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Understanding Poverty

Mar 17, 2022 8:00:00 AM

Understanding poverty, unemployment, homelessness, drug-addiction, or any other socio-economic stress and unfortunate situation is a challenge for those of us who are so fortunate not have such an affliction. This essay is the first of two raising awareness to those living nearby folks with these overwhelming conditions.

What does it feel like to be homeless or impoverished? What happens when your car breaks down and you are broke—living from paycheck to paycheck? Or you have an acute medical need and no insurance or a high deductible? Sadly, one of these unexpected, disabling events begins a cascade of other troublesome stresses that can ultimately end in joblessness, bankruptcy, homelessness, malnourishment, and illness. The vicious cycle can become multigenerational, overwhelming, and pervasive, extending over entire geographic regions.

Interestingly, many communities have an economic divide between two adjacent areas. Living on the “wrong side of the tracks” captures the disparity. Huge differences in economic abilities are easy to ignore if you are fortunate to have resources, but hard to take if you are at or below the poverty line.

Poverty is relative—if everyone around you has similar circumstances, the differences are not so stark. Ruby Payne, in her Framework for Understanding Poverty, shares some key points to remember. Poverty becomes more apparent when others better off than you are present for comparison.

Poverty is ubiquitous across America and all nations, particularly as the middle class shrinks and wealth concentrates. The eight-five richest people in the world have as much wealth as the 3.5 billion poorest according to the World Economic Forum’s paper entitled, Working For the Few.

Economic class is continuous without clear-cut lines of distinction. The poverty thresholds were originally developed in 1963-1964 by Mollie Orshansky of the Social Security Administration. Orshansky based her poverty thresholds on the economy food plan—namely, the cheapest of four food plans developed by the Department of Agriculture that would feed a family of two. Larger families would have proportionally larger thresholds. At that time, other family costs were not as great as they are today, e.g. for healthcare, residences, fuel, etc. Thus, now poor families have even greater stress.

A very important point about poverty is the distinction between generational poverty and situational poverty. Generational poverty occurs in two or more consecutive generations whereas situational poverty can be the result of illness, death in a family, divorce, unemployment, etc. Situational poverty can and should be addressed as quickly as possible to avoid a further deterioration into generational poverty.

Classical family diagrams in the middle class are easy to trace with husband and wife having children and the next generation producing grandchildren. Even with the current divorce rate greater than 50%, middle class family trees are orderly.

However, family patterns in generational poverty typically center around the mother or maternal grandmother who are the primary care-givers. Family diagrams are difficult to construct because generational poverty families lack many legal documents—marriages sometimes don’t occur, little or no property needs splitting, children usually stay with mom, and legal documents serve limited purpose.

Anthropologist Oscar Lewis, in his study of cultural poverty (one of four horsemen, the other three being pollution, famine, and violence), wrote:

The economic traits which are most characteristic of the culture of poverty include the constant struggle for survival, unemployment and underemployment, low wages, a miscellany of unskilled occupations, child labor, the absence of savings, a chronic shortage of cash, the absence of food reserves in the home, the pattern of frequent buying of small quantities of food many times a day as the need arises, the pawning of personal goods, borrowing from local money lenders at usurious rates of interest, spontaneous informal credit devices organized by neighbors, and the use of second-hand clothing and furniture.

“How well would you survive in poverty?” will be addressed in next week’s Blue Zones Project Blog.

Allen S. Weiss, MD, FACP, FACR, MBA

Written by Allen S. Weiss, MD, FACP, FACR, MBA

Dr. Allen Weiss is Chief Medical Officer for Blue Zones Project. Having practiced rheumatology, internal medicine, and geriatrics for 23 years and been President and CEO for 18 years of a 716-bed, two-hospital integrated system, Dr. Weiss now has a national scope focused on prevention.

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