Poverty in America: how public health practice can make a difference.

Health inequities linked to poverty remain entrenched in certain subgroups in the United States, despite public health efforts to the contrary. My experiences in working with the poor in Nepal and Pakistan informed my later approach to addressing health and poverty in the Appalachians of eastern Tennessee. Three aspects of this approach include enhancing community power through participation in local decisionmaking about health, educating students within the actual context of poverty, and increasing local opportunity by employing people from the communities of concern to serve as a means to reach those communities. Empowerment, education, and opportunity can serve as ways to ameliorate poverty and may serve to modulate the persistent underlying conditions that create and sustain poverty.