Tag Archives: Poverty

The big problem with one of the most popular assumptions about the poor

By Roberto A. Ferdman

In the late 1960s, Walter Mischel, a researcher at Stanford University, invited several hundred children to participate in a game in which they were given a choice: They could eat one sweet right away, or wait and have two a little later. Initially, the goal was simple: to see how and why people (kids in this case) delayed gratification. But after the end of the experimentMischel began to check in with as many of the participants’ families as he could, and over the following decade he learned that his little experiment probably had much larger implications than he had anticipated.

Many of the children had trouble resisting the single, immediate treat (a marshmallow), which was to be expected. The magnetic force that exists between kids and candies is no secret. What was surprising, however, was that that tendency — the inability to forego something good right now in exchange for something better in a bit — was associated with all sorts of negative life outcomes, including lower levels of academic achievement and higher rates of obesity.

Over time, Mischel’s experiment, which is often referred to as “the Marshmallow Test,” has turned into perhaps the most famous study of its kind, inspiring many others, including follow-ups by Mischel himself.

Watch Walter Mischel, the creator of the Marshmallow Test, discuss its implications


Time and again, poor children have performed significantly worse than their more fortunate counterparts. A 2011 study that looked at low-income children in Chicago noted how poor children struggled to delay gratification. A 2002 study, which examined the physical and psychological stresses that accompany poverty, did too. And so have many others.

The realization has sparked concerns that poverty begets a certain level of impulsiveness, and that that tendency to act in the moment, on a whim, without fully considering the consequences, makes it all the more difficult for poor children to succeed. But there’s an important thing this discussion seems to miss. Poor kids may simply not want to delay gratification. Put another way, their decisions may not reflect the sort of impulsive nature we tend to attribute them to.

“When resources are low and scarce, the rational decision is to take the immediate benefit and to discount the future gain,” said Melissa Sturge-Apple, a professor of psychology at the University of Rochester who studies child development. “When children are faced with economic uncertainty, impoverished conditions, not knowing when the next meal is, etc. — they may be better off if they take what is in front of them.”

A recent two-part study conducted by Sturge-Apple shows how the tendency of poorer children to pounce on immediate rewards might not be the result of impulsiveness but rather of careful consideration.

In the first experiment, she monitored the heart rate of 200 low-income 2-year-olds. The monitoring allowed her to approximate each child’s vagal tone — a measure of the activity of the vagus nerve, which has been shownto indicate how well a given individual performs under stress (i.e., reads social cues, reacts to environmental contexts, and adjusts behaviors). High vagal tone is good: it suggests a heightened ability to act relatively calmly under stress. Low vagal tone is bad: it suggests just the opposite.

Two years later, at the age of 4, the same children were presented with a choice. Each was sat a table where two plates and a bell were placed. One plate held two M&Ms, while the other held five. The children were told that they could either ring the bell and have the two M&Ms immediately or enjoy the plate of five as soon as the experimenter returned.

Interestingly, each child’s vagal tone appeared to have a significant effect on their decision. But — and this is an important but — it didn’t have the sort of effect many would have imagined. The higher the child’s vagal tone — the greater, in other words, a child’s ability to act calmly under pressure — the more likely the child was to ring the bell. The calmer the children were to think it through, the more likely they were to choose the immediate reward.

In other words, they probably weren’t acting on impulses or whims, as one might assume. The calculation might have not have been optimal, but it was likely considered, and that informs the sort of intervention psychologists might use to help.

In the second experiment, Sturge-Apple used data from a longitudinal study, which included a sample of 140 mother-and-child pairs. The information gathered was similar. Vagal tone was measured for each child at 18 months. The same test was also administered, this time with three and eight M&Ms, and at age 5 instead of 4. This time, roughly half of the mothers were both college-educated and wealthy, while the other half were both non-college-educated and poor. And it produced a fascinating outcome.

The children born to college-educated mothers of high socioeconomic status acted exactly as one would expect. The higher their vagal tone, or calmness under stress, the more likely they were to hold out for the five extra M&Ms. For children born to non-college-educated mothers of low socioeconomic status, on the other hand, the outcome was exactly the opposite. The higher their vagal tone, the less likely they were to wait.

The chart below, plucked from the study, shows just how stark the divergence is.


(Source: APS journal Psychological Science)

Why exactly socioeconomic status appears to have such a severe influence on how children approach this problem is unclear, but Sturge-Apple believes it probably has to do with context. The circumstances in a controlled experiment might be the same for poor and rich kids alike. But the reality for poor and rich kids, which influences not only their behavior but also the inner pendulum that informs their decisions, is quite different.

“One size does not necessarily fit all,” Sturge-Apple said. “Our theories, which are based upon limited samples, may not reflect the realities faced by many children.”

This might seem like a nuanced point, but it’s an important one, because it shapes how we label certain behavior and lift up impoverished youth. If a child is choosing immediate rewards at the expense of future gains not because the child is impulsive, then helping that child adjust to an environment in which resources such as money and other assets (or even just marshmallows and M&Ms) are easier to come by should reflect that understanding.

“It changes the nature of the question from one asking is this a ‘bad’ or a ‘good’ behavior to asking, ‘What is the function of this behavior for survival and thriving in a resource-poor environment?’ ” said Sturge-Apple. “I think once we start asking that question, we may find better ways to tailor intervention and prevention work for children at risk.”

In some ways, this uncovers a broader problem with how we perceive the actions of people who live very different lives than we do. We brand certain actions and choices as mistakes, when they might simply be developmental adjustments necessary to cope with their environment. For those who don’t worry about their next meal, because they never had to, choosing a marshmallow now instead of two marshmallows in a few minutes, all things equal, could only be the result of impulse-driven folly. For those who do have to worry about the next meal, passing up food now for the promise of food later is the misguided move.

