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Arnold School of Public Health

Rural and Minority Health Research Center partners with Sisters of Charity Foundation to produce report on poverty in South Carolina

March 3, 2021 | Erin Bluvas,

When Melinda Merrell, a research assistant professor with the Rural and Minority Health Research Center, was invited to help lead a study on the structural factors associated with poverty in South Carolina, she gladly accepted. Merrell has spent her entire career – all 12-plus years of it – focusing on rural and minority health issues and disparities in South Carolina, which are significantly influenced by poverty status.

“Working with rural communities across the state to address local concerns regarding health needs highlighted for me the critical needs many of our neighbors have—especially those who identify as a racial/ethnic minority,” Merrell says. “If an individual does not have the means necessary to pay their rent or mortgage, or feed their family, it is difficult for them to even think about, let alone prioritize, their health needs. On another level, we know that simply not having access to safe, affordable housing and adequate nutritious foods affects health directly, which is really what this research was about.”

The Sisters of Charity Foundation of South Carolina, a ministry of the Sisters of Charity Health System that works to address the root causes of poverty, awarded Merrell a grant in 2020 to conduct this research. She recruited Arnold School students Allyson Malbouf (Health Services Policy and Management (HSPM)) and Gabriel Benavidez (Epidemiology and Biostatistics) to join the research team, which also included Foundation staff members Chynna Phillips (research and policy director and 2018 alumna of the combination degree Master of Social Work/Master of Public Health in HSPM program) and Donna Waites (vice president of programs).

Defining poverty as “an experience that occurs when people do not have adequate resources to fully engage in society,” the authors focused on identifying structural factors (i.e., those outside individual control or are at an institutional, community or public policy level) that contribute to poverty. They used data from the U.S. Census Bureau and other national databases to look at six structural factors: economic stability, neighborhood and physical environment, education, food security, community and social context, and healthcare.

Within these categories, the researchers analyzed data related to income levels, medical debt, asset accumulation, use of/access to mainstream (e.g., FDIC-insured) financial institutions, housing affordability (including rental costs, home ownership, and eviction rates), education barriers (e.g., lack of investment in teachers/schools/students, access to preschool, high quality K-12, and technology/Internet), food affordability, health insurance, healthcare access, COVID-19 impacts, and many others. They compared this data by location (e.g., county, nationwide), among different groups and across various points in time.

The authors shared their findings in a detailed, 84-page report as well as a 10-page research brief/executive summary, entitled South Carolina: Structural Factors Associated with Poverty. At the end of January, the Foundation hosted a Screen Side Chat Series on Removing Barriers to Prosperity where Merrell and Phillips shared an in-depth look into the study’s findings.

Some of these key findings included South Carolina’s ranking as one of the poorest states in the United States. Approximately 16 percent of South Carolinians experience poverty, compared to the national average of 14 percent. The annual median household income in South Carolina is $51K while the national average is $60K, and nearly one third of employers in the state offer no benefits. In terms of medical debt, South Carolina’s rates are three times the national average (27 percent vs nine percent).

Based on 2015 data, the researchers observed that nearly half of the state’s residents (approximately 2.3 million) live in areas of low food access. This particular barrier is compounded by the closure of grocery stores (e.g., 105 closures between 2016 and 2020) and transportation challenges. Public, especially reliable/affordable, transportation access is limited in many areas of South Carolina, leading families to spend an estimated 34 percent (compared to 28 percent nationally) of their income on transportation – which impacts many other aspects of their lives (e.g., access to employment, education, healthcare, fresh food).

“Poverty in South Carolina is a complex, multifactorial phenomenon that needs to be examined as such,” the authors write in the report’s conclusion. “Clearly much work is necessary to reconfigure and perhaps even dismantle the structural factors perpetuating poverty in South Carolina if the state is to reduce the frequency and severity of need among its residents.”

Since 1996, the Sisters of Charity Foundation has invested over $75 million across all 46 South Carolina counties through more than 3,000 grants. In 2020, as an outcome of the Foundation’s strategic plan, staff members partnered with the Rural and Minority Health Research Center at the University of South Carolina to conduct research that quantitatively assesses the factors that contribute to poverty throughout the state. The explicit goal of the research was “to identify, acknowledge, and examine the systemic and policy factors that lead to, reinforce, and exacerbate poverty specifically for the residents of South Carolina.”


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