Features — 22 April 2017 — by Dr. Pam Reyes

Hello everyone. Did you know that how much money you make determines the quality of health care you receive (if any), and how long you may live? Wealth inequality and the perception of wealth inequality are two different things. Thus, if you’re poor or low-to middle-income, poverty is hazardous to your health. Here are some hard stats: The top 1% wealthy in America makes 380 times in one hour more than what the average worker in a CEO’s company makes in a whole month (I’m not talking about the janitor, but the average worker in his company). That same 1% owns half (50%) of all of the country’s stocks, bonds, and mutual funds, and owns 40% of ALL of America’s wealth. On that same chart, the poor and the middle-income people have only 7% of the nation’s wealth between them, even though they make up 80% of the country’s population. The rest of the 20% of the population comprises the rich, the very rich, and that 1% wealthy we spoke about. Together, they control most of the country’s wealth (minus the paltry 7% distributed to the poor and middle income). Now, I’m using the U.S. as an example; however, global economists will tell you that the poverty lines and the distribution of wealth may be worse, not just in second and third world poverty-stricken countries, but even throughout many parts of Europe.

BY THE WAY: The middle-income population does not make very much more money than the poor or low income—even though they may work full-time jobs. Many middle-income people, who work full-time low-income to mediocre-income jobs, still live in poverty-stricken conditions with their families. Some live in their cars if they have one, or in makeshift tents somewhere. They live with relatives and friends, or even in someone’s garage, and so on. Many still receive government-aid food stamps, and have no medical insurance because they’re “working”, albeit minimum-wage or low-income jobs, so they may not qualify for free Care California insurance (or in whichever state, also known as “Obamacare”). Paying for major medical insurance would take away too much money from their already small paychecks that they greatly need for food and shelter. These conditions are not relative solely to California; it is nationwide. In the state of Pennsylvania, for example, 41% of the population lives below the poverty line. These poverty conditions in the U.S. have only gotten worse in the last 10 to 20 years. So let us break down these statistics into how that 7% of the wealth distributed among 80% of the population equates to their access to health care and the type of health care received by the poor and middle income.

MEDICAID: Medicaid, which is a type of government-subsidized insurance plan, is limited to only specific low-income groups. However, in states that do not expand Medicaid, there will be large gaps in coverage, leaving millions of low-income adults with no affordable insurance options/coverage. Interestingly, in year 2007, 62% of all bankruptcies were influenced by illness and medical bills poor people could not pay. Of these medical-related bankruptcies, more than three-fourths of the individuals involved had some form of medical insurance, including Medicaid.

ECONOMICS & ACCESS: A study done by the Michigan Department of Community Health Behavioral Risk Factor Survey shows that low incomes coincide with high diabetes rates. The study found that the lower the household income, the higher diabetes rates climb—the highest diabetic rates being with incomes below $20,000/year. This could be as a result of several factors, such as cost: people who are economically deprived may not be able to afford fresh foods they need to be healthy, i.e., fruits and vegetables tend to be more expensive than processed foods that are cheaper at small convenient stores. There is also the access factor, since many poor neighborhoods do not have supermarkets, and many low-income people do not own a car to drive to far-away supermarkets. Therefore, poor people without transportation may shop at small 7-Eleven stores or liquor stores that may not carry healthful, fresh foods that are offered in large supermarkets. After all, you are what you eat. Thus, eating badly takes a toll on one’s health.

EQUITY IN HEALTH CARE: Providing equity in health care should not vary in quality because of personal characteristics, such as gender or ethnicity, no more than it should because of one’s socio-economic status. Still, good health care in America is provided to individuals who can afford to pay the high cost of medical insurance (anywhere from $200/month—which is still high for starters in my book — to as high as $900/month per person (I’ve been told) depending on which insurance carrier one uses and how much one earns). Other poor people’s choices would be to go to public Emergency facilities (i.e., County General Hospital) for the poor and indigent where one’s wait to see a nurse or an intern-M.D. (not necessarily a fully-licensed medical doctor), could be anywhere from 24 hours to as much as 48 hours. Then, at the end of that wait, you possibly could be given only a prescription for over-the-counter aspirin or some other form of “Band-Aid” type treatment. If you have the flu, bronchitis, pain, or an inflammatory condition, after a lengthy wait, if you haven’t already expired in the waiting area, you may be fortunate to receive a prescription for a small bottle of cough medicine, some antibiotics, and/or pain medication to hold you over until you can see a regular doctor, at your expense.

CHILD POVERTY & HEALTH CARE: One in four children in the U.S. lives in poverty. Of course this impacts access to good health care for minors. Let’s break this topic down into its many complex parts. Firstly: child safety. Homelessness: Many children live in their parents’ vehicles or in the streets where it is unsafe to live because they have nowhere else to go. Secondly, many have very little or no food. Thirdly, many of them need medical attention. You ask, “Is this going on in the U.S.?” Yes, it is! It’s also going on in other parts of the world too. Why? There are many dynamics. For example: They may be abandoned. Parental neglect. The system. Their family has no money to pay for medical insurance. They may be involved in filling out voluminous county paperwork and tedious interviews with county Social Services. Take your pick. I already mentioned what the public emergency health care dynamics are like at a public emergency hospital in Los Angeles. In other parts of the world, many children and their families don’t even have those state and county-type options. So, it could be worse, globally.

This topic is a painful one to discuss, especially where children are concerned, because lack of availability of resources to meet their basic human needs (i.e., good health care, etc.) produces toxic stress on them, which then impacts the children’s brain development, and (because of unmet needs for safety, food, shelter, love) ultimately, their positive self-actualization in the society where they live. It is incumbent upon societies, everywhere, to do whatever we can to help each other, but most importantly, to help the children, the elderly, and those who cannot help themselves. Are we our brother’s and sister’s keeper? Resoundingly: Yes, we are! We’ll continue this dialogue in another Amandala paper. Remember, action/help begins with dialogue. Governments, NGO’s, churches, businesses, and the general public must address these difficult issues and then do something about it. So, let us start. Peace to all.

Dr. Pam Reyes is Chairwoman of Caribbean Educational Media, a California 501(c)(3) nonprofit corporation, dispersing information on health, educational & legal issues, and exploring the information & communication highway of the present and future, via the media of the Internet, print journalism, nonprofit public radio & television, and nonprofit public participation.

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