Service-Learning in a Free Clinic: Cultivating Culturally Informed Care

Background

Poverty affects 14.4% of persons in the US (Center on Poverty & Social Policy, 2022). Approximately 30% of US residents are low-income making less than 200% of Federal Poverty Guidelines (FPG) and this number is rising. Income levels impact minority groups disproportionately with 41% of Black households and 40% of Hispanic considered low-income vs. 24% of white households (Kochhar & Sechopoulos, 2022). Income has a major impact on health. Poverty is recognized as being one of the greatest predictors of poor health outcomes in the US (Healthy People 2020, 2022). The life expectancy of the poorest one percent is 10-15 years shorter than the richest one percent and the income gradient corelates well along the continuum (Chetty et al., 2016). Low-income people are at higher risk for five of the ten top causes of disease and disability including cardiovascular disease, diabetes, depression, obesity, and chronic lung disease. Low-income adults are five times more likely to report their health as poor to fair than families with incomes over 400% of federal poverty guidelines. Their children are four times more likely to have poor health and are at higher risk for asthma, heart disease, and elevated lead levels (Woolf et al., 2015). Low-income patients are more likely to lack health insurance or delay seeking medical care due to costs (Ortaliza et al., 2022).