Health experts targeting the worst killer: poverty Baltimore conference draws global interest

September 15, 1997|By Diana K. Sugg | Diana K. Sugg,SUN STAFF

More than 300 people from around the globe are gathering in Baltimore today to trade stories on how to beat the world's No. 1 killer: poverty.

From industrialized to developing nations, experts realize that people living in poverty face common problems and that a solution to a public health problem in Kenya could work just as well in a Baltimore neighborhood such as Sandtown-Winchester.

Sponsored by the World Health Organization, the state Department of Health and Mental Hygiene and the University of Maryland, Baltimore County, the unusual conference aims to prod doctors, business people, academicians and bureaucrats to join to attack ingrained problems that have haunted inner cities for decades -- mainly, poverty.

Consider the case of Baltimore resident Wanda Smith.

She felt trapped, getting by on welfare and living in rundown housing. Her roof leaked, her furnace didn't work and she kept the windows shut in the hot summer for fear of intruders. Her daughter, scared to venture outside because of drug dealers, played in the hallway. Smith's hair fell out, her blood pressure soared and she struggled with asthma.

Experts say her poverty and poor health are linked.

"When you're talking about poverty, it's a rippling effect, a multiplier effect," said Daisy Morris, a center director for Healthy Start in Sandtown-Winchester and Harlem Park. Morris' center helps people like Smith, who are mired in poverty, work their way out. It trains people for jobs, enables them to get high school equivalency diplomas, and gives them day care and access to medical care.

"Health is central for people to develop themselves, to seek gainful employment and to lead productive lives," said Dr. David Brandling-Bennett, deputy director of the Pan American Health Organization, WHO's regional office in Washington.

A broad focus

At the three-day meeting, experts will tackle everything from managed care for urban populations to tobacco use, adolescent health and the civic responsibility of businesses.

Organizers hope that by the end of the meeting, a task force of U.S. health professionals will be formed to monitor trends and develop policy in this country. Already, participants plan to sign a "Baltimore Charter," a commitment to improve the health of the area's neediest people.

Dr. Martin P. Wasserman, state health secretary, believes delegates will draw on each other's energy. "Some of these problems seem so overwhelming that if you're not doing it, I'm not sure I can do it," he said. "But if you're doing it, I can commit the resolve to do it."

The connections between poverty and poor health have been well documented. But in the past few years, the growing disparity between rich and poor has galva- nized physicians and researchers to monitor what's happening and search for solutions. They've held meetings all over the world. The Baltimore conference, the first in the United States, grows out of an agreement the state of Maryland made with the World Health Organization in the summer of 1994.


The delegates will discuss statistics such as this: The wealth of the richest 358 individuals in the world is roughly equal to the income of 45 percent of the world's population, or 2.3 billion people.

In addition, the ratio of incomes of the richest 20 percent of the world's population to the poorest 20 percent increased from 30 to 1 in 1961 to 61 to 1 in 1991.

Dr. Andrew Haines, professor of primary health care at University College in London, got involved when he saw new studies showing that the more unequal in income a society, the worse its health. A recent study showed that since the income of young, poor men in Britain has dropped, they have higher rates of suicide, Haines said. Over the past 20 years, the gap in life expectancy rates between unskilled and professional English men has steadily widened. Overall, studies show about 20 percent of the world's population, or 1 billion people, live in "absolute" poverty, meaning they lack the basic resources for survival: food, water, clothing and shelter.

Yet a shrinking amount of money is going for the simple tools that have made the most difference in health, such as efforts to ensure clean water and safe food.

Dr. Alfred Sommer, dean of the Johns Hopkins School of Hygiene and Public Health, said such public health strategies are the ones that sparked major drops in rates of measles and tuberculosis, even before medicines were discovered that stopped the diseases.

"Ninety-five percent of the health we have today has nothing to do with heart transplants, lung transplants and fancy hospitals. Health is largely dependent on having a better-nourished, better-housed, more-educated society," said Sommer. "But now we have this philosophy: 'I don't have to prevent it, because when I get it, I'll just get a pill.' "

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