Note: In 1988, I wrote this article, and it appeared as a cover story in the Washington Monthly. There have been myriad changes in public policy toward poverty in the intervening 35 years, including the enactment of welfare reform and the short-lived expansion of the child tax credit during the pandemic. Republicans have decimated SNAP, widely known as food stamps, and Medicaid. But I wanted to republish it on Christmas last year and this because it remains, I think, relevant. We have had great works of art that focus on the poor in the years since. HBO’s The Wire is often and rightly called Dickensian. Its societal indictments, moral complexity, attention to personal agency, and riveting installments over the years echo Dickens, whose novels were serialized. But with due respect to David Simon, the show’s creator, I’d argue that we still need a new Dickens, an artist who commands global fame and unalloyed praise and whose work helps those who need help the most. That’s a lot to ask for this troubled and war-torn Christmas, Hanukkah, and Kwanzaa, but we can hope as 2026 approaches.

Matthew Cooper
Christmas Day, 2025

Christmas is always the busy season for Charles Dickens, but this year there’s more going on than usual. There’s a Bill Murray remake of A Christmas Carol (playing the perfect ’80s Scrooge—a TV exec too busy to do lunch with his ghost) and, for the truly sturdy, a two-part, six-hour film of Little Dorrit. Coming soon: Disney’s Oliver Twist. And a new biography of Dickens is getting prominent reviews, including front-page billing in The Washington Post Book World.

But what’s been missing from the articles I’ve read about these works is the recognition of Dickens’s central accomplishment: He prodded (and entertained) millions of readers into caring about the poor. Instead of seeing the poor, as Malthus did, as some abstract, seething mass of “surplus population,” Dickens saw them as individuals, engaging enough to merit novels of 700, 800, and 900 pages. He made his readers see them that way too. And that was a revolutionary accomplishment.

One indication of his influence lies in numbers. He was the best-selling author in Victorian England, writing novels that became standard household items, as common as candles and brooms. In the 12 years after he died, nearly 4 million copies of his books sold in Britain alone—an amazing feat even by Stephen King standards. When it came to influence, Daniel Webster argued that Dickens had “done more to ameliorate the condition of the English poor than all the statesmen Great Britain had sent into Parliament.” Even the conservative Economist conceded that Dickens fueled “the age’s passion—we call it so designedly—which prevails to improve the condition of the working classes.” Queen Victoria hailed his humanizing influence on the nation and his “strongest sympathy with the poorer classes.”

As for the poor themselves, they not only saw Dickens as their champion, they read him. Journals of the period are filled with accounts of chimney sweeps and factory hands captured by his work. And when they couldn’t make out all the words, there were plenty of illustrations to help them along. The working classes responded by deluging Dickens with invitations to speak before their guilds. “Ah! Mr. Dickens!” shouted a carriage driver to Dickens’s son, on the day of the novelist’s funeral. “Your father’s death was a great loss to all of us—and we cabbies were in hopes that he would be doing something to help us.”

It was not without reason, then, that Dostoevsky called Dickens “the great Christian.’” Characters like Oliver Twist and Mr. Bumble, who ran the infamous workhouse, carry lessons as old as the New Testament. When Mr. Bumble terrorized Oliver for asking for a second helping of gruel, even affluent Englishmen knew how the orphan felt. They knew, too, that they had an obligation to help. That kind of empathy stoked the era’s major reform movements. The resulting bouquet of triumphs included everything from fewer working hours to free education and universal suffrage.

There’s more to Dickens, though, than misty-eyed sentiment. His was a subtle and muscular vision that recognized (and condemned) the sins of impoverished individuals as well as the collective guilt of society. Dickens gives us not only Oliver Twist but also Fagin, the criminal ringleader who press-gangs Oliver into service. He’s no victim of society. Fagin’s problem is Fagin.