While Sturge-Apple’s research has focused on children, there’s reason to believe the same dubious assumption likely affects how we treat low-income adults. In the United States, contrary to international trends, poor people are far more prone to obesity than their wealthier counterparts. And while there is good reason to believe it is, at least in part, a result not of how much poorer households are eating but of what they are eating, there is also evidence that those who suffer through poverty at a young age develop a fractured ability to regulate eating that can last a lifetime. A three-part study conducted earlier this year found that adults who grew up in low-income households tended not only to eat but to eat roughly the same amount of food, whether they were hungry or full.

To some, this might seem like a question of willpower, but that’s likely a bit shortsighted. Assuming the poor are more prone to impulsivity doesn’t properly consider the severe circumstances in which many are forced to live, and how those circumstances shape a person’s rational behavior.

“When you grow up in these types of environments, you’re effectively being trained to eat when you can instead of when you’re hungry,” Sarah Hill, who teaches psychology at Texas Christian University, told The Washington Post earlier this year.

You might also be programmed to eat when possible because experience tells you the next bit of food, however large it might be, is never guaranteed.



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Blood Plasma, Sweat, and Tears

How America’s poor sell the contents of their veins to get by


There is no money to be made selling blood anymore. It can, however, pay off to sell plasma, a component in blood that is used in a number of treatments for serious illnesses. It is legal to “donate” plasma up to two times a week, for which a bank will pay around $30 each time. Selling plasma is so common among America’s extremely poor that it can be thought of as their lifeblood.

But no one could reasonably think of a twice-weekly plasma donation as a job. It’s a survival strategy, one of many operating well outside the low-wage job market.

In Johnson City, Tennessee, we met a 21-year-old who donates plasma as often as 10 times a month—as frequently as the law allows. (The terms of our research prevent us from revealing her identity.) She is able to donate only when her husband has time to keep an eye on their two young daughters. When we met him in February, he could do that pretty frequently because he’d been out of work since the beginning of December, when McDonald’s reduced his hours to zero in response to slow foot traffic. Six months ago, walking his wife to the plasma clinic and back, kids in tow, was the most important job he had.

The first thing the 21-year-old does when she gets to the donation center is check in, and as a regular donor, she can bypass the initial, time-consuming health screening. She proceeds to a kiosk, rhythmically clicking the mouse to answer the required questions about her health. “When you get there, they have you fill out … 22 questions … They ask you about your health and, like, if you’ve had any recent tattoos or been in jail or had any piercings lately.” Her husband has too many tattoos and doesn’t remember the exact times and places he acquired all of them, details that the plasma center requires. He says he has been told he “need not come by” to donate.

After completing these initial steps, she sits in the waiting room, listening for her name to be called. She describes what happens after that: “They take your blood pressure and your temp. And then if everything is okay, you wait and get your finger pricked to test for your iron and your protein and stuff … Usually, it be during my time of the month that my iron really goes down.” Lately, the iron pills she has tried haven’t been working. This terrifies her, because “donating” is the bedrock of the family’s finances right now. The phlebotomist in charge of the finger pricking has told her that “if the iron pills don’t help, [it means] I could be, like, anemic.” Anemics are barred from donating.

Today, like other days, she’s nervous—what will happen if she is not allowed to give plasma? The family desperately needs the $30. They’re now nearly three months behind on the rent. Once she passes all the tests, she proceeds to the back room, where she’s directed to a recliner. Today she has brought along a Nicholas Sparks novel she checked out of the library. “I always bring a book with me,” she says.

A technician feels around for her vein with a plastic-gloved finger, rubs on some iodine with a Q-tip, positions an IV, and inserts a needle. For the usual donor, the procedure takes about 45 minutes, but for her it takes well over an hour, as she is just over the minimum weight of 110 pounds. “I get tired. Especially if my iron’s down, I get, like, really tired,” she says. The ritual takes roughly three hours, door to door. Even so, the payoff is relatively good: $10 an hour. As long as her iron, blood pressure, and temperature are okay, she’ll donate as often as she is legally allowed.

Later, she says the procedure makes her squeamish. “I can’t ever look at it. I never look at it when they do it. They do it right here,” she says, pointing to the obvious indentation at the crease in her arm, which looks somewhat like a drug track line. Many among the extreme poor bear these small scars from repeated plasma donations.

* * *

Before welfare died in 1996, a family of three couldn’t live solely on the $360 or so the program provided on average. Just prior to welfare reform, it took roughly $875 to meet such a family’s monthly expenses, but families could generally get only about three-fifths of that from the combination of cash welfare and food stamps.

To make matters worse, when a mother secured a job, she would lose about a dollar in welfare benefits for every dollar she earned. Often, she couldn’t afford to rely only on earnings from work in the formal economy. Work paid only a little more than welfare but cost a lot more in terms of added expenses for transportation, child care, health care, and the like. It was more expensive to go to work than stay on the welfare rolls.

Back then, neither welfare nor work could singlehandedly bring a poor family’s budget into balance, yet the ability to combine them legally was limited at best. How did these single mothers survive?

Some gleaned some sustenance through private charities, as the couple in Johnson City do now. In addition, at any given time, almost half of single mothers on welfare were secretly working. Some used a false identity to avoid detection, or hopped from job to job, since short stints wouldn’t typically get reported to the welfare office. Those without a formal job did hair, babysat, sold meals, cleaned homes, or, occasionally, resorted to fencing stolen goods or selling drugs or sex. Back before welfare reform, the strategies poor single mothers employed were hardly get-rich-quick schemes; they provided a few dollars here and there, often garnered with considerable effort. When combined with welfare, plus a lot of old-fashioned frugality, these strategies usually allowed for a bare-bones survival.

Today, a striking number of Americans live on extremely small incomes. As of early 2011, 1.5 million households (with roughly 3 million children) were surviving on cash incomes of no more than $2 per person, per day, during any given month. What’s different these days—and what affects the $2-a-day poor so profoundly—is that welfare can no longer be counted on to provide a floor of cash that families can depend on.

