Çocukluk Çağı Yoksulluğunun Yetişkinlikte Kadın Sağlığına Yansımaları: Nitel Bir Çalışma

Abstract

Amaç: Bu araştırmanın amacı, çocukluk çağı yoksulluğunun yetişkinlik döneminde kadın sağlığı üzerindeki yansımalarını belirlemektir. Yöntem: Bu çalışma, temellendirilmiş teori yaklaşım yöntemi kullanılarak yürütülen nitel bir çalışmadır. Amaçlı örnekleme yöntemi ile belirlenen on bir kadınla görüşülmüştür. Veriler, kişisel bilgi formu ve yarı yapılandırılmış görüşme formu kullanılarak kadınlarla görüşülerek toplanmıştır. Veriler, içerik analizi yöntemi kullanılarak analiz edilmiş ve temalar oluşturulmuştur. Kadınların yaşları 32-49 arasında olup, 8'i lisans düzeyinde eğitime sahip, 9'u evliydi ve 7'sinin geliri giderlerine eşitti. Bulgular: Çalışmada yoksunluk (alışkanlık, sosyal dışlanma, ihmal) ve dayanıklılık (başa çıkma çabası, beceri) olmak üzere iki ana tema belirlenmiştir. Sonuç: Sonuç olarak, çocukluk çağında yaşanan yoksulluk, kadınların sağlıklarına yansımıştır. Bu bağlamda, sağlık profesyonelleri tarafından sağlık açısından önemli bir sosyal belirleyici olan yoksullukla ilgili eylem ve politikaların temelini oluşturmak için daha fazla araştırma, eğitim, savunuculuk ve iş birliği yapılmalıdır.

Keywords

• Çocukluk Çağı Yoksulluğu
• Kadın Sağlığı
• Yetişkinlik
• Nitel Çalışma

The Reflections of Childhood Poverty on Women's Health in Adulthood: A Qualitative Study

Abstract

Objectives: The aim of this study is to determine the reflections of childhood poverty on women’s health in adulthood. Methods: This study was a qualitative study conducted using a grounded-theory approach. Eleven women who were identified by the purposeful sampling method were interviewed. The data were collected by interviewing women with a personal information form and a semi-structured interview form. The data were analyzed using the content analysis method and themes were created. The ages of the women were between 32 and 49 years, eight had undergraduate level education, nine were married and seven had income equal to their expenses. Results: Two main themes were identified in the study as deprivation (habit, social exclusion, neglect) and resilience (coping effort, skill). Conclusion: As a result, the poverty experienced in childhood is reflected in the healthy lifestyle behaviors of women. In this context, more research, education, advocacy and cooperation should be done by health professionals to form the basis for actions and policies regarding poverty, which is an important social determinant of health.

Keywords

• Adulthood
• Childhood Poverty
• Women’s Health
• Qualitative Study

Supporting Institution

This research received no financial support

Ethical Statement

This study was approved by the Hacı Bektaş Veli University Non-Interventional Clinical Research and Publication Ethics Committee (Date: 28.03.2022, Decision no:28)

Thanks

We would like to thank the participants who contributed to this study

References

1. Atkinson, P. A., Martin, C. R., & Rankin, J. (2009). Resilience revisited. Journal of Psychiatric and Mental Health Nursing, 16(2), 137–145. https://doi.org/10.1111/j.1365-2850.2008.01341.x
2. Béné, C., Newsham, A., Davies, M., Ulrichs, M., & Godfrey Wood, R. (2014). Resilience, poverty and development. Journal of International Development, 26(5), 598–623. https://doi.org/10.1002/jid.2992
3. Campbell, J. A., Walker, R. J., & Egede, L. E. (2016). Associations between adverse childhood experiences, high-risk behaviors, and morbidity in adulthood. American Journal of Preventive Medicine, 50(3), 344–352. https://doi.org/10.1016/j.amepre.2015.07.022
4. Cavenagh, Y., & Simerson, D. (2022). A Lifestyle intervention program to improve knowledge and health behaviors in women. Nursing for Women’s Health, 26(1), 51-62. https://doi.org/10.1016/j.nwh.2021.11.002
5. Cohen, B. E., & Reutter, L. (2007). Development of the role of public health nurses in addressing child and family poverty: A framework for action. Journal of Advanced Nursing, 60(1), 96–107. https://doi.org/10.1111/j.1365-2648.2006.04154.x
6. Creswell, J., & Poth, C. (2018). Qualitative inquiry & research design: Choosing among five approaches (4th ed.). Sage Publications
7. Fonseca, M. A. (2014). Eat or heat? The effects of poverty on children's behavior. Pediatric Dentistry, 36(2), 132–137.
8. De France, K., Evans, G. W., Brody, G. H., & Doan, S. N. (2022). Cost of resilience: Childhood poverty, mental health, and chronic physiological stress. Psychoneuroendocrinology, 144, Article 105872. https://doi.org/10.1016/j.psyneuen.2022.105872

