Why It's ImportantEconomic stability has many dimensions - material deprivation (of food, shelter, sanitation, and safe drinking water), social exclusion, lack of education, unemployment, and low income - that all work together to reduce opportunities, limit choices, undermine hope, and, as a result, threaten health. Poor economic stability is associated with health conditions and risk factors, and is hypothesized to influence health through a variety of pathways, including:
- Health Care
- Environmental Exposure
- Health Behavior
- Chronic Stress
What Is KnownLiving in poverty is associated with lower life expectancy, high infant mortality, poor reproductive health, higher rates of infectious diseases (notably tuberculosis and HIV infection), higher rates of substance use (tobacco, alcohol and illegal drugs), higher rates of non-communicable diseases, depression and suicide, and increased exposure to environmental risks. Poor children are more likely to die by the age of five years and to suffer from acute respiratory infections, diarrhea, congenital anomalies and chronic diseases.
How To Reduce Risk
Actions to reduce health disparities caused by economic instability include:
- Increase community awareness of disparities as problems with solutions;
- Set priorities among disparities to be addressed at the federal, state, tribal, and local levels;
- Articulate valid reasons to expend resources to reduce and ultimately eliminate priority disparities;
- Implement the dual strategy of universal and targeted intervention strategies based on lessons learned from successes in reducing certain disparities (e.g., the virtual elimination of disparities in certain vaccination rates among children); and
- Aim to achieve a faster rate of improvement among vulnerable groups by allocation resources in proportion to need and a commitment to closing gaps in health, longevity, and quality of life.
How It's Tracked
Economic stability is tracked in several federal data systems, including but not limited to:
- Behavioral Risk Factor Surveillance System
- U.S. Census Bureau
- U.S. Health and Human Services
Poverty is measured differently according to its use. The Federal Poverty Level is an imprecise term for the statistical measure using the Census Bureau's poverty thresholds for calculating the number of people in poverty. The Department of Health and Human Services (HSS) uses poverty guidelines for determining financial eligibility for certain programs. The two poverty measures differ in their computation.
Poverty thresholds are measured using a detailed (48-cell) matrix of thresholds that varies by family size, number of children, and for 1- and 2-person units, whether or not elderly. Weighted average thresholds vary by family size and for 1- and 2-person units, whether or not elderly. There is no geographic variation; the same figures are used for all 50 states and D.C.
Poverty guidelines vary by family size. In addition, there is one set of figures for the 48 contiguous states and D.C.; one set for Alaska; and one set for Hawaii.
The HHS poverty guidelines, or percentage multiples of them (such as 125%, 185%, or 200% of poverty) are used as an eligibility criterion by a number of federal programs. Most of these programs are non-open-ended programs - that is, programs for which a fixed amount of money is appropriated each year. A few open-ended or "entitlement" programs that use the poverty guidelines for eligibility are the Supplemental Nutrition Assistance Program (formerly Food Stamps), the National School Lunch Program, certain parts of Medicaid, and the subsidized portion of Medicare - Prescription Drug Coverage.
Some state and local governments have chosen to use the federal poverty guidelines in some of their own programs and activities. Examples include financial guidelines for child support enforcement and determination of legal indigence for court purposes. Some private companies (such as utilities, telephone companies, and pharmaceutical companies) and some charitable agencies also use the guidelines in setting eligibility for their services to low-income persons.
Major means-tested programs that do not use the poverty guidelines in determining eligibility include the following:
- Supplemental Security Income (SSI)
- Earned Income Tax Credit (EITC)
- State/local-funded General Assistance (in most cases)
- Some parts of Medicaid
- Section 8 low-income housing assistance
- Low-rent public housing