Jan 23 2014
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Focus on Health to End Poverty

Janice Johnson Dias, PhD, is a Robert Wood Johnson Foundation New Connections alumnus (2008) and president of the GrassROOTS Community Foundation, a health advocacy that develops and scales community health initiatives for women and girls. She is a graduate of Brandeis and Temple universities and a newly tenured faculty member in the sociology department at City University of New York/John Jay College of Criminal Justice.

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Policy action and discussion this month have focused on poverty, sparked by the 50th anniversary of Lyndon Johnson’s War on Poverty and Dr. King’s birthday. Though LBJ and King disagreed about the Vietnam War, they shared a commitment to ending poverty. Half a century ago, President Johnson introduced initiatives to improve the education, health, skills, jobs, and access to economic resources for the poor. Meanwhile, Dr. King tackled poverty through the “economic bill of rights” and the Poor People's Campaign. Both their efforts focused largely on employment.

Where is health in these and other anti-poverty efforts?

The answer seems simple: nowhere and everywhere. Health continues to play only a supportive role in the anti-poverty show. That's a mistake in our efforts to end poverty. It was an error in 1964 and 1968, and it remains an error today.

Let us consider the role of health in education and employment, the two clear stars of anti-poverty demonstrations. Research shows that having health challenges prevents the poor from gaining full access to education and employment. Sick children perform more poorly in schools. Parents with ill children work fewer hours, and therefore earn less. Health care costs can sink families deeper into debt.

With all of this evidence, why can’t health get a better role in the anti-poverty story? 

The answer is: agents and supporters of health haven't done as good of a job promoting its connection to poverty. We need to do better.

With less than a month since the Affordable Care Act insurance mandate started, we might say that the President is keenly aware of the importance of health as an economic driver.  However, health was nowhere to be found in his anti-poverty announcement on January 9th.  

I had the pleasure of being invited to the White House for the launch of the Promise Zones initiative, which is President Obama’s new anti-poverty measure. The program replicates the efforts of Geoffrey Canada and the Harlem Children’s Zone (HCZ). During the President’s introduction to the Promise Zones, he described the activities of the HCZ. While health made a special and brief appearance, it was no the star of the show. The leading roles were played by education and employment; they were the George Clooney and Matt Damon to health’s Morgan Freeman. Yet, for those on the ground, health has a commanding and central presence. HCZ infuses health practices and policies into its anti-poverty efforts, from providing fresh fruits and veggies for children to creating targeted programs for obesity and asthma—major health concerns for the poor. Adopting a HCZ frame gives hope to the federal anti-poverty policies.  

One of the core reasons health is a sidekick to employment in the anti-poverty narrative is because creators of the anti-poverty story want a summer blockbuster hit with wide appeal, not a biopic for selected audiences. Anti-poverty policies are designed to be universal, not targeted policies. Yet poverty has clear target groups: the poor are young, black, and brown, girls and mothers. U.S. Census data bears this out: almost a quarter of the poor (23%) are below 18 years old; 53 percent of African Americans and Hispanics live in poverty; and roughly a third of mothers are poor. Thus, if we want to solve poverty, we will have to create targeted policies for these populations.

As an advocate for women and girls, I take the position that, given our limited resources, if we want to get the biggest bang for our buck and end multi-generational poverty, we need to focus on impoverished women and girls. More than half of the U.S. population is made up of girls, many of whom will grow to be mothers. In the case of black and brown girls and women in the United States, their children’s fathers and partners are very likely to become incarcerated and/or suffer premature death. These girls and women are then left to raise and live in families with little financial or human support.

The burden of this likely life circumstance coupled with other social ills can create or perpetuate poverty.  Reducing premature deaths and their impact will reduce poverty. Therefore, if we really want to help, we should be devoting our energies toward this vulnerable group of individuals. When we invest in the health of a girl, we help her escape poverty and gain resources that she will bring to her family, community, and country.

Investing in health is our best anti-poverty policy. 

Tags: Barriers to care: financial, Black (incl. African American), Human Capital, Latino or Hispanic, New Connections, Social determinants of health, Underserved populations, Voices from the Field, Women and girls