The variety of survival strategies used by today’s $2-a-day poor are variations on the same tactics poor families used a generation ago to get by: private charity, a variety of small-time, under-the-table schemes, and plain old thriftiness. Even those somewhat higher up the income ladder today, who have steady jobs, draw on such strategies from time to time when the money doesn’t quite stretch to the end of the month. But the degree to which people must resort to the riskiest strategies—those that can exact a sharp psychological, legal, and even physical toll—appears to be an order of magnitude greater for the virtually cashless poor than it is for poor families with some cash on hand.

Far from being passive, many among the $2-a-day poor take what few resources they have and try to “make the best out of a bad,” as the son of one cash-strapped parent put it. While the circumstances that they find themselves in may appear wholly un-American, in many ways their actions and outlooks are as American as they come: often surprisingly optimistic, creative, family-focused, scrappy, and imbued with a can-do spirit that belies their desperate circumstances. They may be officially jobless, but they are laboring intently. Their work can be grueling, and, at times, it’s work into which they’re literally pouring their blood, sweat, and tears.

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Posted by on September 1, 2015 in African American Health


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Income inequality begins at birth and these are the stats that prove it

Children riding home from school on a school bus watch as Baltimore residents celebrate at the corner of West North Avenue and Pennsylvania Avenue after Baltimore authorities released a report on the death of Freddie Gray on May 1, 2015 in Baltimore. Photo by Win McNamee/Getty Images

Editor’s note: In this essay, Economist John Komlos argues that we must look more deeply at the recent events in cities like Baltimore, New York and Ferguson, Missouri, and consider the socioeconomic plight of young black men in America, especially in neighborhoods where educational attainment is low and poverty is high. Komlos is the author of “What Every Economics Student Needs to Know and Doesn’t Get in the Usual Principles Text.”

Even conservative Republican Alan Greenspan, an ardent advocate of free markets, is beginning to see inequality as a fundamental threat to the system and admits that, “You cannot have the benefits of capitalist market growth without the support of a significant proportion, and indeed, virtually all of the people; and if you have an increasing sense that the rewards of capitalism are being distributed unjustly the system will not stand.”

Well, the system was not standing very sturdily during the days of rage in Baltimore or in Ferguson. So we need to look beyond the ugly surface manifestations of young black men being shot in the back or suffocated and consider the deeper socioeconomic plight of this demographic in this country in 2015. The truth of the matter is that people of color are disadvantaged by the current socio-economic system from the very beginning of their lives.Problem no. 1: babies born in low-income neighborhoods will go to bad schools. Problem no. 2: bad schools mean low educational attainment. In Baltimore, 22 percent of African Americans have no high school diploma compared to 15 percent of whites. At the national level, the ratio is 2:1 (15 percent to 7.6 percent).

What is the system that keeps people of color at the lower echelons of the socio-economic hierarchy? It begins at birth.

Problem no. 3: low skills mean no jobs. The inconvenient truth is that the unemployment rate among African Americans is 10.4 percent — twice that of whites. But that is not the whole picture. The underemployment rate is more relevant, because it reflects more accurately the real amount of pain in the system. The underemployment rate includes people who are so discouraged that they are not looking for work any more or they no longer have gas money to look for a job. This group — 11 percent of the labor force at the national level — also includes those who would like to work full time but can only find part time jobs. That seems bad enough but the blunt truth is that among African Americans the underemployment rate is a whopping 22 percent. (By the way, it is revealing that I had to calculate this number myself because it is kept secret by the statistical bureaus: you won’t find it on any of their internet sites or published statistics. It is too pessimistic for the official circles, so better keep it quiet.)Think about this 22 percent for a moment: that means that one out five African American does not have a full-time job and are scraping by with the skin of their teeth. They are the excluded. No more hope left for the American dream. There is more sad news: among African American teenagers, the unemployment rate is 25 percent which means that the underemployment rate is probably in the 40-50 percent range. Plenty of time to throw stones at the system or at their representatives.

Problem no 4: of course, no jobs means no incomes. In Baltimore, 12 percent of African American families have total incomes less than $10,000 compared to just 4 percent of whites. Poverty rates in Baltimore are also much higher among African Americans than among whites: 28 percent versus 15 percent. No wonder that a third of African American households had to rely on food stamps to keep body and soul together in contrast to just 9 percent of white families. In seven St. Louis County neighborhoods, with the median family income a paltry $21,000, half the population is at or below the poverty line. (The federal poverty rate for a family of four in the lower 48, plus D.C., is $24,250.)

In Baltimore’s census tract no. 1504 — near New Shiloh Baptist Church where the funeral of Freddie Gray was held — 30.6 percent of households have incomes less than $15,000.

At the national level 13.9 percent of African American families earn less than $20,000. The comparable share among whites is 5.5 percent. And even more depressingly, the median income has been falling since the year 2000. Among African American families, the decline has been $3,500 — the same as among whites — but in percentage terms the decline is 8.4 percent compared to 5.3 percent among whites. In 2000, the median income among African American families was 63 percent of white incomes whereas by 2009 it declined to 61.4 percent.In Baltimore’s census tract no. 1504 — near New Shiloh Baptist Church where the funeral of Freddie Gray, the man whose spine was broken while in police custody in April, was held — 30.6 percent of households have incomes less than $15,000. In nearby tract no. 1506, 43 percent of households earn less than $15,000. This race-based poverty gap also shows up in Ferguson. In census tract number 2119 near Ferguson, 30 percent of households had annual income below $15,000. (Tim Cook, CEO of Apple Inc., earns as much every morning before noon, including weekends and holidays.) And six miles south of Ferguson, there are dozens of census tracts where the median family income ranges from $100,000 to $163,000. To the black residents of Ferguson, proximity to this evidence that the American Dream is a reality for whites must be a chronic irritant in the best of times, an unbearable provocation in the worst. Under such socio-economic conditions it is difficult to sustain functional families and vibrant communities.

