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Aim: This article draws on the poverty and access to health care framework to explore the barriers to access and utilization of primary health care among aged indigents under the Livelihood Empowerment Against Poverty Programme (LEAP) in Ghana. Background: Although many developing countries have made progress in extending primary health care to their populations following the Alma-Ata Declaration of 1978, the establishment of the Millennium Development Goals, and the Sustainable Development Goals (SDGs), barriers remain pervasive, particularly among vulnerable population groups. Previous studies have hardly paid in-depth attention to this important indicator for measuring progress toward achieving SDG 3. Methodology: To this end, we conducted a case study of access to health care services and utilization among aged indigents enrolled on the LEAP programme in the Daffiama Bussie Issa District of the Upper West. We collected and analyzed qualitative data from indigents aged 65 years and above, health care providers, and staff of the LEAP and the National Health Insurance Scheme (NHIS). Findings: Our analysis found geographic inaccessibility of health care, high costs of drugs and related services, exclusion of essential services from NHIS benefits package, and irregular transfer of cash to negatively influence access and utilization of health care among aged LEAP beneficiaries in the district. In addition to the need to strengthen the economy, provide health infrastructure and human resources for health in rural areas, the government needs to review the beneficiaries' bimonthly stipends to reflect the daily minimum wage, eliminate the delay in payments, and review the benefits package of the NHIS to include essential services and medical devices commonly used by aged people. Yet implementing these recommendations has affordability implications that require innovation to mobilize additional resources and create the desired fiscal space and institutions that can sustainably implement universal coverage programmes such as the LEAP. [ABSTRACT FROM AUTHOR]

How does poverty influence political participation? This question has interested political scientists since the early days of the discipline, but providing a definitive answer has proved difficult. This article focuses on one central aspect of poverty—the experience of acute financial hardship, lasting a few days at a time. Drawing on classic models of political engagement and novel theoretical insights, I argue that by inducing stress, social isolation, and feelings of alienation, acute financial hardship has immediate negative effects on political participation. Inference relies on a natural experiment afforded by the sequence of bank working days that causes short-term financial difficulties for the poor. Using data from three million individuals, personal interviews, and 1,100 elections in Germany, I demonstrate that acute financial hardship reduces both turnout intentions and actual turnout. The results imply that the financial status of the poor on election day can have important consequences for their political representation. [ABSTRACT FROM AUTHOR]

Background: Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear.Aims: We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed.Method: This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model.Results: A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (P = 0.006). Controls showed a positive correlation between total grey matter volume and income (R = 0.14, P = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (R = -0.076, P = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure.Conclusions: Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments. [ABSTRACT FROM AUTHOR]

Experiencing poverty increases vulnerability for dysregulated hypothalamic–pituitary–adrenal (HPA) axis functioning and compromises long-term health. Positive parenting buffers children from HPA axis reactivity, yet this has primarily been documented among families not experiencing poverty. We tested the theorized power of positive parenting in 124 parent–child dyads recruited from Early Head Start (Mage = 25.21 months) by examining child cortisol trajectories using five samples collected across a standardized stress paradigm. Piecewise latent growth models revealed that positive parenting buffered children's stress responses when controlling for time of day, last stress task completed, and demographics. Positive parenting also interacted with income such that positive parenting was especially protective for cortisol reactivity in families experiencing greater poverty. Findings suggest that positive parenting behaviors are important for protecting children in families experiencing low income from heightened or prolonged physiologic stress reactivity to an acute stressor. [ABSTRACT FROM AUTHOR]

This article discusses the challenges affecting the achievement of financial inclusion for the poor and low-income earners in South Africa. The concept of financial inclusion could be defined as the provision of affordable financial products and services to all members of the society by the government and/or other relevant role-players such as financial services providers. This article identifies unemployment, poverty, financial illiteracy, over-indebtedness, high bank fees, mistrust of the banking system, lack of relevant national identity documentation and poor legislative framework for financial inclusion as some of the challenges affecting the full attainment of financial inclusion for the poor and low-income earners in South Africa. Given these flaws, the article highlights the need for the government, financial institutions and other relevant stakeholders to adopt legislative and other measures as an antidote to financial exclusion and poverty challenges affecting the poor and low-income earners in South Africa. [ABSTRACT FROM AUTHOR]