9. Dufford, A. J., Kim, P., & Evans, G. W. (2020). The impact of childhood poverty on brain health: Emerging evidence from neuroimaging across the lifespan. International Review of Neurobiology, 150, 77–105. https://doi.org/10.1016/bs.irn.2019.12.001
10. Friedli, L. (2009). Mental health, resilience and inequalities. World Health Organization. https://apps.who.int/iris/bitstream/handle/10665/107925/E92227.pdf
11. Ge, T., & Ngai, S. S. Y. (2020). Three pathways to promote poverty resilience: The effects of poverty on children's educational and behavioral performance under multisystems in China. Children and Youth Services Review, 113, Article 104962. https://doi.org/10.1016/j.childyouth.2020.104962
12. González, L., Estarlich, M., Murcia, M., Barreto-Zarza, F., Santa-Marina, L., Simó, S., Larrañaga, M. I., Ruiz-Palomino, E., Ibarluzea, J., & Rebagliato, M. (2023). Poverty, social exclusion, and mental health: The role of the family context in children aged 7–11 years. European Child & Adolescent Psychiatry, 32(2), 235–248. https://doi.org/10.1007/s00787-021-01848-w
13. Gupta, R. P., de Wit, M. L., & McKeown, D. (2007). The impact of poverty on the current and future health status of children. Paediatrics & Child Health, 12(8), 667–672. https://doi.org/10.1093/pch/12.8.667
14. Hernandez, D. C., & Pressler, E. (2014). Accumulation of childhood poverty on young adult overweight or obese status: Race/ethnicity and gender disparities. Journal of Epidemiology & Community Health, 68(5), 478–484. https://doi.org/10.1136/jech-2013-203062
15. Hostinar, C. E., & Miller, G. E. (2019). Protective factors for youth confronting economic hardship: Current challenges and future avenues in resilience research. American Psychologist, 74(6), 641–652. https://doi.org/10.1037/amp0000520
16. Houweling, T. A. J., & Grünberger, I. (2024). Intergenerational transmission of health inequalities: research agenda for a life course approach to socioeconomic inequalities in health. Journal of Epidemiology and Community Health, 78(10), 650–653. https://doi.org/10.1136/jech-2022-220163
17. Hughes, M., & Tucker, W. (2018). Poverty as an adverse childhood experience. North Carolina Medical Journal, 79(2), 124–126. https://doi.org/10.18043/ncm.79.2.124
18. International Council of Nurses (ICN). (2017). Nurses’ role in achieving the Sustainable Development Goals. https://www.icnvoicetolead.com/wp-content/uploads/2017/04/ICN_AVoiceToLead_guidancePack-9.pdf
19. Johnson, S., & Raphael, D. (2020). Poverty in Canada: Implications for health and quality of life. In D. Raphael (Ed.), Poverty and Health (pp. 228–269). Canadian Scholars.
20. Knight, A., O’Connell, R., & Brannen, J. (2018). Eating with friends, family or not at all: Young people's experiences of food poverty in the UK. Children & Society, 32(3), 185–194.
21. Kyngäs, H., Mikkonen, K., & Kääriäinen, M. (2019). The application of content analysis in nursing science research. In H. Kyngäs, K. Mikkonen, & M. Kääriäinen (Eds.), The Application of Content Analysis in Nursing Science Research (pp. 3–11). Springer Nature.
22. Lee, H., Slack, K. S., Berger, L. M., Mather, R. S., & Murray, R. K. (2021). Childhood poverty, adverse childhood experiences, and adult health outcomes. Health & Social Work, 46(3), 159–170. https://doi.org/10.1093/hsw/hlab018
23. Lister, R. (2006). Poverty, material insecurity, and income vulnerability: The role of savings. In S. Sodha & R. Lister (Eds.), The Saving Gateway: From Principles to Practice (pp. 8–33). IPPR.
