Turkana County, Kenya

IntroductionIndigenous Wild edible plants (IWEPs) are consumed daily in some form by at least one in seven people worldwide. Many of them are rich in essential nutrients with the potential for dietary and nutrition improvement particularly for poor households. They are, however, often overlooked. This study investigated diversity, consumption frequency, and perceptions of IWEPs and the contribution they make to the food security of communities in Turkana County, northern Kenya. Our findings are aimed at stimulating targeted discussions among stakeholders involved in food security programs on best way to overcome the poverty stigma associated with IWEPs consumption and to promote their utilization for food security, nutritional and dietary improvement, and enhanced community resilience.MethodsApplying a mixed-methods approach, we collected data using 12 gender-disaggregated focus group discussions and a questionnaire applied to a random sample of 360 households.Results and DiscussionParticipants identified 73 IWEPs, of which 24 were consumed in the preceding six months by 48.5% of households. Almost all surveyed households (96%) were classified as severely food insecure, and food insecurity did not differ significantly between households that consumed IWEPs and those that did not. Our results indicate that more IWEPs consumers than non-consumers reported eating foods they had not wanted to consume to cope with food scarcity, as well as having to eat fewer meals than normal. Just over half of the respondents (57.1%) held positive attitudes towards IWEPs, which was positively associated with a higher likelihood of IWEPs consumption. Long distances to harvest sites, lack of knowledge about the plants, their seasonality, and how to cook them appetizingly, coupled with overall unfavorable perceptions, are probable reasons for non-consumption of IWEPs among the survey respondents. In line with other studies cited on wild foods, we conclude that IWEPs have the potential to bridge food and nutritional deficits in food insecure households in the study area, although currently their consumption remains limited. Given this potential, further analysis of IWEPs’ nutritional composition and restoration of wild edible foods to local areas should be given priority, as well as interventions that help to overcome the challenges to their consumption and promote their wider use.

From passerby to ally: Testing an intervention to challenge attributions for poverty and generate support for poverty‐reducing policies and allyship

AbstractDespite the ubiquity of poverty, its causes remain largely misunderstood and many attribute poverty to individual shortcomings. This stigma not only predicts negative physical and mental health outcomes for those living in poverty, it also psychologically distances them from the economically advantaged. Thus, solutions to the problem of poverty should include efforts to reduce stigma among the economically advantaged, who are often crucial decision‐makers with the power and resources to act as allies. The current research utilized an intensive and immersive intervention designed to challenge the attributions that underpin poverty stigma. In two studies, we tested the effectiveness of this intervention. Results of both studies demonstrate that participation in the intervention consistently predicted more favorable attributions for poverty, and that these changes in attributions, in turn, had meaningful positive effects on participants’ support for poverty‐reducing policies and willingness to engage in poverty‐related allyship.

Poverty stigma, mental health, and well‐being: A rapid review and synthesis of quantitative and qualitative research

AbstractPoverty is associated with higher rates of mental illness and lower levels of well‐being. Poverty affects mental health and well‐being through a range of mechanisms, one of which may be experiences of stigma associated with living in poverty or accessing services designed to assist individuals on low incomes (including social security). The aim of this study was to synthesise published research on the relationship between individuals' experiences of poverty stigma and aspects of mental health and well‐being. A rapid review was undertaken of quantitative and qualitative research published between January 2005 and February 2021. In total, 22 (5 quantitative and 17 qualitative or mixed methods) studies met the inclusion criteria, the findings of which were extracted and analysed using thematic synthesis. Experiences of poverty stigma were found to be associated with four broad aspects of mental health and well‐being: negative self‐evaluations, diminished social well‐being, negative affect, and mental ill‐health. Several forms of poverty stigma, including self, received, perceived, anticipated, and endorsed stigma were implicated in these associations. Poverty stigma may contribute to inequalities in mental illness and well‐being, although further quantitative and longitudinal research is required to test its impact on mental health.

The Campaign for Universal Free Lunch in New York City: Lessons Learned.

