Take Control!: Linking asset development and chronic disease self-management for low-income working adults

Poverty is one of the strongest determinants of poor health, yet public health organizations rarely design programs to directly address individuals' economic status. One reason for this is the complex and inter-connected relationship of poverty and health. However, the limited evidence of health outcomes from anti-poverty programs and the strong negative impact of poverty on health, suggest a need for public health organizations to include economic interventions as part of their programming. Take Control! is a conceptual map and proposal for integrating asset development (AD) into community-based health settings. AD is an emerging approach to poverty alleviation and wealth accumulation, which aims to help low-income individuals save money to purchase assets such as homes, small businesses, or education, through behavioral and institutional mechanisms (Sherraden, 2007). Through Take Control!, AD can be integrated into existing chronic disease management (CDM) programs. Chronic disease affects more than 25 million people, and CDM programs are established venues for intervening with poor adults (CDC, 2008). The asset development components of Take Control! include: 1) individual development accounts (IDAs), or matched savings accounts; 2) individual financial counseling; 3) financial literacy classes; and 4) community health worker (CHW) peer support. All components can be integrated into chronic disease self-management programs through referrals, and CHWs can provide assessment, support and education through the existing interventions. AD in low-income communities could have positive health effects, but rigorous evaluation would be needed. Take Control! provides the conceptual framework for a pilot program to integrate anti-poverty and public health initiatives.