24. Min, J., Xue, H., & Wang, Y. (2018). Association between household poverty dynamics and childhood overweight risk and health behaviours in the United States: An 8‐year nationally representative longitudinal study of 16,800 children. Pediatric Obesity, 13(10), 590–597. https://doi.org/10.1111/ijpo.12292
25. Ngoma, C., & Mayimbo, S. (2017). The negative impact of poverty on the health of women and children. Annals of Medical and Health Sciences Research, 7(6), 442–446.
26. Nguyen, T. T. P., Phan, H. T., Vu, T. M. T., Tran, P. Q., Do, H. T., Vu, L. G., Doan, L. P., Do, H. P., Latkin, C. A., & Ho, C. S. H. (2022). Physical activity and social support are associated with quality of life in middle-aged women. PLoS ONE, 17(5), e0268135. https://doi.org/10.1371/journal.pone.0268135
27. Nikulina, V., & Widom, C. S. (2014). Do race, neglect, and childhood poverty predict physical health in adulthood? A multilevel prospective analysis. Child Abuse & Neglect, 38(3), 414–424. https://doi.org/10.1016/j.chiabu.2013.09.007
28. O’Donnell, Owen. (2024). Health and health system effects on poverty: A narrative review of global evidence. Health Policy, 142, 105018. https://doi.org/10.1016/j.healthpol.2024.105018
29. Olson, C. M., Bove, C. F., & Miller, E. O. (2007). Growing up poor: Long-term implications for eating patterns and body weight. Appetite, 49(1), 198–207. https://doi.org/10.1016/j.appet.2007.01.012
30. O'Donnell, P., Moran, L., Geelen, S., O’Donovan, D., van den Muijsenbergh, M., & Elmusharaf, K. (2021). “There is people like us and there is people like them, and we are not like them.” Understanding social exclusion–A qualitative study. PLOS ONE, 16(6), e0253575. https://doi.org/10.1371/journal.pone.0253575
31. Ortiz-Llorens, M., Cabib, I., & Bambs, C. (2022). Childhood socioeconomic position and cardiovascular disease among older women and men: The moderating role of parenthood onset. International Journal of Public Health, 67, 1604884. https://doi.org/10.3389/ijph.2022.1604884
32. Price, J. H., Khubchandani, J., & Webb, F. J. (2018). Poverty and health disparities: What can public health professionals Do?. Health Promotion Practice, 19(2), 170–174. https://doi.org/10.1177/1524839918755143
33. Radey, M., & McWey, L. M. (2021). Safety nets, maternal mental health, and child mental health outcomes among mothers living in poverty. Journal of Child and Family Studies, 30(3), 687–698. https://doi.org/10.1007/s10826-021-01909-3
34. Radey, M., Ledermann, T., & McWey, L. (2022). Informal support and obligation contribute to fewer child behavior problems over time. Family Relations, 71(3), 1004–1017. https://doi.org/10.1111/fare.12659
35. Raphael, D. (2011). Poverty in childhood and adverse health outcomes in adulthood. Maturitas, 69(1), 22–26. https://doi.org/10.1016/j.maturitas.2011.02.011
36. Round, A., & Longlands, S. (2020). Child poverty and devolution in North East England (pp. 8–39). IPPR North.
37. Saasa, S., Okech, D., Choi, Y. J., Nackerud, L., & Littleton, T. (2021). Social exclusion, mental health, and social well-being among African immigrants in the United States. International Social Work, 64(2), 249–263. https://doi.org/10.1177/0020872820963425
38. Sapkota, T., Houkes, I., & Bosma, H. (2021). Vicious cycle of chronic disease and poverty: a qualitative study in present day Nepal. International Health, 13(1), 30–38. https://doi.org/10.1093/inthealth/ihaa016
39. Seponski, D. M., Somo, C. M., Kao, S., Lahar, C. J., Khann, S., & Schunert, T. (2019). Family, health, and poverty factors impacting suicide attempts in Cambodian women: A qualitative analysis from a randomly selected national sample. Crisis, 40(2), 141–145. https://doi.org/10.1027/0227-5910/a000548
