Category Archives: Poverty

Medicine and Sustainability

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Two important stories that will make sense to all of you, but specifically to those “I wanna be a doctor” folks among us.  As you’ll learn in the California story, doctors get paid by the task — office visit, exam, surgery, etc.  This is not sustainable given where health care may be headed; it’s certainly not beneficial to the consumer.   Also as you’ll hear, given the cost of medical school and the loans MD’s have to pay back after graduation, specialization in the system drives doctors away from where they are indeed needed — primary care.

In California, Facing Down a Family Physician Shortage

In another story that shows us how wonderful we are, this is concerns Global Health.  In fact, this link will take you to several stories concerning Global Health — cholera perhaps spreading to the DR and Miami, organ trafficking, and a global food crisis.

As you ponder your last “mini” essays, think about some of these challenges.

Robert Moses and Majora Carter – Terrible Infrastructure and Environmental Justice

I had an interesting discussion with my architecture professor, James Butler, who introduced me to the source of New York’s horrible infrastructure in low income areas. Robert Moses, who is seen as a savior to residents of Westchester County, Rockland County and Long Island, pushed for the construction of major freeways throughout NYC. One of his projects, the Cross-Bronx Expressway, abruptly cut through the South Bronx, demolishing countless apartments and displacing over 600,000 working class people on a month’s notice. Since Moses was well-connected with the upper-class and was also backed up by Master’s from Oxford and a fancy PH.D from Columbia, he neglected the voice of the neighborhoods he destroyed and just let business dominate. My professor states “Moses was so politically powerful, that all he needed was to find the most talented architectures, and manipulate them to fullfil his projects.”

Another point about Moses is that his environmental projects, i.e Riverside Park, East River Park and Central Park were reserved for areas where mostly the upper-class lived. Although willing to destroy and increase car pollution in countless neighborhoods for highways, he never decided to place a pool or a park in Hunts Point or Bed-Stuy.

Also,

I also found an interesting interview with Majora Carter. Addressing the same tensions, Carter states the reasons why environmental concerns in low income areas are inevitable. Her point express how corps can still profit by engaging in projects that equalize environmental sustainability in all neighborhoods.

Check it out. It was intriguing to listen to, and they typed-up the interview if you just want to read through the ideas.

Edit 11/16/10 : Her interview basically reiterates the points in Cooper’s essay which we read today. Thanks Cooper for introducing us to Majora Carter’s ideas.

For those of you driving back home for Thanksgiving, think about the cities/towns you pass by. Is it evident that infrastructure has cut through low income areas near you? Please share.

http://www.democracynow.org/2010/7/22/neither_the_destruction_of_the_9th – link to  Carter interview.

http://en.wikipedia.org/wiki/Robert_Moses

http://gothamist.com/2007/01/25/caro_gets_snubb.php

Pic of the Cross Manhattan Expressway Moses designed.

“There is nothing more frightful than ignorance in action.”  – Johann Wolfgang

Best,

Frederic

Understanding Social Determinants of Health

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Understanding the Social Determinants of Health: Breaking the Link between Poverty and Health

Brown graduates working with Project Health (program where college students work in local health clinics) based in Providence, Rhode Island. Samantha Murder (Program Manager) and Hanna Nichols (National Talent and Technology Coordinator)

Cycle of Poverty

  • MONEY is needed for healthy food, healthy housing, childcare (so you can go to work), education and school, clothing (job interviews), health care, utilities, medicine
  • in order to get money you need a JOB
  • in order to have a job, you need EDUCATION

Need education and a good job for money, but need money for education and chance for a job! Not a linear path and a difficult cycle to enter.

Project Health works to provide resources and knowledge.

Social Determinants of Health- “economic and social conditions under which people live which determine their health”

  • The Big Five: Food, housing, energy, education, and employment/insufficient income.
  • Shaped by the distribution of money, power, and resources (influenced by policy choices)
  • Social determinants are mostly responsible for health inequities

What do we mean by Poor?

Mentioned that the federal poverty line has been used a lot throughout the symposium as a measure of poverty. They stressed that people are struggling for money well above the federal poverty line. The federal poverty line for a family of 4 is $22,050, but, in suburban Illinois for instance, a family needs at least $58,000 for necessities (study done by NCCP -see budget calculator)

FOOD

Food insecurity greatly increases likelihood for poor health (ex. low birth weight for mothers)

Compared nationally, Vermont is doing well, subsidized lunches and breakfasts at school are critical (50% of kids in Essex county use this) Essex also has high levels of low birth weight.

What’s out there? Resources to combat food insecurity

ENERGY

Heat or eat?

Energy insecure households- 22% increased chance of being hospitalized since birth

What’s out there?

  • LIHEAP (covers a large amount of monthly winter heating bill, if you can’t meet cutoff your utilities will be shut off- difficult to pay back. Grants are getting smaller)
  • local neighborhood funds
  • Special protections for disabilities
  • Payment plans (utilites prefer some money)

HOUSING

Related to health. Household mold (makes you 2.2 times more likely to experience asthma!), cockroaches, cold, lead poisoning, unsafe housing conditions, stress from not being able to pay rent contribute to asthma and low nutrition, hospitalizations, poor health

Housing is considered not affordable when it costs more than 30% of income.

