"Except for a small class of highly affluent Americans, income for the entire U.S. population has fallen since 2000," study lead author Steven Woolf, professor of family medicine at Virginia Commonwealth University, told United Press International. "And there is a very strong link between income and health."

The percentage of Americans living in severe poverty -- with incomes less than half of the federal poverty line -- grew by 20 percent, or 3.6 million individuals, between 2000 and 2004, according to the study of U.S. Census data that appears in the October issue of the American Journal of Preventive Medicine.

In 2004 the federal poverty line for a family of four was $19,307.

Meanwhile, the incomes of Americans above the federal poverty line also seem to be migrating downward, except for those in the top 1 percent, a phenomenon the researchers call the "sinkhole effect."

"This is not just a problem for the poor," Woolf said. "In general Americans are worse off."

Children are being especially hard hit, according to the study. One in three of the individuals living in severe poverty were children, and children under age 5 are twice as likely to be living in severe poverty as the rest of the population.

And minority children were at the greatest risk of all. The researchers reported that almost half of Hispanic and African-Americans living in severe poverty were children.

"The burden of raising children under the conditions of extreme poverty falls disproportionately on minorities," he said.

That poverty has a variety of far-reaching negative effects for public health, Woolf said.

The severely poor are less likely to have good jobs that come with health insurance, and they have less income available to pay for healthcare out of pocket, he said. Health-club memberships and healthy foods are nearly impossible to afford on a tight budget, and the poor are generally clustered in neighborhoods that are unhealthy environments.

As a result, the poor are much more susceptible to chronic conditions, or severe health problems that happen when needed care gets put off, Woolf said, and that increase in poor health, especially in children, will have ramifications for the entire health system.

"As a result of the growth in poverty, the health system will have a much bigger task on its hands. The consequences of childhood exposure to severe poverty will be living with us for many years," he said.

The trend of increased poverty is affecting the opportunities available to Americans in a variety of areas including healthcare, housing and education, Alan Jenkins, executive director of the Opportunity Agenda, a non-profit social justice group, told UPI.

In terms of healthcare, "as people who are working are getting poorer and poorer, they can't afford access," Jenkins said.

In the future, this gap is likely to increase, he said. "It's a cycle. If you can't raise a healthy family, it's much less likely your kids will grow up and be able to."

In addition, for many families a bout of severe illness is a financial calamity from which it is difficult to ever recover, he said.

The best solution to the growing divide is a universal healthcare system, Jenkins said. "It's an achievable goal. The benefits will be vast and extend throughout our entire society.

"If we can be healthier as a country, we won't face the devastating consequences of illness."

However, though the negative effects of poverty on health are not disputed, federal income statistics may actually be overstating the hardship poor individuals face, Nick Eberstadt, a researcher at the conservative American Enterprise Institute, told UPI.

"The official poverty rate is an increasingly misleading indicator of material deprivation in the United States," he said. "Although official poverty has indeed been rising, what has also been rising is the expenditure level of the poorest fifth of the U.S. population."

The difference between expenditure level and income is explained by the fact that most families are not perpetually severely poor, Eberstadt said. Most families cycle in and out of severe poverty, so they can use savings, assets and credit accumulated in good years to bolster their spending power in lean years.

"Only a very small fraction of households have very low incomes year-in and year-out," he said.

Likewise, though the official poverty rate is increasing, the access of the poor to healthcare is also on the rise, he said. "The access of the poverty population to medical care has been steadily increasing."

When viewed in this way, the trend for all groups -- including the severely poor -- is positive.

And though the poor have less access to healthcare than their wealthier counterparts, they still have more access to better healthcare than anyone did 20 years ago, he added.

"The trends are going in the right direction, not the wrong direction," Eberstadt said.

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