De Wikipedia, la enciclopedia libre
Saltar a navegación Saltar a búsqueda
Ver también: Enfermedades tropicales desatendidas

Las enfermedades de la pobreza (también conocidas como enfermedades relacionadas con la pobreza ) son enfermedades que son más prevalentes en las poblaciones de bajos ingresos. [1] Incluyen enfermedades infecciosas, así como enfermedades relacionadas con la desnutrición y los malos hábitos de salud. La pobreza es uno de los principales determinantes sociales de la salud. El Informe sobre la salud en el mundo, 2002 establece que las enfermedades de la pobreza representan el 45% de la carga de morbilidad en los países con una alta tasa de pobreza que se pueden prevenir o tratar con las intervenciones existentes. [2] Las enfermedades de la pobreza a menudo son comórbidas y ubicuas con la desnutrición. [3]

La pobreza aumenta las posibilidades de padecer estas enfermedades, ya que la privación de vivienda, agua potable, alimentos nutritivos, saneamiento y acceso a los servicios de salud contribuye a un comportamiento de mala salud. Al mismo tiempo, estas enfermedades actúan como una barrera para el crecimiento económico de las personas afectadas y las familias que las cuidan, lo que a su vez se traduce en un aumento de la pobreza en la comunidad. [4]

Estas enfermedades producidas en parte por la pobreza contrastan con las enfermedades de la opulencia , que son enfermedades que se cree que son el resultado del aumento de la riqueza en una sociedad. [5]

El virus de la inmunodeficiencia humana (VIH) , la malaria y la tuberculosis (TB), también conocidos como "los tres grandes", han sido reconocidos como enfermedades infecciosas que afectan de manera desproporcionada a los países en desarrollo. [6] La pobreza y las enfermedades infecciosas están relacionadas causalmente. Incluso antes de la época de las vacunas y los antibióticos, antes de 1796, se puede especular que los líderes estaban adecuadamente protegidos en sus castillos con comida decente y alojamiento estándar, por el contrario, la gran mayoría de la gente vivía en hogares modestos e insalubres; conviviendo con sus animales. [7] [8] [9]Durante este tiempo, la gente, sin saberlo, estaba muriendo de enfermedades infecciosas en un evento que; tocaban a sus animales enfermos, tenían cortes en la piel, bebían algo que no estaba hervido o comían alimentos contaminados por microbios. Para agravar la situación, surgirían epidemias conocidas como plagas que acabarían con toda la comunidad. [10] Durante este tiempo, la gente no tenía conocimiento sobre la causa de esta serie desfavorable de eventos. Después de especulaciones de que sus enfermedades estaban siendo causadas por un ejército invisible de diminutos seres vivos, microorganismos, Antoni van Leeuwenhoek inventó el primer microscopio que confirmó la existencia de microorganismos que no se pueden visualizar a simple vista (alrededor del siglo XVII). [11] [12]

El VIH es una enfermedad viral que puede transmitirse sexualmente, por transfusión, agujas compartidas y durante el parto de madre a hijo. Debido a su largo período de latencia, existe el peligro de que se propague sin acción. [13] Afecta al cuerpo humano al dirigirse a las células T, que son responsables de la protección contra infecciones y cánceres poco comunes. Se maneja con medicamentos que prolongan la vida conocidos como medicamentos antirretrovirales (ARV). La tuberculosis fue descubierta por Robert Koch en 1882. [14] [15]Se caracteriza por fiebre, pérdida de peso, falta de apetito y sudores nocturnos. A lo largo de los años, ha habido una mejora en la mortalidad y morbilidad causadas por la tuberculosis. Esta mejora se ha atribuido a la introducción de la vacuna contra la tuberculosis en 1906. A pesar de esto, cada año la mayoría de los infectados por la tuberculosis son los pobres. Por último, la malaria solía prevalecer en todo el mundo. Ahora se limita a las regiones cálidas y en desarrollo; África, Asia y América del Sur.

Factores contribuyentes [ editar ]

Debido a muchos factores ambientales y sociales, incluidas las malas condiciones de vivienda y de trabajo, el saneamiento inadecuado y la ocupación desproporcionada como trabajadoras sexuales , los pobres tienen más probabilidades de estar expuestos a enfermedades infecciosas . La desnutrición, el estrés mental, el exceso de trabajo, los conocimientos inadecuados y la atención médica mínima pueden dificultar la recuperación y agravar la enfermedad. [16] La desnutrición está asociada con el 54% de las muertes infantiles por enfermedades de la pobreza, y la falta de asistentes capacitados durante el parto es la principal responsable de las altas tasas de mortalidad materna e infantil entre los pobres. [17]

Falta de acceso al ejercicio [ editar ]

La falta de ejercicio es un problema fuertemente relacionado con la pobreza, debido a la falta de acceso a áreas recreativas adecuadas. La falta de actividad física aumenta el riesgo de desarrollar enfermedades crónicas de salud, cáncer , además de disminuir la calidad de vida. [18] La pobreza es un factor de riesgo para muchos problemas de salud diferentes, que pueden verse afectados por su falta de acceso. La obesidad y los riesgos de enfermedades crónicas de salud se pueden prevenir aumentando la actividad física y teniendo acceso a lugares para hacer ejercicio. La inactividad física no es solo una elección personal, sino también relacionada con el nivel socioeconómico.

Para las personas en situación de pobreza, puede resultar difícil encontrar un lugar para hacer ejercicio. Dentro de los barrios o pueblos de bajos ingresos, hay menos oportunidades para aumentar la actividad física debido a la falta de; parques, oportunidades dentro de las escuelas para participar en deportes o actividades recreativas e instalaciones recreativas dentro de la comunidad. [19] En las comunidades de bajos ingresos, solo una de cada cinco casas tiene parques dentro de una distancia de media milla, y aproximadamente la misma cantidad tiene un gimnasio o un centro de recreación dentro de esa distancia. [20] Dado que hay una falta de lugares para aumentar la actividad física, las tasas de obesidad y enfermedades crónicas de salud están aumentando entre los que viven en la pobreza.

Una de las principales preocupaciones de los vecindarios empobrecidos es la seguridad, que es un factor determinante de la frecuencia con la que las personas hacen ejercicio dentro de la comunidad. La capacidad de encontrar transporte también puede causar problemas debido a la falta de acceso al ejercicio debido al transporte e incluso al costo que los padres podrían pagar si hay transporte disponible. Los niños y adultos que no hacen ejercicio con frecuencia reducen su calidad de vida, lo que los afectará a medida que envejecen. [18] Uno de cada tres niños es físicamente activo a diario, y los niños pasan siete o más horas al día frente a una pantalla, ya sea una computadora, un televisor o videojuegos. [20] Con solo participar en ejercicio durante 30 minutos, 3 veces a la semana puede mostrar muchos beneficios en la vida. [21]Algunos ejemplos de beneficios del ejercicio incluyen; controlar mejor el peso, disminuir el riesgo de enfermedades cardíacas y ataques cardíacos, disminuir la presión arterial, reducir los tiempos de recuperación de una lesión, mejorar el estado de ánimo y los patrones de sueño, aumentar el contacto social y hace que uno se sienta mejor en general. [21]

Estrés mental [ editar ]

La salud mental es “un estado de desempeño exitoso de la función mental, que resulta en actividades productivas, relaciones satisfactorias con otras personas y la capacidad de adaptarse al cambio y hacer frente a la adversidad”. [22] La pobreza tiene un efecto profundo en la salud mental de una persona . Según Alyssa Brown de Washington DC Gallup, el 31% de las personas que viven en la pobreza han informado que en algún momento han sido diagnosticadas con depresión en comparación con el 15,8% de las que no viven en la pobreza. Muchas personas atribuyen su depresión al desempleo, factores estresantes de la vida y presenciar más violencia. Estos son muy relevantes en el mundo empobrecido.

