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Nursing Intervention for Poverty Essay Introduction
Poverty is inextricably connected with global healthcare inequalities. According to the World Bank (2008) report, about 1.5 billion people live below the poverty line. For poor people, poverty deprives them of their human dignity and denies them access to quality healthcare opportunities. The poor are often prone to ill health, HIV/AIDS, and undernourishment due to lack of income and expensive care costs. Moreover, most of the world’s poor endures intense physical labor, unhealthy diet, and environmental risks that pose a threat to their health.
Health promotion among the world’s poor requires concerted efforts from multiple political, humanitarian, and healthcare organizations to address the health challenges at the population level. Community health nursing practice is well placed to improve the health of marginalized groups or communities, as it involves diverse community-level care approaches that reflect the social and political realities of the populations. This paper examines the impact of poverty on health, the community nursing interventions, and organizations that provide care for the world’s poor.
Nursing Diagnosis for Poverty Statistics
Women and children constitute the largest proportion of the world’s poor. It is estimated that about 70 percent of the world’s poor are women (World Health Organization [WHO], 2000). This demographic group is vulnerable to poverty due to high levels of illiteracy, challenges associated with childcare, and gender inequality that denies women access to land. Poverty is also prevalent among female-headed households in low-income nations (WHO, 2000). Poverty lowers the health outcomes of women as well as those of their children. Children from poor families experience malnourishment that affects their physical health and growth. In addition to women and children, the native communities, the elderly, and war refugees, who are often denied equal economic opportunities, are other populations affected by poverty.
Ill health is prevalent among the poor. The World Bank (2008) reports that “20 percent of the world’s poor individuals die from close to two thirds of preventable communicable diseases, maternal and infant mortality, and nutritional deficiencies” (Para. 8). The poor health outcomes among the world’s poor have been attributed to poverty.
Many social, political, environmental, and dietary factors cause poverty and disease among vulnerable populations. Most of the world’s poor lack access to healthy food, comfortable shelter, and clothing. They also live in unhealthy conditions characterized by the lack clean water, quality health care, and sanitation, which make them vulnerable to diseases, such as diarrhea and URT infections. It is estimated that about one billion people, who are citizens of developing nations, lack proper shelter while another 1.5 billion do not have safe drinking water (World Bank, 2008). The lack of proper sanitation is also common among the world’s poor, affecting close to three billion people, which is about 46 percent of the population (World Bank, 2008). Nutrition is also a problem in these countries where a third of children aged below five years are malnourished.
The overcrowding observed in urban areas has led to the rise of poor neighborhoods characterized by overcrowding and inadequate sanitation, which allow insect vectors to thrive. Furthermore, due to high levels of literacy, most of the urban poor, lack knowledge about disease vectors and ways of preventing them. Studies establish that interventions that promote health, facilitate social policy change, and create awareness among people living in poverty-stricken areas can reduce child mortality and improve the people’s health (Farmer, 2003). In this regard, preventive care interventions that reflect the socioeconomic realities of the communities can help improve the health of the poor.
Nursing Diagnosis for Poverty Causes
Inadequate food is the main cause of ill health among the world’s poor. Malnutrition and starvation have been attributed to many infections, as they weaken the people’s immune defenses, making them vulnerable to diseases (Wagstaff, 2002). The poor people, in both rural and urban areas, often have one meal in a day, which is not adequate for their daily nutritional requirements. Lack of food also affects breastfeeding infants, as mothers cannot produce sufficient breast milk for the children (Wagstaff, 2002). Besides weakening one’s physical health, hunger also causes anxiety and psychological stress among the poor.
The lack of clean drinking water is also linked to ill health among the poor. Shortages are prevalent in some parts of sub-Saharan Africa, where people have to travel long distances to find water (Farmer, 2003). Water quality, quantity, and availability are the main factors that affect human health in dry regions. Flooding and water pollution also contaminate piped water channeled to homes. Contaminated water is a great health risk to people, especially those living in poor urban neighborhoods. Frequent droughts, especially in rural areas, affect crop production and food security of the rural poor. It also forces people to trek long distances in search of water. This may be injurious to the health of women, children, and the elderly.
Urban residents, especially in poor neighborhoods, lack proper sanitation services. Rapid urbanization in countries, such as Bangladesh, has constrained sanitation facilities (latrines) making them unable to serve all the residents in poor neighborhoods (Farmer, 2003). Open sewer lines pose great health risks to residents, especially schoolchildren. In Latin American countries, some urban areas are littered with waste from cane factories that harbors disease vectors that may cause illnesses (Farmer, 2003). In low-lying plains, floods contaminate drinking water with heavy chemicals and silt from the highlands. The chemicals are health hazards, as they cause various diseases, including skin infections to the residents.
