Poverty and Nursing

¶ … beliefs or values about poverty, homelessness, addictions or mental disorders? What has been one of your personal or professional experiences with poverty, homelessness, addiction or mental disorders? Over the course of my personal and professional education in the field of healthcare, I have come to realize that poor heath and a patient's socio-economic status are inexorably interlinked. Poorer people have less money for healthier food and less access to such foods. They lack the time and access to places where they can engage in effective exercise.

It is easy to look dismissively upon someone who is poor and say "why can't they change their lifestyle?" But looking at the price of produce in the grocery store and considering the fact that even a pair of running shoes can average around $100, it is easy to see how difficult it can be for someone who is under extreme economic pressures to make lifestyle changes.

As well as the economic pressures poverty places upon health, within high-poverty environments there is often a culture which can contribute to poor health as well, in the sense that perceptions of what is a healthy weight can become skewed by the appearance of close friends and neighbors.

Quite simply, if it is normalized that everyone in the family eats a high-fat diet that is high in sugar, making what might seem like reasonable, meaningful changes like cutting out fast food from the diet can seem impossible in the eyes of the patient. Thus, the economics and culture of poverty can create dual influences that the nurse must treat effectively beyond simply giving dietary and exercise recommendations.

These recommendations must address the specific issues present in the patient's life to ensure that they seem reasonable and meaningful to the patient as a way of enacting positive changes. The nurse must treat the 'whole person' as he or she exists as a result of a constellation of various environmental and personal factors, not as an abstract patient who is not affected by the real world. A patient is never just a disease. I learned this in my own experience dealing with patients who are managing type II diabetes.

One patient was having a great deal of difficulty keeping her blood sugar in check. She was regarded as uncooperative and inconsistent in terms of her medication and her eating habits. However, I was also aware of the fact that she was under a great deal of family stress, partially because of economic reasons and also because of a number of personal factors (including a daughter who was pregnant) that was resulting in her using food as a coping mechanism.

Also, adhering to the careful schedule of monitoring blood glucose and keeping track of her medications was very difficult to balance between work and home. The nurses must understand the patient's context rather than simply regard.