A History of Poverty in America

Poverty in Urban America: Its Causes and Cures by David Hilfiker Chapter I ¦ Chapter II ¦ Chapter III ¦ Chapter IV ¦ Chapter V ¦ Display All Chapters
David Hilfiker

Introduction When Americans want to "do something" about poverty, we usually set about "improving poor people."1 We may

  • offer education or job training,
  • attempt to improve the parenting skills of young mothers,
  • require addiction treatment as a condition of receiving housing,
  • put a time limit on welfare benefits in order to motivate poor people to work, or
  • limit welfare benefits to discourage additional childbearing.

The practice of improving poor people ha a long history in the United States. Early reformers traced extreme poverty to intoxication, laziness, and other kinds of unacceptable behavior, so they tried to use public policy and philanthropy to elevate the character of poor people, hoping to change the unacceptable behavior. Later reformers emphasized evangelical religion, temperance legislation, punitive conditions for relief, the forced breakup of families, and threats of institutionalization … all with the purpose of "improving poor people." This approach rests in the belief that the primary causes of poverty are the individual characteristics of the poor themselves: ignorance, lack of training, addiction, laziness, poor character, sexual promiscuity, too many children, and so on. It's not surprising, of course, that a nation so strongly committed to individualism should also find the roots of poverty in individual characteristics. In this brief book I want to look from a different point of view. I want to suggest that the primary causes of poverty lie not so much in individual behavior but in social structures, in forces outside of the individual's control. This is not to deny that some poor people could use some improving (as could most of us), but it is to suggest that the primary causes of American poverty lie elsewhere: in segregation, the lack of jobs on which one might support a family, inadequate access to health care, inadequate education, non-existent vocational training, particular historical realities, and so forth. I am a physician. In 1983, after seven years as a Minnesota country doctor, I moved to Washington DC to practice medicine in the inner city. For five of those fifteen years my family and I lived in Christ House, a medical recovery shelter for homeless men. In 1990 we started Joseph's House, a community and hospice for eleven formerly homeless men dying with AIDs, where we also lived for three years. So, I am no stranger to the individual weaknesses of poor people. It is the nature of a doctor's work to see people in trouble, and it often seemed that the immediate causes of my patients' poverty lay in their own behavior. For some, addictions consumed their time and energy. Others couldn't (or wouldn't) cooperate with my medical treatment plans. Still others lacked parenting skills or had no discernible job skills. And some didn't seem to want to work. But the longer I worked with my patients the more obvious it became that virtually all of them were doing the best they could in the overwhelming environment they inhabited. The odds against which they were struggling, however, were overwhelming. In New American Blues,2 Earl Shorris writes about the "surround of force" confronting poor people. Living in the ghetto, one faces the drug trade, the problems within public housing, family violence, abuse, graffiti, landlords, criminals, illness, meanness, bad luck, guns, isolation, hunger, ethnic antagonisms, racism, and other obviously "bad" forces. But there are also some seemingly "good" forces that can make life miserable for the poor: the law, the media, government, helpers, merchandising, neighbors, police, and so on. And one has to contend with all of these forces—any one of which would be overwhelming—all at one time, without a break. When one problem is solved, three take its place. The cumulative effect of the "surround" is more than the sum of individual forces. There is no space to breathe. After fifteen years in the inner city, I no longer believe that poverty should best be attacked by improving poor people. The argument that inner-city poverty comes primarily from the individual weaknesses of poor people simply cannot be sustained. Among African-American children in this country, half live in poverty. Among African-American males between the ages of eighteen and thirty-four in the city of Washington, half are in the criminal justice system. There are only two forms of explanation for these (and many other similar) statistics. Either African-American people are genetically predisposed to poverty or something has happened to them! Charles Murray's arguments in The Bell Curve notwithstanding, the scientific consensus offers no support to genetic inferiority as a cause of poverty. In this book I will argue what should by now be obvious: something awful has been done to poor people in this country. But how does one explain, then, what appear to be significant rates of personal weaknesses among poor African Americans (and other groups of Americans in poverty)? How does one account for the extraordinarily high rates within the black ghettos of single parenthood (which is highly correlated with poverty), widespread substance abuse, poor parenting, criminal behavior? Where did it all begin? How did it perpetuate itself? Even after fifteen years of urban medical practice, I could not have said. So, I decided to find out. I volunteered to teach a course on the causes of urban poverty and began to read. I was often shocked at how little I had known. This is a brief summary of what I've learned.3 Although this book is specifically about black, urban, ghetto poverty, it is important to remember that most poor people in the United States are neither black nor urban. The poor in our country are split pretty evenly between white, black, and Latin American, and the majority lives in rural areas or, increasingly, in the suburbs. The meaning of the word "poverty," of course, is relative. For the purposes of simplicity, I will use the term "poor people" to refer to the economically poor, defined as those who live in families with incomes below the Federally determined poverty level. Although this definition of poverty is the most widely used in the United States, its history suggests that it probably understates the number of people who live in what most Americans consider poverty. The "official poverty level" first seeped into government parlance in 1961 when the Social Security Administration needed an objective measure of poverty for statistical purposes. A staff economist chose to develop a standard based on the cost of food. Since it was estimated at the time that the average American family spent about a third of its income on food, the poverty level was defined as the cost of a minimum adequate diet multiplied by three. The poverty levels (which increase with increasing family size) have subsequently been updated annually for price inflation. To determine a family's poverty status, its resource—defined as cash income before taxes—are compared with the appropriate threshold for its size. In 1998, the poverty level for a single individual was an income of $8,050 per year; for a family of four, the level was $16,450. The poverty level has been criticized both for being too low and too high. Because it excludes non-cash income (most importantly food stamps and housing subsidies), it can be criticized as too high for those who receive those benefits. On the other hand, the average American family in 1999 spends closer to one-fourth of its income on food than the one-third estimated in 1961, so it would be reasonable to reset the level by multiplying the least expensive food plan by four rather than by three. From a more practical point of view, the government fair market rent of $692 for a one-bedroom apartment is over 60% of the poverty level for a family of three. If food should cost 33% of that budget, that leaves 6% or $68 a month for all other expenses, including childcare and health care. In 1998, after almost a decade of economic boom times, when unemployment was at its lowest level in decades, 13.3% of all Americans, more than one out of every eight people lived below a poverty level that underestimates what most of us would consider poverty. Almost 20% of all American children (and over 50% of African-American children) live in poverty. Why? In the next pages, we will look at some answers. Footnotes 1 Katz, Michael, Improving Poor People 2 Shorris, Earl, New American Blues 3 I make no claims to the originality to the originality of this work, which is essentially a summary of material from a small number of other sources. As will be obvious to anyone who has read in the field of urban poverty, I have borrowed heavily from the works of Michael Katz, William Julius Wilson, Douglas Massey, and others. I have cited references to direct quotations, but it would be impossible to cite references to all of the ideas without creating a blizzard of footnotes. I am grateful to these authors for their work.

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David Hilfiker

is a physician and cofounder of Joseph's House. He's the author of Not All of Us Are Saints: A Doctor's Journey with the Poor and Urban Injustice: How Ghettos Happen.