Youth health[ edit ] Adolescent health has been proven to be influenced by both structural and proximal determinants, but structural determinants play the more significant role. Structural determinants such as national wealth, income inequality, and access to education have been found to affect adolescent health. Access to education was determined to be the most influential structural determinant affecting adolescent health. Proximal determinants include household and community factors, such as household environment, familial relationships, peer relationships, access to adequate food, and opportunities for recreation and activity.
But those who are food-insecure or low-income also face unique challenges in adopting and maintaining healthful behaviors, as described below.
Limited resources and lack of access to healthy, affordable foods. Instead, residents — especially those without reliable transportation — may be limited to shopping at small neighborhood convenience and corner stores, where fresh produce and low-fat items are limited, if available at all.
Comprehensive literature reviews examining neighborhood disparities in food access find that neighborhood residents with better access to supermarkets and limited access to convenience stores tend to have healthier diets and reduced risk for obesity Larson et al.
Households with fewer resources e. Food choices and purchases may be constrained by limits on how much can be carried when walking or using public transit e. Transportation costs also cut into the already limited resources of low-income households, and these costs plus travel time can be substantial Rose et al.
When available, healthy food may be more expensive in terms of the monetary cost as well as for perishable items the potential for waste, whereas refined grains, added sugars, and fats are generally inexpensive, palatable, and readily available in low-income communities Aggarwal et al.
Households with limited resources to buy enough food often try to stretch their food budgets by purchasing cheap, energy-dense foods that are filling — that is, they try to maximize their calories per dollar in order to stave off hunger DiSantis et al.
When available, healthy food — especially fresh produce — is often of poorer quality in lower income neighborhoods, which diminishes the appeal of these items to buyers Andreyeva et al.
Low-income communities have greater availability of fast food restaurants, especially near schools Fleischhacker et al. These restaurants serve many energy-dense, nutrient-poor foods at relatively low prices.
Fast food consumption is associated with a diet high in calories and low in nutrients, and frequent consumption may lead to weight gain Larson et al. Cycles of Food Deprivation and Overeating Those who are eating less or skipping meals to stretch food budgets may overeat when food does become available, resulting in chronic ups and downs in food intake that can contribute to weight gain Bruening et al.
Unfortunately, overconsumption is even easier given the availability of cheap, energy-dense foods in low-income communities Drewnowski, ; Hilmers et al.
Such a coping mechanism puts them at risk for obesity — and research shows that parental obesity, especially maternal obesity, is in turn a strong predictor of childhood obesity Dev et al. High Levels of Stress, Anxiety, and Depression Members of low-income families, including children, may face high levels of stress and poor mental health e.
A number of recent studies find associations between food insecurity and stress, depression, psychological distress, and other mental disorders Laraia et al.
Research has linked stress and poor mental health to obesity in children and adults, including for adults stress from job-related demands and difficulty paying bills Block et al. In addition, a number of studies find associations between maternal stress or depression and child obesity Gross et al.
Emerging evidence also suggests that maternal stress in combination with food insecurity may negatively impact child weight status Lohman et al. There also is growing evidence that low-income mothers struggling with depression or food insecurity utilize obesogenic child feeding practices and unfavorable parenting practices that could influence child weight status Bronte-Tinkew et al.
Fewer Opportunities for Physical Activity Lower income neighborhoods have fewer physical activity resources than higher income neighborhoods, including fewer parks, green spaces, and recreational facilities, making it difficult to lead a physically active lifestyle Mowen, Research shows that limited access to such resources is a risk factor for obesity Gordon-Larsen et al.
There is emerging evidence that food insecurity is associated with less physical activity and greater perceived barriers to physical activity e.
This is not surprising, given that many environmental barriers to physical activity exist in low-income communities. When available, physical activity resources may not be attractive places to play or be physically active because low-income neighborhoods often have fewer natural features e.
Crime, traffic, and unsafe playground equipment are common barriers to physical activity in low-income communities Neckerman et al.
The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. These conditions are also shaped by political, social. Yet understanding how and why people in poverty are statistically at greater risk for disease is more complex. Diet and exercise play a big role in determining a person’s health status; however, research shows that health behaviors like these are largely driven by the context of where people live.
Because of these and other safety concerns, children and adults alike are more likely to stay indoors and engage in sedentary activities, such as watching television or playing video games.
Not surprisingly, those living in unsafe neighborhoods are at greater risk for obesity Duncan et al. Low-income children are less likely to participate in organized sports C.
Students in low-income schools spend less time being active during physical education classes and are less likely to have recess, both of which are of particular concern given the already limited opportunities for physical activity in their communities Barros et al.
Greater Exposure to Marketing of Obesity-Promoting Products Low-income youth and adults are exposed to disproportionately more marketing and advertising for obesity-promoting products that encourage the consumption of unhealthful foods and discourage physical activity e.
Such advertising has a particularly strong influence on the preferences, diets, and purchases of children, who are the targets of many marketing efforts Institute of Medicine, ; Institute of Medicine, This results in lack of screening for food insecurity and referrals for food assistance, as well as lack of diagnosis and treatment of emerging chronic health problems like obesity.Except from the cash register poverty and how it influences peoples understanding of healthcare at Wal-Mart Understanding Africa: A Geographic Approach United States Military Academy West Point.
held in Kunstler America does not . Understanding Neighborhood Effects of Concentrated Poverty. Highlights. A core challenge of neighborhood effects research is distinguishing the role of individual and family circumstances from the effect of the neighborhood itself.
Food-insecure and low-income people are subject to the same often challenging influences as other Americans in trying to consume a healthful diet and maintain a healthful weight (e.g., more sedentary lifestyles, increased portion sizes).
Health care for the poor: For whom, what care, and residence in areas with high levels of pollution, also contribute to poor health.2 Equally important, the link between poverty and poor health does not go in just one direc- greater understanding of the links be-tween health and ability to .
Poverty is a major cause of ill health and a barrier to accessing health care when needed. This relationship is financial: the poor cannot afford to purchase those things that are needed for good health, including sufficient quantities of quality food and health care.
4 Social and community influences. Here the role of social and community influences on health are considered. The concept of social capital has become very popular within public health in recent years, although, like many similar concepts, it been used in different ways by different people.