Effects of poverty on children's health

A local group recently held a Poverty Forum and asked me as one of the speakers to work up a talk on the effects of poverty on children’s health. The idea was to rally state and local resources to discuss the most significant issues resulting from underemployment and reduced government supports for families in our region.

My piece of the action was to line out what scarcities affect children’s well-being, and to look at what actions have proved effective in the past to insulate children from those effects.

The group readily acknowledged children as our most valuable resource, requiring and deserving optimal support to be as good, smart and healthy as they can be. Healthy in mind, body and spirit, children need to be positioned to take up the burdens and blessings of civilization and keep the show on the road. Of course, the reality is less rosy.

Poverty for children is scarcity of any of these resources: effective parenting, education, housing and health. Poverty is not only financial. A child’s family can be quite well-off, and yet their children can be losing out on a number of fronts. We sometimes find that our rural children read more, are outdoors more, and because they are often part of running a family farm or other business, they gain competencies that their suburban counterparts lack. They have access to fresh food and clean water and air, at least if they are not in a coal county, and live in a low-crime setting as well.

On the other hand, we see children whose parents smoke or abuse drugs or alcohol; are stressed by having distant or inflexible work; too much work; or by not having work. We also see children whose parents provide marginally nutritional meals, who live in inadequate housing and who spend too much time in front of the television or video game screens.

So there is a spectrum of risk that is not tied absolutely to family income. Where children are at economic risk for impoverished lives, there is large-scale assistance predicated on engaging our political will — the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and Children’s Health Insurance Program (CHIP), for example — and also small-scale efforts, such as our local Christian Assistance Network food pantry and vigorous Habitat for Humanity program powered by local volunteers.

Government certainly has a role in buffering the long-term effects of child poverty. President Lyndon B. Johnson’s “War on Poverty” in the 1960s showed an immediate and positive effect on infant mortality. Teen pregnancy initiatives in the 1990s significantly decreased the number of babies born into poverty, and State Children’s Health Insurance Program (Title XXI of the Social Security Act) in 1997 mandated CHIP’s access to health care for 7.6 million children previously not covered. The Affordable Care Act (ACA) of 2013 has seen 6 million previously uninsured children aged 0 to 26 years sign up on some sort of policy. The efficacy of which remains to be seen, but hopes are high.

Other national initiatives include the AAP’s Back to Sleep campaign that has nearly eliminated sudden infant death syndrome (SIDS) in the past decade, and campaigns to support breast-feeding and improved pre- and neonatal care.

Much other anti-poverty action is local. Poverty in maternal resources leads to nutritional deficits across developmental stages. Our clinic, like most, stays in touch with pregnant women, providing folic acid and prenatal vitamins and good prenatal care, preventing neonatal morbidity and mortality (neural tube, hepatitis B surface antigen-positive mothers). We encourage breast-feeding over formula, but also link mothers to WIC’s nutritional and support services.

To ward off poverty-linked ailments, such as diabetes and obesity, we have several initiatives to encourage our children, from toddlers to teens, to get started with good habits of diet and exercise, and to limit “screen” time.

To head off poverty of mind, we have a selection of books for children to choose among before their well-child checkups. These are all small local efforts, but they add up to benefit individual children.

Many children experience scarcity of educational resources, such as good teachers, books, computers, Internet and educational experiences. Critical thinking skills need to be developed, by practice and by example. Children are in jeopardy on many levels when parents do not know the facts regarding food labeling, vaccination, how to ask questions at clinic visits, and just generally lack academic and life competencies. Critical thinking skills enable us to distinguish between opinion and fact; all forms of poverty batten in their absence.

The worst deficiency can be the poverty of ideas — easy when you are cold, hungry, uneducated, frightened or feel unloved. With love and commitment, both children and society can overcome the rest.

to wonder
to dream
to believe in the future
to be happy.

That is riches indeed.

— by Jane and King Seegar, MD