No se sabe si la pobreza provoca depresión o la depresión provoca pobreza. Lo cierto es que los dos están estrechamente relacionados. [23] Una razón para este vínculo podría deberse a la falta de grupos de apoyo como los centros comunitarios de la iglesia. El aislamiento juega un papel integral en la depresión. Por ejemplo, los resultados de un estudio de cohorte de aproximadamente 2,000 adultos mayores de 65 años o más de las poblaciones establecidas de New Haven para el estudio epidemiológico de los ancianos encontraron que el compromiso social se asoció con puntuaciones de depresión más bajas después de ajustar por diversas características demográficas, actividad física y estado funcional. [22] Esto prueba que un aumento en los centros comunitarios debería disminuir las enfermedades mentales en las áreas de alta pobreza de los Estados Unidos.

Agua contaminada [ editar ]

Cada año, muchos niños y adultos mueren como resultado de la falta de acceso a agua potable y un saneamiento deficiente. Muchas enfermedades relacionadas con la pobreza, como la diarrea, se adquieren y se propagan como resultado del acceso inadecuado al agua potable. Según UNICEF, cada día mueren 3.000 niños en todo el mundo debido al agua potable contaminada y al saneamiento deficiente. [24]

Aunque el Objetivo de Desarrollo del Milenio (ODM) de reducir a la mitad el número de personas que no tenían acceso a agua potable para 2015, se alcanzó cinco años antes de lo previsto en 2010, todavía hay 783 millones de personas que dependen de fuentes de agua no mejoradas. [24] En 2010, las Naciones Unidas declararon el acceso al agua potable como un derecho humano fundamental, integral para el logro de otros derechos. Esto hizo que fuera aplicable y justificable permitir que los gobiernos aseguraran a sus poblaciones el acceso al agua potable. [25] Aunque el acceso al agua ha mejorado para algunos, sigue siendo especialmente difícil para las mujeres y los niños. Las mujeres y las niñas soportan la mayor parte de la carga de acceder al agua y suministrarla a sus hogares.

En la India , África subsahariana y partes de América Latina, las mujeres deben viajar largas distancias para acceder a una fuente de agua limpia y luego traer algo de agua a casa. Esto tiene un impacto significativo en el nivel educativo de las niñas. [25] [26]

Se han realizado más esfuerzos para mejorar la calidad del agua utilizando nueva tecnología que permite desinfectar el agua inmediatamente después de la recolección y durante el proceso de almacenamiento. El agua limpia es necesaria para cocinar, limpiar y lavar la ropa porque muchas personas entran en contacto con patógenos que causan enfermedades a través de sus alimentos o mientras se bañan o se lavan. [27]

Un problema continuo de agua contaminada en los Estados Unidos ha tenido lugar en Flint, Michigan . El 4 de septiembre de 2018, se encontró evidencia de E Coli y otros organismos que pueden causar enfermedades en el agua. El problema del agua contaminada en Flint, Michigan, comenzó cuando la fuente de agua potable en Flint se cambió del lago Huron y el río Detroit al muy barato río Flint. [ cita requerida ]

Educación inadecuada [ editar ]

La educación se ve afectada por la pobreza, lo que se conoce como brecha de rendimiento de ingresos. Esta brecha muestra que los niños que viven en la pobreza o tienen ingresos más bajos tienen menos probabilidades de tener los niveles cognitivos y de alfabetización temprana de aquellos que no los tienen. [28] La cantidad de ingresos afecta la cantidad de dinero extra que una familia tiene para gastar en programas educativos adicionales; incluyendo campamentos de verano y asistencia fuera de la escuela. Además de las finanzas, las toxinas ambientales, incluido el plomo y el estrés, y la falta de alimentos nutritivos pueden disminuir el desarrollo cognitivo. [28]

En la educación posterior, los estudiantes considerados de bajos ingresos o en pobreza tienen más probabilidades de abandonar la escuela o solo recibir un diploma de escuela secundaria. [29] La imposibilidad de alcanzar niveles más altos de educación se atribuye al ciclo de pobreza que puede continuar por generaciones en la misma familia e incluso en la comunidad. [29] Un mayor rendimiento educativo se correlaciona con la consecución de un empleo y un futuro económico más seguros. [30]

Saneamiento inadecuado [ editar ]

Una de cada tres personas en todo el mundo no tiene acceso a un saneamiento adecuado . Un saneamiento inadecuado puede provocar enfermedades diarreicas que a menudo provocan enfermedades graves y, con frecuencia, la muerte, especialmente en los niños. Estas enfermedades diarreicas contribuyen no solo a la disminución de la salud de un individuo, sino también a un aumento de la pobreza. Enfermedades de esta naturaleza provocan la imposibilidad de asistir a la escuela y al trabajo, lo que reduce directamente los ingresos y el desarrollo educativo. [ cita requerida ] El problema del saneamiento inadecuado es de naturaleza cíclica; así como es causado por la pobreza, también empeora la pobreza.

Mala nutrición [ editar ]

La desnutrición afecta de manera desproporcionada a las personas del África subsahariana. Más del 35 por ciento de los niños menores de 5 años en el África subsahariana muestran signos físicos de desnutrición. [31] La desnutrición, el sistema inmunológico y las enfermedades infecciosas operan de manera cíclica: las enfermedades infecciosas tienen efectos nocivos sobre el estado nutricional y las deficiencias nutricionales pueden disminuir la fuerza del sistema inmunológico, lo que afecta la capacidad del cuerpo para resistir infecciones. [31] De manera similar, la desnutrición tanto de macronutrientes (como proteínas y energía ) como de micronutrientes (como hierro , zinc y vitaminas) aumentan la susceptibilidad a las infecciones por el VIH al interferir con el sistema inmunológico y mediante otros mecanismos biológicos. El agotamiento de macronutrientes y micronutrientes promueve la replicación viral que contribuye a mayores riesgos de transmisión del VIH de madre a hijo, así como a través de la transmisión sexual. [32] El aumento de la transmisión de madre a hijo está relacionado con deficiencias específicas de micronutrientes como la vitamina A. [33] [34] Además, la anemia , una disminución en la cantidad de glóbulos rojos , aumenta la diseminación viral en el nacimiento canal, que también aumenta el riesgo de transmisión de madre a hijo. [35]Sin estos nutrientes vitales, el cuerpo carece de los mecanismos de defensa para resistir las infecciones. [31] Al mismo tiempo, el VIH reduce la capacidad del cuerpo para ingerir nutrientes esenciales. La infección por VIH puede afectar la producción de hormonas que interfieren con el metabolismo de carbohidratos, proteínas y grasas. [31]

En los Estados Unidos, el 11,1 por ciento de los hogares luchan contra la inseguridad alimentaria. [36] La inseguridad alimentaria se refiere a la falta de acceso a alimentos de calidad para un estilo de vida saludable. [36] La tasa de hambre y desnutrición en los hogares encabezados por mujeres triplicó el promedio nacional en 30,2 por ciento. Según la Organización de las Naciones Unidas para la Agricultura y la Alimentación, el 10 por ciento de la población de América Latina y el Caribe se ve afectada por el hambre y la desnutrición. [37]

