The Price of Poverty

by Pia K. Hansen

Last week, the Spokane Regional Health District published the report, "Growing Up in Spokane," which focuses exclusively on Spokane children's health. This is the fist time the health district has compiled a comprehensive assessment of the health of Spokanites ages zero to 24.

Here are a few nuggets the report uncovered:

Teenage pregnancy rates for girls ages 15-17 declined by 41 percent, and abortion rates declined by 35 percent between 1993 and 1999. But sexually active teens between 18 and 19 have the highest rate of sexually transmitted diseases of all age groups, every year, from 1993-99.

There was a 41 percent decline in the number of children killed in motor vehicle crashes from 1990-99. Though 145 still lost their lives, that's down from 247 in the previous decade. But 5,236 child abuse cases were reported in 2000 -- that's up from 4,945 in 1999.

Of toddlers 18-36 months old, 68 percent were up-to-date on all nine required vaccinations, but slightly more than one-quarter of children less than five years old live in extreme poverty. And 17.5 percent of children and youth ages five to 17 live below the federal poverty level.

"Children's health figures prominently in the state of Spokane's health because poverty disproportionately affects children in our community," says Dr. Kim Thorburn, health officer for the Spokane Regional Health District. "Children under the age of five and between the ages of five to 17 represent the two age groups in which the highest number live in poverty in Spokane." For the older group of children, living in poverty may mean going to school hungry in the morning. In Spokane County, 36 percent of students qualify for a free or reduced lunch program, while in District 81 that number is 44 percent.

The City of Spokane's Human Services Department and the Homeless Coalition estimate through their community-wide intake and assessment systems that homelessness is a daily fact for 7,764 people, of which 2,451 are children. (Keep in mind that an unknown number of homeless people never seek help or assistance and therefore can not be counted.)

"Kids stand out when it comes to poverty. They have more trouble accessing health care services, and poverty contributes to family instability and impacts school performance," says Thorburn. "When there is a problem paying the rent, families are more likely to move, and this impacts school performance. Kids living in poverty are at higher risk for substance abuse and exposure to violence."

Among youth in Spokane, substance abuse remains a major public health concern. The most prevalent substances used by youth in 1999, reports the Health District, are alcohol (49 percent), cigarettes (32.8 percent) and marijuana (30.6 percent). Meth use was not accessed in this survey, but the report states that as many as 27 percent of people arrested in Spokane County tested positive for meth in 1998-99. The Health District report concludes that marijuana use among youth should be addressed by preventive programs as soon as possible.

In spite of the negative trends, the report found that Spokane's health is improving overall.

"When we evaluate temporal trends of disease and injury rates as well as health behaviors among Spokane County residents, the general picture is one of health improvement," says Thorburn.

The Regional Health District's report addresses 11 specific areas impacting the health of children, and it concludes -- among other things -- that Spokane's community profile shows a picture of a community that has a large portion of the population struggling financially.

By addressing poverty, some of the health concerns and issues such as hunger and homelessness would begin to be addressed as well. Currently, the Regional Health District and the city are cooperating in analyzing and collecting data about poverty in Spokane, some of which will be presented at the mayor's May summit on poverty.

"In order to ensure continued improvement, it is important that we acknowledge the health disparities caused by poverty in our community," says Thorburn. "We must work together to eliminate poverty."