There is a saying which many of us who have lived or continue to live below the poverty line, have long known: You have to be rich to be poor. What that translates to is, the poorer you are, the more things cost.
It’s a reality that I’ve become familiar with over the years. First as a child experiencing welfare and WIC, free lunch and other government services, who occasionally had to boil hot water for my bath after my mother couldn’t afford to pay the gas bill. Then again as a broke college student, when stealing milk from the school’s cafeteria and toilet tissue from restaurant stalls was as much about survival as it was a college prank. And again as a young adult, who suffered in pain for more than six months with an infected tooth when my low wage job and lack of healthcare meant that I had to wait and save up enough cash to in order to afford a dentist appointment.
There is a high cost involved with being poor and now new research seems to confirm what many of us who grew up without means seemed to already know: Being poor can literally make you sick and if not careful, it might kill you.
Researchers at Columbia University’s Mailman School of Public Health has begun to look at the contribution of social factors to mortality in the country and have determined that poverty, low levels of education, poor social support and other social factors contribute about as many deaths in the U.S. as heart attacks, strokes and lung cancer. The investigators found that approximately 245,000 deaths in the United States in the year 2000 were attributable to low levels of education, 176,000 to racial segregation, 162,000 to low social support, 133,000 to individual-level poverty, 119,000 to income inequality, and 39,000 to area-level poverty. Overall, 4.5% of U.S. deaths were found to be attributable to poverty.
It might be hard for some folks to understand how individual social factors can contribute to poor health but consider for a minute the theory known as the poverty tax, also known as economic redlining, when businesses charge a premium over the standard price for an item to a captive market, namely the poor who lack the means to go elsewhere. Most people can relate to having to pay extra for a gallon of milk or a loaf of bread at a corner store when supermarkets are closed. But few folks understand what it is like to have to rely on the corner store for a primary grocer, especially when you don’t have reliable transportation to get to a supermarket or super saving box stores (usually located in the suburbs) to save money.
In low-income neighborhoods, you are likely to find more fast food restaurants per capita than places to purchase fresh fruits and vegetables. And while many have the luxury of paying for high priced gym memberships or engaging freely in sports activities at local parks and trails, not everyone, particularly the poor, live in regions with available and safe access to parks and playing fields. But it goes beyond basic nutrition and exercise. In poor neighborhoods, gasoline prices are as much as a nickel more than in middle class neighborhoods and real estate is appraised much higher as well. A recent survey of more than 11,000 Pittsburgh home sales between 2006 and 2010 indicates that properties in many of the city’s poorer neighborhoods are assessed for more than their fair market value.
Likewise, financial institutions tend not to set up shop in poor neighborhoods including banks, which last year, saw a reduction in branches in poorer neighborhoods while branches continued to expand in wealthier areas. The lack of financial institutions often give way to payday lenders, check cashing places and pawn shops, which charge exorbiant rates for their credit services. And despite the widespread belief that the wealthiest Americans carry the burden in taxes, the reality is that, when you include in federal payroll, gas, sales and utility taxes, the wealthy are actually paying less taxes.
Poverty is America’s quietest epidemic. Most who have been, or continue to be, low-income understand fully that there is no greater stress-factor than worrying about how you’re going to pay rent or where your next meal will come from. Not to dismiss the role individual self-determination can play in safeguarding a person’s own well being, but if a community isn’t prosperous enough, it can’t generate the economic thrust necessary for people to not only create wealth and escape poverty but ultimately live healthier lives.
Charing Ball is the author of the blog People, Places & Things.