---

Structural Poverty and Health Outcomes refers to the deep-rooted, systemic inequalities embedded in social, economic, and political institutions that perpetuate poverty and, in turn, drive poor health outcomes—particularly among marginalized populations.

Key Elements of Structural Poverty and Its Impact on Health:

1. Poverty as a Structurally Reproduced Condition

Structural poverty isn’t merely about income deficiency; it is perpetuated through:

• Inequitable access to quality education
• Limited employment opportunities
• Residential segregation
• Racial and gender discrimination
  These systems constrain upward mobility and intergenerational wealth accumulation, especially for Black, Hispanic, Native, and low-income rural communities.

2. Material Deprivation and Health

As highlighted in the Poverty in the United States: 2023 report:

• Individuals without a high school diploma had the highest poverty rates (25.1% official, 30.9% SPM) and also face greater health risks due to lower health literacy, reduced job access, and lack of insurance.
• Medical expenses pushed 7.4 million people into poverty, disproportionately affecting those 65 years and older, underscoring the link between structural costs and deteriorating health.

3. Policy-Driven Inequities

While social safety nets like Social Security and refundable tax credits (e.g., Child Tax Credit) help lift millions out of poverty, their design and implementation often miss those with the highest need—e.g., non-working populations, undocumented immigrants, or families in states with minimal benefit uptake.

4. Health Inequities as a Symptom of Structural Poverty

The Supplemental Poverty Measure (SPM) shows that poverty is higher among:

• Renters (23.9%)
• Black (18.5%) and Hispanic (20.9%) populations
• Those who did not work (31.1%)
  These populations also report higher rates of chronic illness, poor mental health, and limited access to preventive care, linking economic structure directly to physical outcomes.

Educational Implication for Health Equity Curriculum:

Understanding structural poverty equips students and professionals to move beyond surface-level solutions and address:

• Root causes of health disparities (e.g., housing, wages, education)
• Systemic policy reform
• Community-based interventions that are inclusive and equity-centered

It aligns with Chokshi’s assertion that health should be a tool for economic opportunity, not just a consequence of economic status. Reframing health outcomes through this structural lens is essential for training healthcare professionals and policymakers to advocate for systemic change.