Malas condiciones de vivienda [ editar ]

Las familias que viven en la pobreza a menudo luchan no solo con problemas de vivienda, sino también con problemas de seguridad y asequibilidad en el vecindario. [38] Evitar los problemas de seguridad del vecindario a menudo significa quedarse en casa, lo que reduce la oportunidad de hacer ejercicio fuera del hogar, lo que agrava los problemas de salud debido a la falta de ejercicio. Quedarse en el hogar puede significar la exposición al plomo , el moho y los roedores dentro de ese hogar, lo que puede aumentar el riesgo de enfermedades debido a estos problemas de vivienda inadecuada. [38]

Falta de acceso a los servicios de salud [ editar ]

Según la OMS, informe de estrategias médicas, aproximadamente el 30% de la población mundial no tiene acceso regular a los medicamentos. En las partes más pobres de África y Asia, este porcentaje sube al 50%. [39]La población que se encuentra por debajo del umbral de la pobreza no tiene acceso debido al mayor precio minorista y la falta de disponibilidad de los medicamentos. El mayor costo puede deberse al mayor precio de fabricación o debido al impuesto local o regional y al Impuesto al Valor Agregado. Existe una disparidad significativa en la investigación realizada en el sector de la salud. Se afirma que solo el 10% de la investigación sanitaria realizada a nivel mundial se centra en el 90% de la carga de morbilidad. Sin embargo, enfermedades como el cáncer, las enfermedades cardiovasculares, etc., que tradicionalmente estaban asociadas con la comunidad más rica, ahora también son más frecuentes en las comunidades pobres. Por lo tanto, la investigación que se realiza ahora es relevante para la población pobre. [40]La prioridad política es también uno de los factores que contribuyen a la inaccesibilidad. El gobierno de los países pobres puede asignar menos fondos a la salud pública debido a la escasez de recursos.

Ciclo de la pobreza [ editar ]

El ciclo de la pobreza es el proceso a través del cual las familias que ya están en la pobreza probablemente permanecerán en esas circunstancias a menos que haya una intervención de algún tipo. Este ciclo de pobreza tiene un impacto en los tipos de enfermedades que padecen estas personas y, a menudo, se transmiten de generación en generación. Las enfermedades mentales son particularmente importantes cuando se habla del ciclo de la pobreza, porque estas enfermedades mentales impiden que las personas obtengan un empleo remunerado. [41] La experiencia estresante de vivir en la pobreza también puede exacerbar las enfermedades mentales. [41]

This cycle of poverty also impacts the familial diseases that are passed down each generation.[42] By experiencing the same stressful situations for decades, individuals become more susceptible to diseases like cardiovascular disease, obesity, diabetes, and mental illnesses including schizophrenia and bipolar disorder.

Diseases[edit]

Together, diseases of poverty kill approximately 14 million people annually.[43] Gastroenteritis with its associated diarrhea results in about 1.8 million deaths in children yearly with most of these in the world's poorest nations.[44]

At the global level, the three primary PRDs are tuberculosis, AIDS/HIV and malaria.[45] Developing countries account for 95% of the global AIDS prevalence[46] and 98% of active tuberculosis infections.[43] Furthermore, 90% of malaria deaths occur in sub-Saharan Africa.[47] Together, these three diseases account for 10% of global mortality.[45]

Treatable childhood diseases are another set which have disproportionately higher rates in poor countries despite the availability of cures for decades. These include measles, pertussis and polio.[40] The largest three poverty-related diseases (PRDs) — AIDS, malaria, and tuberculosis — account for 18% of diseases in poor countries.[40] The disease burden of treatable childhood diseases in high-mortality, poor countries is 5.2% in terms of disability-adjusted life years but just 0.2% in the case of advanced countries.[40]

In addition, infant mortality and maternal mortality are far more prevalent among the poor. For example, 98% of the 11,600 daily maternal and neonatal deaths occur in developing countries.[17]

Three other diseases, measles, pneumonia, and diarrheal diseases, are also closely associated with poverty, and are often included with AIDS, malaria, and tuberculosis in broader definitions and discussions of diseases of poverty.[48]

Neglected diseases[edit]

Main article: Neglected tropical diseases

Based upon the spread of research in cures for diseases, certain diseases are identified and referred to as "neglected diseases". These include the following diseases:[40]

  • African trypanosomiasis
  • Chagas disease
  • Leishmaniasis
  • Lymphatic filariasis
  • Dracunculiasis (“Guinea worm disease”)
  • Onchocerciasis
  • Schistosomiasis
  • Trichomoniasis

Tropical diseases such as these tend to be neglected in research and development efforts. Of 1393 new drugs brought into use over a period of 25 years (1975–1999), only a total of thirteen, less than 1%, related to these diseases. Of 20 MNC drug companies surveyed for research on PRDs, only two had projects targeted towards these neglected PRDs. However, the combined total number of deaths due to these diseases is dwarfed by the enormous number of patients affected by PRDs such as respiratory infections, HIV/AIDS, diarrhea and tuberculosis, besides many others.[40]Similar to the spread of tropical neglected diseases in developing nations, these neglected infections disproportionately affect poor and minority populations in the United States.[49] These diseases have been identified by the Centers for Disease Control and Prevention, as priorities for public health action based on the number of people infected, the severity of the illnesses, and the ability to prevent and treat them.[50]

Trichomoniasis[edit]

Trichomoniasis is the most common sexually transmitted infection affecting more than 200 million people worldwide. It is especially prevalent among young, poor and African American women. This infection is also common in poor communities in Sub-Saharan Africa and impoverished parts of Asia. This neglected infection is one of special concern because it is associated with a heightened risk for contracting HIV and pre-term deliveries.[51]

In addition, availability of cures and recent advances in medicine have led to only three diseases being considered neglected diseases, namely, African trypanosomiasis, Chagas disease and Leishmaniasis.[40]

Malaria[edit]

Africa accounts for a majority of malaria infections and deaths worldwide. Over 80 percent of the 300 to 500 million malaria infections occurring annually worldwide are in Africa.[52] Each year, about one million children under the age of five die from malaria.[53] Children who are poor, have mothers with little to no education, and live in rural areas are more susceptible to malaria and more likely to die from it.[54] Malaria is directly related to the spread of HIV in sub-Saharan Africa.[55] It increases viral load seven to ten times, which increases the chances of transmission of HIV through sexual intercourse from a patient with malaria to an uninfected partner.[56] After the first pregnancy, HIV can also decrease the immunity to malaria. This contributes to the increase of the vulnerability to HIV and higher mortality from HIV, especially for women and infants.[57] HIV and malaria interact in a cyclical manner—being infected with malaria increases susceptibility to HIV infection, and HIV infections increase malarial episodes. The co-existence of HIV and malaria infections helps spread both diseases, particularly in Sub-Saharan Africa.[58] Malaria vaccines are an area of intensive research.

Intestinal parasites[edit]

Intestinal parasites are extremely prevalent in tropical areas.[59] These include hookworms, roundworms, and other amoebas. They can aggravate malnutrition by depleting essential nutrients through intestinal blood loss and chronic diarrhea. Chronic worm infections can further burden the immune system.[60][61] At the same time, chronic worm infections can cause immune activation that increases susceptibility of HIV infection and vulnerability to HIV replication once infected.