We extend the Base of the Pyramid (BoP) poverty-alleviation approach by recognizing the poor as valuable suppliers—specifically of intellectual property. Although the poor possess huge reserves of intellectual property, they are unable to participate in global knowledge networks owing to their illiteracy and poverty. This is a crippling form of social exclusion in todays growing knowledge economy because it adversely affects their capabilities for advancement at several levels. Providing the poor access to global knowledge networks as rightful participants—as suppliers of intellectual property—leads to poverty alleviation as a result of their increased social inclusion, not only through economic benefits, but also through the poor's improved well-being as a result of their increased self-esteem and dignity. Using concepts from social network theory, we develop a poverty-alleviation approach to harness and integrate the intellectual property of the poor into global knowledge networks through trust-based partnerships among the poor, non-governmental organizations, and multinational corporations. [ABSTRACT FROM AUTHOR]

The debate on the land–poverty nexus is inconclusive, with past research unable to identify the causal dynamics. We use a unique global panel dataset that links survey and census derived poverty data with measures of land ecosystems at the subnational level. Rainfall is used to overcome the endogeneity in the land–poverty relationship in an instrumental variable approach. This is the first global study using quasi-experimental methods to uncover the degree to which land improvements matter for poverty reduction. We draw three main conclusions. First, land improvements are important for poverty reduction in rural areas and particularly so for Sub-Saharan Africa. Second, land improvements are pro-poor: poorer areas see larger poverty alleviation effects due to improvements in land. Finally, irrigation plays a major role in breaking the link between bad weather and negative impacts on the poor through reduced vegetation growth and soil fertility. [ABSTRACT FROM AUTHOR]

What undermines cooperation in ethnically diverse communities? Scholars have focused on factors that explain the lack of inter-ethnic cooperation, such as prejudice or the difficulty to communicate and sanction across group boundaries. We direct attention to the fact that diverse communities are also often poor and ask whether poverty, rather than diversity, reduces cooperation. We developed a strategic cooperation game where we vary the income and racial identity of the interaction partner. We find that beliefs about how poor people behave have clear detrimental effects on cooperation: cooperation is lower when people are paired with low-income partners, and the effect is particularly strong when low-income people interact among themselves. We observe additional discrimination along racial lines when the interaction partner is poor. These findings imply that poverty and rising inequality may be a serious threat to social cohesion, especially under conditions of high socioeconomic segregation. [ABSTRACT FROM AUTHOR]

Objective: To understand low-income adults' expectations and experiences using an innovative smartphone and theory-based eLearning nutrition education programme, entitled Food eTalk.Design: Longitudinal mixed-methods single case study including a series of focus group and individual interviews, demographic and Internet habits surveys, and user-tracking data. Interviews were transcribed verbatim, analysed using the constant comparative method and digitalized using Atlas.ti. Descriptive statistics were analysed for demographics and user-tracking data.Setting: Community-based locations including libraries, public housing complexes, schools, safety-net clinics and food pantries.Subjects: Low-income Georgian adults aged ≥18 years (n 64), USA.Results: Participants found Food eTalk easy to navigate and better designed than expected. Primary themes were twofold: (i) motivation to engage in eLearning may be a formidable barrier to Food eTalk's success but improved programme content, format and external incentives could mitigate this barrier; and (ii) applying knowledge to change nutrition-related behaviour is challenging. To encourage engagement in eLearning nutrition education, programme format should highlight interactive games, videos, be short in length, and feature content that is relevant and important from the perspective of the priority audience. Examples of these topics include quick and easy recipes, chronic disease-specific diet information and tips to feed 'picky' children. Additionally, external incentives may help mitigate barriers to healthful eating behaviour and increase engagement in the programme.Conclusions: The findings suggest eLearning nutrition education programmes are best designed to match low-income adults' typical smartphone habits, include content considered particularly relevant by the intended audience and highlight solutions to barriers to healthful eating. [ABSTRACT FROM AUTHOR]

