The Greatest Threat to Children's Well-Being
Snap quiz: What do you think is the greatest public health threat to children in the U.S.?
Hints:
What could it be? Obesity? Drug resistant bacteria? Car accidents? TV? Sex, drugs and rock & roll? Jerry Springer?
The answer is poverty.
Poverty is - by far - the greatest public health menace facing American children. Its victims, however, are small, powerless, and seemingly far away. It is, in large part, a silent epidemic.
I'm sure it comes as no surprise that children born into impoverished circumstances are at higher risk for any bad health or developmental outcome you can name. In fact, they experience "double jeopardy":
I have spent my professional career working in an urban, inner-city hospital and have witnessed poverty's devastating impact on children and families. But let me be clear: I'm neither a masochist nor a saint. More often than not I am inspired as I see children and families triumphing over their adverse circumstances, working with all their hearts to fashion meaningful and worthwhile lives out of the many challenges. I often wonder: would I be as courageous, as resourceful, as resilient, had I been born into such economic adversity?
Having said that, I don't want to romanticize the lives of poor families. Poverty sucks - no two ways about it. It can contaminate all aspects of a child's well-being and, subtly and tragically, prevent a child from reaching his full potential - for academic success, for rewarding work, for meaningful relationships, for good health, for happiness.
Given poverty's pervasiveness and its corrosive effect on our society, I'm distressed that the needs of poor families are pretty much off the political radar screen. That's why I hope you'll stick around my blog as I share some what I've learned about children and families living in poverty and why I think it's such an important issue to tackle.
Let's start with a simple question: what makes a family "poor"?
Since being poor is an intensely personal experience, I'd like you to think about what would be your definition of poverty for your own family. Let's assume you are living in a family of 4 - two adults and two kids. What is the minimum income you would need to not consider yourself poor? I realize, of course, that this is totally arbitrary (as all definitions of poverty are) but go ahead and be as arbitrary and as personal as you like. What is your poverty line for a family of 4?
Here's what Uncle Sam has to say on this matter. The established Federal poverty line for a family of 4 is $20,640.
Surprised? I suspect your personal poverty line was much higher than $20,000 (most come up with at least 2-4 x that amount). It seems so paltry. Where did this number come from?
The federal poverty line was created in the 60's to boost the War on Poverty (after all, how can you conduct a war if you can't identify the enemy?). They were looking to set an absolute income threshold below which families would "lack the resources to meet the basic needs for healthy living, having insufficient income to provide the food, shelter and clothing needed to preserve health." Fair enough.
Then they reasoned thusly: A family spends about 1/3 of their income on food, 1/3 on housing and 1/3 on other stuff. Let's estimate the minimum a family could pay for food and remain adequately nourished (called the "thrifty food plan"). Multiply that number by 3 and, presto, the federal poverty line is born.
Do the math and you'll see that in 2007 this amounts to spending about $15 a day on food for a family of four. You got a problem with that? And, as I'm sure you've realized, housing now grabs much more than 1/3 of most folk's income. And the cost of living is much higher in some areas. And non-cash benefits (like Medicaid, food stamps) are not added to the equation (as a result the "near poor" - who are not eligible for federal and state subsidies - are often in even worse shape than the poorer families who who are eligible).
The bottom line is an unrealistically low poverty threshold. If used alone as a measure of poverty, it vastly underestimates the number of poor families in the U.S. That's why many programs (like Medicaid, food stamps) allow an income 2-3 times the federal poverty line to gain eligibility. (The current debate over children's supplemental health insurance has to do with how much income a family must have to be eligible. Some states want 3-4 times the poverty line, but the president nixed that as too much income to qualify and a step to socialized medicine).
So, when you hear the about the numbers of kids in poverty ask yourself: how is "poverty" being defined and how many more kids and families could be considered poor if the criteria for poverty were changed (for example, if your personal poverty line were used)?
So much for Poverty 101. In the next post, I'd like to talk about why poor families are poor, why poverty has such a negative effect on some kids but not on others, and perhaps what we might try to do about it.
In the meantime, I'd be interested in your thoughts:
Related Topics: Technorati Tags: poverty, medicine, pediatrics, health and wellness
Hints:
- Approximately 13-40 million children in the U.S are exposed to this risk (depending on how you define it).
- The younger you are, the more likely you are to be exposed to it (43% under 3 years, 35% ages 15-17).
- Minority children are more likely to be exposed to it (35% of black children, 29% American Indian, 28% Latino, 11% Asian and 10% white)
- Because most kids in the U.S. are Caucasian, more white kids are exposed than any other group.
What could it be? Obesity? Drug resistant bacteria? Car accidents? TV? Sex, drugs and rock & roll? Jerry Springer?
