Poverty: An important concern for nurses

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• Background
• Assessment
• Recommendations
• Copyright

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• Linda Burnes Bolton, DrPH, RN, FAAN

Poverty is the great equalizer within our global community. It affects children and elders, nomads and urbanites, men and women, and people of all colors, faiths, and belief systems across the universe. It is mean-spirited—robbing individuals of hope and lowering their capacity to withstand the insults to body, mind, and human spirit from disease, malnourishment, dehydration, environmental contagion, illiteracy, and discrimination. Poverty stymies human development in all forms—physical growth, cognition, ability to interact with others, reasoning, ability to problem-solve, creativity, and societal contributions. Poverty as a social condition linked to health is an important concern for nurses and the American Academy of Nursing.

This special issue of Nursing Outlook presents articles on global poverty and human development and offers recommendations for our consideration. The topic is timely as the world continues to struggle with the various factors resulting in world poverty and limitation of human potential. War and the unrelenting attacks on people who differ from each other has claimed multiple lives and left entire regions such as Darfur, Sudan impoverished. As a people we have been unsuccessful in the adoption of universal policies to prevent the antecedents to war and have continued relief strategies that provide mere temporary sustenance. As a people we have failed to create a national burning platform to address the poverty resulting from natural disasters and neglect such as those that continue to exist along the Gulf Coast of Mississippi and New Orleans.

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Background 

The United Nations estimated in its Millennium Development project that 1.2 billion people wake up in poverty daily. The goals of the Millennium Development project are to eradicate extreme poverty and hunger, provide universal primary education, develop a global partnership for development, reduce child mortality, combat HIV/AIDS, malaria and other infections, ensure environmental stability, and promote gender equality and empower women. The target for completion of these goals is 2015 and, at present, it appears that it will be difficult to achieve the targets. The Academy’s Expert Panels have an opportunity to contribute recommendations on what actions should be taken to achieve the goals.

In the United States, children are the most impoverished with 20%, or 1 in 5 of all children living below the 100% poverty level. Thirty-three percent of African-American children live at the extreme poverty level and 28% of Hispanic children live at this level. Eleven percent of persons ≥ 75 years of age live below the 100% poverty level and the percentage is higher for people of color.¹

Lack of access to health insurance and the inability to purchase healthcare services are structural variables contributing to the poor health of children and older adults in the United States. These structural variables combined with unequal treatment given to poor and diverse populations are underlying factors that contribute to health disparities.

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Assessment 

Many strategies and national policies are insufficient for eradication of poverty and are the antecedents to poor health that exists in the United States and the world. Through its Raise the Voice campaign, the Academy is committed to disseminating examples of programs that work. Like the UN Millennium Development initiative, Raise the Voice will continue to profile best practices for providing efficient, effective, safe, and reliable care for the poor and uninsured populace in the United States. Through the work of our Expert Panels, we hope to provide examples from around the world of successful initiatives to promote human growth and development in impoverished regions. We hope that the universities and clinical sites with programs throughout the world will nominate programs for recognition by the Academy’s Edge Runner initiative.

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Recommendations 

We have the knowledge to improve the human condition, do we have the will? Our historical roots as nurses are deep and rich with examples of addressing poverty and human development. Florence Nightingale’s foray into the Crimean War and her solicitation of the wealthy to aid the sick and poor is well-chronicled. Ruth Watson Lubic’s birthing center in the District of Columbia (DC) provides birthing services for low-income families. The work of this center could be replicated around the world to facilitate the prevention of low birth weight babies. The Payne-Phalen Living at Home/Block Nursing Program is another example. This successful program provides training to community volunteers who serve as nurses’ eyes and ears, observing and reporting on the health and social support needs of seniors. A block nurse makes home visits and works with volunteers to ensure that needs for food and health care are met.

Through the work of its Expert Panels and individual fellows, the Academy is committed to shining a light on the issue of poverty and human development through research, writing, and providing recommendations for changes in social and health policy. Each of us must take our individual stand; use our knowledge, will, and resources to address poverty. It is our duty as nurses with knowledge and a commitment to human caring to address any limitation to human development like poverty. I hope you agree and will, in your own way, contribute to this important issue.