Problem no 5: no income means no wealth, not surprisingly. African Americans are heavily represented among the have-nots of this country. There are 15 million African American households. The poorest 3 million, or 20 percent, of them have no wealth whatsoever, just debt. The median net worth is -$2,500 and the mean net worth is -$21,000. This is worse than among the Russian serfs: they at least had no debt! Among whites, the situation is not very different among the bottom 20 percent. Now let’s look at the next 20 percent, or next 3 million households. Now we get into positive territory but both the median and mean are less than $700. That’s all. Taken together the mean value of the bottom 40 percent of African American households is negative: -$10,000. So the bottom 6 million households still have nothing but debt on average and all in all fully half of the African American population has absolutely no wealth at all — no skin in the game whatsoever. In contrast, in 2004 there were 2,728,000 people in this country with assets worth in excess of $1.5 million. Their total net worth was an astronomical $10,201,246,000,000, that’s $10 trillion.

What is the system that keeps people of color at the lower echelons of the socio-economic hierarchy? It begins at birth. Most of those who happen to be born on the wrong side of the tracks are trapped. So many of them eventually end up on the wrong side of the law or disappear in gang violence. That is why there are 1.5 million missing black men in this country today. We have to realize that children are not responsible for the schools in the neighborhood in which they happened to be born. They chose neither their skin pigment nor their parents. So they can hardly be held responsible for the poverty of their parents or for their dysfunctional neighborhoods. Although they deserve better, they will not get the proper education for a knowledge economy and once they become adults they join the ranks of the have-nots, because there will not be any jobs for them. The employers are not responsible for not hiring those who are unqualified, unskilled, uneducated and without diplomas. So that is the real existing system of Capitalism with a poverty trap. It is against that system that people were throwing rocks. But how do you throw rocks against a system?

This inhumane system will not change until the American people realize that this system is fundamentally and deeply unfair and elect representatives in Congress with a vision to create a capitalism with a human face. All we have to do is to clean up the slums, provide top notch schools capable of competing with those in Finland, bring some jobs back that have been exported to distant shores, and we should be in good shape. No more food stamps, no more welfare payments, no more Medicaid, no more expenditures on incarceration and lower expenditures on the police force! It will be an America in which the determining factor of the life chances of newborns will not depend on the happenstance of the zip code of their birth.


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A Sheriff And A Doctor Team Up To Map Childhood Trauma

Alachua County Sheriff Sadie Darnell (left) and Dr. Nancy Hardt, University of Florida.

Alachua County Sheriff Sadie Darnell (left) and Dr. Nancy Hardt, University of Florida.

Bryan Thomas for NPR

The University of Florida’s Dr. Nancy Hardt has an unusual double specialty: She’s both a pathologist and an OB-GYN. For the first half of her career, she brought babies into the world. Then she switched — to doing autopsies on people after they die.

It makes perfect sense to her.

“Birth, and death. It’s the life course,” Hardt explains.

A few years ago, Hardt says, she learned about someresearch that changed her view of how exactly that life course — health or illness — unfolds.

The research shows that kids who have tough childhoods — because of poverty, abuse, neglect, or witnessing domestic violence, for instance — are actually more likely to be sick when they grow up. They’re more likely to get diseases like asthma, diabetes and heart disease. And they tend to have shorter lives than people who haven’t experienced those difficult events as kids.

“I want to prevent what I’m seeing on the autopsy table,” Hardt says. “I’ve got to say, a lot of times, I’m standing there, going, ‘I don’t think this person had a very nice early childhood.’ ”

Back in 2008, Hardt was obsessing about this problem. She wanted to do something to intervene in the lives of vulnerable kids on a large scale, not just patient by patient.

Hardt’s Map Of Medicaid Births

The deep blue and red spot on the left shows the Gainesville area’s most dense concentration of babies born into poverty — to parents on Medicaid.

Medicaid birth map

So, by looking at Medicaid records, she made a map that showed exactly where Gainesville children were born into poverty. Block by block.

Right away she noticed something that surprised her: In the previous few years, in a 1-square-mile area in southwest Gainesville, as many as 450 babies were born to parents living below the poverty line.

It just didn’t make sense to her — that was an area she thought was all fancy developments and mansions.

So Hardt took her map of Gainesville, with the poverty “hotspot” marked in deep blue, and started showing it to people. She’d ask them, “What is this place? What’s going on over there?”

Eventually she brought the map to the CEO of her hospital, who told her she just had to show it to Alachua County’s sheriff, Sadie Darnell.

So Hardt did.

And, to Hardt’s surprise, Sheriff Darnell had a very interesting map of her own.

Darnell had a thermal map of high crime incidence. It showed that the highest concentration of crime in Gainesville was in a square-mile area that exactlyoverlaid Hardt’s poverty map.

“It was an amazing, ‘Aha’ moment,” says Darnell.

“We kind of blinked at each other,” Hardt says. “And — simultaneously — we said, ‘We’ve got to do something.’ ”

The hotspot is dotted with isolated, crowded apartment complexes with names like Majestic Oaks and Holly Heights. The first time she visited, on a ride-along with Sheriff Darnell’s deputies, Hardt tallied up all things that make it hard for kids here to grow up healthy.

Dr. Nancy Hardt's free "clinic on wheels," parked in December at an apartment complex in Gainesville, Fla., gets about 5,000 visits from patients each year.

Dr. Nancy Hardt’s free “clinic on wheels,” parked in December at an apartment complex in Gainesville, Fla., gets about 5,000 visits from patients each year.

Bryan Thomas for NPR

There’s a lot of poorly maintained subsidized housing. Tarps cover leaky roofs. Mold and mildew spread across stucco walls. Sherry French, a sergeant from the sheriff’s office, says lots of families here have trouble getting enough to eat.

Hardt added hunger to her list and substandard housing. And she noticed something else: almost a total lack of services, including medical care.

She mapped it out and determined that the closest place to get routine medical care if you’re uninsured — which many people here are — is the county health department. It’s almost a two-hour trip away by bus. Each way.

This was a problem a doctor like Hardt could tackle. She would bring medical care to the hotspot, by rustling up a very large donation: a converted Bluebird school bus, with two exam rooms inside.

Hardt organized a massive crew of volunteer doctors and medical students from the University of Florida, where she teaches, and raised the money to hire a driver and a full-time nurse.

