• by Bill Coontz , Op-Ed Contributor, March 7, 2017

There is perhaps no bigger contributing factor to one’s health and life expectancy than poverty. Today, we are seeing the impact among those in lower socioeconomic groups in urban and rural areas.

According to a 2016 study in the medical journal JAMA, the difference in life expectancy between the poorest and most wealthy Americans is between 10 and 15 years. There are several contributing factors. At the very top of the list are those living in poverty struggling to meet basic needs, even with government assistance programs like Medicaid.

Research has demonstrated that poor health can be linked to everything from where one lives to the ability to exercise and eat well. Those living in low-income neighborhoods are also in areas with underperforming schools, high crime rates and a high preponderance of food deserts, which offer no access to healthy foods.

“It’s difficult to exercise in an unsafe neighborhood, or to eat well in a neighborhood where healthy foods are either not sold or are more expensive than unhealthy options,” explains Nancy Adler, director of the Center for Health and Community at the University of California San Francisco.

Yet, the vortex of poverty is mainly generational in nature. If your grandparents lived in poverty, it’s likely that your parents did, too, making it more likely that the current generation will live in poverty, as well.

According to a study from the National Bureau of Economic Research, children from poor families are far less likely to work in adulthood than their counterparts from middle-class families. Approximately 60% of children from the country’s poorest families are employed at the age 30. Contrast that with 80% of children from median-income families, and you can see the divide.The study also found that the more a person’s parents made, it was much more likely he or she would be employed as an adult.

The poverty numbers are staggering. According to the U.S. Census Bureau, more than six% of the entire U.S. population is in deep poverty, including nearly 6.5 million children under the age of 18, which comprises approximately one-third of the deep poverty population. 

How are marketers responding to the impact of poverty and its impact on healthcare decisions? Let’s look at four factors influencing this trend.

A Shifting Focus to Education. Providers and healthcare systems have pivoted to provide a stronger focus on educating patients and engaging with them on a more direct level. According to a survey by the Advisory Board Co., a healthcare consultancy, more than two-thirds of health systems expect their marketing departments to allocate an increased spend on influencing patient behavior, rather than traditional tactics that target physicians and providers. This is a particularly big consideration for those in poverty. Factors like living in “food deserts” with no access to healthy foods is not a situation that can be easily remedied, but education on eating healthy is a more effective strategy for marketers.

An Emphasis on Basic Needs. Lower income households – particularly individuals in the Medicaid population have a very different struggle. Their challenges come in the form of tradeoffs that must be made. For instance, putting food on the table, transportation or housing costs come first and make it difficult for those living below the poverty line to pay for prescription medication or doctor co-pays. Often, they delay getting the medical care they need or treating illnesses simply because they cannot afford the added expenses. In Georgia, where the Medicaid population is serviced by four Care Management Organizations (CMOs), a primary strategy among these CMOs is to focus on solving basic needs. Educating this segment on specific benefits outside of basic healthcare needs is a primary tactic to attract members, particularly during open enrollment periods, where members can sign up or switch providers.

The Move to Mobile. Mobile marketing is an especially well-performing strategy for targeting the Medicaid population, as many Medicaid members have access to a free smartphone via the Lifeline program. As Neng Bing Doh outlined in a story for Managed Healthcare Executive, mobile messaging has emerged as a central part of healthcare marketers overall marketing strategy, shifting from a tactical tool to being integrated into overall strategy. According to a report by Moby Affiliates, a B2B media services company, mobile advertising spending is estimated to reach nearly $200 billion by 2019, 10 times more than was spent in 2013. 

The Trump Effect. In addition to those in deep poverty, healthcare marketers are also targeting groups like millennials, who are struggling with considerable student debt and underemployment. For instance, with the new Trump administration vowing to repeal the Affordable Care Act, there’s an uneasiness about the provision that allow young adults to remain on their parents’ insurance until age 26. Considering the millennial mindset, a growing consideration for healthcare marketers is the fact that there is a strong incentive among this group to shop around for providers, or even forego insurance altogether, choosing instead to pay the fine mandated in the ACA. 

To summarize, healthcare brands and marketers have got to move away from traditional strategies to reach those in lower socioeconomic groups. Marketers need to focus on education and engagement on a direct level and communicate how they can help fulfill basic needs such as transportation and healthy eating habits that contribute to poor overall health. Finally, healthcare brands and marketers should consider increased resources for a mobile marketing strategy. As technology becomes more sophisticated, we will no doubt see additional strategies being developed to target those low-income groups in a meaningful and authentic way.