Philadelphia Medicine Summer 2018 - 26

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Feature

The Relationship Between

Poverty and Health
in Philadelphia
By: Susan Robbins, MD, MPH, FAAP

overty. It's not what most people first think of when considering what contributes to the entity of health in a population.
Usually things such as access to physicians and other medical
care come to mind quickly. But it has been shown that clinical care
only accounts for about 10-20 percent of modifiable contributors
to health. What are known as the social determinants of health
(SDH) generally account for the rest, and poverty is intertwined in
the middle. Health behaviors, employment status and education,
family and social supports, community safety, housing, and more,
are all affected by or related to poverty in some manner.
With Philadelphia ranked as having the highest poverty rate
among the nation's 10 largest cities, and with almost half of all of the
poor residents in the city living in deep poverty (with family incomes
at 50% or below the federal poverty level), poverty is touching the
health and wellbeing of many of its residents.
In order to analyze what is occurring in the city and to spur on
action, research was conducted and the Urban Health Collaborative at
the Dornsife School of Public Health at Drexel University published
a data brief on May 24, 2017. They compared health measures in
areas of great poverty versus health measures in more affluent areas.
Some of their findings, as partially noted in the attached charts,
include the following:
There are large social inequalities among the neighborhoods in
the city. As an example, 1/4th of the census tracts had a poverty
rate of 13 percent or less, while 1/10th of the census tracts had
a poverty rate of 49 percent or more, with more Blacks and
Hispanics tending to live in the poorer neighborhoods.

26 Philadelphia Medicine : Summer 2018

There was a significant difference between the age- and sex-adjusted mortality rates between those who live in the lower vs
higher poverty tracts.
Blacks in the city tend to die at younger ages compared with
white or Hispanics.
Those living in higher poverty tracts tend to smoke more, have
worse diets, and be more obese.
Individuals living in higher poverty tracts saw more violent incidents and had more self-reported mental health disorders than
those living in lower poverty tracts.
The health effects of poverty, particularly concentrated poverty,
are evident in this report. While there may be a way to change
some of the environments in the poorer tracts and strive for health
equity across the city, considerable planning efforts, resources and
investment are needed.
You can read the entire report by going to: http://drexel.edu/
uhc/resources/briefs/ *
Dr. Robbins is a member of the PCMS Editorial Board.

http://philamedsoc.org http://www.drexel.edu/uhc/resources/briefs/ http://www.drexel.edu/uhc/resources/briefs/

Table of Contents for the Digital Edition of Philadelphia Medicine Summer 2018