The “clinic on wheels” first made it out to the hotspot in 2010, parking right inside one apartment complex there. Patients could walk in without an appointment and get treatment free of charge, approximating the experience of a house call. Today, the mobile clinic gets an average of 5,000 visits from patients per year, in under-served areas all over Gainesville.

Physician assistants and undergraduate care coordinators treat patients in the mobile clinic parked at Majestic Oaks, a low-income apartment complex in Gainesville.

Physician assistants and undergraduate care coordinators treat patients in the mobile clinic parked at Majestic Oaks, a low-income apartment complex in Gainesville.

Bryan Thomas for NPR

But the clinic is really just one piece of the puzzle.

Because after the day that Hardt and the sheriff matched up their maps, they kept digging into the data. And, a few years later, Hardt made some new maps. They showed that the crime in the hotspot included the highest concentration of domestic violence, child abuse and neglect in Gainesville.

Childhood Trauma Maps

The reddish pink spots on these maps of the Gaineseville area, indicate an increased density of reports of child abuse and neglect (top map) and domestic violence (bottom). Deep blue indicates the highest concentration.

two maps of crime

That revelation brought Dr. Hardt back to her original mission — to head off bad health outcomes in the most vulnerable kids. So she teamed up with Sheriff Darnell and other local groups and grass-roots organizers from the neighborhood. They collaborated to create the SWAG (Southwest Advocacy Group) Family Resource Center, right in the Linton Oaks apartment complex.

The SWAG Center opened in 2012. Kids can come play all day long. There’s a food pantry, free meals, a computer room, AA meetings. A permanent health clinic is slated to open up across the street next week.

All the resources here are designed to decrease the likelihood of abuse and neglect by strengthening families.

“I think we knew it intuitively — that health issues are associated with crime, [and] crime is associated with health issues and poverty,” Darnell says. “But seeing that direct connection literally on a map … it helped to break down a lot of walls.”

Child abuse and domestic violence are still serious problems, but there has been a small drop in the numbers of such calls over the past few years, according to the data.

Hardt says that investing in families and health now can help kids grow up healthy — and save money in the future.

“Conservatives or liberals, everybody gets that,” she says. “That we have limited resources and we need to really spend them wisely. I think the maps — the hotspot maps — just tell us policywise, where we need to be going and what we need to be doing.”

Hardt’s next goal is to make more people aware of the links between health and early education. Last summer, the county got a new superintendent of schools. Hardt has been to visit him three times already — maps in hand.

This story is part of the NPR series, What Shapes Health? The series explores social and environmental factors that affect health throughout life. It is inspired, in part, by findings in a poll released this month by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.


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The Legacy of Roe v. Wade and the War on Poverty

by Heidi Williamson
SOURCE: AP/Susan Walsh

Pro-choice demonstrators rally outside the Supreme Court in Washington, Wednesday, January 22, 2014.

This column contains a correction.

This year we celebrate both the 41st anniversary of the Supreme Court’s landmark Roe v. Wade decision and the 50th anniversary of the War on Poverty. Less than 10 years before the Supreme Court handed down a decision that allowed women the right to an abortion, President Lyndon B. Johnson declared an “unconditional war on poverty” in 1963. The subsequent creation of social safety net programs such as Medicaid, Head Start, and the Supplemental Nutrition Assistance Program, or SNAP, marked the beginning of an incredible journey that helped reframe the destiny of American women.

The legalization of abortion bolstered the promise of the War on Poverty for women and families. In the years prior to the Roe decision, poor women bore the brunt of unplanned pregnancy. Although the U.S. Food and Drug Administration, or FDA, approved birth control pills in 1960, many states did not allow doctors to prescribe them to unmarried women. Coupled with the drug’s high cost, women who lived in poverty struggled to control their family size and take advantage of America’s economic opportunities. President Johnson’s War on Poverty, however, gave women unprecedented access to necessary health care services through the first federal family planning grants. Family planning dollars further increased when Congress enacted Title X in the 1970s, which explicitly funded reproductive health services for low-income women.

Increasing women’s reproductive autonomy was an investment in more educated and empowered families that could strengthen their communities and ultimately the nation. The War on Poverty was the catalyst to move women toward greater economic mobility, access to affordable health care, and the promise of equal economic and social opportunity in America.

Economic mobility

The War on Poverty was the beginning of a new day. For the first time, the theory of economic mobility was put into practice through President Johnson’s budget and a series of new laws that guaranteed rights to health care, food, and education. For women, however, economic mobility was not simply a matter of managing money or resources but also the ability to control if and when they would have children. Women’s health has always had a direct impact on families’ well-being, but after Roe, it began to influence the workforce as well.

Legalized abortion, access to birth control pills, and civil rights legislation allowed women to be more self-sufficient, both by controlling their fertility and taking advantage of the various educational and economic opportunities created by the War on Poverty. By the late 1960s, women were approaching education, career, marriage, and children in a way that no generation had before. The social and economic impact of Roe not only ushered women into the workforce, but it also allowed women to contribute to the economic stability of their families. Fifty years later, women make up 50 percent of the workforce and are increasingly breadwinners or co-breadwinners for their families. The high percentage of women working outside of the home is directly linked to access to birth control and legalized abortion. It has also played a critical role in enabling women to contribute to the economic mobility of their families. However, a woman’s contribution often hinges on her ability to control her health and balance her unique set of circumstances.

Equal access to health care

President Johnson understood that affordable health care was critical to lifting people out of poverty and maintaining economic prosperity. The creation of Medicaid had a profound effect on women, particularly women of color, getting access to the care they needed. After Roe became the law of the land, this included abortion services as well as the preventive care that comes with family planning. Prior to the passage of the 1976 Hyde Amendment, which prevents the spending of federal dollars for abortion services except in the case of rape, incest, or the life of the mother, poor women used this vital source of funds to take care of their health, and in many instances, it saved their lives.