Schistosomiasis[edit]

Schistosomiasis (bilharzia) is a parasitic disease caused by the parasitic flatworm trematodes. Moreover, more than 80 percent of the 200 million people worldwide who have schistosomiasis live in sub-Saharan Africa.[62] Infections often occur in contaminated water where freshwater snails release larval forms of the parasite. After penetrating the skin and eventually traveling to the intestines or the urinary tract, the parasite lays eggs and infects those organs.[59][62] It damages the intestines, bladder, and other organs and can lead to anemia and protein-energy deficiency.[63][64] Along with malaria, schistosomiasis is one of the most important parasitic co-factors aiding in HIV transmission. Epidemiological data shows schistosome-endemic areas coincide with areas of high HIV prevalence, suggesting that parasitic infections such as schistosomiasis increase risk of HIV transmission.[65]

Tuberculosis[edit]

Tuberculosis is the leading cause of death around the world for an infectious disease.[66] This disease is especially prevalent in sub-Saharan Africa, and the Latin American and Caribbean region. While the tuberculosis rate is decreasing in the rest of the world, it is increasing by rate of 6 percent per year in Sub-Saharan Africa. It is the leading cause of death for people with HIV in Africa. Tuberculosis (TB) is closely related to lifestyles of poverty, overcrowded conditions, alcoholism, stress, drug addiction and malnutrition. This disease spreads quickly among people who are undernourished.[3] According to the Center for Disease Control and Prevention, in the United States, tuberculosis is more prevalent among foreign born persons, and ethnic minorities. The rates are especially high among Hispanics, Blacks and Asians.[67][68]HIV infection and TB are also closely tied. Being infected with HIV increases the rate of activation of latent TB infections, and having TB, increases the rate of HIV replication, therefore accelerating the progression of AIDS.[3]

AIDS[edit]

AIDS is a disease of the human immune system caused by the human immunodeficiency virus (HIV).[69] Primary modes of HIV transmission in sub-Saharan Africa are sexual intercourse, mother-to-child transmission (vertical transmission), and through HIV-infected blood.[59][70][71] Since rate of HIV transmission via heterosexual intercourse is so low, it is insufficient to cause AIDS disparities between countries.[59] Critics of AIDS policies promoting safe sexual behaviors believe that these policies miss the biological mechanisms and social risk factors that contribute to the high HIV rates in poorer countries.[59] In these developing countries, especially those in sub-Saharan Africa, certain health factors predispose the population to HIV infections.[33][63][72][73][74]

Many of the countries in Sub-Saharan Africa are ravaged with poverty and many people live on less than one United States dollar a day.[75] The poverty in these countries gives rise to many other factors that explain the high prevalence of AIDS. The poorest people in most African countries suffer from malnutrition, lack of access to clean water, and have improper sanitation. Because of a lack of clean water many people are plagued by intestinal parasites that significantly increase their chances of contracting HIV due to compromised immune system. Malaria, a disease still rampant in Africa also increases the risk of contracting HIV. These parasitic diseases, affect the body's immune response to HIV, making people more susceptible to contracting the disease once exposed. Genital schistosomiasis, also prevalent in the topical areas of Sub-Saharan Africa and many countries worldwide, produces genital lesions and attract CD4 cells to the genital region which promotes HIV infection. All these factors contribute to the high rate of HIV in Sub-Saharan Africa. Many of the factors seen in Africa are also present in Latin America and the Caribbean and contribute to the high rates of infections seen in those regions. In the United States, poverty is a contributing factor to HIV infections. There is also a large racial disparity, with African Americans having a significantly higher rate of infection than their white counterparts.[75]

Asthma[edit]

More than 300 million people worldwide have asthma. The rate of asthma increases as countries become more urbanized and in many parts of the world those who develop asthma do not have access to medication and medical care.[76] Within the United States, African Americans and Latinos are four times more likely to suffer from severe asthma than whites. The disease is closely tied to poverty and poor living conditions.[77] Asthma is also prevalent in children in low income countries. Homes with roaches and mice, as well as mold and mildew put children at risk for developing asthma as well as exposure to cigarette smoke.[78]

Unlike many other Western countries, the mortality rate for asthma has steadily risen in the United States over the last two decades.[79] Mortality rates for African American children due to asthma are also far higher than that of other racial groups.[80] For African Americans, the rate of visits to the emergency room is 330 percent higher than their white counterparts. The hospitalization rate is 220 percent higher and the death rate is 190 percent higher.[78] Among Hispanics, Puerto Ricans are disporpotionatly affected by asthma with a disease rate that is 113 percent higher than non-Hispanic Whites and 50 percent higher than non-Hispanic Blacks.[78] Studies have shown that asthma morbidity and mortality are concentrated in inner city neighborhoods characterized by poverty and large minority populations and this affects both genders at all ages.[81][82] Asthma continues to have an adverse effects on the health of the poor and school attendance rates among poor children. 10.5 million days of school are missed each year due to asthma.[78]

Cardiovascular disease[edit]

Though heart disease is not exclusive to the poor, there are aspects of a life of poverty that contribute to its development. This category includes coronary heart disease, stroke and heart attack. Heart disease is the leading cause of death worldwide and there are disparities of morbidity between the rich and poor. Studies from around the world link heart disease to poverty. Low neighborhood income and education were associated with higher risk factors. Poor diet, lack of exercise and limited (or no) access to a specialist were all factors related to poverty, though to contribute to heart disease.[83]Both low income and low education were predictors of coronary heart disease, a subset of cardiovascular disease. Of those admitted to hospital in the United States for heart failure, women and African Americans were more likely to reside in lower income neighborhoods. In the developing world, there is a 10 fold increase in cardiac events in the black and urban populations.[84]

Obstetrical fistula[edit]

Obstetric fistula or vaginal fistula is a medical condition in which a fistula (hole) develops between either the rectum and vagina (see rectovaginal fistula) or between the bladder and vagina (see vesicovaginal fistula) after severe or failed childbirth, when adequate medical care is not available.[85] It is considered a disease of poverty because of its tendency to occur women in poor countries who do not have health resources comparable to developed nations.[86]

Dental decay[edit]

Dental decay or dental caries is the gradual destruction of tooth enamel. Poverty is a significant determinant for oral health.[87] Dental caries is one of the most common chronic diseases worldwide. In the United States it is the most common chronic disease of childhood. Risk factors for dental caries includes living in poverty, poor education, low socioeconomic status, being part of an ethnic minority group, having a developmental disability, recent immigrants and people infected with HIV/AIDS.[88] In Peru, poverty was found to be positively correlated with dental caries among children.[89] According to a report by U.S health surveillance, tooth decay peaks earlier in life and is more severe in children with families living below the poverty line.[89] Tooth decay is also strongly linked to dietary behaviors, and in poor rural areas where nutrient dense foods, fruits and vegetables are unavailable, the consumption of sugary and fatty food increases the risk of dental decay.[90] Because the mouth is a gateway to the respiratory and digestive tracts, oral health has a significant impact on other health outcomes. Gum disease has been linked to diseases such as cardiovascular disease.[91]

Consequences[edit]