40. Singh, G., Zhu, H., & Cheung, C. R. (2021). Public health for paediatricians: Fifteen-minute consultation on addressing child poverty in clinical practice. Archives of Disease in Childhood. Education and Practice Edition, 106(6), 326–332. https://doi.org/10.1136/archdischild-2020-319636
41. Smith, M. V., & Mazure, C. M. (2021). Mental health and wealth: Depression, gender, poverty, and parenting. Annual Review of Clinical Psychology, 17, 181–205. https://doi.org/10.1146/annurev-clinpsy-071219-022710
42. Southwick, S. M., Sippel, L., Krystal, J., Charney, D., Mayes, L., & Pietrzak, R. (2016). Why are some individuals more resilient than others: the role of social support. World psychiatry, 15(1), 77–79. https://doi.org/10.1002/wps.20282
43. Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups. International journal for quality in health care, 19(6), 349–357. https://doi.org/10.1093/intqhc/mzm042
44. Umeda, M., Oshio, T., & Fujii, M. (2015). The impact of the experience of childhood poverty on adult health-risk behaviors in Japan: A mediation analysis. International Journal for Equity in Health, 14, 145. https://doi.org/10.1186/s12939-015-0278-4
45. Ungar, M., & Liebenberg, L. (2011). Assessing resilience across cultures using mixed methods: Construction of the child and youth resilience measure. Journal of Mixed Methods Research, 5(2), 126-149. https://doi.org/10.1177/1558689811400607
46. UNICEF. (2020). Child poverty: For a child, poverty can last a lifetime. https://data.unicef.org/topic/child-poverty/overview/
47. UN Women. (2021). Economic empowerment: Four facts you need to know about gender and poverty today. https://data.unwomen.org/features/four-facts-you-need-know-about-gender-and-poverty-today
48. Van Duin, L., Bevaart, F., Zijlmans, J., Luijks, M. J. A., Doreleijers, T. A., Wierdsma, A. I., & Popma, A. (2019). The role of adverse childhood experiences and mental health care use in psychological dysfunction of male multi-problem young adults. European Child & Adolescent Psychiatry, 28(8), 1065–1078. https://doi.org/10.1007/s00787-018-1263-4
49. Vilar-Compte, M., Burrola-Méndez, S., Lozano-Marrufo, A., Ferré-Eguiluz, I., Flores, D., Gaitán-Rossi, P., Teruel, G., & Pérez-Escamilla, R. (2021). Urban poverty and nutrition challenges associated with accessibility to a healthy diet: a global systematic literature review. International Journal for Equity in Health, 20(1), 40. https://doi.org/10.1186/s12939-020-01330-0
50. Yuchs, K. C., & Bonham, C. E. (2022). Caring for the poor: Analysis of nurses' attitudes toward the culture of poverty. Journal of Christian Nursing: 39(1), 28–35. https://doi.org/10.1097/CNJ.0000000000000772
51. Żukiewicz-Sobczak, W., Wróblewska, P., Zwoliński, J., Chmielewska-Badora, J., Adamczuk, P., Krasowska, E., Zagórski, J., Oniszczuk, A., Piątek, J., & Silny, W. (2014). Obesity and poverty paradox in developed countries. Annals of Agricultural and Environmental Medicine, 21(3), 590–594. https://doi.org/10.5604/12321966.1120608
52. Wise P. H. (2016). Child poverty and the promise of human capacity: Childhood as a foundation for healthy aging. Academic Pediatrics, 16(3 Suppl), S37–S45. https://doi.org/10.1016/j.acap.2016.01.014
53. World Health Organization (WHO). (2010). Poverty, social exclusion and health systems in the WHO European Region. WHO Regional Office for Europe.
54. World Health Organization (WHO). (2025). World report on social determinants of health equity. WHO. https://www.who.int/publications/i/item/9789240107588