Low Socioeconomic Status And Equal Access To Healthcare

When one thinks of socioeconomic status (SES), three terms may come to mind; low, middle, and high SES. However, SES can be determined by three different factors; educational level, occupational status, and income level. Ones SES can determine their privileges and opportunities they have within society, as well as their attributes to their quality of life. Someone who lives in a higher SES, has easier access to food, water, shelter, and healthcare. Someone who lives in middle SES, may still have access to these items, however, it may be a little difficult to obtain them. Now, someone who is living in low SES will have a harder time obtaining these items, if any, and obtaining all of them at the same time. Poverty is distinguished by multiple psychosocial and physical stressors. Ones SES is a high indicator of the outcomes they will have throughout their lifetime, as well as their psychological and physical health. Someone living in poverty, or in low SES, does not have the same equal access to healthcare, as one living in high or middle SES. People living in low SES do not have equal access to healthcare. Many people living in low SES are of low income or unemployed, resulting in no insurance or minimal coverage. Edward Berchick, from the U. S. Census Bureau, reports that, in 2017, 28 million Americans were without insurance. Many of those Americans, had a high school diploma or less and made up 26. 9 percent of the uninsured population. When one is without insurance, they tend to not seek medical attention, because they cannot afford it. Someone who cannot afford to seek medical attention, is at risk for turning their small concern into a larger one. Someone who is unemployed, is at risk for homelessness, if they are not already.

The risk of infections and medical concerns rises in people who are homeless. This is due to the fact, that they may be living on the streets and in unhealthy and unsanitary conditions. Someone who is without insurance, does not necessarily mean they are without a job. Some employers do not offer health insurance, resulting in one having to find private insurance, which can be very costly. The Kaiser Family Foundation (KFF), reports that “In 2017, 45% of uninsured adults said that they remained uninsured because the cost of coverage was too high” (2018). However, one’s access to healthcare can change, as one’s situation may change. Many people are under a family members insurance or spouse’s insurance. KFF reports, that “More than one in ten were uninsured because of a marital status change, the death of a spouse or parent, or loss of eligibility due to age or leaving school (11%), and some lost Medicaid because of a new job/increase in income or the plan stopping after pregnancy (11%)”. There are many financial consequences to one being uninsured. “The uninsured often face unaffordable medical bills when they do seek care. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings”. Hospitals tend to charge people who are uninsured, higher than those who have coverage. Those without insurance, and high medical bills, tend to have a financial burden. When one lacks insurance coverage, in can result into medical debt, which can then lead to one living in poverty. This is because, they have exceeded all their financial earnings, including savings. According to Berchick, “Working-age adults made up a much larger share of the uninsured population than any other age group. In fact, most uninsured people (84. 6%) were 19- to 64-year-olds”. Those who were of ages 26-34, were the highest to be uninsured, making that 1 in 4 Americans without insurance.

Although there are more women in the U. S. than men, more than half of the people uninsured in 2017 were men. Berchick reports, that “About 4 in 10 uninsured people were non-Hispanic white, while nearly 6 in 10 people in the United States were non-Hispanic white” (2018). The majority of those uninsured lived in the south, with those living in the west, being second highest to be without insurance. Children made up about ¼ of the population in 2017, however, 14 percent of people under age 19 were without insurance. Not all who are homeless live on the streets or in tents under a bridge. Homelessness comes in different forms, for example, living in shelters, group homes, or even living with family members. It is estimated, “That 1. 5 million people experience homelessness a year, however, twice that number are actually without housing in any given year”. Poor health is one of the leading causes to homelessness. Unemployment can escalate very quickly when one has an injury or illness, that requires time off work. This is especially difficult for those who have physically demanding jobs and are unable to perform their work duties accurately. NHCHC stated, that “Ultimately, poor health can lead to unemployment, poverty, and homelessness” (2019). When one is ill and requires time off, or there is loss of employment, it then becomes a cruel cycle. This is due to the fact, that there are no funds to pay for the healthcare that is needed, whether that may be medications or even surgery. Due to not having funds for treatment, one is unable to heal appropriately, in order to return to work.