The poor often live in shanty dwellings or mud huts that have poor ventilation. Moreover, the shelters are often built with unsafe roofing materials, such as reeds in countries like Ecuador and bamboo in Vietnamese huts (Farmer, 2003). Rusted zinc used to roof houses also pose a risk to public safety and health. Moreover, in poor neighborhoods, the types of housing that people live in cannot keep out disease vectors and vermin. The roofing materials used in roofing slum shelters are combustible and thus, unsafe. Shanty houses are usually located in unhealthy environments like near chemical plants that release toxic gas emissions that can cause respiratory infections and cancer.
Disability is another cause of social determinant of health among the poor. Physical disability deprives people the capacity to work and support themselves economically. Disability may be caused by the lack of child immunization due to illiteracy among poor mothers. It may also result to work-related injuries for individuals involved dangerous occupations without protective gear. Disability leads to ill health when the affected individuals lack support services or endure discrimination. In countries like Bulgaria, the disabled are thought to be unproductive economically (Farmer, 2003). Furthermore, in most countries, specialist care and disability allowance, which could help improve the health of the disabled, are nonexistent.
Significance of Poverty for Nursing Practice
Poverty alleviation has implications for nursing practice. Nursing interventions can help fight poverty in order to improve the health of the world’s marginalized groups. Nurses, as the primary care professionals, understand poverty as a social determinant of health. From a nursing perspective, improved access to proper nutrition, income, and healthcare services is essential for the poor. The promotion of healthcare among the marginalized communities, such as the indigenous sub-populations, the minorities, and the poor is a fundamental public health policy (Wagstaff, 2002). Community health nurses, as the primary caregivers, are more acquainted with the health inequalities in poor neighborhoods. Thus, they are better equipped to address health issues like HIV/AIDS, prostitution, and infant mortality at community level.
In poverty-stricken areas, the nursing role extends beyond care provision to include advocacy. According to Zanchetta, Leite, Perreault, and Lefebre (2005), “knowing how to care” not only encompasses aspects like “treatment, health promotion, and prevention”, but it also involves an evaluation of the social and political contexts of the people (p. 657). Community health nursing practice employs a number of approaches to address health challenges at the community level. This means that the nursing role includes socio-political actions aimed at improving the general health of the population.
Preventive services in poor community settings resonate with the principles of medical practice. Farmer (2003) writes that preventive care at the community level should include “caring and supporting people with HIV/AIDS in poor countries” to live normal lives. Moreover, for preventive services to be effective, they should be grounded on the local realities and culture. They should reflect the various aspects of local practices and demographic variables. In such settings, the nursing actions should involve evidence-based practice, even when the relevant variables are lacking.
Strategies for Reducing Ill Health among the Poor
Policymakers can employ diverse strategies to improve the health of the poor. One such strategy is the use of a participatory approach that involves the people in identifying their health care needs (International Council of Nurses [ICN], 2000). The poor have a deep understanding of their health problems and thus, they should be consulted in the formulation and implementation of policy interventions that touch on their health. Interventions that do not involve the poor make them feel helpless and unable to participate in alleviating the causes of their ill health (ICN, 2000). Participation processes that involve people of all demographic characteristics ensure that the health interventions formulated meet the needs of the poorest and the marginalized. Policymakers should seek for ways of enhancing participation through community networks and groups in poverty-stricken areas.
Ill health among the poor can also be reduced through the prioritization of public health. It is evident that poor health and poverty are closely related. Ill health not only aggravates poverty among marginalized groups, but it also hampers poverty alleviation efforts. It affects individual productivity and family income. On the other hand, a healthy population is more productive and less vulnerable to poverty. Therefore, poverty reduction interventions should focus on improving the health of the population and thus, create a healthy workforce. More importantly, social inequalities in a country should be addressed, as a way of fighting poverty and poor health among the poor. A more equitable resource allocation can help alleviate poverty and improve the health of the disadvantaged groups.
In low-income countries, programs that address public health issues in underserved regions are very crucial. As noted before, the major causes of ill health among the world’s poor are lack of sanitation, proper shelter, safe drinking water, and food. Improved access to nutrition, water, housing, and education can reduce ill health among disadvantaged groups. Proper coordination of public health programs serving different areas should be the central goal of health ministries. Based on a nation’s health care needs and priorities, much focus should be directed towards the poor people’s health in order to address inequalities.