Is there any relevance in this today? After all, the sprawling squalor of Victorian Britain has gone the way of the workhouse. The laissez-faire liberalism that Dickens deplored is light-years away from today’s social welfare state. (No food stamps had Oliver. No caseworker.) But America today is in at least one way like the England of the 1830s: Most of us see the underclass as a seething, abstract mob. Of course, it’s not just our artists who’ve failed us, but our politicians, too. And it’s too much to expect all art to serve as social glue, binding each of us to the concerns of the less fortunate. But today, when so much fiction is either mired in minimalist ennui or panting with the lifestyles of the rich and promiscuous, we need someone who can animate our social concern. We need a new Dickens.

A street-walking man

Where to find one? My guess is that it can only be someone who has seen poverty up close; perhaps a journalist. Dickens himself became acquainted with the poor as what today’s social scientists would call a “participant observer.” He was one of them.

His father, John Dickens, tried to give his children a life of parlors and singing lessons on the paycheck of a Navy clerk. As a result, like so many working people of the time, the Dickens family floated in and out of debtors’ prison (bringing their servant with them, as was the custom of the day). By 1822, when Charles was 10, debt’s constant tug forced his family to yank him out of school and place him in a factory pasting labels on pots of shoe polish. When not at work, he spent long days wandering the alleys of work-weary London. With his parents often imprisoned, describing what he saw became a way of mastering a hostile world. He’d jot down dozens of “sketches,” detailed descriptions of just about anything he’d run into. They captured not only turmoil and toil but character, as well. Typical was the one about his uncle’s Soho barber, a man who, playing Monday-morning quarterback, recounted how he would have guided Napoleon’s troops at Waterloo.

Eventually, his family earned its freedom, and Dickens became a law clerk, allowing him to tame “the savagery of stenography,” as he put it, and later become a reporter. At the time, reporting mostly meant taking shorthand, but Dickens was so talented one editor called him “the most rapid, the most accurate, and the most trustworthy reporter then engaged on the London press.”

With his star rising, Dickens didn’t leave the poor behind. Instead, he sketched them. Under the pseudonym “Boz,” he churned out copy about vulgar vendors, ragged children, and raging arguments. In “The Pawnbroker’s Shop,” Dickens presented his comfortable readers with a prostitute: “The lowest of the low; dirty, unbonneted, flaunting and slovenly.” In his “Visit to Newgate,” he took them inside a prison that housed children. “Fourteen terrible little faces we never beheld. There was not one redeeming feature among them—not a glance of honesty—not a wink expressive of anything but the gallows and the hulks, in the whole collection.”

This kind of firsthand experience became central to Dickens’s fiction. To write Hard Times, for instance, he traveled to the north to cover a workers’ strike. He was no sit-in-the-study author. After writing in the mornings, Dickens would take afternoon walks of 10 miles or more that returned him to the streets that powered his prose.

Obviously, it wasn’t just the reporting that made Dickens Dickens. It takes a little more than stenography, and a lot of something called imagination, to spin a 900-page novel. But Dickens’s immersion in street life made his novels richer. When a barrister picked up Dickens’s work, he saw his servants and his slums. He saw his London.

The stenographer’s eye and the novelist’s mind gave Dickens the ability—virtually unprecedented—to make the poor seem real. As Gertrude Himmelfarb explains in The Idea of Poverty, this was a time when servants were invisible, even to their masters. When a contemporary critic hailed Dickens’s talent for making a “washerwoman as interesting as a duchess,” it was a tribute not only to Dickens’s wonderful prose, but also to his new vision.

After all, one of the main characters in his first lengthy work of fiction, the serial Pickwick Papers, is Sam Weller, a servant. He not only fails to remain invisible; more often than not he seems a good deal wiser than his master. When he first signs on as Pickwick’s valet, the negotiations turn into a “Who’s-on-first?” routine that sounds like Weller is hiring Pickwick. Weller still seems in control when Pickwick checks into an inn. After Pickwick stumbles into the wrong bedroom, only to be kicked out by a very unhappy woman, it’s Weller who rescues him and guides him to his room. “You rayther want somebody to look arter you, Sir, when your judgment goes out a wisitin’,” Weller chirps. The servant’s introduction in the serial’s fourth issue sent sales surging.

