The constraints of poverty can cause a cycle of poor mental and physical health, according to psychologists who presented research at APA's 2003 Annual Convention on the impact of poverty on people's well-being.

The psychologists highlighted findings on poverty's mental health effects among minority groups, older adults, rural residents and, in particular, people with HIV/AIDS at a session sponsored by APA's Board for the Advancement of Psychology in the Public Interest.

In the United States, a family of two with a household income of less than $12,120 a year is considered to be living in poverty. Studies have shown that poverty can lead to low self-efficacy, helplessness, hopelessness and limited access to health care and medical insurance. Such realities show that poverty needs more attention from psychologists, said Karen Wyche, PhD, associate professor of psychology at the University of Miami.

"I am concerned that many of our colleagues are not interested in social class factors, nor in poverty and how it influences the outcomes of people's lives," Wyche told the audience. "I think that we fail to have effective interventions, clinical strategies or social policy programs that help these people because we fail to look at the interactive factors of poverty on social class and how it influences outcomes."

Interactive factors

Psychologists are beginning to examine those interactive factors, though. For example, George Washington University associate clinical psychology professor Marcia Cecilia Zea, PhD, and doctoral student David Dove found in a study of 155 Latino gay men who were HIV-positive--40 percent of whom made less than $400 a month--that poverty was linked with poorer mental health. Specifically, they found that poverty was related to depression and anxiety in the participants, which in turn negatively affected their HIV prognosis.

Dove said psychologists need to better address this social class factor and how it can potentially influence mental health. "We can change professional policy by passing specific laws to implement systems and standard practices of care that ensure we meet the mental health needs of the clients we manage," Dove said. "Research and practicing psychology should address poverty and ensure access to health quality."

The need to address poverty is all the more important because it is so widespread, said Beth Hudnall Stamm, PhD, a research professor and director of telehealth at Idaho State University who studies the biopsychosocial effects of rural poverty on aging. Nearly three-fourths of older adults live below the poverty level, she said.

Moreover, nearly 40 percent of people in rural areas of the United States are living in poverty. "That is a huge correlation," Stamm said. "Clearly, rural and poverty go together."

Poverty can also affect depression and HIV-risk behavior beyond the rural setting, said Jose Toro-Alfonso, PhD, a researcher at the University of Puerto Rico, San Juan. In his ongoing research with Puerto Rican youth living in poverty, Toro-Alfonso has found that 45 percent of 61 participants show high symptoms of depression, whereas 55 percent show low symptoms of depression.

Alfonso emphasized the need for more intervention programs for HIV-positive adolescents that address poverty and cultural values, especially since past studies show that such interventions can empower individuals to overcome these factors.