Diseases of poverty, also known as poverty-related diseases (PRDs), 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.
Poverty and infectious diseases are causally related. Even before the time of vaccines and antibiotics, before 1796, it can be speculated that, leaders were adequately protected in their castles with decent food and standard accommodation, conversely, the vast majority of people were living in modest, unsanitary homes; cohabiting with their animals. During this time people were unknowingly dying of infectious diseases in an event that; they touched their sick animals, had cuts in their skins, drank something that was not boiled or ate food that was contaminated by microbes. To exacerbate the situation, epidemics known as plagues then would emerge and wipe out the whole community. During this time, people had no knowledge on infectious diseases and their causes. After speculations that their illnesses were being caused by an invisible army of tiny living beings, microorganisms, Antonie van Leeuwenhoek invented the first microscope that confirmed the existence of microorganisms that cannot be visualised with the naked eye (around the 17th century).
Human immunodeficiency virus (HIV), malaria, and tuberculosis (TB), also known as "the big three", have been acknowledged as infectious diseases that disproportionately affect developing countries. HIV is a viral illness that can be transmitted sexually, by transfusion, shared needles and during child birth from mother to child. Due to its long latent period, there is a danger of its spread without action. It affects the human body by targeting T-cells, that are responsible for protection from uncommon infections and cancers. It is managed by life prolonging drugs known as antiretroviral drugs (ARVs). TB was discovered by Robert Koch in 1882. It is characterised by fever, weight loss, poor appetite and night sweats. Throughout the years, there has been an improvement in mortality and morbidity caused by TB. This improvement has been attributed to the introduction of the TB vaccine in 1906. Despite this, each year the majority infected by TB are the poor. Finally, malaria used to be prevalent throughout the world. It is now limited to developing and warm regions; Africa, Asia, and South America.
Contributing factors The prevalence of unfavorable environmental and social factors that contribute to disease are highest among individuals living in poverty. These communities are at a higher risk of adverse health outcomes, particularly with infectious diseases and noncommunicable diseases.
Physical activity Physical activity is a protective factor against chronic conditions such as type 2 diabetes, high blood pressure, and coronary heart disease. Lack of physical activity is related to socioeconomic status, with a higher prevalence of sedentary lifestyles among less affluent groups. There are several factors which contribute to the barriers of exercise among these groups.
Within low-income communities in the US, there is reduced access to environments that promote physical activity including parks, recreational facilities, and gyms. Only about one in five homes in low-income areas have parks within a half-mile distance, and about the same number have a fitness or recreation center within that distance. Expanded availability of local environments enabling exercise is associated with an increase in physical activity and a decrease in individuals with an overweight status.
In addition, concerns of unsafe neighborhoods in low-income areas may result in reduced physical activity in both adults and children. Children from low-income families are more likely to engage in sedentary, indoor activities due to challenges in obtaining adult supervision of outdoor play and parental concern for noise complaints. One in three children are physically active on a daily basis, and children spend seven or more hours a day is spent in front of a screen whether it be a computer, a TV, or video games. Children and adults who do not exercise frequently lower their quality of life, which will impact them as they age.
Mental health
Mental health is "a state of successful performance of mental function, resulting in productive activities, fulfilling relationships with other people, and the ability to adapt to change and to cope with adversity". Poverty has a profound effect on a person's mental health. According to Alyssa Brown of the Washington D.C. Gallup, 31% of people living in poverty have reported at some point been diagnosed with depression compared with 15.8% of those not in poverty. There is evidence that low income or loss of income are associated with worsening mental health while wealth and gain of income are linked with improvements in mental health. Furthermore, individuals living in poverty are disproportionally exposed to air pollution, temperature extremes, and violence, which all negatively impact mental health. These factors can induce chronic stress, which result in high cortisol levels. Excess cortisol is associated with unfavorable health outcomes, such as hypertension, diabetes, osteoporosis, and increased risk of infections.
