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Americans and Poverty

Americans and Poverty

 American Poverty Affects Children’s Health

 By Lisa René LeClair
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This November, Microsoft News is putting a focus on Poverty in America with a 2-week series examining the root causes of poverty, what poverty really means to the many different kinds of people affected, and what we can do to contribute to the most meaningful solutions. We teamed up with some of our most trusted news partners to bring you custom content and highlight quality journalism that helps us understand these issues. We hope you’ll join us in supporting the organizations that are helping Americans in poverty with both their immediate needs and long-term pathways to more stable and prosperous lives.

If you’ve ever struggled—I mean, really struggled—to pay the bills, imagine how hard it would be to raise a family in poverty.

Nearly 15 million kids in the United States are living below the federal poverty threshold because parents—despite collecting paychecks—are unable to afford basic necessities, such as food, clothing, transportation, housing and education, according to The National Center for Children in Poverty (NCCP). But did you know that living in poverty could also be detrimental to a child’s health?


Based on information provided by the American Academy of Pediatrics (AAP), stripping away the essential needs of a child can profoundly affect birth weight, infant mortality, chronic illness and language development. And let’s not forget the lack of nutrition they could be experiencing because the good stuff doesn’t come cheap.

But wait, there’s more.

Impoverished children often experience “toxic stress”—another way of saying anxiety—because living in poverty is about as stressful as it gets. They are also more likely to suffer “accidental injuries” from living in rough neighborhoods or homes that aren’t safe. As for school readiness, poverty presents a struggle, too. How are parents, who often can’t afford to put enough food on their kids’ plates, supposed to pay for books, supplies and extracurricular activities at school? The answer is simple: They don’t.

Another way to measure the impact poverty has on a child’s health is by taking a look at their environment. The vast majority of these families live in older homes where lead exposure—which can cause serious damage to a child’s development—exceeds the threshold for safety, the AAP reported in 2003. At the time, more than 1.5 million children (younger than 6 years) showed signs of elevated levels of lead in their blood.

From physical and mental health struggles to problems with self-regulation and executive functions, such as inattention, impulsivity, defiance and poor peer relationships, the list of adverse effects that living in poverty has on a child goes on and on.

What’s worse, even short-term poverty can impede a child’s social, emotional and intellectual growth.

“Child poverty is associated with lifelong hardship,” reports the AAP. “Poor developmental and psychosocial outcomes are accompanied by a significant financial burden, not just for the children and families who experience them but also for the rest of society.”

On top of all that, inner-city communities typically fall short when it comes to building social networks for low-income parents, which can lead to increased stress and, sadly, even child abuse. That is to say, these parents have no other choice but to shake off their fear and face communities that “exacerbate rather than mitigate the disadvantages of poverty.”

Thankfully, the world is full of people who want to help underprivileged families. These advocates, primarily those who double as pediatricians, may be a poverty-stricken child’s best chance at living a normal, healthy life.

“Pediatricians provide a unique and powerful voice to advocate for children and families impacted by poverty,” reports the AAP. “By addressing poverty as a critical child health and development issue, pediatricians can influence public policies and support programs that improve the lives of low-income children and families.”

For those in need of medical care, NeedyMeds offers an easily searchable database of free, low-cost or sliding-scale clinics by ZIP code. Children’s Health Fund is another great resource, but their locations are fairly limited.

The Vaccines for Children Program (VFC) is another way low-income parents can keep their children healthy. Created by the Centers for Disease Control and Prevention (CDC) in 1993, the federally funded VFC provides immunization free of charge to children who otherwise might not be able to afford the vaccines.

For pregnant women, especially those considered “at-risk,” The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is the answer to women’s new mother questions. Not only do they help with breastfeeding, they also teach parents how to improve their family’s health and provide opportunities for their children.

In addition, low-income families get full access to critical nutrition support programs, such as Women, Infants, and Children (WIC), Supplemental Nutrition Assistance Program (SNAP) and The National School Lunch Program, as well as educational tools like Reach Out and Read—suggesting books and reading aloud to stimulate early brain development—and Video Interaction Project (VIP), an evidence-based parenting program that uses videotaping and developmentally appropriate toys to strengthen early development and literacy in children.

Though many families living in poverty don’t have access to a computer, nearly every public library in the U.S. does, and access to their Internet is 100 percent free.

