For some poor children, unstable or dangerous physical environments compound the difficulties created by their economic circumstances. These include children without permanent homes because low-cost housing is unavailable, children whose parents are migrants, and children who are in foster care. Native American children and children who live in rural areas or central-city urban areas also experience special health problems. The reasons for higher rates of health problems among poor infants and children are complex and difficult to analyze. These include less than a high school education, birth outside of marriage, single-parent household, teenage motherhood, and feelings of stress and depression.
Poverty also makes it difficult to purchase some of the commodities conducive to good health.
These include adequate housing, nutritious food, transportation, drugs, medical equipment, and safety devices. In addition, poor families frequently have little time available for health-promoting activities. The availability of health services also plays a major role in determining the health status of poor children. Poor families face a number of obstacles in obtaining appropriate health care. Financial problems make it difficult for them to pay for care, and Medicaid and other programs designed to defray health costs are not accessible to all in need.