Poverty in America/Child Abuse and Neglect/The Forgotten Elderly

Introduction to Literature Review

This is a tripartite literature review revolving around the issue of poverty, child abuse and neglect as well as abandonment of the elderly. Despite the fact that the USA is perhaps the richest nation of earth, it has within it some of the poorest people alive. From the perspective of social stratification, these belong to the lower class. This class encompasses two major categories; the working poor and the underclass. The working poor consists of individuals struggling to break the cycle of poverty through hard work but are yet to succeed while the underclass are the member of the lower class who for one reason or the other cannot work or would not work. The objective of the review seeks to find out the reality of poverty in the USA, the extent thereof, effects and possible remedies. 

The second issue is related to child abuse and neglect. This entails the acts of omission or commission by a parent, guardian or caretaker that results in a threat of or actual fatal or injurious consequences on the child. This literature review seeks to find the types, extent and consequences of child neglect as well as the solutions thereof. The research will also seek to establish any correlation between child neglect and poverty. 

The final issue regards the issue of the forgotten elderly. The developed world has an increasing number of the elderly due to improved healthcare facilities. Further, several factors including improved communication, urbanization and engaging careers have increased the propensity for separation of family units. This has increased chances of the old being abandoned with its kindred consequences. Among the solutions sought for this problem includes the creation of care homes for the elderly. Unfortunately, this solution also carries unique challenges. This literature review will also look at the extent of abandonment for the elderly, its causes, effects and probable remedies. It will also seek to establish any correlation between poverty and abandonment of the elderly.

Literature Review on Poverty

History of the Issue

Poverty has been a part of the American society from the very beginning. According to the article by Evans (2015), poor relevant government policy has always ensured preponderance of poverty in the USA. Whereas there have always been elements of the rich in the society, a majority of the American people have lived in dire poverty. This dates back to as early as slavery and marginalization of the Indian communities. Further, many of the European settlers traveled through bond servitude and this ensured that they started life in America under circumstances that provided little chance for economic growth. 

Later, the indigenous communities were segregated into reserves with little provision in the way of economic activities. This created a major cycle of poverty. Furthermore, the emancipation of slaves was carried out with little or any consideration to the future economic activities of the freed slaves. This created a difficult working environment for the mainly colored community during and post the Jim Crow era. Despite their hard work, through discrimination and lack of opportunities, majority of the descendants of former slaves remain poor.

Causes

Among the leading causes of poverty in the US according to Brady and Bostic (2015) is inequality. America is an extremely capitalist nation meaning that the ability to make money is directly proportional to the ability to invest. The principle investment in the country is education. When some relatively poorer nations in the Nordic region and the Arabic Peninsula provide free education for their citizenry, this is not available in the US. 

From pre-primary education to post elementary education, tuition is extremely expensive. This creates a trend where a poor background almost guarantees poverty in adulthood (McCarthy, 2016). Indeed, even the free elementary education becomes a challenge for children from the underclass. Inability to afford basic amenities such as food, clothing, and shelter makes provision of free education futile (McCarthy, 2016). Even when the child is able to attend school, psychological issues emanating from poverty related complications ensure inability to learn. 

It is also among the poor communities that the issue of substance abuse is prevalent (McCarthy, 2016). This severely limits the ability to earn in future. Another cause of poverty is illegal immigration (Rodriguez & Dawkins, 2016). Currently, there are about 11 million illegal immigrants in the USA and their status almost guarantees a life of poverty. Among the primary grounds for this is exploitation by unscrupulous employers who will seek to pay them way below minimum wages (Rodriguez & Dawkins, 2016). 

Disability also contributes greatly to poverty. This may be occasioned by mental or physical handicap. Most handicapped people find it difficult to get employment and the law also exempts them from minimum wage provisions, thus paving way for exploitation (Walker & Druss, 2016). This ensures that despite their hard work, they remain poor. 

Statistics and Trends

Main Research Overview

An in depth analysis and research regarding poverty in the USA was conducted through a research reported by Shaefer, Wu and Edin (2016). This study was premised on a popular contemporary argument that there are no poor people in the USA and that the lower class seem poor because of the relative prosperous nature of the country. Therefore, the so called poor in the US would seem affluent in poorer nations. This study, therefore, divided poverty into 4 attributive dimensions. 

These dimenstions are life expectancy, infant mortality, risk of homicide and risk of incarceration. Points of comparison were first world countries such as Sweden and Germany and third world countries such as Rwanda, Colombia, Granada, and Sri Lanka. The research used a generalization in determining the poor for ease of statistics. The non-Hispanic whites were the representative of the affluent while African American communities were representative of the American poor.