The health systems of a country should provide essential services to the poor. Poor people cannot afford expensive specialist services that the rich can access. Thus, a health system that does not enhance the accessibility of essential medical services to poor communities affects their health outcomes. Outreach services and increased allocation of health resources to underserved areas can help improve preventive care (ICN, 2000). Moreover, health care costs for primary care should be reduced, as expensive plans prevent the poor from seeking medical help. Affordable health coverage plans, such as the Self-Employed Women’s Association scheme in certain states of India, can enhance healthcare accessibility ((ICN, 2000).
Health Organizations’ Actions
International and non-governmental organizations have played a crucial role in reducing ill health among the poor people. In the 1970s, the WHO initiated the “Health for All” global initiative to improve healthcare accessibility to all people by 2000. Its goals include the reduction of healthcare inequalities among nations and the universal access to basic care. This calls for equity in health care resource allocation to benefit disadvantaged groups. In this regard, health organizations offer outreach programs that target poor communities in order to enhance healthcare accessibility. The outreach programs encompass extended nursing care to communities.
Health organizations in low-income countries help set the public health agenda. In particular, community-based and faith-based organizations help governments in identifying healthcare needs of the communities to inform resource allocation. They also design health promotion interventions for the poor. The International Council of Nurses (ICN) is another healthcare organization that advocates for the improvement of nursing care for the disadvantaged. ICN provides the code of ethics for nurses working in community settings globally. This enhances healthcare equity and quality. Health organizations also implement a number of initiatives targeting the poor. These organizations, in partnership with the government and private players, run HIV/AIDS prevention and health promotion initiatives in underserved areas. NGOs also increase public awareness about preventable diseases, initiate small projects for women, extend credit to the poor, and educate them in a bid to reduce poverty and improve the health of vulnerable groups.
Effects on Community Health
Poor people are more prone to ill physical and mental health than the rich are. One of the effects of poverty is mortality due to lack of nutrition or preventable infections. Maternal and infant mortality is high in poverty-stricken areas, where people lack access to essential care services. Poverty is both a cause and a consequence of poor health in the population (Wagstaff, 2002). It creates a vicious cycle that aggravates the health of the poor. Poverty also causes diseases, such as diarrhea and skin infections, which affect the health outcomes of the population. Ill health weakens people and reduces their productivity. Moreover, poor people cannot afford proper housing and sanitation and thus, are prone to communicable diseases.
Nursing Diagnosis for Poverty Essay Conclusion
It is evident that poor health and poverty are closely linked. Community nurses who are conversant with the dynamics of the health of the poor can run successful health promotion initiatives. Nursing interventions that center on poverty eradication, improvement of economic opportunities for the poor and public education can enhance healthcare accessibility and prevent ill health among marginalized groups.
Annotated Bibliography
Farmer, P. (2003). Health, healing, and social justice. Insight from liberation theology. Berkley: University of California Press.
The book provides a detailed account of the health challenges of the poor in Latin America and Russia. It serves as a useful reference for this paper because it focuses on the economic and social aspects of poverty and disease. It also explains the relationship between poverty and poor health.
International Council of Nurses [ICN]. (2000). ICN on Poverty and Health: Breaking the Link. Web.
This reference explains the issues surrounding community healthcare from a nursing perspective. In this research paper, it has been used as a reference for the strategies to reduce ill health among the poor and health organization actions.
Wagstaff, A. (2002). Poverty and Health Sector Inequalities. Bulletin of the World Health Organization, 80(2), 97-103.
The article discusses the healthcare costs and healthcare inequality in the world. Its explanations regarding the causes of health disparities and nursing interventions are useful in this paper.
World Bank. (2008). Dying for Change: Poor people’s experience of health and ill-health. Web.
This World Bank report identifies the causes of ill health and poverty in developing countries. It provides useful statistics for this research paper. It also gives public health improvement strategies for marginalized groups.
World Health Organization [WHO]. (2000). The World Health Report 2000—Health Systems: Improving Performance. Web.
The report provides guidance on choosing nursing interventions and healthcare prioritization. In this research paper, it has been used to analyze the appropriateness of nursing interventions targeting poor communities.
Zanchetta, M., Leite, L., Perreault, M. & Lefebre, H. (2005). Education and professional strengthening of the community health agent – an ethnography study. Brazilian Journal of Nursing, 4(3), 657-662.
The article explores the role of community health agents (CHAs) in poor neighborhoods in Rio de Janeiro. In this paper, it was used to illustrate the role of healthcare organizations in fighting poverty and poor health.