“Poverty is an important social determinant of health and contributes to child health disparities,” the AAP reports. Perhaps their call to action, demanding reforms “to eliminate child poverty,” will one day be heard by those who can truly make a difference: you, me, anyone and everyone willing to lend a helping hand.

his November, Microsoft News is putting a focus on Poverty in America with a 2-week series examining the root causes of poverty, what poverty really means to the many different kinds of people affected, and what we can do to contribute to the most meaningful solutions. We teamed up with some of our most trusted news partners to bring you custom content and highlight quality journalism that helps us understand these issues. We hope you’ll join us in supporting the organizations that are helping Americans in poverty with both their immediate needs and long-term pathways to more stable and prosperous lives.

Why society might be more stable if we had more poverty and less inequality.

Researcher Keith Payne has found something surprising: When people flying coach are forced to walk past the pampered first-class flyers in the front of the plane, the likelihood of some sort of air rage incident rises sharply.

In his 2017 book The Broken Ladder, Payne, a social psychologist at the University of North Carolina, argues that humans are hardwired to notice relative differences. When we’re reminded that we’re poorer or less powerful than others, we become less healthy, more angry, and more politically polarized.

I reached out to Payne because his argument seems to lead to a counter-intuitive conclusion: American society would be more be more stable if we had more poverty and less inequality. I reached out to him to see if that’s what he’s come to believe after writing his book.

A lightly edited transcript of our conversation follows.

Sean Illing

Tell me what you think we least understand about the social costs of inequality.

Keith Payne

One big misunderstanding is that when people start talking about inequality, their minds go straight to poverty, but poverty’s only half of the equation. Inequality is about the size of the gap between the wealthy and the poor. It’s obviously important to be concerned about poverty and to alleviate the suffering that accompanies it, but that’s still only half the problem.

Sean Illing

What’s the other half of the problem?

Keith Payne

What people under appreciate is how having extreme inequality driven by the high end of wealth also causes trouble for society and for people’s well-being. Poverty is a related but separate problem. The presence of extreme inequality destabilizes a society in ways that are hard to understand but absolutely devastating.

Sean Illing

Let’s get into that. What sorts of problems spring from these wealth gaps?

Keith Payne

For starters, it produces serious health problems, and not subjective problems but objective health problems, like chronic diseases, obesity, drug and alcohol problems, and, ultimately, shorter life expectancies. You see comparatively higher rates of these health issues in countries with the most income inequality, and that’s after controlling for average income.

Sean Illing

I know what you mean when you say “controlling for average income,” but can you make that clear for people who don’t have a background in statistics?

Keith Payne

Sure, it means that if you take two people who make the same income, but one lives in a very high-inequality place and one lives in a low-inequality place, the person in the high-inequality location is more likely to deal with these chronic diseases, more likely to deal with these drug and alcohol problems, more likely to actually die sooner than the same person living in a low-inequality environment.

The high-inequality countries also have more crime, more incarceration, more school dropouts — things that we normally associate with poverty, but in wealthy developed countries, they’re actually more closely linked to inequality than to poverty rates.

Sean Illing

It seems obvious that wealthier people with more resources and better access to medical care will be healthier than poor people. But when you compare across societies, you find that the average person in a high-inequality society like America is less healthy than the average person in a low-inequality society like Sweden or Norway. How do you explain this gap?

Keith Payne

The perception of inequality around us has a couple of different effects. One is that it makes the average person feel poorer, [in] comparison to those who have more. And the second is that it raises our expectations. It raises our standards for what we think it is to be normal. Now, that all seems very subjective, but when you perceive yourself as poor compared to other people, that sets off a chain of events that translates into physical outcomes.


Editor’s note: This November, Microsoft News is putting a focus on Poverty in America with a 2-week series examining the root causes of poverty, what poverty really means to the many different kinds of people affected, and what we can do to contribute to the most meaningful solutions. We teamed up with some of our most trusted news partners to bring you custom content and highlight quality journalism that helps us understand these issues. We hope you’ll join us in supporting the organizations that are helping Americans in poverty with both their immediate needs and long-term pathways to more stable and prosperous lives.

Growing up, I never thought of myself as particularly poor-mostly because I never wanted for food or clothes or warmth or home. I knew I was lucky, because I grew up in a part of town where others weren’t so well off. I often saw my friends and their parents struggle. Even before I made it to double digits, I could appreciate that mine were working their asses off-my mom got a nursing degree with two young kids to take care of. 

But when you grow up in a town that hovers around 23% under the poverty line (far above the national average); when plenty of your meals consist of cheap standbys like mac and cheese and ramen; when you know what free lunch programs taste like (why was the ham sandwich always so wet?!) and you end up going to a prestigious university and later, moving to one of the most expensive places to live and earning a salary that makes you rethink following your passions, you get it. The conversations you have with your parents are very different than the ones your cubicle mate is having with theirs.