Diseases of poverty reflect the dynamic relationship between poverty and poor health; while such diseases result directly from poverty, they also perpetuate and deepen impoverishment by sapping personal and national health and financial resources. For example, malaria decreases GDP growth by up to 1.3% in some developing nations, and by killing tens of millions in sub-Saharan Africa, AIDS alone threatens “the economies, social structures, and political stability of entire societies”.[92][93]

For women[edit]

Women and children are often put at a high risk of being infected by schistosomiasis, which in turn puts them at a higher risk of acquiring HIV.[59] Since the mode of schistosomiasis transmission is usually through contaminated water in streams and lakes, women and children who do their household chores by the water are more likely to acquire the disease. Activities that women and children often do around waterfront include washing clothes, collecting water, bathing, and swimming.[59][62] Women who have schistosomiasis lesions are three times more likely to be infected with HIV.[94]

Women also have a higher risk of HIV transmission through the use of medical equipment such as needles.[59] Because more women than men use health services, especially during pregnancy, they are more likely to come across unsterilized needles for injections.[70][94] Although statistics estimate that unsterilized needles only account for 5 to 10 percent of primary HIV infections, studies show this mode of HIV transmission may be higher than reported.[59][95] This increased risk of contracting HIV through non-sexual means has social consequences for women as well. Over half of the husbands of HIV-positive women in Africa tested HIV-negative.[96] When HIV-positive women reveal their HIV status to their HIV-negative husbands, they are often accused of infidelity and face violence and abandonment from their family and community.[59][96]

Relating to human capabilities[edit]

Malnutrition associated with HIV impacts people's ability to provide for themselves and their dependents, thus limiting the human capabilities of both themselves and their dependents.[31] HIV can negatively affect work output, which impacts the ability to generate income.[97] This is crucial in parts of Africa where farming is the primary occupation and obtaining food is dependent on the agricultural outcome. Without adequate food production, malnutrition becomes more prevalent. Children are often collateral damage in the AIDS crisis. As dependents, they can be burdened by the illness and eventual death of one or both parents due to HIV/AIDS. Studies have shown that orphaned children are more likely to display physical symptoms of malnutrition than children whose parents are both alive.[31]

Public policy proposals[edit]

There are a number of proposals for reducing the diseases of poverty and eliminating health disparities within and between countries. The World Health Organization proposes closing the gaps by acting on social determinants.[98] Their first recommendation is to improve daily living conditions. This area involves improving the lives of women and girls so that their children are born in healthy environments and placing an emphasis on early childhood health. Their second recommendation is to tackle the inequitable distribution of money, power and resources. This would involve building stronger public sectors and changing the way in which society is organized. Their third recommendation is to measure and understand the problem and assess the impact of action. This would involve training policy makers and healthcare practitioners to recognize problems and form policy solutions.[98]

Health in All Policies[edit]

The 8th Global Conference on Health Promotion held in Helsinki in June 2013 [99] has proposed an approach termed Health in All Policies. Health inequalities are shaped by many powerful forces and social, political, and economic determinants. Governments have a responsibility to ensure that their people are able to live healthy lives and have equitable access to achieving a reasonable state of good health. Policies that governments craft and implement in all sectors have a significant and ongoing impact on public health, health equity, and the lives of their citizens. Increases in technology, medical innovation, and living conditions have led to the disappearance of diseases and other factors contributing to poor health. However, there are many diseases of poverty that still persist in developed and developing countries. Tackling these health inequalities and diseases of poverty requires a willingness to engage the whole government in health. The Helskinki Statement lays out a framework of action for countries and calls on governments to make a commitment to building health equity within their country.

Health in All Policies (HiAP) is an approach to public policies across all sectors of government that takes into account the health implications of all government and policy decisions to improve health equity across all populations residing within the borders of a country. This concept is built upon principles in line with the Universal Declaration of Human Rights, The United Nations Millennium Development Declaration, and principles of good governance:[99] legitimacy given by national and international law, accountability of government, transparency of policy making, participation of citizens, sustainability ensuring policies meet the needs of both present and future generations, and collaboration across sectors and levels of government.

Finally the Framework lists and expands upon six steps for implementation [99] that may be undertaken by a country in taking action towards Health in All Policies. These are components of action and not a rigid checklist of steps to adhere to. The most important aspect of this policy is that governments should adapt the policy to suit the needs of their citizens, their socioeconomic situation, and their governance system.

  1. Establish the need and priorities for HiAP
  2. Frame planned action
  3. Identify supportive structures and processes
  4. Facilitate assessment and engagement
  5. Ensure monitoring, evaluation, and reporting
  6. Build capacity.[99]

HIV/AIDS policy[edit]

  • Nutrition Supplements: Focusing on reversing the pattern of malnutrition in sub-Saharan African and other poor countries is a one possible way of decreasing susceptibility to HIV infections. Micro-nutrients such as iron and vitamin A can be delivered and provided at a very low cost. For example, vitamin A supplements cost $0.02 per capsule if provided twice a year. Iron supplements per child cost $0.02 if provided weekly or $0.08 if provided daily.[59]
  • Eliminating Co-factors: Tackling the very diseases that increase risk of HIV infections can help slow down the rates of HIV transmission. Co-factors such as malaria and parasitic infections can be combated in an effective and cost-efficient manner. For example, mosquito nets can be easily used to prevent malaria.[59] Parasites can be eliminated with medication that is cost-effective and easy to administer. Twice-yearly treatments range from $0.02 to $0.25 depending on the type of worm.[100][101]

See also[edit]

  • Diseases of despair
  • Effects of poverty on mental health
  • Health equity
  • Hygiene hypothesis
  • Inequality in disease
  • Social determinants of health
  • Social determinants of obesity
  • Social epidemiology
  • Typhus § History
  • Unnatural Causes: Is Inequality Making Us Sick?

References[edit]

