Worldwide, 1.2 billion people live in extreme poverty. This means they may have little or no access to safe housing, clean water, basic toilet facilities, or any health care. Educational levels in poor areas are often low. Poor people have a shorter life expectancy than wealthier people, and more mothers and children die in poor areas than in richer areas. Each year, 9.7 million children worldwide die before their fifth birthday.
Infectious diseases of all types are present in poor areas. Close contact among persons sharing housing and limited sewage and waste treatment means that infections can spread more easily, including infections spread by insects. Unsafe sex practices and prostitution spread sexually transmitted diseases, including the human immunodeficiency virus (HIV). HIV is a major health issue in all areas of the world, and the number of infected individuals has increased rapidly in Asia, Africa, and the Americas.
Individuals living in poor areas often lack preventive health care or the means to manage chronic diseases, even in developed countries. Children and adults who live in poverty may have poor nutrition, including vitamin deficiencies and protein-calorie malnutrition, which can affect mental functioning and physical health.
Education may not be available in poor areas of the world. If schools are available, many children may not be able to attend because they must work to support themselves or their families. Low literacy rates (number of persons who can read and write) and educational levels contribute to poor health and to the cycle of poverty.
The October 24/31, 2007, issue of JAMA is a theme issue on poverty and human development and contains articles about the effects of poverty on worldwide health. The articles discuss a number of ways in which health and poverty can be improved around the world.
Clean water and sanitation
Child mortality and maternal health
Education and literacy
The United Nations has created the Millennium Development Goals to reduce poverty and improve health globally by 2015. The goals address many health-related issues, including reducing extreme poverty, reducing child mortality, improving maternal health, halting the spread of HIV/AIDS, and providing universal education. Several of the JAMA articles refer to these goals.
World Health Organizationhttp://www.who.int
International Federation of Red Cross and Red Crescent Societieshttp://www.ifrc.org
United Nations Educational, Scientific and Cultural Organization (UNESCO)http://www.unesco.org
United Nations Millennium Development Goalshttp://www.un.org/millenniumgoals/
To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish. A Patient Page on malnutrition in children was published in the August 4, 2004, issue; one on chronic diseases of children was published in the June 27, 2007, issue; one on preventing HIV infection was published in the July 19, 2006, issue; one on infant feeding was published in the October 1, 2003, issue; and one on refugee mental health was published in the August 3, 2005, issue.
Sources: World Health Organization, UNICEF, UNESCO, International Foundation of Red Cross and Red Crescent Societies
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 203/259-8724.
TOPIC: INTERNATIONAL HEALTH
Torpy JM, Lynm C, Glass RM. Poverty and Health. JAMA. 2007;298(16):1968. doi:10.1001/jama.298.16.1968