Welcome to The Poverty Trap, a newsletter and podcast for people who are fed up with the inequality baked into America’s system and want to individually and collectively make change.
Chronic Illness has increased dramatically in the United States over the last several decades, particularly Heart Disease, Obesity, Hypertension and Type 2 Diabetes. And when healthcare is unavailable or unaffordable, millions of Americans living in poverty or pay check to pay check will spiral into debt, declare bankruptcy or simply go without treatment.
The Growing Burden of Chronic Diseases Within The United States
We’ve talked here on The Poverty Trap about how stressful it is to be a low-income worker or fall below the poverty level in the United States, and how stress negatively impacts a person’s physical and mental health. We’ve also discussed the soaring cost of medical care, including prescription drugs, and the crushing medical debt that accompanies an unexpected or chronic illness.
Data prepared in 2024 by the National Institutes of Health (NIH) show chronic illness in the United States has increased substantially in the last several decades and affects at least 6 in 10 Americans, regardless of economic status. But it’s the poor and those living paycheck to paycheck who will suffer the most. A New York Timesarticle from 2024 discussing the intersection between the steady increase in chronic disease and the increased cost of drugs to manage those diseases says:
For many, the cost of treating those diseases month after month, year after year, can prove to be its own chronic problem — one that can fill people with fear and lead to drastic measures and risky trade-offs….About three in 10 adults reported not taking medications as prescribed over the past year because of cost, according to data published by the nonprofit KFF in October [2024]….“The costs quickly become unaffordable for people, even if they have what they previously thought of as very good health insurance…”, said Dr. Seth A. Berkowitz, an associate professor of medicine at the University of North Carolina at Chapel Hill.
Speaking of stress, experts say it is often difficult to tell the difference between symptoms caused by stress and the same or similar symptoms that indicate a chronic illness. Even worse, stress can actually trigger some chronic illnesses, including heart disease, high blood pressure and autoimmune problems.
A 2024 article in Time summed it up well:
…a growing body of research documents the strong connection between financial anxiety and struggles with physical and mental health, particularly over the long term…In fact, a study published earlier this year by a team of British researchers suggests that among the serious life challenges that people often face—including divorce, disability, caregiving, illness, and bereavement—financial strain is the most detrimental to health.
When chronic illness overlaps with extreme poverty in a rural setting, as it does in many areas across the country, the outcomes are devastating, as described in this 2025 article in The New York Times. This piece describes in horrifying detail the patients of one traveling nurse in West Virginia. The reality is “Americans now spend more years living with chronic disease than people in 183 other countries in the World Health Organization”, and in the last two decades: “…death rates up 25 percent nationally from diabetes, 40 percent from liver disease, 60 percent from kidney disease, 80 percent from hypertension and more than 95 percent from obesity, according to data from the Centers for Disease Control and Prevention”.
What All This Means:
Those living with economic insecurity have a great deal of added stress. This stress can result in increased chronic illness which causes even greater economic insecurity, even for those with health insurance, and managing a chronic illness causes even more stress, resulting in a vicious, nearly inescapable cycle. The continued increase in chronic disease, particularly among low income populations, costs all Americans by:
* Adding a strain on existing health care services and increasing the cost of medical care for everyone when those priced out of the health care market cannot pay; and
* Lost wages and productivity at work and the resulting increased costs for businesses.
* Ninety percent of the nation’s $4.9 trillion in annual health care expenditures are for people with chronic and mental health conditions.1,2
Interventions to prevent and manage these diseases can have significant health and economic benefits.
After a nearly three-week government shut down, we know that if the government re-opens without curing the draconian cuts to Medicaid and Affordable Care Act subsidies, millions more Americans likely will develop chronic illness from the added economic burdens, accumulate medical debt or go without treatment. In fact, a study quantifying the impact of these cuts, conducted by Yale University and the University of Pennsylvania, shows that over 50,000 Americans will die each year because they can’t afford medical care.
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Do these statistics shock you? Are you, family member or friend living with a chronic illness? Can you afford to pay for your care? Let me know your thoughts in the Comment Section below. And while you’re in the area, please Like, Share and Re-stack this post—thanks in advance!
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