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I was amazed that many of the symptoms described below parallel some of the more common symptoms of Parkinson's disease. Barb Mallut [log in to unmask] ------------------------------------------------------ Wednesday December 24 5:16 PM EST Poverty Increases Health Risks NEW YORK (Reuters) -- Poverty and sustained economic hardship increase the risk of developing serious physical and mental health problems, according to a 29-year study from the University of Michigan School of Public Health in Ann Arbor. "High levels of income inequality in the United States, and reduced access to medical care for the poor are likely to have serious short- and long-term public health consequences," said lead author John W. Lynch. The study, published this week in The New England Journal of Medicine, also found a strong "dose-response" relationship between the number of times people experienced economic hardship and the subsequent development of physical and psychological problems. "The greater the number of episodes, the worse the health profile over 30 years," said Lynch, an assistant research scientist in the university's department of epidemiology. The study defined sustained economic hardship in terms of the number of times records showed a household income was twice that of the poverty line for the years 1965, 1974, and 1983. In 1994, researchers evaluated the physical, psychological, social, and cognitive functioning of the more than 1,000 study participants. Compared with people without economic hardship, those with one episode of economic hardship in either 1965, 1974, or 1983 were 1.49 times more likely in 1994 to have difficulties managing basic activities of daily living, such as cooking, shopping, and handling money. Those with two or three episodes were respectively 1.85 and 3.79 times more likely to have problems with these basic activities in 1994. A similar "dose-response" trend was noted for other activities of daily living, such as walking, eating, dressing, and using the toilet. Lynch said that men and women who experienced more than one episode of economic hardship were also more likely to report problems in cognitive functioning in 1994 -- including "having difficulty remembering where you put things, forgetting names." A similar trend was also observed for the development of depression. The study found that those who had experienced one bout of hardship were only slightly more likely to report symptoms of depression compared with those who had not, but those who had dealt with two "doses" of economic hardship were 1.72 times more likely to report depression, and this rose to 3.24 times among those who had gone through three periods of poverty. Lynch commented that the study participants were a relatively young group when the study began, in their 30s and 40s. Moreover, he notes that statistically adjusting for risk factors (smoking, obesity) and disease did not greatly alter the findings. "I think we've provided the best scientific evidence to date that being in economic hardship causes poor health outcomes," he said. "Even when we looked at people who were young and healthy in 1965, those who experienced greater economic hardship over the next 25 years, had worse functioning." The researcher said the findings "do have implications for policy and things that we need to think about as a society." Lynch commented that, given the shift toward managed health care, "I think we should all be very concerned that those people who might actually get the most health benefit from medical intervention -- those experiencing economic hardship -- are the least likely to access and receive that care." SOURCE: The New England Journal of Medicine (1997;337:1889-1895)