Health and the Poverty Line

By Allen Tullos

Vol. 14, No. 4, 1992, pp. 1-3

"The curse of poverty," wrote Martin King in 1967, "has no justification in our age. It is socially as cruel and blind as the practice of cannibalism. The time has come for us to civilize ourselves by the total, direct, and immediate abolition of poverty." In 1964, the U.S. poverty rate was 19 percent. Relatively good economic times and War on Poverty programs dropped the rate to 11 percent by 1973. Today, it is more than 14 percent for the nation as a whole, and 16 percent in the South. Given the current economic situation, these rates are almost certain to continue to move upward. With the coming and going of another set of Census Bureau statistics, the early 1990s finds us cruel and blind as ever, still given to picking our teeth with the bones of the poor.

For many observers of the recent South, it's become a truism that this section of America has finally integrated itself within the nation and the national economy. Perhaps. But only if you imagine a national economy that is itself pocketed with affluent white suburbs here, shut-down factories and underclass ghettos there, and forgotten-about rural hinterlands forever beyond the horizon.

Actually, the South today continues in many ways its tradition of distinctiveness. Any listing of the "worst states" according to current measurements of poverty, health care, housing, workers' climate, concern for the environment and general quality of life continues to be disproportionately Southern.

Poverty in the South of the 1990s exacts its cruelest costs in unnecessary illness, infant mortality, and pre-


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mature adult deaths. These costs are cruel because they are preventable. They are preventable, that is, whenever we finally decide to break the "curse of poverty" and take on the powerful political and economic interests who stand in the way of national health care.

One feature of the "curse" that has long held much of white America in its spell is the stereotype of the Undeserving Poor. The poor deserve their plight, goes this notion, because they are lazy, irresponsible, and immoral. Lately, except in the most right-wing camp of curmudgeons, this caricature has become harder to sustain.

Working people throughout the United States in the 1990s put in more hours on the job than they did 10 years ago but have less real income to show for their labor. Tens of millions of Americans are only one medical crisis away from financial disaster. How many feel they are "undeserving" of health care? Anyone reading these words can no doubt list friends or relatives who have lost jobs in the ongoing economic crisis or who are without health insurance. The nation has seen these true life stories dramatized this television season by the Connor family on Roseanne. Last year's downwardly mobile household becomes this year's working poor.

We are left to ask, are the 4 percent of Americans who, thanks to Reagan-Bush economics, now make as much money each year as the bottom 51 percent more deserving?

Economic status is the major determinant of health in America. The South's high rates of infant mortality, low birth weight, bad nutrition, diabetes, hypertension, heart disease, smoking-related cancers, and stroke are all directly related to poverty.

In the 1960s, Dr. King pointed out that more than twice as many whites as blacks were in poverty in America. This remains true today. Yet, Census data and public health studies tell us that for the African-American population as a whole the extent of poverty and poor health, as well as a newborn's prospects for a long life, are far worse than for whites. Half of all African-American children under age five live in poverty. Life expectancy for whites is about 75 years, for African-Americans it is less than 70. A Black male born today can plan on living about 65 years. For middle-aged African-Americans, a Centers for Disease Control study has shown, the inability to afford medical care accounts for the difference in the black and white death rate.

"We have the best health care system in the world," say the American Medical Association and the health insurance industry. Their claim recalls a scene from Andy Griffith's first movie, "No Time for Sergeants." Will Stockdale, the character Andy plays, is bailing out of the back of an airplane in flames. While the plane flies on


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automatic, the pilot and co-pilot are asleep in the cockpit. "Surely," Private Stockdale says, looking back from under his parachute, "they're not so easy going as to not know they're on fire."

Those who profit from sickness and death in America have no plans to bail out. They'd much rather go on spending a million dollars a year in Congress blocking any reform proposals, calling them "socialized medicine." At the same time, insurers practicing capitalist medicine refuse to cover—or they drop from coverage—the poorest, sickest, oldest, and the most high-risk groups, such as AIDS patients. At least 35 million Americans now have no health insurance at all.

Our country has the resources to make comprehensive, high-quality, health care available to all. We also have the resources to put an end to poverty. At present, 35 percent of our national wealth is owned by the top 1 percent of the U.S. population. The huge gap between rich and poor in America indicates how undemocratic our social system has become. As Victor Sidel, past president of the Physicians for Social Responsibility, puts it, "higher taxes on the wealthy and on corporations is the only just response to this maldistribution, and it also happens to be an answer to our need for publically-financed services." Access to health care starts out as a demand for the redistribution of wealth and resources. It soon becomes a political struggle for social justice.

"National health insurance," Barbara Ehrenreich observes, "is an idea whose time has come, and gone, and come again." This time around we should seize the moment as one step toward civilizing ourselves.

Poverty and the South in 1991

% in Poverty Rank
AL 18.8 48
AR 17.3 44
FL 15.4 35
GA 17.2 43
KY 18.8 48
LA 19 49
MS 23.7 51
NC 14.5 30
OK 17 42
SC 16.4 41
TX 17.5 45
VA 9.9 9
WV 17.9 46

Source: US Census. The poverty level in 1991 for one person was $6,932, for a family of four, $13, 924.