Before Roe v. Wade, many women sought illegal abortion services. Poor women and women of color, who often sought out cheaper and consequently more dangerous services, had higher rates of death or damaging complications such as hemorrhaging and septic shock. This resulted in a public health crisis that impacted everyone, not just women. Approximately 5,000 women died annually from illegal abortions—many of whom were mothers, wives, and caregivers. Many others suffered from other long-term health problems such as high-risk future pregnancies or infertility. Women as caregivers and human beings needed to have more control over their lives and the dignity of access to safe health care, regardless of their income.

After the passage of Hyde, poor women once again ceased to have the War on Poverty’s promise of access to affordable health care for all of the essential services that impact their reproductive lives. Medicaid continued to cover sterilizations, experimental drugs that prevented pregnancy, and childbirth but not abortion. While 17 stateshave decided through legislative action or court decision to use their own budgets to cover this procedure, poor women in the remaining states still lack access to abortion.

Equal opportunity and the American Dream

A critical result of the War on Poverty and the Roe decision is the realization that economic security, educational opportunity, and health are inseparable. More importantly, women’s right to control their own fertility and government action to protect that right are essential to ensure that the War on Poverty’s promise becomes a lived experience. Abortion access is a critical component to women’s lives as they balance raising a family, engaging in healthy relationships, and pursuing economic and educational opportunities.

Abortion is not affordable or easily accessible today and thereby is not truly a right for all women. According to Dr. Susan Wood, abortions costs as much as a month of rent for some women. Accessing this legal health service should not require women to choose between medical care and their family’s economic stability.


This year, we will celebrate Roe by working to ensure that all women have access to abortion services, regardless of their income or source of insurance. The War on Poverty rages on, and it must continue until all women and girls have the economic, social, and political power and resources to make healthy decisions about their bodies, sexuality, and reproduction for themselves, their families, and their communities in all areas of their lives.

Heidi Williamson is a Senior Policy Analyst for the Women’s Health and Rights program at the Center for American Progress.

*Correction, January 24, 2014: This column incorrectly stated the number of states that offer Medicaid coverage for abortion. The correct number is 17.

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Posted by on February 19, 2014 in African American News


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Income, Poverty and Health Insurance Coverage in the United States: 2012

The U.S. Census Bureau announced today that in 2012, real median household income and the poverty rate were not statistically different from the previous year, while the percentage of people without health insurance coverage decreased.

Median household income in the United States in 2012 was $51,017, not statistically different in real terms from the 2011 median of $51,100. This followed two consecutive annual declines.

The nation’s official poverty rate in 2012 was 15.0 percent, which represents 46.5 million people living at or below the poverty line. This marked the second consecutive year that neither the official poverty rate nor the number of people in poverty were statistically different from the previous year’s estimates. The 2012 poverty rate was 2.5 percentage points higher than in 2007, the year before the economic downturn.

The percentage of people without health insurance coverage declined to 15.4 percent in 2012 ─ from 15.7 percent in 2011. However, the 48.0 million people without coverage in 2012 was not statistically different from the 48.6 million in 2011.

These findings are contained in the report Income, Poverty, and Health Insurance Coverage in the United States: 2012. The following results for the nation were compiled from information collected in the 2013 Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC). The CPS-ASEC was conducted between February-April 2013 and collected information about income and health insurance coverage during the 2012 calendar year. However, the information on shared households pertains to the circumstances at the time of the survey. The CPS-based report includes comparisons with one year earlier. State and local results will be available on Thursday from the American Community Survey.


  • Real median incomes in 2012 for family households ($64,053) and nonfamily households ($30,880) were not statistically different from the levels in 2011.
  • A comparison of real household income over the past five years shows an 8.3 percent decline since 2007, the year before the nation entered an economic recession.

Race and Hispanic Origin 
(Race data refer to people reporting a single race only; Hispanics can be of any race)

  • Changes in real median household income were not statistically significant for race and Hispanic-origin groups between 2011 and 2012. (See Table A.)


  • The West experienced an increase of 3.2 percent in real median household income between 2011 and 2012, while the changes for the remaining regions were not statistically significant. In 2012, households with the highest median incomes were in the West and the Northeast (with medians that were not statistically different from each other), followed by the Midwest and the South. (See Table A.)


  • In 2012, households maintained by a naturalized citizen or a native-born citizen had higher median incomes than households maintained by a noncitizen. The real median incomes of households maintained by a native- or foreign-born person, regardless of citizenship status, in 2012 were not statistically different from their respective 2011 medians. (See Table A.)


  • The changes in the real median earnings of men and women who worked full time, year- round between 2011 and 2012 were not statistically significant. In 2012, the median earnings of women who worked full time, year-round ($37,791) was 77 percent of that for men working full time, year-round ($49,398) ─ not statistically different from the 2011 ratio. The female-to-male earnings ratio has not experienced a statistically significant annual increase since 2007.
  • The number of men working full time, year-round with earnings increased by 1.0 million between 2011 and 2012; the change for women was not statistically significant.

Income Inequality

  • The Gini index was 0.477 in 2012, not statistically different from 2011. Since 1993, the earliest year available for comparable measures of income inequality, the Gini index has increased 5.2 percent. (The Gini index is a measure of household income inequality across the nation, with zero representing total income equality and one equivalent to total inequality.)
  • Changes in income inequality between 2011 and 2012 were not statistically significant as measured by the shares of aggregate household income that each quintile received.


  • In 2012, the family poverty rate and the number of families in poverty were 11.8 percent and 9.5 million. Neither level was statistically different from the 2011 estimates.
  • In 2012, 6.3 percent of married-couple families, 30.9 percent of families with a female householder and 16.4 percent of families with a male householder lived in poverty. Neither the poverty rates nor the estimates of the number of families in poverty for these three family types showed any statistically significant change between 2011 and 2012.


  • As defined by the Office of Management and Budget and updated for inflation using the consumer price index, the weighted average poverty threshold for a family of four in 2012 was $23,492.

(See <> for the complete set of dollar value thresholds that vary by family size and composition.)