Housing in context- Vermont. Top 10 occupations in Vermont include retail salespeople, cashiers, janitors and cleaners- none of whom have a salary high enough to pay for housing. Not a livable salary! Poverty is “not just about getting a job”

What’s out there

  • public subsidized housing (projects)
  • private subsidized housing (contracted out)
  • housing choice voucher Program (Section 8)- pay up to 30% of income and government pays rest- HARD TO GET, 5 to 8 year wait for voucher in Rhode Island
  • shelters
  • transitional housing
  • rental assistance
  • legal action- something unsafe in house- legal pressure on landlord (less expensive than moving)

EDUCATION

They highly suggested the film “Waiting for Superman”! (check out the trailer)

What’s out there

  • GED classes
  • ESOL classes (English is 2nd language)
  • Adult basic education
  • Computer literacy
  • Child enrichment
  • Head start and early head start (includes literacy classes for parents, checkup for kids, losing seats right now)

INSUFFICIENT INCOME/ EMPLOYMENT

Related to obesity and other health issues. Not knowing what will happen raises stress and sickness- lack of locus of control.

People below the poverty line live an average of 9.6 health adjusted years less than Americans above the poverty line!

What’s out there

  • Child care subsidies
  • Food stamps

PROJECT HEALTH

Founder noticed underlying health problems involved with evictions

Doctors could do nothing for patients suffering from unemployment, poor housing.

Student in project health connect families to resources/volunteers. For example, they often connect families to food pantries or call utilities to arrange payment plans.

HOW THEY WORK

  • guided referrals
  • resource knowledge
  • identification of barriers
  • creative solutions
  • education
  • advocacy
  • connections

Conversations about food security and housing are important to both doctors and patients, but those conversations weren’t happening. Health services often don’t have the time or the knowledge to refer people, which is where Project Health steps in. Project Health also works to collect data that can be used in advocacy movements and campaigns.

Located in 6 cities, with 600 volunteers, and has helped over 5,000 families.

If you’re interested, check them out here!

The Corrosion of America

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Bob Herbert writes, in The Corrosion of America, that, “Aging and corroded pipes are bursting somewhere every couple of minutes. Dilapidated sewer systems are contaminating waterways and drinking water. Many local systems are so old and inadequate — in some cases, so utterly rotten — that they are overwhelmed by heavy rain.”

This is creating a very dangerous situation throughout the US.  And if you look at this “corrosion” and couple it to Fred’s post, below, about poverty, then

If this were a first-class society we would rebuild our water systems to the point where they would be the envy of the world, and that would bolster the economy in the bargain. But that would take maturity and vision and effort and sacrifice, all of which are in dismayingly short supply right now.

We can’t even build a railroad tunnel beneath the Hudson River from New Jersey to New York.

Improving water systems — and infrastructure generally, if properly done — would go a long way toward improving the nation’s dismal economic outlook. According to the U.S. Conference of Mayors, every dollar invested in water and sewer improvements has the potential to increase the long-term gross domestic product by more than six dollars. Hundreds of thousands of jobs would be created if the nation were serious about repairing and upgrading water mains, crumbling pipes, water treatment plants, dams, levees and so on.

Millions of jobs would be created if we could bring ourselves to stop fighting mindless wars and use some of those squandered billions to bring the nation’s infrastructure in the broadest sense up to 21st-century standards.

Harlan Beckley – US Poverty “It’s Time to be Ashamed”

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I attended the Student Organized Symposium’s (Topic of US Poverty) opening lecture today. Dr. Harlan Beckley gave insightful presentation on the ethics of the US poverty rate, while focusing on how to aid the more disadvantaged communities. Working closely with Washington and Lee University and Middlebury Alumni, Nancy Shepherd, Beckley is the founding program director for the Shepherd Program, which is a program that promotes the academic study of poverty and human capability to undergraduate and law students. The program strives to combine this academic rigor with the personal experience of its students. The resulting goal is a cognitive approach and initiative to engage in various endeavors to counter this rising conflict. I found that Beckley himself exemplified this in his lecture by combining his mastery of economics with the behavioral struggles poverty causes.

Beckley commenced by explaining that the set poverty rate for a US household of four is under $22,000 and currently 14.3% of the US population lives under that statistic.  What’s even more disappointing is the break-up of that percentage. Both Single Parents and 31% of people who have not acquired a high school diploma directly affect the high poverty rate. As a developed nation, it is essential that we have an organized method of countering this portion, but I feel there is a reluctance of the public to look for these statistics rather than maintaining an “Illusion of Happiness” that doesn’t confront this reality. Yet, the sad truth is still that one in every five children currently lives under impoverished conditions, and if you are Black/Latino your chances of living below the poverty line are also multiplied by three.  Our infant mortality rate is also repulsively higher than most developed nations, confirming 21 countries with better rates. Yet, Beckley also pointed out however that the poverty rate for citizens above the age of 65 has been reduced as a result of social security. So if we can identify an importance in protecting our elderly in this system, than why not our infants and children? Why can’t we improve living conditions for our bottom wing? Is this the result of inequity of voice in our society?

I also found remarkable how Beckley compared the Poverty Rate to Per Capita GDP. His statistics exhibited that Per Capita GDP of a nation may rise, but the poverty rate does not have to fluctuate as a result. So a nation can undergo vast economic growth and while having half of its citizens still below the poverty line. I was shocked to see Beckley’s statistic, which illustrated a wage comparison between the poorest wings in the USA to that of Germany. The lowest economic branch of US Citizens, still having a Per Capita GDP that is 20% greater than Germany, collect less than half the wages of the lowest Germans. This is the income inequality that the forces society to have unequal environmental concern, and class struggle. If wages aren’t going to be properly distributed, how can we expect market forces to act accordingly? This also made me wonder, if GDP wasn’t even a recorded statistic, could the US possibly be considered a developing country?

A reason we study history is to learn not repeat the same political mistakes our species has made in the past. However, we still consistently make the same mistakes in other things, like how we value numbers. Would it be ranting to be connecting the “Illusion of Wealth” our GDP creates to the “Illusion of Wisdom” in our SAT scores? If not, that comparison should run parallel to a history lesson.

Here’s a link to the Shepherd Program: http://www.wlu.edu/x12034.xml