Poverty increases both exposure and vulnerability to disease by restricting access to safe housing, sanitation, nutrition and healthcare. The relationship is also cyclical: illness can reduce income and push households further into poverty.
This issue belongs to the Health topic area of the HL extension and connects directly to Poverty, Development and Sustainability, and Rights and Justice.
| Poverty-related factor | Mechanism linking it to disease |
|---|---|
| Unsafe water and sanitation | Contaminated water and inadequate waste disposal increase transmission of diseases such as cholera. In Zambia, densely populated parts of Lusaka with limited clean water and sanitation experienced particularly high cholera incidence during the 2023 to 2024 outbreak. By March 2024, Zambia had recorded 22,720 cases and 723 deaths. |
| Overcrowded housing | Close contact and poor ventilation accelerate airborne transmission. This is especially important for tuberculosis. |
| Undernutrition | Inadequate nutrition weakens immune responses, making infection more likely to develop into serious disease. The World Health Organization estimated that undernutrition contributed to approximately 0.97 million new tuberculosis cases in 2024. |
| Limited healthcare access | Treatment fees, transport costs and weak local health systems delay diagnosis and treatment. Infected people therefore remain untreated for longer and may transmit disease to others. |
The relationship also involves power and interdependence. Governments decide how resources are distributed between sanitation, housing and healthcare, while organizations such as the World Health Organization coordinate surveillance, vaccination and emergency support across borders. Unequal access can be analysed through Galtung's concept of structural violence, although this model is an analytical tool rather than prescribed theory.
A common misconception is that poverty directly causes pathogens. It does not. Poverty creates social and political conditions that make exposure, transmission and severe outcomes more likely.
Exam technique: In an HL Paper 3 response, explain the causal chain rather than merely stating that poverty and disease are correlated. Use a dated case, identify relevant actors, and connect Health to at least one other HL topic area, such as Poverty, while evaluating both domestic policy and international action.