  • In 2012, 13.6 percent of males and 16.3 percent of females were in poverty. Neither poverty rate showed a statistically significant change from its 2011 estimate.

Race and Hispanic Origin 
(Race data refer to people reporting a single race only; Hispanics can be of any race)

  • The poverty rate for non-Hispanic whites was lower in 2012 than it was for other racial  groups. Table B details 2012 poverty rates and numbers in poverty, as well as changes since 2011 in these measures, for race groups and Hispanics. None of these groups experienced a statistically significant change in their poverty rate between 2011 and 2012.


  • In 2012, 13.7 percent of people 18 to 64 (26.5 million) were in poverty compared with 9.1 percent of people 65 and older (3.9 million) and 21.8 percent of children under 18 (16.1 million).
  • No age group experienced a statistically significant change in the number or rates of people in poverty between 2011 and 2012, with one exception: the number of people 65 and older in poverty rose between 2011 and 2012.


  • The 2012 poverty rate was not statistically different from 2011 for either the native-born, naturalized citizens, noncitizens, or the foreign-born in general. Table B details 2012 poverty rates and the numbers in poverty, as well as changes since 2011 in these measures, by nativity.


  • The West was the only region to show a statistically significant change in its poverty rate, which declined from 15.8 percent in 2011 to 15.1 percent in 2012. The South was the only region in which the number in poverty changed, rising from 18.4 million in 2011 to 19.1 million in 2012. (See Table B.)

Shared Households

Shared households are defined as households that include at least one “additional” adult: a person 18 or older who is not enrolled in school and is not the householder, spouse or cohabiting partner of the householder.

  • In spring 2007, prior to the recession, there were 19.7 million shared households. By spring 2013, the number had increased to 23.2 million and their percentage of all households rose by 1.9 percentage points from 17.0 percent to 19.0 percent. Between 2012 and 2013, the number and percentage of shared households increased.
  • In spring 2013, 10.1 million young adults age 25-34 (24.1 percent) were additional adults in someone else’s household. Neither of these were statistically different from 2012.
  • It is difficult to precisely assess the impact of household sharing on overall poverty rates. Young adults age 25-34, living with their parents, had an official poverty rate of 9.7 percent, but if their poverty status were determined using only their own income, 43.3 percent had an income below the poverty threshold for a single person under age 65.

Health Insurance Coverage

  • The number of people with health insurance increased to 263.2 million in 2012 from 260.2 million in 2011, as did the percentage of people with health insurance (84.6 percent in 2012, 84.3 percent in 2011).
  • The percentage of people covered by private health insurance in 2012 was not statistically different from 2011, at 63.9 percent. This was the second consecutive year that the percentage of people covered by private health insurance coverage was not statistically different from the previous year’s estimate. The percentage covered by employment-based health insurance in 2012 was not statistically different from 2011, at 54.9 percent.
  • The percentage of people covered by government health insurance increased to 32.6 percent in 2012, from 32.2 percent. The percentage covered by Medicaid in 2012 was not statistically different from 2011, at 16.4 percent. The percentage covered by Medicare rose over the period, from 15.2 percent in 2011 to 15.7 percent in 2012. Since 2009, Medicaid has covered more people than Medicare (50.9 million compared with 48.9 million in 2012).
  • The percent of children younger than 18 without health insurance declined to 8.9 percent (6.6 million) in 2012 from 9.4 percent (7.0 million) in 2011. The uninsured rates did not show a statistical change for all other age groups: 19 to 25, 26 to 34, 35 to 44, 45 to 64 and people 65 and older.
  • The uninsured rate for children in poverty (12.9 percent) was higher than the rate for children not in poverty (7.7 percent).
  • In 2012, the uninsured rates decreased as household income increased from 24.9 percent for those in households with annual income less than $25,000 to 7.9 percent in households with income of $75,000 or more.

Race and Hispanic Origin 
(Race data refer to those reporting a single race only; Hispanics can be of any race)

  • The uninsured rate for Asians and Hispanics declined between 2011 and 2012, while the number of uninsured did not change significantly. For non-Hispanic whites and blacks, both measures in 2012 were not statistically different from 2011. (See Table C.)


  • The proportion of the foreign-born population without health insurance in 2012 was about two-and-a-half times that of the native-born population. The uninsured rate declined for the foreign-born population between 2011 and 2012, while the 2012 rate was not statistically different from the 2011 rate for naturalized citizens and noncitizens. Table C details the 2012 uninsured rate and the number of uninsured, as well as changes since 2011 in these measures, by nativity.


  • The Northeast had the lowest uninsured rate in 2012. Between 2011 and 2012, the uninsured rate decreased for the Midwest and the West, while there were no statistically significant differences for the remaining two regions. Similarly, the number of uninsured people declined in the Midwest and the West, while there were no statistically significant changes for the other two regions. (See Table C.)

Supplemental Poverty Measure

The poverty statistics released today compare the official poverty thresholds to money income before taxes, not including the value of noncash benefits. The Census Bureau’s statistical experts, with assistance from the Bureau of Labor Statistics and in consultation with other appropriate agencies and outside experts, have developed a supplemental poverty measure to serve as an additional indicator of economic well-being by incorporating additional items such as tax payments and work expenses in its family resource estimates. It does not replace the official poverty measure and will not be used to determine eligibility for government programs.

Both the Census Bureau and the interagency technical working group that helped develop the supplemental poverty measure consider it to be a work in progress and expect that there will be improvements to the statistic over time. See Income, Poverty, and Health Insurance Coverage in the United States: 2012 for more information. The Census Bureau published preliminary poverty estimates using this supplemental measure in November 2011 and November 2012. Supplemental poverty estimates for 2012 will be published in fall 2013.

State and Local Estimates from the American Community Survey

On Thursday, the Census Bureau will release single-year estimates for 2012 of median household income, poverty and health insurance coverage for all states, counties, places and other geographic units with populations of 65,000 or more from the American Community Survey. These statistics will include numerous social, economic and housing characteristics, such as language, education, the commute to work, employment, mortgage status and rent. Later today, subscribers will be able to access these estimates on an embargoed basis.