People living in poverty are particularly vulnerable to shocks, including those caused by natural disasters such as floods and droughts. This paper analyses household survey data and hydrological riverine flood and drought data for 52 countries to find out whether poor people are disproportionally exposed to floods and droughts, and how this exposure may change in a future climate. We find that poor people are often disproportionally exposed to droughts and floods, particularly in urban areas. This pattern does not change significantly under future climate scenarios, although the absolute number of people potentially exposed to floods or droughts can increase or decrease significantly, depending on the scenario and region. In particular, many countries in Africa show a disproportionally high exposure of poor people to floods and droughts. For these hotspots, implementing risk-sensitive land-use and development policies that protect poor people should be a priority. [ABSTRACT FROM AUTHOR]

Understanding the local socioeconomic context is important for the design of appropriate conservation initiatives and associated monitoring strategies, especially in areas with high degrees of inequality, to ensure conservation interventions do not inadvertently further disadvantage vulnerable people. Typical assessments of wealth inequality in remote rural areas are constrained by limited engagement with a cash economy, complex family and tribal ties, and an absence of basic infrastructure. This paper presents a simple participatory approach to measure wealth inequality that does not predefine indicators, such as income or assets, but allows the local people choose the most appropriate indicators. A case study from the Solomon Islands revealed poor households in Kahua were characterized by fewer members, fewer members of working age, and fewer male members than wealthier households. The poor also owned fewer of the locally defined indicators of wealth that were collectively correlated with limited land tenure, and, consequently, conservation or development initiatives that are tied to land in Kahua will be less likely to assist the poorest. Adopting this participatory approach could improve the effectiveness of community-based conservation, through facilitating opportunities to explore local poverty and routes for alleviation. [ABSTRACT FROM PUBLISHER]

The literature on homelessness tends to focus on risk factors in people's social and personal lives that contribute to their situation of being without a permanent home. Alternatively, the following describes innate factors of intimate relationships that contribute to a situation of homelessness for men and women. We conducted interviews with 61 people experiencing homelessness in Calgary, Alberta, Canada. We were particularly interested in documenting with greater specificity their perceptions of their individual pathways to and from homelessness. Three themes emerged from the data describing the intersection between respondents’ intimate relationships and their situation of homelessness: (1) relationship breakdown; (2) the role and impact of having intimate partners during a period of homelessness; and (3) the nature of the intimate relationship and its impact on housing. The data suggest that aspects of intimate relationships should be considered by social service agencies when addressing a person's situation of homelessness. [ABSTRACT FROM PUBLISHER]

This article seeks to evaluate how democratic and deliberative the direct participation of citizens experiencing poverty is in the definition and implementation of public policies that affect them. A comparison of Belgian and Quebec processes involving persons in situation of poverty indicates that the procedural dimensions of participation (franchise, quality and accountability) are clearly strengthened by institutionalized processes and weakened when processes become politicized. However, the authenticity of the process (a dimension tied to outcomes) remains largely independent from the nature of these processes and depends instead on the mobilization of social actors and especially of anti-poverty organizations. [ABSTRACT FROM PUBLISHER]

There is a long tradition in social policy of discussing and critiquing the notion of ‘deservingness’ in relation to ‘the poor’. This paper will apply such debates to ‘the rich’ to consider the grounds on which this group might be considered ‘deserving’. The paper identifies three sets of arguments. The first set of arguments concerns the appropriateness of rewarding merit/hard work/effort/risk-taking etc. The second concerns more consequentialist/economic arguments about providing incentives for wealth creation. And the third considers the character and behaviour of the rich. As well as discussing the potential criteria for deservingness, the paper will also debate whether the degree of income and wealth gained by the rich is deserved. Finally, the paper will discuss the social policy implications, including taxation policies, which emerge from this debate. [ABSTRACT FROM PUBLISHER]