The New York City (NYC) Department of Education is the largest public school system in the United States, with an enrollment of >1.1 million students. Students who participate in school meal programs can have higher dietary quality than nonparticipating students. Historically, family income documentation qualifying students in the NYC Department of Education for free or reduced-price meals reimbursed by the National School Lunch Program perpetuated poverty stigma. Additionally, National School Lunch Program qualification paperwork was a deterrent to many vulnerable families to participate and impeded all eligible children's access to nutritious meals, potentially magnifying food insecurity. The Healthy, Hunger-Free Kids Act of 2010 provided a viable option for schools to serve free meals to all students, regardless of income status, as a universal free lunch (UFL) through a Community Eligibility Provision if ≥40% of students already participated in another means-based program, such as the Supplemental Nutrition Assistance Program. In this case study, we describe the processes of (1) strategic coalition building of the Lunch 4 Learning campaign (a coalition of students, parents, school-based unions, teachers, pediatricians, community leaders, and children's advocacy organizations) to bring UFL to all NYC public schools, (2) building political support, (3) developing a media strategy, and (4) using an evidence-based strategy to overcome political, administrative, and procedural challenges. The Lunch 4 Learning campaign successfully brought UFL to all NYC public schools in 2017. This case study informs further advocacy efforts to expand UFL in other school districts across the country and national UFL advocacy.

Reframing Intersectional Stigma for a South African Context Integrating Tuberculosis, HIV and Poverty Stigmas.

Intersectionality is closely intertwined with Black feminism within the context of the United States. As a result, intersectionality is often overlooked in non-Western contexts where racial homogeneity may reduce some of the impact of race on marginalization. This article will look at intersectional stigma from the South African context using the tuberculosis/HIV (TB/HIV) treatment environment in South Africa to exemplify intersectionality's versatility as an analytic method outside of the United States. We will use colonial history and contemporary research to reframe intersectionality considering a new set of stigmatized identities, including HIV stigma, TB stigma, and poverty stigma, to create a situation-specific framework adapted from a model by Bulent Turan and colleagues.

Drivers of Car Ownership in a Car-Oriented City: A Mixed-Method Study

This paper presents a mixed-method analysis of car ownership in Reykjavik, Iceland, a location with a high motorization level and deeply rooted car culture. We utilize qualitative interviews to understand vehicle possession reasons and elaborate the study with statistical analysis using a softGIS survey dataset with characteristics of the respondents and their residential location. We focus on adults aged 25 to 40, who are suggested to be less car-oriented than older generations. We also describe the historic development of Reykjavik’s car culture to give a perspective for the findings. We show that even among the studied age group, car ownership is still seen as a social norm, with few even seeing it possible to live without a car, and the public transport system is seen as giving a poverty stigma. However, we still find an increasing share of car-free households towards the city center. Still, the built environment impact is limited to the city center, which has a higher proportion of small adult-only households residing in shared apartments than other areas. Moreover, there seems to be a three-fold connection between having a child, acquiring a car (if not already possessed), and choosing a suburban residential location. Some indications of residential self-selection related to car ownership were found, but pro-car attitudes and residential location independently influenced car ownership. This study helps to understand the reasons for high car dominance and supports designing policies to reduce car-dependency, not just in Reykjavik but also elsewhere.

Impacts of poverty stigma on negative affect among welfare recipients: path analysis on Mainland China and Hong Kong SAR

ABSTRACT Using two random sampling surveys from Mainland China and Hong Kong SAR, this study aims to compare the poverty stigma, perceived living standards and subjective well-being of welfare and non-welfare recipients in the two regions. The results show that means-tested welfare recipients generally experience high levels of stigma and negative affect. Path analysis models reveal that the direct impact of such stigma on negative affect is significant in Mainland China. However, in Hong Kong SAR, the impact of stigma on negative affect is indirect, through social interaction and self-rated health.

Community-Based Participatory Research: How Residents of a Small Low-Income Racially Homogenous Disadvantaged Neighborhood Perceive the Effects of Poverty Stigma, Community Disorder, & Feelings of Unsafety on Health

Although research indicates that social determinants impact minority health, there remains a dearth of knowledge on how economically disadvantaged communities perceive the effects of poverty stigmatization, community disorder, and feelings of unsafety on their health status. This qualitative study used community-based participatory research methods to explore how minority residents (n=23) from an urban neighborhood of concentrated poverty perceived the impact of residential and environmental factors on their health. Thematic analysis highlighted how the combination of high crime rates and community disorder negatively affected residents’ ability to maintain a healthy lifestyle due to increased levels of stress and decreased access to health resources. Additionally, perceptions of stigmatization and feelings of unsafety adversely impacted levels of community connectedness and collective efficacy and prevented efforts to improve their individual and neighborhood health conditions.