The American Community Survey provides a wide range of important statistics about people and housing for every community across the nation. The results are used by everyone from town and city planners to retailers and homebuilders. The survey is the only source of local estimates for most of the 40 topics it covers for even the smallest communities.

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Posted by on September 17, 2013 in African American News


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Ramen To The Rescue: How Instant Noodles Fight Global Hunger


A child eats instant noodles on a train at the Harbin Railway Station in northeast China.

A child eats instant noodles on a train at the Harbin Railway Station in northeast China.

Wang Jianwei/Xinhua /Landov

Ask about the foods that have conquered the world and you’re likely to hear about Coca-Cola and McDonald’s Big Macs.

But the most successful industrial food ever produced flies far under the radar. And it has finally been outed by three anthropologists in a fascinating new book The Noodle Narratives, which analyzes the precipitous rise — or “brilliant career,” as the authors say — of instant ramen, from its birth in postwar Japan to its sales of just over 100 billion servings worldwide in 2012.

Take a moment to digest that figure: It’s about 14 servings for every single person on Earth, at a cost of just a few cents apiece. That’s an astonishing quantity, especially to American consumers, who don’t tend to think of the stiff, wavy blocks of noodles as an important staple (though they are for some college students, inmates and low-income Americans). And while our foodie culture currently has a fling with ramen (think ramen bars and the ramen burger), we’re only the world’s sixth-biggest market for the noodles, according to the World Instant Noodles Association. Our consumption is dwarfed by that of China and India — and even Vietnam.

The Noodle Narratives

Indeed, it’s the multinational noodle companies’ conquest of countries like Papua New Guinea, Nigeria, Brazil and Mexico that really interests the anthropologists: Frederick Errington of Trinity College, Tatsuro Fujikura of Kyoto University and Deborah Gewertz of Amherst College. And it’s here that they make one of their most intriguing arguments: Instant noodles do good by alleviating the hunger of millions of people around the world. These supercheap, superpalatable noodles, they write, help the low-wage workers in rich and poor countries alike hang on when the going gets tough.

“They’re cheap and tasty and tweakable,” Gewertz tells The Salt. “They’re capable of being transformed to everyone’s cultural taste.”

In Thailand, instant ramen is seasoned with lemongrass and cilantro. Mexicans can buy Maruchan noodle soup cups flecked with shrimp, lime and habanero, among other flavors. Papua New Guineans have incorporated the noodles into rituals as cardinal as weaning babies and honoring the dead, she says.

In Japan, the birthplace of instant ramen, the consumer appetite for novel ramen products is so ravenous that manufacturers introduce 600 new flavors a year, the authors report. But it all started in the postwar period.

Back in 1957, businessman Momofuku Ando (yes, the namesake of Chef David Chang’s beloved restaurants) decided he wanted to invent an industrial take on freshly made ramen — the stuff Chang has helped make trendy again — for his hungry, budget-minded compatriots using surplus wheat donated by the U.S.

It took Ando years to perfect the process of making a dry block of noodles. But ultimately he succeeded by applying the “principle of tempura”: steaming and dousing the noodles in chicken broth and then bathing them in hot oil. This dried them out and made them shelf-stable but also easy to rehydrate. He added the winning combination of MSG, salt and sugar (which now comes in a flavor packet) to round out the flavor. And to this day, manufacturers haven’t strayed far from Ando’s original recipe.

While not exactly nutritious, instant noodles are a “proletariat hunger killer,” as the anthropologist Sidney Mintz would say. They’re made with wheat flour, which has a high glycemic index (a metric for how soon a food is likely to make you hungry again). But they’re also fried in palm oil, which is 49 percent saturated fat — higher than pork lard (40 percent) and soybean oil (14 percent).

All that fat keeps you feeling full longer and helps bring the noodles’ overall glycemic index down. The fact that instant noodles become soup once you add water helps, too — as the authors note, soup provides longer satiety than, say, noodles alone. And that helps explain why ramen have become a staple of the world’s undernourished and part of some humanitarian food aid packages.

Palm is the industry’s oil of choice because it’s cheap, it can withstand high heat, and it has a longer shelf life than other oils. But in the U.S., we’re told to eat palm oil sparingly because it raises bad LDL cholesterol levels. So is it really wise for so many people around the world to be so reliant on instant ramen for sustenance? Why can’t the urban poor eat something more nutritious than this highly processed, high-fat food?

Sure, that would be ideal, the authors say, but the reality is that in many global cities, the urban poor lack affordable alternatives that are more healthful than ramen. “How are you going to feed these people?” says Gewertz. “I would love to feed them with fruits and vegetables at the local markets, but they are expensive.”

Passengers eat instant noodles at the railway station in Shenyang, China in January 2013.

Passengers eat instant noodles at the railway station in Shenyang, China in January 2013.

YANG XINYUE/Xinhua /Landov

The authors say that “real food” advocates like journalist Michael Pollan, who wring their handsover rising consumption of industrial food like ramen, raise important questions about its perils. But the authors also call ramen a “virtually unstoppable” phenomenon. And they foresee a world of 9 billion people “in which the affluent will be presented with too many food choices and [will be] called upon to use their survival skills to choose wisely, and in which the poor will have to use their survival skills to get by on cheap food” like ramen.

“I’d love to take Michael Pollan to a squatter settlement and have him deal with poor, hungry people in such circumstances, who have no choice of going back home to grow subsistence crops or be part of a regional food system,” says Gewertz. “Subsistence agriculture is hard, dirty and hot work. People want out of it. It’s not to be over romanticized.”

Instead, as Gerwertz tells us, a better way to help the poor who rely on ramen is to make the noodles more nutritious: They could be “reduced-sodium, lower-fat, higher-fiber, better fortified,” though that will also translate into a slightly higher price.

“We find it difficult to imagine the increasingly urbanized food future without this humble form of salt, MSG-enhanced, oily and sometimes sugary” food, they write. But “we conclude [that it’s for the best] with great reluctance.”


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