The percentage of Americans living in poverty rose in 2022, the first increase in the poverty rate since 2010. According to U.S. Census Bureau data, the overall supplemental poverty rate, which includes government assistance in the calculation as well as medical and work expenses, was 12.4% in 2022, up from 7.8% in 2021. The increase was particularly high for children, with the rate of child poverty more than doubling from 5.2% in 2021, a record low, to 12.4% in 2022. More Americans over 65 years of age also fell into poverty in 2022, 14.1% compared with 10.7% a year earlier.

The increase in the poverty rate is attributed to the expiration of pandemic assistance programs coupled with high inflation in 2022. In 2020 and 2021, individuals and families benefited from multiple government assistance programs, including direct payments to households, expanded unemployment benefits, and rental assistance. These programs expired in 2022, coinciding with higher costs of living. The demise in 2021 of the enhanced Child Tax Credit, which contributed to historic lows in child poverty and food insecurity, is considered a major factor underlying the spike in child poverty.

The rise in poverty has significant implications for health across the life span, lowering life expectancy and increasing risk of chronic disease, higher mortality, toxic stress, and disability. In children, poverty is also associated with developmental delays and nutritional deficits.

Daphne C. Hernandez, the Lee and Joseph Jamail Distinguished Professor at the University of Texas Health Science Center at Houston, whose research focuses on health disparities, notes that poverty increases the risk that patients and families will experience “financial toxicity” due to their inability to pay medical expenses. “Financial toxicity can have a spillover effect on physical and mental health,” Hernandez told AJN. “Patients experiencing financial strain need to decide between paying for medicine/medical care expenses or paying for food.” Instead of consistently following prescribed care, patients may resort to “economic tradeoffs in order to maintain prescribed medical care some months,” she said.

Hernandez underscored the role of nurses in educating patients on public assistance programs and community-based services but added that awareness alone is not sufficient for some patients to access these programs. She urged nurses to bring caseworkers into the mix to follow up with patients and assist them, as needed, “in making the necessary connections.” Nurses can also act as advocates for programs that assist low-income patients and families.

One program that Hernandez encourages all nurses to support is the federal Supplemental Nutrition Assistance Program (SNAP). “It seems that any time there are proposed budget cuts, public programs such as SNAP are at risk,” she said. “SNAP has reduced poverty and consequently hunger and is associated with improved health outcomes and lower medical costs.”—Karen Roush, PhD, RN, FNP-BC, news director