Poverty, violence, and you

If you listen to the conservatives who constantly whine about any and all social programs, you'd get the idea that "poverty" was some abstract philosophical state that matters only in the context of a partisan discussion of economic and social policy. But poverty occurs in the real world, to real people. And violence tends to be pretty strongly associated with poverty, with the violence also also occurring in the real world to real people.

Not surprisingly, given the recent turn of "advanced" societies toward the right, with the obligatory blind eye toward poverty, there seems to be renewed medical interest in exploring the effect that poverty has on the health of the poor.

Here's a short review of what some recent studies have reported (an abstract of the study, if one exists, can be found on the National Library of Medicine web site's "PubMed" database.

In a study of New York City residents that began in 2002, the authors of Urban neighborhood poverty and the incidence of depression in a population-based cohort study, published in the Annals of Epidemiology (vol 17, No. 3, page 171) report that they found an independent association between socioeconomic status (SES) of a person's neighborhood and the likelihood of developing depression.

Another team of researchers undertook a study of 100 African American neonates whose families resided in low-income environments. In Parsing the relations between SES and stress reactivity: examining individual differences in neonatal stress response, published in the journal Infant Behavior & Development (vol 30, No. 1, page 134), the authors report that they found associations between infant behavior, measured by physiologic and behavioral response to being pricked in the heel, and the infant's score on the Neonatal Behavioral Assessment Scale, and "three domains of perinatal risk: socio-demographic, obstetrical complications, and maternal psychological factors during the perinatal period." They report that "Greater magnitude of perinatal risk was associated with both higher and lower than average neonatal stress reactivity."

Switching to an analysis of what relationship might exist between rates of childhood asthma and rates of violent assault in the community, the authors of The association between childhood asthma and community violence, Los Angeles County, 2000 , published in the journal Public Health Reports (vol 121, No. 6, page 720) found a statistically significant correlation between hospitalization rates for childhood asthma and community violence as measured by the rate of hospitalization for assault.

Finally, the article Social capital, socio-economic status and psychological distress among Australian adults, published in the journal Social Science & Medicine (vol 63, No. 10, page 2546), reports that "having trust in people, feeling safe in the community and having social reciprocity are associated with lower risk of mental health distress."

Poverty and violence are not, it seems, merely some abstract philosophical states that matter only in the context of some partisan discussion of economic and social policy (nor are poverty and violence unrelated to each other).

If both poverty and violence affect the physical and mental health of those who experience them, is there any doubt that the rest of society is affected in various adverse ways by this impact on the poor and violence-exposed?

Equally important, if poverty and violence beget physical and mental health problems, and those problems in turn beget more poverty and violence, how many generations of this spiral do you think it takes before a country ceases to even be "advanced?"

Jordan's drug prices soar--can you say "free trade?"

A report by Oxfam indicates that another nation has begun to feel those masochistic benefits of "free trade."

Strong intellectual property protections in U.S. free trade deals have hurt developing countries, pushing up drug prices in Jordan by 20 percent, an aid advocacy group said in a report released on Tuesday.

Beefed-up property rights for drug makers, which have been built into U.S. free trade deals like the one with Jordan, "will make it harder and harder to sustain public health systems," said Rohit Malpani, a trade analyst with the advocacy group Oxfam in Washington.

U.S. trade officials disputed the report's findings, saying the trade agreements fairly balanced intellectual property protections and health care needs.

The Oxfam report found that drug prices in Jordan have increased by 20 percent since 2001, when the bilateral deal with the United States was implemented, and are up to six times higher than comparable drug prices in Egypt.

Oxfam said a big driver of higher drug prices is a rule that guards, for a time, against sharing of clinical trial information that can be used to make generic drugs.

"In developing countries ... public health systems are very fragile and only a small percentage of the population has health insurance," so higher drug prices can have serious health consequences, Malpani said.

Strong stuff. But is the U.S. worried that our free trade mania is having adverse consequences? I'm sure you knew this before I told you---Nope.

But a U.S. trade official, who requested anonymity, said: "We strongly disagree with Oxfam's contention that intellectual property protection is at odds with an effective response to global health crises.

"We believe that our (trade agreements) represent an appropriate means of advancing high standards of IP protection, while safeguarding the ability of trading partners to respond to legitimate public health needs," the official added.

The big test is how strongly the Democrats in congress feel about the issue, and that remains to be seen, although the battle lines are being tested:

Malpani believes support is gathering among some Democratic lawmakers for loosening those rules for developing countries.

Democrats on the House of Representatives Ways and Means Committee, which oversees trade, recently released their own vision for trade including a goal to "reestablish a fair balance" in setting IP rules for medicine with developing countries.

Last month, a group of lawmakers sent a letter to U.S. Trade Representative Susan Schwab saying that trade deals "appear to undermine" a pledge from all World Trade Organization members to give poorer countries flexibility in protecting public health.

Some Democrats are also calling for stronger protection for workers and the environment to be woven into pending deals.

At last, true growth in America: severe poverty

The American Enterprise Institute, The Heritage Foundation, the Hoover Institution, and John Stossel all notwithstanding, it appears that maybe poverty in America just might be a (severe) problem after all. The McClatchey Newspapers report that:

The percentage of poor Americans who are living in severe poverty has reached a 32-year high, millions of working Americans are falling closer to the poverty line and the gulf between the nation's "haves" and "have-nots" continues to widen.

A McClatchy Newspapers analysis of 2005 census figures, the latest available, found that nearly 16 million Americans are living in deep or severe poverty. A family of four with two children and an annual income of less than $9,903 - half the federal poverty line - was considered severely poor in 2005. So were individuals who made less than $5,080 a year.

The McClatchy analysis found that the number of severely poor Americans grew by 26 percent from 2000 to 2005. That's 56 percent faster than the overall poverty population grew in the same period. McClatchy's review also found statistically significant increases in the percentage of the population in severe poverty in 65 of 215 large U.S. counties, and similar increases in 28 states. The review also suggested that the rise in severely poor residents isn't confined to large urban counties but extends to suburban and rural areas.

The plight of the severely poor is a distressing sidebar to an unusual economic expansion. Worker productivity has increased dramatically since the brief recession of 2001, but wages and job growth have lagged behind. At the same time, the share of national income going to corporate profits has dwarfed the amount going to wages and salaries. That helps explain why the median household income of working-age families, adjusted for inflation, has fallen for five straight years.

These and other factors have helped push 43 percent of the nation's 37 million poor people into deep poverty - the highest rate since at least 1975.

The share of poor Americans in deep poverty has climbed slowly but steadily over the last three decades. But since 2000, the number of severely poor has grown "more than any other segment of the population," according to a recent study in the American Journal of Preventive Medicine.

Okay, time for the right wing thinkers to spend another $100 million trying to spin this report away. I'm beginning to think that the money spend to distort the state of economic decay in the US may be the last thing keeping the whole damn structure from collapsing.