The Cause of Causes

“St. Martin and the Beggar” by El Greco (c. 1598), National Gallery of Art (Accession No. 1942.9.25), Source Web Gallery of Art (PD)

“Socioeconomic status is the most powerful predictor of disease, disorder, injury and mortality we have.”

– Tom Boyce, MD, Chief of Division of Developmental Medicine, Dept. of Pediatrics, UCSF

Epidemiologists term poverty the “cause of causes” because it underlies so many illnesses.

The life expectancy of an adult living at or below the federal poverty level ($11,770 per one-person household) in the Rust Belt or rural South is 7-8 years less than that of an individual making the average American income of $55,775 [1].

Race, Poverty, and Chronic Illness

Race further widens the gap.  Chronic illnesses (responsible for 70% of the deaths in this country) show earlier onset and greater frequency in minority populations living in poverty [2].

According to the Gallup-Healthways Well-Being Index, Americans living in poverty suffer from depression at twice the rate of those not in poverty.  Asthma, diabetes, hypertension, and heart attack rates are, also, higher among the poor [3].

And the United States is second to last among 29 developed countries ranked by child poverty rates – scoring worse than Poland, Latvia, Hungary, and Lithuania [4][5].

A Complex Relationship

The available data barely scratches the surface of the relationship between poverty and illness.

The relationship between poverty and depression is, we know, complex.  Depression can both cause and be caused by poverty [6].

Other health problems may be influenced by the limited healthcare available to the poor, and the environmental conditions under which they  live.  Lead pipes, for example, are common in America’s inner cities [7].

The Most Toxic Aspect

But the sheer stress of poverty may be its most toxic aspect.

The countless traumas of poverty – the absence of a reliable source of income (and, therefore, a reliable source of nourishing food); the chronic instability, including frequent relocation and school transfers made necessary by eviction; the unsafe neighborhoods; the dilapidated housing; the inadequate schools; the constant disappointments; the lack of resources, role models for success, or means of escape – take a terrible toll.

Those traumas deprive a child of all hope.  Later in life, the patterns of behavior they generate chain the children raised in poverty to the same destitution which held their parents captive [8].

“If a brother or sister is naked and destitute of daily food, and one of you says to them, ‘Depart in peace, be warmed and filled,’ but you do not give them the things which are needed for the body, what does it profit?” (James 2: 15-16).

Thomas Aquinas famously argued that God is the First Cause – a cause unto Himself, and the origin of all other causes.

When we look into the face of poverty, we cannot help but wonder what role God plays.  Can He not feel the same pity we do?  Will He not intervene?

Yes, He can and will.  That is why He put us here.  We are not meant to recite homilies at the poor then pass them by, smug and self-satisfied.  We are meant to share their burdens, meant to share their pain.

After all, Christ does.  In fact, it is His face we see.

—

[1][2]  University of California, San Francisco (UCSF), “Poor Health:  When Poverty Becomes Disease” by Claire Conway, 1/6/16, https://www.ucsf.edu/news/2016/01/401251/poor-health.

[3][6]  US News, “Americans in Poverty at Greater Risk for Chronic Health Problems” by Danielle Kurtzleben, 10/30/12, http://www.usnews.com/news/articles/2012/10/30/americans-in-poverty-at-greater-risk-for-chronic-health-problems.

[4]  UNICEF, Innocenti Report Card 11, “Children’s material well-being”, https://www.unicef-irc.org/publications/pdf/rc11_eng.pdf.

[5]  Malaria, tuberculosis, and AIDs are responsible for about 18% of illness by the poor, worldwide.  Treatable childhood diseases like polio, measles, and whooping cough make up another 5%.  Respiratory infections take some 3.9 million lives annually.  Diarrheal diseases, the result of inadequate sanitation, take an additional 1.8 million.  See, World Health Organization (WHO), “Diseases of Poverty and the 10/90 Gap” by Philip Stevens, 11/04, http://www.who.int/intellectualproperty/submissions/InternationalPolicyNetwork.pdf.

[7]  Huffington Post, “Poor Americans Face More Toxic Exposure”, 1/27/11, Updated 5/25/11, http://www.huffingtonpost.com/heres-life-inner-city/poor-americans-face-more-_b_814847.html.

[8]   National Child Traumatic Stress Network (NCTS), Family-Informed Trauma Treatment Center (FITT), “Understanding the impact of trauma and urban poverty on family systems:  Risks, resilience and interventions” by Collins, K., Connors, K., Davis, S., Donohue, A., Gardner, S., Goldblatt, E., Hayward, A., Kiser, L., Strieder, and Thompson, E., 2010, http://www.nctsnet.org/sites/default/files/assets/pdfs/understanding_the_impact_of_trauma.pdf.

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