  1. ^ Singh, Ajai R.; Singh, Shakuntala A. (2008). "Diseases of Poverty and Lifestyle, Well-Being and Human Development". Mens Sana Monographs. 6 (1): 187–225. doi:10.4103/0973-1229.40567. PMC 3190550. PMID 22013359.
  2. ^ World Health organization(WHO). "World Health Report, 2002". Retrieved 15 November 2018.
  3. ^ a b c Singh A. R., Singh S. A. (2008). "Diseases of Poverty and Lifestyle, Well-Being and Human Development". Mens Sana Monographs. 6 (1): 187–225. doi:10.4103/0973-1229.40567. PMC 3190550. PMID 22013359.
  4. ^ Sachs J (2008). "The end of poverty: economic possibilities for our time". European Journal of Dental Education. 12: 17–21. doi:10.1111/j.1600-0579.2007.00476.x. PMID 18289264.
  5. ^ "Can Money Buy Happiness?". Taking Charge of Your Health & Wellbeing. UNIVERSITY MINNESOTA. Retrieved 2 January 2021.
  6. ^ Singh, Ajai R.; Singh, Shakuntala A. (2008). "Diseases of Poverty and Lifestyle, Well-Being and Human Development". Mens Sana Monographs. 6 (1): 187–225. doi:10.4103/0973-1229.40567. PMC 3190550. PMID 22013359.
  7. ^ Plotkin, Stanley (2014-08-26). "History of vaccination". Proceedings of the National Academy of Sciences of the United States of America. 111 (34): 12283–12287. Bibcode:2014PNAS..11112283P. doi:10.1073/pnas.1400472111. PMC 4151719. PMID 25136134.
  8. ^ "Timeline | History of Vaccines". www.historyofvaccines.org. Retrieved 2019-12-05.
  9. ^ van Panhuis, Willem G.; Grefenstette, John; Jung, Su Yon; Chok, Nian Shong; Cross, Anne; Eng, Heather; Lee, Bruce Y.; Zadorozhny, Vladimir; Brown, Shawn; Cummings, Derek; Burke, Donald S. (2013-11-28). "Contagious Diseases in the United States from 1888 to the Present". The New England Journal of Medicine. 369 (22): 2152–2158. doi:10.1056/NEJMms1215400. PMC 4175560. PMID 24283231.
  10. ^ Falcini, Louise (July 2018). Cleanliness and the poor in eighteenth-century London (Thesis).
  11. ^ Gest, Howard (May 2004). "The discovery of microorganisms by Robert Hooke and Antoni Van Leeuwenhoek, fellows of the Royal Society". Notes and Records of the Royal Society of London. 58 (2): 187–201. doi:10.1098/rsnr.2004.0055. PMID 15209075. S2CID 8297229.
  12. ^ Steensels, Jan; Gallone, Brigida; Voordeckers, Karin; Verstrepen, Kevin J. (May 2019). "Domestication of Industrial Microbes". Current Biology. 29 (10): R381–R393. doi:10.1016/j.cub.2019.04.025. PMID 31112692.
  13. ^ "HIV/AIDS". World Health Organization. 30 November 2020.
  14. ^ "History of World TB Day". Centers for Disease Control and Prevention.
  15. ^ Barberis, I.; Bragazzi, N.L.; Galluzzo, L.; Martini, M. (2017). "The history of tuberculosis: from the first historical records to the isolation of Koch's bacillus". Journal of Preventive Medicine and Hygiene. 58 (1): E9–E12. PMC 5432783. PMID 28515626.
  16. ^ "Health and Poverty". UNFPA State of World Population 2002. United Nations Population Fund.
  17. ^ a b "Ensuring skilled care for every birth" (PDF). World Health Organization. Cite journal requires |journal= (help)
  18. ^ a b "Poorer people are less physically active - Economic and Social Research Council". esrc.ukri.org. Retrieved 2019-03-26.
  19. ^ "Why Low-Income and Food-Insecure People are Vulnerable to Poor Nutrition and Obesity". Food Research & Action Center. Retrieved 2019-03-26.
  20. ^ a b President’s Council on Sports, Fitness & Nutrition (2012-07-20). "Facts & Statistics". HHS.gov. Retrieved 2019-03-26.
  21. ^ a b Services, Department of Health & Human. "Physical activity - it's important". www.betterhealth.vic.gov.au. Retrieved 2019-03-26.
  22. ^ a b Heflin, Colleen M.; Iceland, John (2009-12-01). "Poverty, Material Hardship and Depression". Social Science Quarterly. 90 (5): 1051–1071. doi:10.1111/j.1540-6237.2009.00645.x. PMC 4269256. PMID 25530634.
  23. ^ "Can Poverty Lead To Mental Illness?". NPR.org. Retrieved 28 December 2020.
  24. ^ a b UNICEF (Water). Archived April 9, 2008, at the Wayback Machine
  25. ^ a b Singh Nandita, Wickenberg Per, Åström Karsten, Hydén Håkan (2012). "Accessing water through a rights-based approach: problems and prospects regarding children". Water Policy. 14 (2): 298–318. doi:10.2166/wp.2011.141.CS1 maint: multiple names: authors list (link)
  26. ^ Voelker, R. (2004). "Access to Clean Water and Sanitation Pose 21st-Century Challenge for Millions". JAMA. 292 (3): 318–20. doi:10.1001/jama.292.3.318. PMID 15265835.
  27. ^ Mintz E., Reiff F., Tauxe R. (1995). "Safe water treatment and storage in the home. A practical new strategy to prevent waterborne disease". JAMA. 273 (12): 948–953. doi:10.1001/jama.1995.03520360062040. PMID 7884954.CS1 maint: multiple names: authors list (link)
  28. ^ a b "The other achievement gap: Poverty and academic success". Child Trends. 2016-08-22. Retrieved 2019-04-02.
  29. ^ a b "Lack of Education Creates Poverty". The Great Gathering. 2014-11-17. Retrieved 2019-04-02.
  30. ^ Porter, Eduardo (10 September 2014). "A Simple Equation: More Education = More Income". New York Times. Retrieved 27 April 2020.
  31. ^ a b c d e f Piwoz, Ellen G.; Preble, Elizabeth A. (December 2000). "HIV/AIDS and Nutrition: A Review of the Literature and Recommendations for Nutritional Care and Support in Sub-Saharan Africa" (PDF). Washington DC: Academy for Educational Development. PN-ACK-673.
  32. ^ Friis H, Michaelsen KF (March 1998). "Micronutrients and HIV infection: a review". Eur J Clin Nutr. 52 (3): 157–63. doi:10.1038/sj.ejcn.1600546. PMID 9537299.
  33. ^ a b Semba RD, Miotti PG, Chiphangwi JD, et al. (June 1994). "Maternal vitamin A deficiency and mother-to-child transmission of HIV-1". Lancet. 343 (8913): 1593–7. doi:10.1016/S0140-6736(94)93056-2. PMID 7911919. S2CID 20540787.
  34. ^ Nimmagadda A, O'Brien WA, Goetz MB (March 1998). "The significance of vitamin A and carotenoid status in persons infected by the human immunodeficiency virus". Clin. Infect. Dis. 26 (3): 711–8. doi:10.1086/514565. PMID 9524850.
  35. ^ John, Grace C.; Nduati, Ruth W.; Mbori-Ngacha, Dorothy; Overbaugh, Julie; Welch, Mary; Richardson, Barbra A.; Ndinya-Achola, Jeckoniah; Bwayo, Job; Krieger, John; Onyango, Francis; Kreiss, Joan K. (January 1997). "Genital Shedding of Human Immunodeficiency Virus Type 1 DNA during Pregnancy: Association with Immunosuppression, Abnormal Cervical or Vaginal Discharge, and Severe Vitamin A Deficiency". The Journal of Infectious Diseases. 175 (1): 57–62. doi:10.1093/infdis/175.1.57. PMC 3372419. PMID 8985196.
