After working in the hospital setting for about eleven years, my nursing career changed courses. I cared for many hospitalized patients who were the working poor or below poverty level. Research indicates that poverty is a known contributor to psychological conditions, and chronic and complex medical conditions that can lead to an earlier death. My career path and passion for empowering people in poverty took me out in the community. For approximately nineteen years, I was employed as a consultant and certified case manager for several corporations. I was responsible for managing the medical care of a large population of people throughout the United States. I was responsible for assessing, planning, monitoring and evaluating actions required to meet my client’s health and human service needs. I was a facilitator, advocate and educator. My passions led me to learn more about policies affecting the vulnerable and under-served population. Prior to retiring, I changed courses again and worked as a leader in the healthcare industry for two managed care corporations.
Years after obtaining my degree in nursing, my passion for justice allowed me to earn a Master’s Degree in Health Law. Health is linked to income and income is influenced by public policy. For this reason, economic policy must be viewed as health policy. There are many non-clinical factors that influence and affect health outcomes. The population of people we were privileged to serve was low income and receiving Medicaid, called TennCare in Tennessee. I retired but my passion did not retire. As a person who survived the clutches of poverty, my passion is helping to empower others to escape the same clutches. This empowerment may consist of many steps. People living in poverty need help encouragement and guidance. Sharing the steps out and offering assistance may provide a different view. People not living in poverty or who never lived in poverty should be tolerant of those who are. It takes changing the mindset of both groups.
The working poor are the new faces of poverty. Poverty knows no race, age or gender. In our nation, the ranks of people in poverty increases daily. Many people have disdain for people in a different socio-economic level. We need to understand and be tolerant. We can’t condemn others who have fallen on hard times or don’t know the way out. We know that poverty may a consequence of many factors beyond one’s control. We also have a personal responsibility to uplift ourselves and not expect others to support our laziness. Physically and mentally abled bodied adults should work instead of relying on government assistance that was meant to help, not be a lifestyle. When my family was living in poverty, Dad walked to look for jobs. We didn’t have a telephone and internet was unheard of. Able bodied people relying on welfare programs long term is not effective in reducing poverty. Hard work in itself is not effective in reducing poverty. People are working hard at multiple low paying jobs without benefits to compensate for one well- paying job.
According to information on the U. S. Census website, the gains from economic growth have benefited the wealthiest people. When the government invests in programs and policies to help uplift people from poverty the poverty rates will decrease. This include program and policies to increase living wage jobs with benefits, pay equity, paid leave and sick days, investment in affordable high quality child care and early intervention. This also includes affordable medical and dental coverage, lower cost of medications, Medicaid expansion, criminal justice reforms, and Congress rejecting cuts to programs. According to the website, the Earned Income Tax Credit must be increased. This tax credit helped more than 6.5 million Americans; including 3.3 million children avoid poverty. According to another source on the Center for American Progress Website, studies show that from 1959 to 1973, a strong economy, investments in economic security, and civil rights protection helped cut the poverty rate in half. Safety net programs and health insurance expansion lowered infant mortality rates. States that raised the minimal wage (indexed to inflation), illustrated the important role that policy play in combating wage stagnation.
People are considered poor when their income falls below a certain threshold of money. The threshold is determined by the U.S. Census Bureau. Each year, there is an estimate of the level of income needed to cover basic needs. People living below these incomes are considered to be in poverty. In 1964, President Johnson declared a “War on Poverty.” At that time, the national poverty rate was 19%. Congress passed the Economic Opportunity Act allowing federal funds to help eliminate poverty, help improve living conditions for low-income neighborhoods and helping poor people access economic opportunities.
Prior to this Act, there were no government programs and no way to measure how many people were living in poverty. We were one of many forgotten families living in poverty. According to the US Census website, Poverty: The History of a Measure, President Johnson’s January 1964 declaration of his “War on Poverty” generated a new interest in measuring just how many people were in poverty and how those numbers changed from year to year. The next year the Office of Economic Opportunity adopted a working definition of poverty based on a methodology for counting the poor that had been proposed by Mollie Orshansky, an analyst at the Social Security Administration. In 1967, the Census Bureau published its first set of poverty estimates. Two years later, the Office of Management and Budget issued a memorandum that established the nation’s “official” poverty measure and charged the Census Bureau with responsibility for providing annual poverty estimates.
There’s a difference between poverty thresholds and poverty guidelines/levels. The poverty thresholds are determined by the U.S. Census Bureau and the poverty guidelines/levels are issued by the Department of Health and Human Services.