As a result, it is difficult for one to resume employment if they remain sick. Without any income, an illness can easily, and rapidly, become a housing issue, resulting in one exhausting all their savings and relying on friends/family for their basic needs. Once this happens, there are very few opportunities to assist with housing and health care. Homeless people who live in shelters, or even on the streets, are more susceptible to acquiring communicable diseases. For example, respiratory illnesses, hepatitis, the flu, or even tuberculosis. They are also more likely to experience malnutrition and bad weather encounters, both of which could land someone into the hospital. People who are homeless and have a chronic health condition, tend to worsen this condition, because they are unable to store their medications properly, let alone being able to afford them. “Maintaining a healthy diet is difficult in soup kitchens and shelters as the meals are usually high in salt, sugars, and starch (making for cheap, filling meals but lacking nutritional content)”. When someone is homeless, they are likely to develop behavioral issues, or worsen the behavioral issues they already have. Those issues could include substance abuse, of any sort, and depression. If someone is involved in a violent act, and receives an injury, that injury is likely to not heal properly, due to limited access to bathing and keeping wounds/sores clean. A homeless person with a common cold, is more susceptible to having that turn into pneumonia, due to the lack of access to healthcare. Stable housing is crucial for someone who is ill, or who has had a recent surgery. Having a stable place to discharge to, lessens the chances of infections occurring and a re-admission into the hospital. It also allows for that person to rest and heal as needed, and not have to worry about where they will be sleeping. Reported by Semega, Kollar, Creamer, and Mohanty, from the U. S. Census Bureau, “The official poverty rate in 2018 was 11. 8 percent, down 0. 5 percentage points from 12. 3 percent in 2017”. The poverty rate of 11. 8 percent equals out to be 38. 1 million Americans living in poverty in 2018. This is the first time, in 11 years, that the poverty rate was significantly lower since right before the recession in 2008. According to the U. S. Census Bureau, of 2017, the amount of people living in poverty, in Indiana, was 14. 6 percent, with the highest percentage being 23. 7 percent, of which were children under the age of five. Between males and females living in poverty, in Indiana, females had the highest rating at 16. 0 percent. African Americans had the highest rating of persons living in poverty, in Indiana, at 29. 9 percent and Hispanics being second highest to live in poverty, at 25. 6 percent.

In Allen County alone, 13. 1 percent of people were living in poverty in 2018. There are many biological factors that come into play with those living in low SES/poverty, especially when it comes to different ethnic and racial minorities. “Health disparities may stem from economic determinants, education, geography and neighborhood, environment, lower quality care, inadequate access to care, inability to navigate the system, provider ignorance or bias, and stress”. It is also to be known, that low SES and one’s ethnicity, have been related to diseases being untreated and avoidable procedures. Another biological factor that is related to low SES and one’s minority status, is low birth weight in children. Children who are born prematurely, tend to have other health issues. According to the University of Rochester Medical Center, children born prematurely are at risk for issues with feeding and gaining weight, lung issues, SIDS, nervous system complications, and even cerebral palsy. The biological effects of living in poverty, can begin to develop as early as in children, during developmental stages. According to Mirre Stallen, “While poverty did not impact brain development in its entirety, it did affect some brain regions more than others. Differences in brain structure were particularly present in areas involved in memory, language processing, and decision-making and self-control”. Children who experience more traumatic/stressful events, tend to have a smaller hippocampus. When one has a smaller hippocampus, it can then affect their short-term and long-term memory, as that is was the hippocampus controls. Stallen also notes, that parenting styles also correlate with a child’s brain function and poverty. “Having nurturing parents and increased exposure to things such as books, trips, and musical instruments at home appears to reduce the impact of poverty on a child’s brain structure”. There are also many psychological impacts to those living in poverty. Those who are of low SES, tend to have more mental health issues. According to the World Health Organization (WHO), mental health disorders are twice as likely to occur in those living in poverty and people are almost twice as likely to suffer from depression if living in low SES. It is also noted by WHO, that those living in low SES, are eight times higher at risk for schizophrenia. Those living in low SES are also at risk of developing PTSD and anxiety.