  36. ^ a b Chilton, Mariana; Rose, Donald (July 2009). "A Rights-Based Approach to Food Insecurity in the United States". American Journal of Public Health. 99 (7): 1203–1211. doi:10.2105/AJPH.2007.130229. PMC 2696644. PMID 19443834.
  37. ^ Freeing Latin America and the Caribbean from hunger Archived September 18, 2011, at the Wayback Machine.
  38. ^ a b Hernández, Diana (May 2016). "Affording Housing at the Expense of Health: Exploring the Housing and Neighborhood Strategies of Poor Families". Journal of Family Issues. 37 (7): 921–946. doi:10.1177/0192513X14530970. PMC 4819250. PMID 27057078.
  39. ^ WHO, Medicines Strategy Report 2002–2003
  40. ^ a b c d e f g Stevens, Philip (November 2004). "Diseases of Poverty and the 10/90 gap" (PDF). International Policy Network. Retrieved 20 March 2012.
  41. ^ a b Anakwenze, U.; Zuberi, D. (1 August 2013). "Mental Health and Poverty in the Inner City". Health & Social Work. 38 (3): 147–157. doi:10.1093/hsw/hlt013. PMID 24437020.
  42. ^ Gentry, Maria (2015). "Poverty Re-Cycles: Why America Needs to Prioritize Child Health Disparities". Lucerna. 10: 82–94. hdl:10355/48996.
  43. ^ a b "RESULTS: World Health/Diseases of Poverty". 2009-07-03. Archived from the original on 2009-07-03. Retrieved 2020-01-29.
  44. ^ Bennett, John E; Dolin, Raphael; Blaser, Martin J, eds. (2020). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. ISBN 978-0-323-55027-7. OCLC 1118693541.[page needed]
  45. ^ a b WHO/WPRO-Poverty Issues Dominate RCM Archived April 3, 2011, at the Wayback Machine
  46. ^ "HIV/AIDS and Poverty". UNFPA State of World Population 2002. United Nations Population Fund.
  47. ^ Roll Back Malaria Partnership: What is malaria? Archived April 23, 2006, at the Wayback Machine
  48. ^ World Health/Diseases of Poverty. Retrieved 05 January 2016.
  49. ^ Hotez PJ (2008). "Neglected Infections of Poverty in the United States of America". PLOS Negl Trop Dis. 2 (6): e256. doi:10.1371/journal.pntd.0000256. PMC 2430531. PMID 18575621.
  50. ^ Centers For Disease Control. Archived May 11, 2016, at the Wayback Machine
  51. ^ Ko H., Jamieson D. J., Hogan J. W., Anderson J., Klein R. S., Susan C., Paula S. (2002). "Prevalence, Incidence, and Persistence or Recurrence of Trichomoniasis among Human Immunodeficiency Virus (HIV)-Positive Women and among HIV-Negative Women at High Risk for HIV Infection". Clinical Infectious Diseases. 34 (10): 1406–1411. doi:10.1086/340264. PMID 11981738.CS1 maint: multiple names: authors list (link)
  52. ^ Crosse, M. (2005). Global malaria control [electronic resource] : U.S. and multinational investments and implementation challenges. Washington, DC : U.S. Government Accountability Office, [2005].
  53. ^ Malaria. World Health Organization (WHO). 2004.[permanent dead link] Retrieved March 2011.
  54. ^ Ingstad, Benedicte; Munthali, Alister C.; Braathen, Stine H.; Grut, Lisbet (11 January 2012). "The evil circle of poverty: a qualitative study of malaria and disability". Malaria Journal. 11 (1): 15. doi:10.1186/1475-2875-11-15. PMC 3295708. PMID 22236358. S2CID 1648013.
  55. ^ Whitworth J, Morgan D, Quigley M, et al. (September 2000). "Effect of HIV-1 and increasing immunosuppression on malaria parasitaemia and clinical episodes in adults in rural Uganda: a cohort study". Lancet. 356 (9235): 1051–6. doi:10.1016/S0140-6736(00)02727-6. PMID 11009139. S2CID 19776584.
  56. ^ Hoffman IF, Jere CS, Taylor TE, et al. (March 1999). "The effect of Plasmodium falciparum malaria on HIV-1 RNA blood plasma concentration". AIDS. 13 (4): 487–94. doi:10.1097/00002030-199903110-00007. PMID 10197377.
  57. ^ Rowland-Jones SL, Lohman B (October 2002). "Interactions between malaria and HIV infection-an emerging public health problem?". Microbes Infect. 4 (12): 1265–70. doi:10.1016/S1286-4579(02)01655-6. PMID 12467769.
  58. ^ Abu-Raddad LJ, Patnaik P, Kublin JG (December 2006). "Dual infection with HIV and malaria fuels the spread of both diseases in sub-Saharan Africa". Science. 314 (5805): 1603–6. Bibcode:2006Sci...314.1603A. doi:10.1126/science.1132338. PMID 17158329. S2CID 7862764.
  59. ^ a b c d e f g h i j k l Stillwaggon, Eileen (2008). "Race, Sex, and the Neglected Risks for Women and Girls in Sub-Saharan Africa". Feminist Economics. 14 (4): 67–86. doi:10.1080/13545700802262923. S2CID 154082747.
  60. ^ Bentwich Z, Kalinkovich A, Weisman Z (April 1995). "Immune activation is a dominant factor in the pathogenesis of African AIDS". Immunol. Today. 16 (4): 187–91. doi:10.1016/0167-5699(95)80119-7. PMID 7734046.
  61. ^ Borkow G, Bentwich Z (May 2002). "Host background immunity and human immunodeficiency virus protective vaccines, a major consideration for vaccine efficacy in Africa and in developing countries". Clin. Diagn. Lab. Immunol. 9 (3): 505–7. doi:10.1128/CDLI.9.3.505-507.2002. PMC 119996. PMID 11986252.
  62. ^ a b c Schistosomiasis. World Health Organization (WHO). 2004.[permanent dead link] Retrieved March 2011.
  63. ^ a b Scrimshaw NS, SanGiovanni JP (August 1997). "Synergism of nutrition, infection, and immunity: an overview". Am. J. Clin. Nutr. 66 (2): 464S–477S. doi:10.1093/ajcn/66.2.464S. PMID 9250134.
  64. ^ Stephenson L (1993). "The impact of schistosomiasis on human nutrition". Parasitology. 107 (Suppl): S107–23. doi:10.1017/S0031182000075545. PMID 8115176.
  65. ^ Harms G, Feldmeier H (June 2002). "HIV infection and tropical parasitic diseases — deleterious interactions in both directions?". Trop. Med. Int. Health. 7 (6): 479–88. doi:10.1046/j.1365-3156.2002.00893.x. PMID 12031069.
  66. ^ Tuberculosis: Commentary on a Reemergent Killer. Barry R. Bloom and Christopher J. L. Murray.
  67. ^ Centers for Disease Control and Prevention. Morbidity and Mortality Report. March 25, 2011.
  68. ^ Centers for Disease Control and Prevention (September 2018). "Take on TB" (PDF). cdc.gov.
  69. ^ Sepkowitz KA (June 2001). "AIDS—the first 20 years". N. Engl. J. Med. 344 (23): 1764–72. doi:10.1056/NEJM200106073442306. PMID 11396444.
  70. ^ a b Gisselquist D, Potterat JJ, Brody S, Vachon F (March 2003). "Let it be sexual: how health care transmission of AIDS in Africa was ignored". Int J STD AIDS. 14 (3): 148–61. doi:10.1258/095646203762869151. PMID 12665437. S2CID 15180099.
  71. ^ BackInfoUnsafe/en/ World Health Organization (WHO). 2003. ‘‘Unsafe Injection Practices: A Plague of Many Health Care Systems.’’[permanent dead link] Retrieved January 2004.
  72. ^ Beisel WR (October 1996). "Nutrition in pediatric HIV infection: setting the research agenda. Nutrition and immune function: overview". J. Nutr. 126 (10 Suppl): 2611S–5S. doi:10.1093/jn/126.suppl_10.2611S. PMID 8861922.