* * * *
The answer is poverty.
Poverty is - by far - the greatest public health menace facing American children. Its victims, however, are small, powerless, and seemingly far away. It is, in large part, a silent epidemic.
I'm sure it comes as no surprise that children born into impoverished circumstances are at higher risk for any bad health or developmental outcome you can name. In fact, they experience "double jeopardy":
- They are more likely to be exposed to threats to their well-being (pick your poisons: inadequate nutrition, underfunded schools, overcrowded homes, lack of access to health care, family dysfunction, neighborhood and domestic violence, abuse and neglect, inadequate child care, lead poisoning...).
- They experience worse long term outcomes when exposed to these threats than do advantaged children.
* * * *
I have spent my professional career working in an urban, inner-city hospital and have witnessed poverty's devastating impact on children and families. But let me be clear: I'm neither a masochist nor a saint. More often than not I am inspired as I see children and families triumphing over their adverse circumstances, working with all their hearts to fashion meaningful and worthwhile lives out of the many challenges. I often wonder: would I be as courageous, as resourceful, as resilient, had I been born into such economic adversity?
Having said that, I don't want to romanticize the lives of poor families. Poverty sucks - no two ways about it. It can contaminate all aspects of a child's well-being and, subtly and tragically, prevent a child from reaching his full potential - for academic success, for rewarding work, for meaningful relationships, for good health, for happiness.
Given poverty's pervasiveness and its corrosive effect on our society, I'm distressed that the needs of poor families are pretty much off the political radar screen. That's why I hope you'll stick around my blog as I share some what I've learned about children and families living in poverty and why I think it's such an important issue to tackle.
* * * *
Let's start with a simple question: what makes a family "poor"?
Since being poor is an intensely personal experience, I'd like you to think about what would be your definition of poverty for your own family. Let's assume you are living in a family of 4 - two adults and two kids. What is the minimum income you would need to not consider yourself poor? I realize, of course, that this is totally arbitrary (as all definitions of poverty are) but go ahead and be as arbitrary and as personal as you like. What is your poverty line for a family of 4?
* * * *
Here's what Uncle Sam has to say on this matter. The established Federal poverty line for a family of 4 is $20,640.
Surprised? I suspect your personal poverty line was much higher than $20,000 (most come up with at least 2-4 x that amount). It seems so paltry. Where did this number come from?
The federal poverty line was created in the 60's to boost the War on Poverty (after all, how can you conduct a war if you can't identify the enemy?). They were looking to set an absolute income threshold below which families would "lack the resources to meet the basic needs for healthy living, having insufficient income to provide the food, shelter and clothing needed to preserve health." Fair enough.
Then they reasoned thusly: A family spends about 1/3 of their income on food, 1/3 on housing and 1/3 on other stuff. Let's estimate the minimum a family could pay for food and remain adequately nourished (called the "thrifty food plan"). Multiply that number by 3 and, presto, the federal poverty line is born.
Do the math and you'll see that in 2007 this amounts to spending about $15 a day on food for a family of four. You got a problem with that? And, as I'm sure you've realized, housing now grabs much more than 1/3 of most folk's income. And the cost of living is much higher in some areas. And non-cash benefits (like Medicaid, food stamps) are not added to the equation (as a result the "near poor" - who are not eligible for federal and state subsidies - are often in even worse shape than the poorer families who who are eligible).
The bottom line is an unrealistically low poverty threshold. If used alone as a measure of poverty, it vastly underestimates the number of poor families in the U.S. That's why many programs (like Medicaid, food stamps) allow an income 2-3 times the federal poverty line to gain eligibility. (The current debate over children's supplemental health insurance has to do with how much income a family must have to be eligible. Some states want 3-4 times the poverty line, but the president nixed that as too much income to qualify and a step to socialized medicine).
So, when you hear the about the numbers of kids in poverty ask yourself: how is "poverty" being defined and how many more kids and families could be considered poor if the criteria for poverty were changed (for example, if your personal poverty line were used)?
So much for Poverty 101. In the next post, I'd like to talk about why poor families are poor, why poverty has such a negative effect on some kids but not on others, and perhaps what we might try to do about it.
In the meantime, I'd be interested in your thoughts:
- What is your definition of family poverty and by what income threshold would you consider your own family "poor"?
- Whose fault is it - society's or the individual's - that the poor are poor in this rich nation, so full of opportunity?
- Why do some poor families and children do well, while others fall down the well?
- What do we as a society owe (if anything) to our poorest citizens - the children?
* * * *
Primary source:
National Center for Children in Poverty
National Center for Children in Poverty
Related Topics: Technorati Tags: poverty, medicine, pediatrics, health and wellness
