Beyond income: Understanding poverty in poor New York City neighborhoods

Poverty is an important social determinant of health. Most poverty measures use income data. Yet the meaning of particular income levels across settings may differ due to several factors, including cost-of-living. We sought to understand poverty beyond income measures. The parent study was aimed at exploring the relation between neighborhood factors and HIV risk, substance use, and mental health. We examined the dimensions of non-income measures of poverty using a cross-sectional study in 38 economically-disadvantaged New York City neighborhoods and conducted a factor analysis to examine dimensions of poverty. The sample (n=1500) was predominantly Black (50.3%) and Hispanic (37.7%); the mean age was 39.1. 63.7% were current drug users, 21.7% were former drug users, and 14.2% were non-drug users. In terms of income, 74.8% reported a legal income of <$000/year and 77.1% reported an untaxed income of <$000/year. Three factors were identified: employment/money, housing/clothing, and health/social assistance. We report the proportion having each item less than half the time in the last 6 months: employment/money [good job for self or spouse (68.5%) and money for buying necessities (34.6%), buying things for self (45%), entertainment (56.7%) and savings (76.7%)], housing/clothing [house or apartment (29.4%), clothes for self/family (24.9%), indoor plumbing/water (17.6%), heat (24.2%), furniture (32.4%)], and health/social assistance [medical (18.9%) and dental care (23.6%) for self/family and adequate public assistance (31.1%)]. Study respondents faced considerable deprivation in terms of income and non-income dimensions of poverty. The non-income measures provide a deeper understanding of the challenges faced by those living in poverty.