Infant Mortality 

Country	Infant Mortality (Per 1000 births)
Non-Hispanic Whites	5
Non-Hispanic Black	12
Germany	4
Sri Lanka	9
Malta	6
Grenada	12

As reflected by the research, the infant mortality among the American poor ranks among the highest in the world alongside third world countries such as Grenada.

Life Expectancy

Country	Life expectancy in years
Non-Hispanic Whites (Educated male)	84
Non-Hispanic Black (Uneducated male)	60
Japan	83
Brazil	73
Lao	64
Rwanda	60

The life expectancy of poor Americans seems congruent to that of Rwanda, among the poorest countries in the world. 

Risk of Homicide

Country	Homicide Rate/100,000 people
USA General	5
USA High Poverty areas	25
Germany	2
Pakistan	7
Libya	5
Rwanda	23

The risk of suffering a violent death in the US seems among the highest in the world and exponentially higher than even Pakistan.

Incarceration

Country	Incarceration/ 100,000
USA White Males	700
USA Black Males	4300
Germany	90
Brazil	300
Malaysia	150
Rwanda	600

The risk of getting incarcerated among the American poor is remarkably high and even higher than any other country on earth including dictators. 

The research, therefore, clearly proves that the American poor are not relatively affluent as compared to other countries in the world, but actually relatively poorer than even recorded failing states. 

Interventions

Among the fundamental mitigating factors as suggested by Poudel and McGowan (2015) is a complete change of policy. From a political perspective, the US government has always been reluctant to interfere with the process of capitalism and this has ensured a generational inheritance of social stratification where the poor have remained poor with the rich getting richer. It is time for the government to borrow social democracy policies from Britain and the Nordic region to temper the current version of extreme capitalism. McCarty (2016), provides a suggestion of investing in children to enable their future prosperity. Issues like education, provision of basic needs and healthcare can ensure a metamorphosis into affluence for children from predominantly poor families. 

Literature review on Child Abuse and Neglect

History of the Issue

Research has proven that propensity of child abuse and neglect is transmitted from one generation to the next (Widom, Czaja, & Dumont, 2015). Indeed, the predicament of child neglect and abuse as defined hereinabove is not novel. The advent of industrialization brought with it the vice of child labor, and child neglect as a desire to make money at all costs engulfed the world (Nemeroff, 2016). Prioritization for earning is still as high if not higher than it was during the advent of industrialization. The situation is however, exacerbated today since both men and women have an equal desire to excel in their careers. 

Causes

In most cases, child abuse mainly results from child neglect (Malaniak & Widom, 2015). Children from affluent families, left predominantly in the care of nannies and servants have a high propensity for abuse. This is however, even higher for children from poor families who will be left in the care of their siblings and a collection of relative and neighbors (Malaniak & Widom, 2015). They may also be placed at the mercy of unregistered and unregulated daycare centers where abuse thrives. 

Another cause for abuse is substance abuse. In majority of the cases where children have been subjected to sexual abuse, narcotic use has played a key role (Nemeroff, 2016). This may be through neglect that breeds abuse since the parent in a drug stupor is unable to cater for the child (Oshri et al., 2016). Older children who abuse drugs are also extremely vulnerable to abuse. Alternatively, the abuser may do so due to psychological problems associated with substance abuse (Oshri et al., 2016). In extreme cases, parents have been reported to prostitute their children in order to get money for narcotics though such are extreme exceptions

Statistics and Trends

Main Research Overview

A comprehensive research of the issue of child abuse and neglect in the USA with comparison with world trends was conducted by Mathews et al. (2015). The main premise of the research was that the level of abuse among children is unknown. This was because the highest propensity for abuse with an exception of sexual abuse fell upon children under the age of one. Further, abuse was inversely proportional to age. Therefore, the reported abuse was only a small fraction of actual abuse. 

This research, therefore, attempted to get a clear understanding of the level of abuse and neglect taking place amongst US children. Further, the research also sought to establish how to improve ways and means of detecting abuse on children. A major assumption by the research was that albeit there was no law to that effect, those handling children including caregivers, teachers, and healthcare personnel have an ethical obligation to check for and report any form of child abuse.

Outline of Statistics and Trends

According to the aforesaid research, child neglect and abuse is prevalent worldwide. However, some forms of abuse are more prevalent than others. Adverse effects of child abuse will almost always endure for a lifetime. Child abuse and neglect is responsible for about 155,000 deaths annually in the globe. The lifelong effects include maiming, psychological problems, delinquency, academic limitations, and inability to flourish. 