It is uncertain whether poverty induces depression or depression causes poverty. What is certain is that the two are closely linked. A reason for this link could be due to the lack of support groups such as community centers. Isolation plays an integral role in depression. Results from a cohort study of approximately 2,000 older adults aged 65 years and older from the New Haven Established Populations for the Epidemiological Study of the Elderly found that social engagement was associated with lower depression scores after adjustment for various demographic characteristics, physical activity and functional status.
Contaminated water Each year many children and adults die as a result of a lack of access to clean drinking water and poor sanitation, which enables the spread of poverty-related diseases. Contaminated water enables the spread of various waterborne-pathogens, including bacteria (E. coli, cholera), viruses (hepatitis A, norovirus), and protozoa (schistosomiasis). According to UNICEF, 3,000 children die every day, worldwide due to contaminated drinking water and poor sanitation.UNICEF (Water).
Although the Millennium Development Goal (MDG) of halving the number of people who did not have access to clean water by 2015 was reached five years ahead of schedule in 2010, there are still 783 million people who rely on unimproved water sources. In 2010 the United Nations declared access to clean water a fundamental human right, integral to the achievement of other rights. This made it enforceable and justifiable to permit governments to ensure their populations access to clean water. There have been efforts to improve water quality using new technology, which allows water to be disinfected immediately upon collection and during the storage process. Clean water is necessary for cooking, cleaning, and laundry because many people come into contact with disease-causing pathogens through their food, or while bathing or washing.
Though access to water has improved for some, it continues to be especially difficult for women and children as they bear most of the burden for accessing water and supplying it to their households. In India, Sub-Saharan Africa, and parts of Latin America, women are required to travel long distances in order to access a clean water source and then bring some water home. This has a significant impact on girls' educational attainment.
An ongoing issue of contaminated water in the United States has been taking place in Flint, Michigan since 2014. The issue of lead-contaminated water began after the source of drinking water was changed from Lake Huron to the Flint River, resulting in corrosion of supply pipes and lead leaching into the city's water supply. Exposure to lead has serious health complications in developing fetuses, children, and adults. Children are particularly vulnerable to low levels of lead, and can display behavioral changes, hearing problems, and other neurologic consequences as a result of lead ingestion.
Air pollution Studies show that there is an association between low socioeconomic status and exposure to higher concentrations of air pollution. This relationship is especially apparent in North America, New Zealand, Asia, and Africa. Exposure to environmental toxins, like ambient particulate matter (or air pollution), has been linked to the development of diseases like cancer, immune system impairment, and reproductive dysfunction.
According to the World Health Organization, 2.4 billion people are exposed to household air pollution through the use of open fire cooking and inefficient stoves. This resulted in 3.2 million deaths per year in 2020 and countless cases of stroke, heart disease, and lung cancer. Exposure to household air pollution is especially prevalent in lower-resourced areas, contributing to the high burden of air pollution-related disease in locations considered "impoverished." Women and children, especially those who bear the burden of household chores in under-resourced areas, face increased risks of household air pollution associated complications because they are the most exposed to cooking, burning, and other household pollution emitting chores.
Education
Education is affected by poverty, which is known as the income achievement gap. This gap shows that children living in poverty or have lower-income are less likely to have the cognitive development and early literacy levels of those who do not. The amount of income affects the amount of extra money a family has to spend on additional educational programs; including summer camps and out of school assistance. In addition to finances, environmental toxins, including lead and stress and lack of nutritious food can diminish cognitive development. In later education, low-income individuals or those living in poverty are more likely to dropout of school or only receive a high school diploma. The failure to achieve higher levels of education attributes to the cycle of poverty which can continue for generations in the same family and even in the community. Studies have linked adults with low educational achievement to worse general health and increases in chronic conditions and disabilities. These individuals are more likely to engage in behaviors that worsen health, such as smoke, have an unhealthy diet, and are less likely to exercise. Higher educational achievement correlates with more opportunities for secure jobs, which enables individuals to generate wealth that can be used to improve factors that impact health outcomes.
Sanitation and hygiene