#WeAreBeneficiaries: Contesting Poverty Stigma Through Social Media

AbstractShowcasing stories of welfare beneficiaries in their own words, a recent Aotearoa (New Zealand)‐based campaign called “We Are Beneficiaries” used social media to create a space of contestation to the widespread stigmatisation of poverty. While existing literature strongly emphasises the role played by traditional media in constructing and reinforcing stigma, and has more recently begun to explore resistance and contestation, relatively few accounts address efforts, like the We Are Beneficiaries campaign, that seek to destigmatise poverty stigma via social media. Accordingly, this paper argues that social media can serve as a counterpublic space for the destigmatisation of poverty. By discussing how the We Are Beneficiaries campaign refuted stigmatising narratives, critiqued institutions and sought to build solidarity among and with welfare beneficiaries, the paper draws attention to the potential of social media in the development of counterdiscourses as well as new political identities and claims‐making.

South Sudan: a young country’s fight against COVID-19

COVID-19 is a highly infectious disease that has started to creep into African countries including South Sudan. Following confirmation of the first few cases, the government enacted preventive measures to curb community transmission. However, daunting challenges deter these precautionary measures. Just after two years the country took its independence from Sudan, civil conflicts sparked and continue to overburden and undermine the fragile healthcare system. The conflicts have caused disruption of health services, destruction of health facilities, death and migration of health workers, displacements of a huge number of people. This scenario continues while the country is grappling with the pandemic. Other concerning issues include: insufficient COVID-19 testing capacity, limited medical and personal protective equipment and an inadequate number of health workers which leave the country ill-equipped in the battle against the pandemic. Non-compliance of COVID-19 prevention protocols by the general public due to high rate of poverty and social stigma contribute to the spread of the virus. The current situation in South Sudan make evident that there is a need for an immediate ceasefire by the warring sides so the available health services including COVID-19 efforts, are not disrupted to ensure the safety of all. The government needs to further build the capacity of its health sector with the cooperation of its international health allies to be able to provide its citizens with the health services they need.

South Sudan: a young country's fight against COVID-19.

COVID-19 is a highly infectious disease that has started to creep into African countries including South Sudan. Following confirmation of the first few cases, the government enacted preventive measures to curb community transmission. However, daunting challenges deter these precautionary measures. Just after two years the country took its independence from Sudan, civil conflicts sparked and continue to overburden and undermine the fragile healthcare system. The conflicts have caused disruption of health services, destruction of health facilities, death and migration of health workers, displacements of a huge number of people. This scenario continues while the country is grappling with the pandemic. Other concerning issues include: insufficient COVID-19 testing capacity, limited medical and personal protective equipment and an inadequate number of health workers which leave the country ill-equipped in the battle against the pandemic. Non-compliance of COVID-19 prevention protocols by the general public due to high rate of poverty and social stigma contribute to the spread of the virus. The current situation in South Sudan make evident that there is a need for an immediate ceasefire by the warring sides so the available health services including COVID-19 efforts, are not disrupted to ensure the safety of all. The government needs to further build the capacity of its health sector with the cooperation of its international health allies to be able to provide its citizens with the health services they need.

The experience of mental health service users in health system strengthening: lessons from Uganda