The total annual economic cost of child abuse is about US$124 billion. Poverty is a major factor influencing abuse where children from poorer background not only have a higher risk of abuse but also less likely to be discovered or reported. Most caregivers, teachers, and healthcare officers feel insufficiently trained to accurately detect and report abuse and this creates a reluctance to report abuse. There is, therefore, a need for training and sensitization of all those who work with children to enable increased detection and reporting of abuse against children.

Interventions

As with the problem of poverty, capitalism is a key culprit. Most people are so keen on looking for money either to survive or thrive that they have abandoned their parental obligations (Metrikin-Gold, 2015). There is an urgent need for a transition towards a more social democratic society. The American dream should be tempered to reflect a holistic wellness as opposed to pecuniary success alone. Further, capitalism creates an element of unconcern about other people’s affairs. This allows for child neglect and abuse to be noticed and ignored. A more socialist approach to life would also cure the same. 

Poverty is a major cause for child abuse resulting from neglect (Metrikin-Gold, 2015). As the problem of poverty is resolved so will the problem of child abuse. Government policy should also be made more stringent with regard to child abuse. Extreme measure should be undertaken upon all who are found to intentionally neglect or abuse children (Metrikin-Gold, 2015). Every parent should be held responsible for the safety of their children. Finally, to curb the issue of non-deception and reporting there should be training and sensitization of all on ways and means of detecting child abuse signs. The obligation to report should also be instilled (Metrikin-Gold, 2015). 

Literature review on the Forgotten Elders

History of the Issue

Unlike poverty and child abuse, dereliction of the duty to take care of the elders is relatively novel. Indeed according to Laborde‐Lahoz, (2015), several historical and contemporary factors have contributed to this situation. The first problem was the breakup of the traditional family unit through industrialization and urbanization. This created a scenario where grownups leave their parental homes and form their own independent nuclear family. Our current generation of the elderly is a product of this nuclear family. The family bond however, remained intact and once a family member was aged or sickly, there would always be a family rural home to retire to. The rural homes eventually petered out or were abandoned and this left the elderly marooned in their nuclear setting. 

Causes

Due to ease of transport and communication, people also began getting jobs far away from home. The USA is a very large nation and it was easy to find individuals from rural areas settling thousands of miles away from home. This increased vulnerability for loneliness in old age. The advent of communication also increased rates of divorce according to Dong (2015) since it removed the last available relative of last resort. This consequently left the elders all alone. The solution being special homes of the elders have also become centers of physical, sexual, and psychological abuse for the elders (Malmedal, Iversen, & Kilvik, 2015). 

Further, due to psychological problem or the traditional customs of machismo, most elders especially males are extremely obstinate (Reynolds et al., 2015). This disenchants relatives and caregivers who abandon the elders and a sense of pride borne out of the said machismo will also not allow the elders to ask for help. They, therefore, suffer neglect in silence. Many of them will result to substance abuse to vent their frustration. Drugs such as opioids are mainly available to the elderly as they mainly suffer from chronic illnesses (West et al., 2015).

Finally, there is the issue of poverty. Among poor families, most people are so busy trying to survive and feed their children that they have no time to cater for the elders. There are also no sufficient funds to hire care givers especially for the invalid or take them to good hospices and care centers. Poverty is perhaps one of the biggest contributors to the problem of neglect of elders.

Statistics and Trend

Senior citizens are most venerable to psychological problems. They are, therefore, persons of extreme interest for the American Psychology Association (APA). This professional body has undertaken an incisive research into the issue of neglect of elders and the kindred abuses, as reported in their article APA (2012). The APA made use of their vast resources and national network to collect statistics and data regarding the instant problem. They then conducted an intensive analysis and study to come up with their report. 

Particulars from the Report

According to the aforesaid research, 4 million elders in the US are victims of some form of abuse or neglect annually. Only 1 out of 23 cases ever get reported (APA, 2012). This is mainly due to isolation of elders. The main forms of abuse include psychological, physical and even sexual abuse. 95% percent of this abuse happens at home as opposed to institutions such as hospitals and care homes (APA, 2012). Whereas the handicapped elders are mainly the victims of abuse, even healthy and agile elders are also subjected to several forms of abuse. This abuse is also universal and cuts across racial and cultural divides with the poor being more vulnerable (APA, 2012).

Interventions

Elders should never be isolated (Pillmer et al., 2016). Unlike children, elders are slightly well known and it is easy to notice that a certain elder from a certain home or family has not been seen for some time. If an elder has been missing for some time, enquiries should be made and in the very least where enquiries are not possible, a report can be made to social services (Pillmer et al., 2016).

