Academic journal article Journal of Mental Health Counseling

Poor, Rural and Female: Under-Studied, Under-Counseled, More At-Risk

Academic journal article Journal of Mental Health Counseling

Poor, Rural and Female: Under-Studied, Under-Counseled, More At-Risk

Article excerpt

The feminization of poverty has been well documented, and the relationship between the experiences of poverty and negative mental health outcomes has been identified. These consequences remain largely unexamined for women living in rural areas that comprise a population both at risk and underserved by mental health professionals. The dynamics of poverty for these women and the relationship between poverty lifestyles and physical and mental well-being is explored. A model for assessment and mental health interventions is presented. Implications for mental health counseling and for research are considered.

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Poverty and its consequences are associated with pervasive and negative outcomes for individuals throughout their lifespan as well as across generations and are a particular concern for women (DeLeon, Wakefield, Schultz, Williams, & VandenBos, 1989; Gatz & Fiske, 2003). Among more than one billion persons living in poverty worldwide, most living in developing countries (Fourth World Conference on Women [FWCW], 2001), 2% are women living in the United States. In this country, 18,445,000 women, or 13% of all women, are poor, and it is estimated that at least half that number live near the poverty level in circumstances defined as low socioeconomic status (SES; U.S. Census Bureau, 2000). Geographic location is a factor associated with poverty, and several epidemiological studies have established that higher rates of poverty exist in rural areas, where 30% of U.S. women reside (American Psychological Association, 2000; Human & Wasem, 1991). Thus, although overall, approximately one in five women is poor or near poor, the proportion of low SES women in rural areas is even higher.

The gender gap in poverty has not remained constant but has continued to widen in recent decades, resulting in a redefinition of poverty as primarily a women's issue, graphically described as "the feminization of poverty" (Fitzpatrick & Gomez, 1997). Moreover, a cycle of poverty has been identified, in which the factors contributing to and the consequences of being poor become self-perpetuating and lifelong (World Health Organization, 2001). The "cycle of poverty and mental disorders" describes these factors and the complex interplay of the experience of poverty, economic impact of poverty, and increased incidence of mental and behavior disorders (WHO). Most studies underlying this model have examined urban poverty; few studies of poverty in rural areas have been conducted (Amato & Zuo, 1992). As a consequence, mental health professionals know a lot about poverty in general and the gender differential in poverty but know little about rural, poor women, who constitute one third of the total female population. There is also less known about within-group differences, though several studies have suggested that minority women living in rural areas are most likely to experience poverty and its associated negative consequences (DeLeon et al., 1989; APA, 2000).

The results of multiple studies suggest that poverty has broad, negative consequences for psychological well-being and quality of life across the lifespan (Amato & Zuo, 1992; Reutter, Neufield, & Harrison, 2001). Although early intervention has been emphasized as a means of addressing the myriad of problems related to poverty (Harris, 1996), within the counseling literature, intervention programs based on holistic models and grounded in research are lacking. Moreover, as noted in a recent APA report concerning the needs of rural women, "there is a dearth of research concerning the behavioral health needs of this substantial, but frequently unnoticed population" (APA, 2000, p. 1). While current models of poverty display a variety of interacting factors and outcomes, they emphasize pathological outcomes and fail to incorporate the inherent strengths possessed by women. Such strengths represent important resources that mental health counselors may draw upon to help meet the needs of this population (Myers, Sweeney, & Witmer, 2000; Palmo, Shosh, & Weikel, 2001). …

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