Dare to be sick: Poverty and health among vulnerable populations

This chapter provides an overview of the role of socioeconomic status (SES) in health, including disease, health behaviors, and access to health. The literature on the social determinants of health is reviewed. The chapter then provides a review of the health status of the homeless, poor, and near-poor. The incidence and mortality rates for leading diseases and health behaviors are reviewed, in addition to issues of environmental exposures, access to care, and health literacy. SES is one of the strongest predictors of health status (Kahng, 2010; Kawachi & Kennedy, 1997; Link & Phelan, 1996). SES is important to health regardless of a persons social status and in general, the more advantaged individuals are, the better their health, and the more disadvantaged individuals are, the greater their chances of increased morbidity and mortality (Adler et al., 1994; Adler & Coriell, 1997, Kidder, Wolitski, Campsmith, & Nakamura, 2007; Zlotnick and Zerger, 2009). The chapter provides an overview of strategies and policies to address the health needs of the poor and vulnerable in our society, including workplace wellness strategies and school-based health clinics. The authors suggest ways to extend these innovative practices. This chapter emphasizes an approach to addressing the health of the poor and nearpoor that acknowledges the significant role that access to social and economic resources plays in the acquisition and maintenance of health. Recommendations for health interventions are focused on strengthening the utilization of community institutions to deliver needed services.