Federal Poverty Threshold
According to The U.S. Census Bureau website, the federal poverty threshold is the measurement of poverty in America. The U.S. Census Bureau uses it to report how many Americans live in poverty each year. The poverty threshold is used for statistical purposes. It does not determine qualifications for poverty-reduction programs such as the Affordable Care Act, Medicaid, or welfare.
There is a lot of interesting statistics on the U.S. Census website. Remember the poverty rate is an estimate. According to the website, the poverty rate in 2018 was 11.8%. The data for 2019 was not available at the time of my search. Compared to a rate of 19% in 1964, the poverty rate only fell 7.2% in 54 years. Something is wrong!
Federal Poverty Guidelines/Level
The poverty guidelines are issued by the Department of Health and Human Services and are used for administrative purposes. It determines whether a person or family is financially eligible for assistance or services under certain Federal programs such as Medicaid, Low income energy programs, and Safety Net Programs. The chart below was extracted from the public website to use for informational purposes only. Each state may be different. It is important to contact the state you live in to determine eligibility for specific programs. As noted in the chart, several programs or states may use percentage of the federal poverty guidelines. The chart excludes the states of Alaska and Hawaii.
(Jan. 15, 2020)
We have included multiple percentages in the Federal Poverty Level chart below, as there are several programs, including Medicaid, that use a percentage of the FPL as the income criteria for program participation.
48 Contiguous States
| # of Persons in Household | 2020 Federal Poverty Level for the 48 Contiguous States (Annual Income) | ||||||
| 100% | 133% | 138% | 150% | 200% | 300% | 400% | |
| 1 | $12,760 | $16,971 | $17,609 | $19,140 | $25,520 | $38,280 | $51,040 |
| 2 | $17,240 | $22,929 | $23,791 | $25,860 | $34,480 | $51,720 | $68,960 |
| 3 | $21,720 | $28,888 | $29,974 | $32,580 | $43,440 | $65,160 | $86,880 |
| 4 | $26,200 | $34,846 | $36,156 | $39,300 | $52,400 | $78,600 | $104,800 |
| 5 | $30,680 | $40,804 | $42,338 | $46,020 | $61,360 | $92,040 | $122,720 |
| 6 | $35,160 | $46,763 | $48,521 | $52,740 | $70,320 | $105,480 | $140,640 |
| 7 | $39,640 | $52,721 | $54,703 | $59,460 | $79,280 | $118,920 | $158,560 |
| 8 | $44,120 | $58,680 | $60,886 | $66,180 | $88,240 | $132,360 | $176,480 |
| Add $4,480 for each person in household over 8 persons |
Source: U.S. Department of Health &Human Services
Curious, I looked at the 1996 Federal Poverty guidelines for a simple comparison. Again, each state may use different percentages. Based on the 2020 chart, the guideline for a family of four is $26,200. In 1996, the guideline for a family of four was $15, 600. This is only an increase of $10, 600 in 24 years! Some people receive more than this in their yearly bonus checks from their employers. The incomes of many working class people with children fall outside these guidelines. These guidelines are listed for informational purposes only. It is necessary to contact the state you live in to determine eligibility for programs and learn how the programs are administered.
Many politicians and citizens are of the opinion that the economy is good and unemployment rates are low. This may not account for the fact that there is group of people working two or three jobs to make ends meet. Often, these are jobs without medical, dental and other benefits. Parents are too tired to take care of their health, attend doctors’ appointments, help their children with homework or attend school activities. Psychological stress may affect children’s studies, cause them to miss time from school, or have disciplinary problems. Some children are basically raising themselves because their parents have to work. Many parents go to work sick or risk being fired. Others are without needed medication or dental care because they can’t afford it. If school is out for any reason, day care is not affordable. Parents risk being fired if they take off work. Many children are unsupervised latch key kids. Parents are too tired to cook and rely on quick and unhealthy fast foods. This may lead to chronic and complex medical conditions.
The working class poor people are struggling in the gap. Children still face the highest rate of poverty because they don’t earn incomes of their own. They have to rely on their parent’s income. They live in households below the poverty line or are children of the working poor. The poverty line is set too low for most of the working poor to be considered. They make too much money to qualify for Safety Net Programs but not enough to get an economic boost. Many parents are working multiple low paying jobs without benefits. According to some research, approximately 43% of the population can’t pay for basic living expense.