Given that poverty is a major cause of elder abuse, all elders are eligible to social services, but many of them lose these vital funds to caregivers or family members. There ought to be some form of follow up by social services to ensure that the lifestyle of the elderly matches their financial status (Pillmer at al., 2016). A culture of respect for the elders should also be encouraged. Finally, extreme measures should be undertaken upon anyone found guilty of any form of elder abuse. 

References

APA (2012).  Elder abuse and neglect: In search of solutions . Retrieved September 13, 2016, from < http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx /> 

Brady, D., & Bostic, A. (2015). Paradoxes of social policy welfare transfers, relative poverty, and redistribution preferences. American Sociological Review, 80 (2), 268-298.

Dong, X. Q. (2015). Elder abuse: systematic review and implications for practice.  Journal of the American Geriatrics Society ,  63 (6), 1214-1238.

Evans, B. M. (2015). Confronting suburban poverty in America.  Planning Perspectives

Laborde‐Lahoz, P., El‐Gabalawy, R., Kinley, J., Kirwin, P. D., Sareen, J., & Pietrzak, R. H. (2015). Subsyndromal depression among older adults in the USA: Prevalence, comorbidity, and risk for new‐onset psychiatric disorders in late life.  International journal of geriatric psychiatry ,  30 (7), 677-685. 

Malmedal, W., Iversen, M. H., & Kilvik, A. (2015). Sexual abuse of older nursing home residents: A literature review.  Nursing research and practice , 2015 . 

Mathews, B., Walsh, K., Coe, S., Kenny, M. C., & Vagenas, D. (2015). Child protection training for professionals required to report child abuse and neglect: Protocol for a systematic review. 

McCarty, A. T. (2016). Child poverty in the United States: A tale of devastation and the promise of hope.  Sociology Compass ,  10 (7), 623-639. 

Metrikin-Gold, B. D. (2015). Personal reflections about the work of the US advisory board on child abuse and neglect.  Child abuse & neglect ,  41 , 3-18. 

Milaniak, I., & Widom, C. S. (2015). Does child abuse and neglect increase risk for perpetration of violence inside and outside the home? Psychology of violence, 5 (3), 246. 

Nemeroff, C. B. (2016). Paradise lost: The neurobiological and clinical consequences of child abuse and neglect.  Neuron ,  89 (5), 892-909. 

Oshri, A., Carlson, M. W., Kwon, J. A., Zeichner, A., & Wickrama, K. K. (2016). Developmental growth trajectories of self-esteem in adolescence: associations with child neglect and drug use and abuse in young adulthood. Journal of youth and adolescence , 1-14. 

Pillemer, K., Burnes, D., Riffin, C., & Lachs, M. S. (2016). Elder abuse: Global situation, risk factors, and prevention strategies.  The Gerontologist ,  56 (Supp 2), 194-205. 

Poudel, R. C., & McGowan, J. G. (2015). Economic growth, development and poverty dynamics: An insight from the social field theory . Retrieved from <http://www.esmsj.upit.ro/ESMSJ%20vol%205(2)%20pentru%20Denis%20pe%20site/ARTICOL%203.pdf/>

Reynolds, K., Pietrzak, R. H., El-Gabalawy, R., Mackenzie, C. S., & Sareen, J. (2015). Prevalence of psychiatric disorders in US older adults: Findings from a nationally representative survey.  World Psychiatry ,  14 (1), 74-81. 

Rodriguez, F. A., & Dawkins, M. (2016). Undocumented Latino Youth: Migration experiences and the challenges of integrating into american society.  Journal of International Migration and Integration , 1-20. 

Shaefer, H. L., Wu, P., & Edin, K. (2016). Can poverty in America be compared to conditions in the world’s poorest countries ? Retrieved from <http://static1.squarespace.com/static/551caca4e4b0a26ceeee87c5/t/57948489d1758ec97e7f783b/1469351050367/Shaefer-international-comparisons.pdf/>

Walker, E. R., & Druss, B. G. (2016). Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the USA.  Psychology, Health & Medicine , 1-9. 

West, N. A., Severtson, S. G., Green, J. L., & Dart, R. C. (2015). Trends in abuse and misuse of prescription opioids among older adults.  Drug and alcohol dependence ,  149 , 117-121. 

Widom, C. S., Czaja, S. J., & DuMont, K. A. (2015). Intergenerational transmission of child abuse and neglect: Real or detection bias?  Science , 347 (6229), 1480-1485.