Private sector development (PSD) has emerged as a core component of donor strategies aimed at making free markets work for ‘the poor’ through assistance to business sector capacity in low-income states. PSD initiatives cannot be understood, however, as technical exercises aimed solely at promoting development through business competitiveness. Instead they serve as normative concessions through which developmentally questionable market-opening has been rationalised by donors in pursuit of lucrative commercial opportunities in emerging economies. Examining the European Union's (EU) PSD framework in bilateral relations with the African, Caribbean and Pacific (ACP) states, the article examines the utilisation of PSD discourse in the ‘development branding’ of Economic Partnership Agreements (EPAs). PSD discourse is seen to facilitate a ‘double-veiling’ of asymmetric ACP–EU trade ties via legitimising images of equitable market-opening and the trickle-down of business wealth to ‘the poor’. Nevertheless, the reality of reciprocal trade structures combined with Europe's anaemic PSD resources bears little resemblance to the strategic illusions of PSD. In particular, the interventions of Europe's Centre for the Development of Enterprise (CDE) in cotton and textiles sectors in East Africa are seen to have dubious outcomes for ‘development’ in ACP former colonies. [ABSTRACT FROM PUBLISHER]

The article discusses the effect of social networks and family relationships on poor people living in England during the first half of the 19th century, with information on the historiography of social conditions for the English poor during this time. Topics include debate regarding the density of local kinship networks; the functionality of English kin with relatives dependent upon welfare relief from their communities under the English and Welsh Old Poor Law; and letters written by the poor demonstrating their rhetoric and strategy for accessing their entitlement.

ABSTRACTBased on observations from all three tropical continents, there is good reason to believe that poor service providers can broadly gain access to payment for environmental services (PES) schemes, and generally become better off from that participation, in both income and non-income terms. However, poverty effects need to be analysed in a conceptual framework looking not only at poor service providers, but also at poor service users and non-participants. Effects on service users are positive if environmental goals are achieved, while those on non-participants can be positive or negative. The various participation filters of a PES scheme contain both pro-poor and anti-poor selection biases. Quantitative welfare effects are bound to remain small-scale, compared to national poverty-alleviation goals. Some pro-poor interventions are possible, but increasing regulations excessively could curb PES efficiency and implementation scale, which could eventually harm the poor. Prime focus of PES should thus remain on the environment, not on poverty. [ABSTRACT FROM AUTHOR]

Background: Understanding of the psychological impact of politically motivated violence is poor.Aims: To examine the prevalence of post-traumatic symptoms subsequent to the 'troubles' in Northern Ireland.Method: A telephone survey of 3000 adults, representative of the population in Northern Ireland and the border counties of the Irish Republic, examined exposure to political violence, post-traumatic stress disorder (PTSD) and national identity.Results: Ten per cent of respondents had symptoms suggestive of clinical PTSD. These people were most likely to come from low-income groups, rate national identity as relatively unimportant and have higher overall experience of the 'troubles'than other respondents.Conclusions: Direct experience of violence and poverty increase the risk of PTSD, whereas strong national identification appears to reduce this risk. [ABSTRACT FROM AUTHOR]

Exposure to developmental risks in three domains (community, economic, and family), and relations between risks and psychosocial well-being, were examined among 918 impoverished Brazilian youth aged 14–19 (M= 15.8 years, 51.9% female) recruited in low-income neighborhoods in one city in Southern Brazil. High levels of developmental risks were reported, with levels and types of risks varying by gender, age, and (to a lesser extent) race. Associations between levels of risks in the various domains and indicators of psychological (e.g., self-esteem, negative emotionality) and behavioral (e.g., substance use) adjustment differed for male and female respondents. Findings build on prior research investigating the development of young people in conditions of pervasive urban poverty and reinforce the value of international research in this endeavor.This study was funded by grants from the World Bank and CNPq to Silvia H. Koller. Manuscript preparation was partially supported by a Faculty Development Fellowship to Marcela Raffaelli from the College of Arts and Sciences, University of Nebraska–Lincoln, and by a Visiting Fellowship at the Key Centre for Womens Health in Society, School of Population Health at the University of Melbourne. The authors acknowledge the assistance of Jaims Ribeiro in developing the questionnaire. [ABSTRACT FROM AUTHOR]

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This paper derives from a LARR-sponsored forum at the LASA 2003 Congress held in Dallas in March 2003. Targeted at younger scholars, a panel of leading researchers whose early work was shaped by marginality and dependency thinking of the 1960s were invited to reflect cross-generationally about how paradigms analyzing poverty in Latin American cities have shifted from that time to the present. Specifically, each of the authors compares "'marginality" as it was construed more than three decades ago with contemporary constructions of poverty and social organization arising from their more recent research. While there are important continuities, the authors concur that the so-called "new poverty" today is very different, being more structural, more segmented and, perhaps paradoxically, more exclusionary than before. Moreover, the shift from a largely patrimonialist and undemocratic state towards one that, while more democratic, is also slimmer and downsized, thereby shifting state intervention and welfare systems ever more to local level governments and to the quasi-private sector of nongovernmental organizations. If earlier marginality theory overemphasized the separation of the poor from the mainstream, today's new poverty is often embedded within structures of social exclusion that severely reduce opportunities for social mobility among the urban poor. [ABSTRACT FROM AUTHOR]

