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Poverty and Human Development – A Global and a Local Issue
Beth
Ulrich, EdD, RN, CHE, FAAN, Editor
One
often hears about the power of the press. Truly, in this age of global
communication, it is possible for an event to occur and news of it to
spread around the globe in minutes, if not seconds. Certainly, if the
media is focused on an event, person, or topic, it becomes public
knowledge very quickly. In recent times, this media focus is often on
inane matters as opposed to providing meaningful information. How much,
for example, do we want or need to hear about the personal lives of
starlets?
And yet the media has helped get the word out about many important
issues. One such issue is poverty and human development. On October 22,
2007, over 230 scientific journals representing over 30 countries came
together to simultaneously publish information on poverty and human
development. The intent of this effort was to raise awareness, and to
stimulate interest and research. With over 40 nursing journals, the
Nephrology Nursing Journal among them, participating in this global
effort, nursing editors hope to bring the issue to the forefront of
thought for the nursing community and to encourage the increased
development of an evidence base on what nurses can do to positively
impact those individuals in poverty and who are in need of human
development.
Poverty and Human Development in the United States
Over
12% of Americans (about 37 million people) live below the poverty level
with over half of those living in what is termed extreme poverty
(having incomes below half of the poverty line) (U.S. Census Bureau,
2007). What is poverty? In 2007, the U.S. Department of Health and
Human Services defines poverty for individuals in the 48 contiguous
states (Hawaii and Alaska have slightly higher levels) as an income of
$10,210 for a family of one, $13,690 for a family of two, $17,170 for a
family of three, $20,650 for a family of four, with about $3,480 being
added for each additional family member. Louisiana and Mississippi have
the highest percentages of all the states for people living in poverty
(19.8% and 21.3% respectively), but individual cities can have much
higher poverty rates. The highest poverty rates are found in Cleveland
(32.4%), Detroit (31.4%), Miami (28.3%), El Paso (27.2%), and Atlanta
and Buffalo (both at 26.9%) (U.S. Census Bureau, 2006).
Where
there is poverty, there are also deficits in human development. Human
development has many aspects including physical development, mental
development, education – all of which are part of the holistic approach
of the nursing profession.
Poverty and Human Development in Nephrology Nursing
Based
on the U.S. data, an average of 12% of patients cared for by nephrology
nurses are living in poverty – with a much higher percentage in some
parts of the country. Many aspects of the life of a patient with ESRD
can be affected by poverty. There is substantial cost, for example,
associated with adhering to special diets, such as a renal diet.
Transportation to a dialysis center three times a week is a burden even
when cost is not an issue, and, when it is, the burden can be
overwhelming. People who have lived in poverty for much of their lives
have human development issues and can present challenges to the best
patient educators. But patient education is so important for
individuals with ESRD that we must find ways to overcome such deficits.
Summary
Often, when patients enter parts of the healthcare system, such as when
they begin dialysis or go on a transplant list, we collect data about
the patients’ physical condition and their healthcare coverage. The
data on poverty and human development would indicate that we should
increase our awareness of those issues as a vital part of the nursing
assessment. Through this global initiative, we hope to achieve that.
References
U.S. Census Bureau. (2006). 2005 American community survey. Washington, DC: Author.
U.S. Census Bureau. (2007). Income, poverty, and health insurance coverage in the United States: 2006. Washington, DC: Author.
Beth Ulrich, EdD, RN, FACHE, FAAN
Editor
E-mail: BethUlrich@aol.com
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