The working class poor people were my patients and are my friends and family members. After divorcing, I had to raise my two daughters as a single parent until they reached adulthood. They were both under the age of three and childcare was expensive. I had a career but it was still difficult. Fortunately, I was able to take care of my children’s needs, had understanding employers and jobs with benefits. People in poverty and the working poor can’t perform a juggling act. It’s difficult to juggle when there are not enough balls to use. Poor people have similar stressors. They are constantly living in survival mode and trying to solve the problems of today. Tomorrow is far away for many of these families.
The support systems that are in place for poorer people may not matter to middle class and wealthy people. They don’t need a safety net. Again, there is an element of judgment in how people view those living in poverty and receiving government assistance. Stereotypes about poor people may not be based on reality. Truth be told, most people are living paycheck to paycheck.
Poverty and low income is characterized by many physical and psychosocial stressors. These stressors often affect physical and mental health. Growing up in poverty or poor can have a detrimental long term effect. Early intervention can help counteract these effects. As a child that survived poverty, I know that safe, stable nurturing relationships and environments are critical to preventing mistreatment. Socioeconomic factors link to crime and violence. Children exposed to violence during their youth may repeat the violence. This includes domestic abuse and child abuse. Adverse childhood experiences have been associated with risky behaviors and chronic health conditions.
I read a website article by Elizabeth Brown “The Nordic Welfare Model: Why There is Less Poverty in Scandinavia.” She wrote that the Nordic countries have the lowest poverty rates in the world. “They put emphasis on social cohesion and equality. Nordic policies are based around the idea that there should be equal opportunities, social solidarity and security for all members of the population. They focus on economic equality and gender equality. Part of the reason the Nordic states have greater health, greater happiness and less poverty is they have a strong welfare state with well -developed social safety nets. Nordic Welfare states are based on the belief everyone should have equal rights and access to healthcare, social services, education and culture. In Scandinavia, the government not only provide people with the resources to make sure they have all the basic necessities they need, they also provide people with the skills and abilities needed to become fully functioning members of society. The Nordic states have made it gender equality in the workplace a priority. Many women do not work because of family responsibilities and the high cost of childcare. In the Nordic states childcare is covered, as is homecare for the sick and the elderly. This means that women who may have had to stay home to care for their families can go to work.”
According to an article published by the U.S. Department of Health and Human Services, “Poverty in the United States: 50 year Trends and Safety Net Impacts,” Safety Net Programs lifted nearly 40 million people and more than 8 million children out of poverty. Over the years, these programs expanded. The initial lift is a direct result of the civil rights movement. The civil rights movement advocated for social security, improved access to jobs and education to name a few. I, and other people in my age range, benefited from the tireless work of the civil rights leaders and workers. After the movement ended, the home front became quiet but all was not well.
Civil rights protections helped my family and me graduate from absolute poverty to poverty and after a long process, we were lifted out. We stayed out because we did not have a poverty mentality. Poverty is more than a lack of money. It is a complex cycle of many factors. My passion is empowering others to be lifted out of the man-made clutches of poverty. People who never lived in poverty should strive to understand and value those who need to rely on government programs. Hopefully, these people will change their mindset. No one chooses to be poor. Poverty is not a character flaw. We all have a role in the fight against poverty! It is time for people to overcome bias against people living in poverty. According to research, The Nordic model lifted more people out of poverty. This sounds like a model to mirror in the United States. We all should have a vested interest in advocating for policies that will increase economic security and expand opportunities for everyone. As patriots who love our country, we must continue to challenge our country to do better for all people.
My granddaughter is in the first grade. She attends a public school and is learning about voting and pay equity. She drew this picture to remind me to vote. We must consider the future generations. We all can affect change!
“Like slavery and apartheid, poverty is not natural. It is man-made, and it can be overcome and eradicated by the actions of human beings.”-Nelson Mandela
References
Elizabeth Brown. “The Nordic Welfare Model: Why There is Less Poverty in Scandinavia.” World News. February 6, 2014. Wikipedia. Accessed March 1, 2020.
Poor Peoples Campaign. Wikipedia. Accessed February 10, 2020.
Rebecca Valles and Melissa Boteach. “Top 10 Solutions to Cut Poverty and Grow the Middle Class.” Center for American Progress. September 17, 2014.Accessed February 11, 2020.
United States Census Website. Wikipedia. Accessed February 11, 2020.
U. S. Department of Health & Human Services. Health and Human Services Poverty Guidelines and Federal Poverty Levels. Wikipedia. Accessed February 10, 2020.
U.S. Department of Health and Human Services, “Poverty in the United States: 50 year Trends and Safety Net Impacts.” Wikipedia. Accessed February 10, 2020.