“I have PB&J Mom, so I can last a couple more days ’til the next paycheck,” you say, knowing that your bank account is about $2 away from being overdrawn and that your mom would send you money she needs to eat because she loves you and doesn’t want your muscles to deteriorate because “you need your protein!” (Eggs are really cheap, thank god.) This, of course, is the same day your roommate announces they just bought some expensive designer shoes at Barneys because they were on sale and “my parents paid my rent this month.”
But this isn’t a pity party. This is about how growing up poor can drastically change your perception of money. I know because it took me a long time (most of my early 20s) to figure it out.

A study by Princeton researchers in 2013 called “Poverty Impedes Cognitive Function” found that those growing up with limited resources had a reduced ability to make better future decisions when it came to, well, anything. Because they already had to mentally make so many trade-offs (“Do I buy my kids bread or do I buy those diapers?”), they couldn’t deal with larger choices that were mentally taxing-which impacts savings, buying insurance, going for a mortgage instead of paying rent, etc. All things that could, eventually, help you into a better place financially.

“When you’re poor you can’t say, ‘I’ve had enough, I’m not going to be poor anymore.’ Or, ‘Forget it, I just won’t give my kids dinner, or pay rent this month.’ Poverty imposes a much stronger load that’s not optional and in very many cases is long lasting,” co-author Eldar Shafir said. “It’s not a choice you’re making-you’re just reduced to few options. This is not something you see with many other types of scarcity.”

But this impacts decision-making on a larger scale, too. As someone who grew up with a small bank account (and have been working since the age of 15), when I got my first influx of cash-I spent it. The $800 that came from my grandfather after his passing when I was 22 and had just moved to New York City went to things I couldn’t buy before-a dinner out with my new friends, drinks with co-workers, and a trip to see my best friend in LA. Did it go to paying off those student loans? Nope. Not a cent.

As one journalist wrote, “When a windfall check is dropped in your lap, you don’t know how to handle it. Instead of thinking, ‘This will cover our rent and bills for half a year,’ you immediately jump to all the things you’ve been meaning to get, but couldn’t afford on your regular income. If you don’t buy it right now, you know that the money will slowly bleed away to everyday life over the course of the next few months, leaving you with nothing to show for it. Don’t misunderstand me here, it’s never a ‘greed’ thing. It’s a panic thing. ‘We have to spend this before it disappears.'”

It’s true. Those who grow up poor are actually more likely to spend-especially in times of crisis-than their wealthier counterparts. It’s not only because we lack the money management skills, but it’s psychological: We don’t want that money to just slip away, and we also want the things that can make us “normal” to others.

“I hear it from people all the time,” financial planner Katie Brewer told “They spoil themselves as adults because they’re making up for all the ways they felt deprived as kids.”

So what do we do? We spend on things because we “deserve them.” We save very little. And we don’t learn about things that could save us heartache in the long run-like 401Ks and IRAs-because 1) We need the money now and 2) That’s what “wealthy” people have, not us.

As a young person in New York, it’s easy for me to get swept up in the trappings of the city. Happy hours here, sample sales there. Working amongst fashion journalists and being the person who tells you what to wear and how to wear it and reporting on the $1,600 bag “everyone” is buying is part of the job-it creates a want for a type of lifestyle I just can’t afford.

And it’s the realization that I can’t afford it-the sobering truth of that statement-that has led me to realize that I don’t need to. After hitting rock bottom around 24 (relatively young, I know), I needed to start from scratch. And making an editor’s salary meant re-learning all the things I should have learned earlier on. So I stopped thinking like a poor person. And I started thinking like the person I wanted to be.

I learned things that seemingly everyone else knew, but I didn’t. I learned how to save by socking away money where I couldn’t see it-in an account separate from my “regular” one that I check infrequently and that automatically pulls from my checking account on payday. I learned how to spend less on things I actually did need to buy and avoid triggers like “20% off” coupons that made me want to buy things I didn’t need because they were on sale. I learned the power of saying “no” to happy hours and to dinner invites and to birthdays where I didn’t even know the person’s middle name.

I learned what a 401K was. I did my research on banks and credit cards and sliced my debt in half. I put myself on payment plans and created a financial forecast.

Did you grow up poor, too? Learning these three behaviors helped me, and hopefully, will help you, too:

  1. If the reason for buying an item is “I deserve it,” put it back.
  2. If the reason that you’re buying an item is that it’s on sale, but you do not use the item regularly, put it back.
  3. If you haven’t saved up for an item, put it back. (This means you haven’t fully thought through the purchase, and you haven’t created a budget around it.)

