A potential role of anti-poverty programs in health promotion

Abstract

Poverty is one of the most pervasive risk factors underlying poor health, but is rarely targeted to improve health. Research on the effects of anti-poverty interventions on health has been limited, at least in part because funding for that research has been limited. Anti-poverty programs have been applied on a large scale, frequently by governments, but without systematic development and cumulative programmatic experimental studies. Anti-poverty programs that produce lasting effects on poverty have not been developed. Before evaluating the effect of anti-poverty programs on health, programs must be developed that can reduce poverty consistently. Anti-poverty programs require systematic development and cumulative programmatic scientific evaluation. Research on the therapeutic workplace could provide a model for that research and an adaptation of the therapeutic workplace could serve as a foundation of a comprehensive anti-poverty program. Once effective anti-poverty programs are developed, future research could determine if those programs improve health in addition to increasing income. The potential personal, health and economic benefits of effective anti-poverty programs could be substantial, and could justify the major efforts and expenses that would be required to support systematic research to develop such programs.

Exercise as a poisoned elixir: inactivity, inequality and intervention

“…Nonetheless policies set to define the future of UK PA promotion still follow ineffective but well-trodden paths(Kay 2016;Weed 2016). ForKay (2016, p.540) PA promotion has been 'weakened by a collective failure to draw on expert analysis of the dynamics of health inequalities'.An alternative approach would be to address the underlying social determinants of PA.Despite UK health care costs associated with poverty (£29 billion,Bramley et al 2016) dwarfing those associated with obesity (£6 billion,Dobbs et al 2014) and egalitarian moral imperatives to reduce human suffering, reducing poverty and inequality is rarely targeted as a way of improving health(Silverman et al 2016, Dorling, 2010). Coalter's (2013) analysis of international PA participation indicated more equal nations with high levels of social mobility generally have more active populations.Coalter (2013, p.18) subsequently argued substantially increasing UK activity levels is well beyond the limits of PA policies because physical activities are to some extent 'epiphenomenal': 'a secondary set of social practices dependent on and reflecting more fundamental structures, values and processes'.…”

Behavior analysts in the war on poverty: A review of the use of financial incentives to promote education and employment

“…Over the past 20 years, Silverman and colleagues have been developing an intervention called the “therapeutic workplace” that could provide a model for a behavior‐analytic, antipoverty program (Silverman, Holtyn, & Jarvis, ). The therapeutic workplace intervention attempts to apply what we know about operant reinforcement contingencies to promote target behaviors of interest.…”

“…Most interventions aimed at reducing health disparities associated with poverty have targeted specific health‐related behaviors (e.g., cigarette smoking) among low‐income adults. Poverty itself could be targeted to improve health, but this approach would require programs that can consistently move poor individuals out of poverty (Silverman, Holtyn, & Jarvis, ).…”

Editorial: 3rd Special Issue on behavior change, health, and health disparities

“…Silverman and colleagues contribute a commentary advocating for using the highly efficacious incentives-based Therapeutic Workplace intervention they developed for maintaining long-term abstinence in chronically unemployed illicit drug abusers to combat chronic poverty more generally (2016—in this issue). This is an idea that warrants serious consideration.…”