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Total Poverty Awareness

February 21, 2004

Total Poverty Awareness


CHEVY CHASE, Md. — Thanks to the focus by John Edwards on the "two Americas," the working poor have become a topic in the Democratic presidential race. Let's hope they will remain so as we move into the general election. Yet nearly 40 years after the national War on Poverty began, much of the public conversation and official response remains disconnected from the real lives of poor families. Instead of approaching poverty as a whole made up of many parts, we tend to address it bit by bit. It's like having all the pieces of a puzzle before you, but letting them lie scattered and unlinked.

Some educators and other specialists speak of a "culture of poverty" as if it were a collection of mores, values and rituals. But poverty is not a culture. It's more like an ecological system of relationships among individuals, families and the environment of schools, neighborhoods, jobs and government services. Professionals who aid the poor witness the toxic interactions every day. Doctors see patients affected by dangerous housing, erratic work schedules, transportation difficulties and poor child-rearing skills. Teachers see pupils undermined by violence at home and malnutrition.

About 35 million Americans live below the federal poverty line. Their opportunities are defined by forces that may look unrelated, but decades of research have mapped the web of connections. A 1987 study of 215 children attributed differences in I.Q. in part to "social risk factors" like maternal anxiety and stress, which are common features of impoverished households. Research in the 1990's demonstrated how the paint and pipes of slum housing — major sources of lead — damage the developing brains of children. Youngsters with elevated lead levels have lower I.Q.'s and attention deficits, and — according to a 1990 study published in The New England Journal of Medicine — were seven times more likely to drop out of school.

Take the case of an 8-year-old boy in Boston. He was frequently missing school because of asthma attacks, and his mother was missing work so often for doctors' appointments that she was in danger of losing her low-wage job. It was a case typical of poor neighborhoods, where asthma runs rampant among children who live amid the mold, dust mites, roaches and other triggers of the disease.

Pediatricians at the Boston Medical Center did what they could with inhalers and steroids, and then dispatched a nurse to inspect the family's apartment. She found a leaky pipe and a wall-to-wall carpet where mites could survive the most vigorous vacuuming. The mother asked the landlord to repair the pipe and remove the rug. Nothing happened. The nurse wrote the landlord a letter. Nothing.

So the pediatrics department turned to its staff of five lawyers, hired for just this kind of situation. "After two telephone conversations with our lawyer," said Dr. Barry Zuckerman, the department's chairman, "the landlord took up the carpeting and fixed the leaky pipe." Within weeks, the boy was back in school regularly and his mother was able to keep her job.

This is a model of what needs to be done for low-income families. Unfortunately, it is employed too rarely by private and government agencies, which tend to tackle only the problem the poor present to a particular office. The assistance is often shallow and temporary and, as a result, leaves people vulnerable to the next crisis.

Most doctors, teachers and police officers have no way to reach outside their jurisdictions. That is why Dr. Zuckerman, using donations, has hired lawyers and social workers to help patients press for safe housing, Medicaid and other benefits. He estimates that about 25 clinics around the country are doing the same. "As pediatricians," he says, "we see failed social policies on the faces and bodies of children daily."

Government is especially bad at connecting the dots. Health is over here, housing over there; budgets are separate and are protected by officials with entrenched interests. Practically every program has its own eligibility requirements and forms, and many working people simply can't take time off the clock to trek from waiting room to waiting room. One-third of those eligible don't get food stamps, according to the Census Bureau, and about 30 percent of the poor who are entitled to Medicaid are not enrolled.

One remedy, tried by community action centers created by the War on Poverty, put a variety of specialists under one roof. Their effectiveness unsettled politicians. "Mayors didn't like them because they were doing something that was very good," recalls Frances Fox Piven, a professor of political science and sociology at City University of New York. "They were badgering municipal agencies to provide services." The money for the centers eventually dried up.

Decades later we are still testing this idea, now called "one-stop shopping," as if it were some dubious proposition. Since last July in five California school districts, applications for subsidized lunches have been used as applications for Medicaid as well. What has to be proven for the rest of the state to follow? In Chicago, schools get computerized lists of children who are enrolled in the lunch program but not in Medicaid. Why not in all of America's schools? Job placement is done at a few public housing sites; why not at every one?

We need more than patchwork projects. We need a sweeping national program to create what could be called gateways. At private and public institutions that are frequented every day — clinics, schools, food banks, housing projects, police precincts and the like — a person should be able to find easy referrals to child-rearing instruction, drug treatment and other assistance.

What works is an intensive, holistic approach like the one used by the Maya Angelou Charter School in Washington. The school brings its 100 students in for breakfast and keeps them until after dinner. They have small classes, homework sessions with 75 volunteers and counseling from three full-time social workers and a psychologist. Most students arrive in 10th grade reading at sixth- or seventh-grade levels; three years later 70 percent go to college. The cost isn't low — it runs over $25,000 annually per student — but it is a humane investment, one that is helped in part by donations. With more money, the school could become a platform for supporting whole families.

The amalgam of charity and government can be effective, but the full force of the nation's financial power can be mobilized only by the federal government. Only then can we alter the ecology of poverty.

David K. Shipler, a former Times correspondent, won the 1987 Pulitzer Prize for nonfiction. He is the author, most recently, of "The Working Poor: Invisible in America."

Copyright 2004 The New York Times Company

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