But not everyone is as lucky as me. Not everyone has the littlest bit to save when bills and necessary expenses are said and done. I get that. I support bills that up the minimum wage. I support services like Planned Parenthood that provides medical treatment that otherwise wouldn’t be available to many. I rally against systems that put others at a disadvantage. I donate free beauty products I get from my job to women’s shelters. And I volunteer my time with homeless services that hopefully make an impact in people’s lives.

Because we all have to understand that being poor isn’t just a condition. It’s a context in which you learn to live the rest of your life. And once we learn how to tackle that mentality, we have to help others do it too. And honestly, that’s really the best way to be rich, isn’t it?

Sean Illing

That’s what I’m getting at: What’s the pathway from subjective perceptions of one’s relative poverty to actual physical health problems?

Keith Payne

One pathway is stress. If you perceive yourself as relatively low on the social ladder compared to others around you, it’s stressful, and the body treats that stress in the same way it treats a physical threat. So if you get the fight-or-flight response, you get immune responses that in the short term are good, but if they go on over the long term, over weeks or months, they can cause health problems.

Another pathway is that feeling lower on the status ladder compared to other people changes the way we approach decision-making in our own minds. It makes us riskier in our decisions; we focus more on the short term as opposed to the long term. So you have more people playing the lottery, taking payday loans, making questionable choices to try to get ahead economically. The long-term effects of these choices are usually bad — economically, emotionally, and physically.

Sean Illing

You also find that high-inequality societies are more polarized, more chaotic, and more dysfunctional. What accounts for this?

Keith Payne

What you find is that people who perceive themselves as having low status in a society often search for meaning in various ways, and one form that takes is believing in conspiracy theories. People disillusioned by their status in society look for various kinds of patterns around them, ways to justify their place, and that often takes irrational forms like conspiracy theories. Other times, it takes more normative forms like enhanced religious devotion.

Feeling lower status also has the effect of leading people to feel that the system is rigged against them. And so you hear a lot in the news about lower-education white voters feeling left behind as a function of the current economy and the kind of political consequences that has.

This feeling of being left behind is a real thing, but it’s not necessarily traceable to the fact that factories have gone overseas and that robots are replacing jobs. That’s clearly part of it, but the resentment is far worse when it happens in a society where people with higher educations and good social connections are getting wealthier and wealthier. It’s not hard to see how that can create political problems.

Sean Illing

Is it fair to say that economic inequality produces more political tribalism?

Keith Payne

I would call it more polarization, but you can call it political tribalism. And it happens on the left and the right. Again, people look for ways to make sense of a world that seems unfair, and often they do that by retreating into tribal identities — whether it’s political or religious or ethnic or whatever.

Sean Illing

A lot of the psychological problems you point to stem from our tendency to measure ourselves in terms of our social status. But humans have done this since we started living in groups, and certainly since the emergence of private property and individual rights. We’re just hardwired to detect relative differences. Is there something unique about what we’re seeing now?

Keith Payne

There’s nothing new about this psychological tendency to measure ourselves against others; that’s no different than it was 100 years ago or 1,000 years ago. What’s different today is the scale of the inequality around us, which is about as high as we’ve seen since we started keeping records of it.

Sean Illing

Do you think we would be healthier and happier if we had more poverty and less inequality?

Keith Payne

I think there’s a case to be made that trading off some measures of wealth, like the gross domestic product, would be worth it for the benefits that come with reduced inequality. The problem now isn’t that there’s too much wealth; it’s that nearly all of the increases are going to the wealthiest members of society.

Even if by some miracle we doubled everyone’s income tomorrow, that would only increase the inequality because when you double the income of millionaires, they get a lot richer than when you double the income of somebody making $20,000.

Usually, there isn’t a trade-off between more wealth and less inequality, because if you look across countries, the countries with lower levels of inequality actually have greater levels of social mobility. It’s easier to climb up that economic ladder if you’re in a place where inequality is on a human scale, as opposed to the astronomical levels of inequality that we see in America.

Sean Illing

A free society is going to produce unequal outcomes, and that’s fine so long as those inequalities don’t explode to epic proportions. So how do we negotiate these tensions?

Keith Payne

You put it well. That’s the trade-off we face. I don’t think there’s one optimum level; each society has to sort this out for itself. What works for Norway might not be the solution for America.

But the argument isn’t that everyone should be the same, or be equally successful. The argument is that democratic societies have got to negotiate these trade-offs and find the right balance between free markets and a progressive taxation system or a safety net that helps to even out the winners and losers in a way that preserves equality of opportunity but doesn’t allow society to become destabilized by inequalities.

I’m not a policy person, so I don’t have the answers. But we have enough data to know that this is something we ought to do if we want to keep our societies stable and healthy.


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