Addressing Contemporary Global Threats to Children’s Health Caused by Poverty and Destitution

Emeritus Professor Alan Glasper from the University of Southampton discusses global threats to child health caused by poverty and destitution which has been highlighted in recent publications from UNICEF and other organizations (UNICEF, 2023).

Undoubtedly, it is children who suffer most from society’s inability to effectively address extreme poverty and destitution worldwide. Exacerbated by war in Eastern Europe and the Middle East, urgent action will be necessary to tackle this growing crisis which is adversely affecting children across the globe.

It should be stressed that it is not just children in the developing world who suffer deprivation caused by poverty and destitution because families in the developed nations are being similarly affected.

In particular, it is food insecurity, which is worrying for many families, and even though there are major concerns about rising levels of obesity in the developed world, food shortages are a real and present concern for increasing numbers of families in high GDP countries.

For example, research by Tarasuk et al. (2020) indicates that food banks which originated in the USA have sprung up in many developed countries as a response to the growing problems of food insecurity despite their comparative affluent standing in the world. In addition to the USA countries, adopting food banks as a means of alleviating hunger within their societies over the last 20 years include Canada, Australia, the UK, and other countries in Europe. For instance, in Spain, Zamora-Sarabia et al. (2019) have considered how food insecurity is being manifested in the context of wider poverty-related problems and suggest that public initiatives to alleviate these problems can reduce the impact on overall child health and child development. For families having no recourse to public funds, the threat of food security is exacerbated. People who have no access to public funding as in, for example, countries such as the UK include those groups who are labeled as temporary migrants. Jolly and Gupta (2022), for instance, have examined the evidence which appears to show that families who are impacted by immigration controls become vulnerable to severe poverty and destitution. Furthermore, Simpson et al. (2023) highlight research findings, which indicate that 2.4 million UK residents experienced destitution in 2019.

Similarly in the USA, unauthorized migrants are not eligible for many types of federal aid. This means that these unauthorized migrants are unable to claim benefits from social programs including food stamps, Medicaid, Medicare, Temporary Assistance for Needy Families (or welfare), and the Low-Income Home Energy Assistance Program, among others (Picchi, 2023).

Undoubtedly, children are more vulnerable to the effects of poverty and subsequent destitution with Jolly and Gupta (2022), suggesting that family disbarment from public funding can be viewed as a form of state driven safeguarding neglect.

Simpson et al. (2023) argue that, in the UK, there should be legal protection against destitution and highlight that in excess of a million children in the country suffered from destitution in 2022, translated as an inability of families to properly feed or clothe them. They found that the rates of destitution in the UK had more than doubled over the previous 5 years and attributed this to social benefit cuts and rising costs of living pressures, undoubtedly exacerbated since the war in Ukraine. These and other factors have left many vulnerable families to increasingly rely on charity to make ends meet.

In 2023, the UK Joseph Rowntree Foundation, which dates its philanthropic work back to the 19^th Century, revealed that many people involved in the welfare of families, including teachers and frontline welfare workers, are increasingly concerned about the impact of destitution on child health and well-being generally. This research suggests that an estimated 1.8 m UK households containing nearly 3.8 million people, including 1 million children, were destitute at some point in 2022 (Fitzpatrick et al., 2023).

Furthermore, the Organisation for Economic Co-operation and Development (OECD) has recently published data from its PISA survey. This is the OECD’s Programme for International Student Assessment, and it shows that 11% of 15-year olds in the UK had missed meals because of poverty (PISA, 2023).

The US children’s defense fund has recently published “The State of Americas Children Report” (2023), which highlights that, among the 74 million children living in the United States, 11 million live in poverty, with 1 in 7 being children of color and with 1 in 6 being children under 5 years of age. Although the COVID-19 pandemic has exacerbated levels of child poverty in the USA and across the world, this report reveals that growing up in poverty can have far reaching and occasionally lifelong effects on children. This puts these children at a much higher risk of experiencing behavioral, social, emotional, and health challenges (Children’s Defense Fund, 2023).

What are the implications for children’s nurses working in clinical practice?

As far back as 2017, a report from the UK’s Nuffield Foundation found that children and young people from the most deprived areas of the UK were fundamentally more likely to be brought to hospital emergency departments and to be treated than children from the least deprived areas. This was particularly true for children with underlying health problems such as asthma and diabetes. The data for this report were solicited from an examination of hundreds of thousands of child patient records and underscored the obvious inequalities between children from the poorest and richest families in society (Kossarova et al., 2017).

Children’s nurses are in a unique position where they can see and record signs of poverty and destitution not least through the undertaking of detailed admission assessments. Such assessments may reveal underlying issues related to poverty and allow nurses to refer such children and their families to the appropriate agencies. However, healthcare professionals such as children’s nurses are not magicians, but their combined voices of concern may trigger a greater societal response to these health inequalities caused by poverty.