  73. ^ Woodward B (January 1998). "Protein, calories, and immune defenses". Nutr. Rev. 56 (1 Pt 2): S84–92. doi:10.1111/j.1753-4887.1998.tb01649.x. PMID 9481128.
  74. ^ Cunningham-Rundles S (January 1998). "Analytical methods for evaluation of immune response in nutrient intervention". Nutr. Rev. 56 (1 Pt 2): S27–37. doi:10.1111/j.1753-4887.1998.tb01641.x. PMID 9481122.
  75. ^ a b Elieen Stillwaggon, Aids and the Ecology of Poverty. Oxford University Press. New York
  76. ^ "Global Burden of Asthma." Archived May 24, 2012, at the Wayback Machine Matthew Masoli, Denise Fabian, Shaun Holt, Richard Beasley. Report developed for: Global Initiative for Asthma.
  77. ^ Flores G (2009). "Urban Minority Children with Asthma: Substantial Morbidity, Compromised Quality and Access to Specialists, and the Importance of Poverty and Specialty Care". Journal of Asthma. 46 (4): 392–398. doi:10.1080/02770900802712971. PMID 19484676. S2CID 25018323.
  78. ^ a b c d "Asthma facts"electronic resource. (2007). [Washington, D.C.] : U.S. Environmental Protection Agency, Office of Air and Radiation, Indoor Environments Division, [2007].
  79. ^ "Global Burden of Asthma," p.86 Matthew Masoli, Denise Fabian, Shaun Holt, Richard Beasley. Report developed for: Global Initiative for Asthma. Archived May 2, 2013, at the Wayback Machine
  80. ^ Yinusa-Nyahkoon L. S., Cohn E. S., Cortes D. E., Bokhour B. G. (2010). "Ecological Barriers and Social Forces in Childhood Asthma Management: Examining Routines of African American Families Living in the Inner City". Journal of Asthma. 47 (7): 701–710. doi:10.3109/02770903.2010.485662. PMID 20726827. S2CID 13115946.CS1 maint: multiple names: authors list (link)
  81. ^ Poverty, race, and medication use are correlates of asthma hospitalization rates : a small area analysis in Boston. Gottlieb DJ, O'Connor GT, Beiser AS. CHEST.1995;108(1) 28-35
  82. ^ Smith, Lauren A.; Hatcher-Ross, Juliet L.; Wertheimer, Richard; Kahn, Robert S. (2005). "Rethinking Race/Ethnicity, Income, and Childhood Asthma: Racial/Ethnic Disparities Concentrated among the Very Poor". Public Health Reports. 120 (2): 109–116. doi:10.1177/003335490512000203. JSTOR 20056761. PMC 1497701. PMID 15842111.
  83. ^ John Yinger, Housing Discrimination and Residential Segregation. Understanding Poverty. New York.
  84. ^ Lee G., Carrington M. (2007). "Tackling heart disease and poverty". Nursing & Health Sciences. 9 (4): 290–294. doi:10.1111/j.1442-2018.2007.00363.x. PMID 17958679.
  85. ^ Creanga, A. A.; R.R. Genadry (November 2007). "Obstetric fistulas: A clinical review". International Journal of Gynecology & Obstetrics. 99 (Supplement 1): S108–11. doi:10.1016/j.ijgo.2007.06.030. PMID 17869255. S2CID 22367850.
  86. ^ Browning, Andrew. "Obstetric Fistula In Ilorin, Nigeria." Plos Medicine 1.1 (2004): 022-024. Academic Search Complete. Web. 25 Oct. 2012.
  87. ^ DYE B (2010). "Trends in Oral Health by Poverty Status as Measured by Healthy People 2010 Objectives". Public Health Reports. 125 (6): 817–30. doi:10.1177/003335491012500609. PMC 2966663. PMID 21121227.
  88. ^ Selwitz R. H., Ismail A. I., Pitts N. B. (2007). "Dental caries". Lancet. 369 (9555): 51–59. doi:10.1016/s0140-6736(07)60031-2. PMID 17208642. S2CID 204616785.CS1 maint: multiple names: authors list (link)
  89. ^ a b Delgado-Angulo, Elsa K; Hobdell, Martin H; Bernabé, Eduardo (7 July 2009). "Poverty, social exclusion and dental caries of 12-year-old children: a cross-sectional study in Lima, Peru". BMC Oral Health. 9: 16. doi:10.1186/1472-6831-9-16. PMC 2713218. PMID 19583867.
  90. ^ Mobley, Connie; Marshall, Teresa A.; Milgrom, Peter; Coldwell, Susan E. (November 2009). "The Contribution of Dietary Factors to Dental Caries and Disparities in Caries". Academic Pediatrics. 9 (6): 410–414. doi:10.1016/j.acap.2009.09.008. PMC 2862385. PMID 19945075.
  91. ^ Ehrlich, Ron (November 2010). "Holistic Healthcare: A Dental Perspective". Journal of the Australasian College of Nutritional and Environmental Medicine. 29 (3): 9–12. doi:10.3316/INFORMIT.823820539387156 (inactive 2021-05-02). ISSN 1328-8040.CS1 maint: DOI inactive as of May 2021 (link)
  92. ^ "Roll Back Malaria Partnership: Economic costs of malaria". Rbm.who.int. Archived from the original on 2012-11-08. Retrieved 2012-07-11.
  93. ^ "UNFPA State of World Population 2002". Unfpa.org. Retrieved 2012-07-11.
  94. ^ a b Kjetland EF, Ndhlovu PD, Gomo E, et al. (February 2006). "Association between genital schistosomiasis and HIV in rural Zimbabwean women". AIDS. 20 (4): 593–600. doi:10.1097/01.aids.0000210614.45212.0a. PMID 16470124. S2CID 37689433.
  95. ^ Drucker E, Alcabes PG, Marx PA (December 2001). "The injection century: massive unsterile injections and the emergence of human pathogens". Lancet. 358 (9297): 1989–92. doi:10.1016/S0140-6736(01)06967-7. PMID 11747942. S2CID 33545603.
  96. ^ a b Gisselquist, David; Potterat, John J.; Salerno, Lilian (2007). "Injured and Insulted: Women in Africa Suffer from Incomplete Messages about HIV Risks". Horn of Africa Journal of AIDS. 4 (1): 15–8.
  97. ^ Hsu, Jean W-C.; Pencharz, Paul B.; Macallan, Dereck; Tomkins, Andrew (April 2005). "Macronutrients and HIV/AIDS: A Review of Current Evidence" (PDF). World Health Organization. Cite journal requires |journal= (help)
  98. ^ a b Commission on the Social Determinants of Health. Closing the Gap in a Generation. World Health Organization, 2008.
  99. ^ a b c d The 8th Global Conference on Health Promotion (2014). Health in all policies: Helsinki statement. Framework for country action. Helsinki, Finland: World Health Organization.
  100. ^ World Bank. 2003. "School Deworming At a Glance." Archived January 3, 2012, at the Wayback Machine Retrieved March 2011.
  101. ^ Montresor A, Ramsan M, Chwaya HM, et al. (July 2001). "Extending anthelminthic coverage to non-enrolled school-age children using a simple and low-cost method". Trop. Med. Int. Health. 6 (7): 535–7. doi:10.1046/j.1365-3156.2001.00750.x. PMID 11469947.

External links[edit]

  • United Nations Population Fund: State of World Population 2002
  • RESULTS: World Health/Diseases of Poverty
  • Roll Back Malaria Global Partnership
  • Agriculture and HIV/AIDS : understanding the links between agriculture and health (brief) by Stuart Gillespie (2006) International Food Policy Research Institute
  • The Poor Pay More—POVERTY'S HIGH COST TO HEALTH