BackgroundMental, neurological and substance use disorders are a public health burden in Uganda. Mental health service user involvement could be an important strategy for advocacy and improving service delivery, particularly as Uganda redoubles its efforts to integrate mental health into primary health care (PHC). However, little is known on the most effective way to involve service users in mental health system strengthening.MethodsThis was a qualitative key informant interview study. At national level, 4 interviews were conducted with national level health workers and 3 service user organization representatives. At the district level, 2 interviews were conducted with district level health workers and 5 service user organization representatives. Data were analyzed using content thematic analysis.FindingsOverall, there was low mental service user participation in health system strengthening at both national and district levels. Health system strengthening activities included policy development, implementation of programs and research. Informants mentioned several barriers to service user involvement in mental health system strengthening. These were grouped into three categories: institutional, community and individual level factors. Institutional level barriers included: limited funding to form, train and develop mental health service user groups, institutional stigma and patronage by founder members of user organizations. Community level barriers included: abject poverty and community stigma. Individual level barriers included: low levels of awareness and presence of self-stigma. Informants also recommended some strategies to enhance service user involvement.ConclusionThe Uganda Ministry of Health should develop a strategy to improve service user participation in mental health system strengthening. This requires an appreciation of the importance of service users in improving service delivery. To address the barriers to service user involvement identified in this study requires concerted efforts by the Uganda Ministry of Health and the district health services, specifically with regard to attitudes of health workers, dealing with stigma at all levels, raising awareness about the rights of service users to participate in health systems strengthening activities, building capacity and financial empowerment of service user organizations.

Poverty stigma is associated with suboptimal HIV care and treatment outcomes among women living with HIV in the United States.

To examine whether experienced poverty stigma is associated with worse HIV care and treatment outcomes. We analyzed cross-sectional data from 433 women living with HIV enrolled in the Women's Adherence and Visit Engagement substudy of the Women's Interagency HIV Study. Exposure was experienced poverty stigma, measured using the Perceived Stigma of Poverty Scale. Outcomes were viral suppression, CD4 cell count at least 350 cells/μl, and attending all HIV care visits in the past 6 months. Multivariable logistic regression models adjusted for income, age, race/ethnicity, education, substance use, months taking antiretroviral therapy (ART), number of antiretroviral pills in ART regimen, unstable housing, relationship status, and exchanging sex for money, drugs, or shelter. We also explored whether self-reported at least 95% ART adherence mediated the relationship between poverty stigma and viral suppression and CD4 cell count at least 350 cells/μl. Experienced poverty stigma was associated with lower adjusted odds of viral suppression [adjusted odds ratio (aOR) 0.76; 95% confidence interval (CI) 0.61-0.96], CD4 cell count at least 350 cells/μl (aOR 0.69; 95% CI 0.52-0.91), and attending all HIV care visits (aOR 0.73; 95% CI: 0.54-0.98). Exploratory mediation analysis suggests that at least 95% ART adherence significantly mediates the relationship between experienced poverty stigma and viral suppression and CD4 cell count at least 350 cells/μl. Longitudinal research should assess these relationships over time. Findings support interventions and policies that seek to reduce poverty stigma among people living with HIV.

Health inequality implications from a qualitative study of experiences of poverty stigma in Scotland

RationaleIndividuals living in Scotland's most deprived communities experience a higher burden of morbidity and early mortality than those living in more affluent areas. Experiences of poverty-based stigma may be one psychosocial mechanism through which socioeconomic position influences health, although there is little available data on this issue from a Scottish perspective. ObjectiveThe aim of this study was to identify which aspects of poverty stigma are particularly salient to individuals with lived experience of poverty, and may therefore contribute to health inequalities. MethodsFive focus groups were conducted with 39 individuals with experience of living on low incomes in Scotland in order to explore their experiences and perceptions of poverty stigma. ResultsFive main themes were identified, reflecting aspects of poverty stigma operating at various structural, public and individual levels: media representations of poverty; negative encounters with social security systems; perceived public attitudes regarding poverty in Scotland; lowered self-esteem and internalisation of negative attitudes, and; emotional responses to stigma. ConclusionThese dimensions of stigma potentially influence public health and health inequalities in Scotland, although future research will be necessary to quantify these and estimate their relationships with health outcomes.

Hunger in the primary school setting: evidence, impacts and solutions according to school staff in the North East of England, UK

ABSTRACTThe issue of ‘holiday hunger’ (i.e. food insecurity during school holidays) has received increased attention in recent years, though research in this area is limited. Through qualitative, semi-structured interviews, the current study investigated the views of 12 primary school staff on the existence, impacts and potential solutions to holiday hunger. Thematic analysis revealed holiday hunger forms part of a broader, year-round experience of deprivation and poor nutritional habits. Staff proposed a need for a multi-agency approach to address a range of complex, inter-related needs. Additionally, the findings highlighted a need to address poverty stigma in the development of familial support.