People living in low SES, are encountering things that they had never expected. For example, low SES people experience the loss of food and shelter. Not having access to shelter and food is a factor in those mental health disorders. Children living in poverty are also at higher risk of behavioral problems, including ADHD and low self-esteem. Those living in low SES, also experience social and spiritual impacts. One who becomes homeless, may experience loss of faith. They may wonder why God would let them become homeless and lose access to resources. As well as, why would God allow them to not have access to food and healthcare. In those circumstances, it would be easy for one to lose faith. Not only are those in low SES experiencing loss of faith, but they are also experiencing loss of relationships, whether they may be with friends, families, or other loved ones. Those experiencing low SES, sometimes exhaust all their resources, including family and other loved ones. When one starts to experience becoming homeless, they may ask to stay with family. Now that may work for quite some time, until other psychological factors start to take place. For example, if one starts to begin drinking and becomes depressed. That family member may no longer want that person living in their home. So now, that person is left with finding another place to live because, they have exhausted that relationship they had, due to psychological factors. The Mind Controversy (2019) website, list other social effects of one living in low SES, those are lack of happiness and criminal activities. Happiness tends to be linked to money, and how much one has. If one is lacking wealth, they tend to be unhappy. Having money, allows for one to live happily, dress well, and live in comfort. People who are of low SES, also suffer from lack of ethics and families becoming weak. By lack of ethics, those in low SES tend to resort in illegal ways of making money. Insufficient financial stability often leads to family arguments and can break-up/ruin many relationships.

Many people living in low SES, are oppressed by not having access to healthcare, due to the government having a higher power over them. Someone who “looks” dirty or “smells” funny, may instantly be turned away by different organizations. Now, anyone can go to the emergency department to seek help, and it is that hospitals duty to treat that patient. Hospital’s are required to make sure the patient is safe and stable. If the patient has no insurance, and they are unable to seek further treatment, due to lack of insurance or funds, the hospital will discharge the patient. However, like mentioned above, it is required by hospitals, to make sure every patient has a low mortality rate when leaving that emergency room. Most people living in poverty, are marginalized and discriminated against by society. This can happen in more than one way. One being, that no one wants to associate with those living in low SES, because they believe they are lazy and just don’t want to work. Now, many people know that, that is not the case for all low SES persons. Many low SES people have tried multiple times to get back on their feet and fail, due to multiple reasons. One being, that some employers don’t want to take that risk, or chance, of hiring someone who is of lower SES. Now, although that is illegal, it is still a problem in the United States. A lot of employers relate low SES, to not having access to a vehicle. Therefore, how would that potential employee get to work on time? On the other spectrum of that, many people living in low SES, do not want to associate with others of higher SES either. This is because people of higher SES, tend to discriminate, and judge, against those in low SES. People living in low SES, tend to be ashamed, or embarrassed, of the situation they are in. Danieli Peterman, of Race, Racism, and The Law, spoke with a child who was living in a shelter. The child informed her, that they would not dare tell anyone at school that they are living in a shelter, because they would get made fun of and have no friends. Another person told Peterman, that she believed she had been turned down from multiple desk jobs, due to the fact of having missing teeth and no money to replace the). It can be difficult, of those trying to escape poverty and are of other ethnic/minority groups other than Caucasian. “Minority racial groups are more likely to experience multidimensional poverty than their White counterparts”.

According to the United States Census Bureau, of 2018, the highest poverty rate by race is found among Blacks (29. 5%), with Hispanics (23. 7%) having the second highest poverty rate, and Native Americans having the third highest poverty rate (22. 1%). According to the Kids Count Data Center, the highest rate of children living in poverty in 2018, was African American children at 32 percent and American Indian children being the second highest at 31 percent (2019).

References

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