The Poverty and Social Exclusion Survey of Britain made it possible first time to explore poverty using three different measures applied at the same time on the same sample. The measures were: lacking socially perceived necessities; being subjectively poor and having a relatively low income. These approaches are all commonly used to identify the poor and to measure poverty but rarely if ever in combination. In this article we have found that there is little overlap in the group of people defined as poor by these dimensions. There are reasons for this lack of overlap, connected to the reliability and validity of the different measures. However the people who are defined as living in poverty by different measures of poverty are different. This inevitably means that the policy response to poverty will be different depending on which measure is employed. We have attempted to analyse overlap in two ways. First, by exploring the dimensions of poverty cumulatively, we have found that, the more dimensions people are poor on, the more they are unlike the non-poor and the poor on only one dimension, in their characteristics and in their social exclusion. Second, by treating particular dimensions as meriting more attention than others, we explored three permutations of this type and concluded that, while each permutation were more unlike the non-poor than those poor on a single dimension, they were not as unlike the non-poor as the cumulatively poor were. These results indicate that accumulation might be a better way of using overlapping measures of poverty than by giving priority to one dimension over another. The implication of the paper is that it is not safe to rely on one measure of poverty - the results obtained are just not reliable enough. [ABSTRACT FROM AUTHOR]

The relationship between welfare benefit levels and the residential choices of the poor raises two issues for federalism in the United States. Do state benefit levels affect the residential choices of the poor? Do residential choices of the poor affect the level at which a state sets its benefit levels? Empirical studies have seldom studied the interconnection between these two issues. This research estimates simultaneously the mutual effects of welfare benefits and poverty rates while controlling for other economic and political variables. When benefit levels become high, the size of the poverty population increases. Conversely, when poverty rates become high, benefit levels are cut. The findings are consistent with the claim that state-determined benefit levels distort policy and residential choices. [ABSTRACT FROM AUTHOR]

Conventional methods of analysis of poverty assume resources are shared so that each individual in a household/family has the same standard of living. This article measures differences between spouses in a large sample in indicators of deprivation of the type used in recent studies of poverty at household level. The quite limited overall imbalance in measured deprivation in favour of husbands suggests that applying such indicators to individuals will not reveal a substantial reservoir of hidden poverty among wives in non-poor households, nor much greater deprivation among women than men in poor households. This points to the need to develop more sensitive indicators of deprivation designed to measure individual living standards and poverty status, which can fit within the framework of traditional poverty research using large samples. It also highlights the need for clarification of the underlying poverty concept. [ABSTRACT FROM AUTHOR]

The article describes the discussions of the Beveridge Committee of 1942 about the ideas of need and measures of poverty to be used. The evidence shows that the Committee knew very well that its proposed benefit levels were not enough for social participation. The author of the article reviews the concepts of poverty and need used by Beveridge and the members of his committee and uses their detailed working papers to show how they arrived at the conclusions embodied in their report "Social Insurance and Allied Services." The issues are important for reasons beyond the political and academic. The word "poverty" has, of course, a great many meanings in common use. Writers on Beveridge have disagreed in their interpretations of the notions of poverty embodied in Beveridge's recommended benefit scales and one aim of this article is to see what the records themselves suggest. Some commentators have suggested that in 1942 Beveridge used more generous and participatory approaches to the definition of human needs than implied by the minimum subsistence level of "primary poverty."

An essay is presented on the support system for meeting basic human needs. It offers a history on the issue of such needs and how these affect those subjects who desperately need it, particularly the poor. The author discusses the three key terms associated with human needs including basic needs, sustainable growth and international support system, in which human needs are analyzed as either subjective requirements or as objective goods that satisfy the necessities of subjects.