Description of Study

Background

Poverty rates and health disparities are among the highest in the Southern United States where people tend to die more from diseases like cancer, diabetes, and heart disease than people in other areas of the country. People who are poor often have less knowledge of health risks and are less likely to protect themselves. While there have been attempts to close these gaps, these attempts have generally not been successful. By gaining a better understanding of this audience and the cultural and social factors that affect their health, we can develop more effective health communication campaigns and interventions targeted towards low-income communities to close health and knowledge gaps.

Research Design and Procedure:

• Formative research explored the perceptions of and response to multiple health risks among the poor in the southern United States. Twelve focus groups and 66 interviews were held in 3 Southern Cities.
• A phone survey was administered to low-income households in South Carolina, Georgia, Alabama, Mississippi and Louisiana to examine health risk perceptions and behaviors for risks they take high and low action to protect themselves against.

Findings:

• People think about risks in terms of their perceived control over them and worry often about chronic health conditions. In interviews, car accidents and cancer were the two biggest worries along with a variety of chronic conditions. Interestingly, obesity appeared to be of little worry to participants despite its connection to chronic conditions.
• When low-income people feel worried about a health condition they more likely to take high action to protect against a health condition. However, this may depend on their level of self-efficacy. Females are also more likely to action than men.
• Feelings of health threat are influenced by family history, race/ethnicity, personal experiences, concerns about health insurance and costs to treat health conditions.
• Barriers to health protection behaviors for low-income people include time, work, family, conflicting information and low self-efficacy.
  

Implications:

This research contributes to existing scholarship on poverty and health disparities by illustrating that persistent poverty influences a wide variety of health risks and the decisions people make about how to address these risks. Our results show that the stressors of living in poverty (e.g. lack of money, time, competing demands, etc.) shape the decisions people make about how to manage existing conditions and their overall health. Campaigns targeted towards low-income individuals in the South should focus on increasing feelings of threat and worry, raise feelings of efficacy, and reduce barriers to engagement in health protection behaviors.