In his next book, Oliver Twist, and throughout the other novels he was to write until his death in 1870, Dickens stuck to the simple proposition that no class had a monopoly on smarts or morality or decency or humor. This was a revolutionary creed at a time when the affluent saw the poor as a mob—to be feared or appeased, perhaps, but definitely not to be considered as individuals. And the rich were scarcely alone in their class-bound vision. As Dickens was spinning novels, the history of the working class in Manchester was being written by a German emigré named Friedrich Engels.

The idea of Jacobin-style revolution haunted Dickens, who poured his fears into prose in A Tale of Two Cities. In our century of failed revolutions, there’s no more haunting or timely image than Dickens’s Madame Defarge, knitting by the guillotine. He recognized that, just as the poor weren’t all good, the rich weren’t all bad. His pages brim with venal landlords, nasty bankers, and callous captains of industry; but good-guy capitalists pop up too. A product of the streets himself, Dickens saw no romance in revolution. It’s not the proletariat who overthrew Scrooge, but his conscience.

If Dickens feared revolution, he didn’t fall into the opposite trap of forgetting why mobs charged the barricades. He understood that the capitalist society was rife with institutions that kept the poor down. The villains of Hard Times aren’t just bad apples but overlords of a cruel factory system, dehumanizing in the monotony of its work. The tragedies of Bleak House, one of his last and gloomiest books, are found in the systematic injustice of the courts. By challenging these institutions, he made the lawyer or factory owner see that they shared responsibility.

The idea of poverty

And when Dickens trained his guns, liberals weren’t exempt. The workhouse that Dickens took on in Oliver Twist was one of the most prominent liberal programs of his day. Today it’s hard to think of the book’s cruel overseers as being progressive. But the Poor Law of 1834 was considered a great liberal victory, one that would segregate the indebted poor and prevent them from dragging their fiscally responsible neighbors into the red. (Talk about the unintended consequences of liberal reform.) When Oliver meekly seeks a double dose of gruel, we see unbridled cruelty. “Enlightened” Victorians saw themselves.

And what they saw was folly. Consider the way that Mr. Bumble—who runs the “progressive” workhouse—understands Oliver’s revolt.

“It’s meat.”

“What?” exclaimed Mrs. Sowerberry.

“Meat, ma’am, meat,” replied Bumble, with stern emphasis. “You’ve over-fed him, ma’am. You’ve raised a artificial soul and spirit in him, ma’am, unbecoming a person in his condition.”

The humor of the scene helps carry its meaning. Had Dickens’s criticisms been heavy-handed, as [the late scholar of the Victorian Era] Steven Marcus points out, middle-class readers wouldn’t have touched his works. Instead of promoting a specific alternative to the workhouse, he satirized it, appealing to his readers’ Christian charity. A second key to Dickens’s success is his choice of the symbol of the good child, in Oliver Twist or Little Dorrit or David Copperfield. He tapped the wellsprings of protectiveness that cultures can be made to feel for the young. Martin Luther King Jr. put that same insight into action when Birmingham schoolchildren stared down firehoses and police dogs, leaving us with one of the most arresting images of the civil rights movement.

But even as he skewered institutions, Dickens understood that the poor were often in the wrong themselves. If anything, there’s a schism in his writing, dividing what you might call, for lack of better terms, the worthy poor from the unworthy—between those who merit our admiration and those who don’t.

Winning hands down in the Worthy Category, family division, are the Christmas Carol’s Cratchits. It’s not just their “conditions” that make them sympathetic—the fact that they’re poor or that Bob Cratchit has a boss like Scrooge or that Tiny Tim needs crutches. It’s the family’s own nobility that lends the story such power, remake after remake. One clear signal to Victorian readers was the Cratchits’ white-glove cleanliness—a paramount virtue at a time when filth was almost always followed by disease. The Cratchits were “darned and brushed” before the Christmas feast. After supper, “the cloth was cleared, the hearth swept.” In the Cratchits, like Oliver Twist, David Copperfield, or Little Dorrit, respectable British middle-class readers found an ideal of themselves.

Meanwhile, a first in Unworthiness might go to the brickmakers of Bleak House, who seem like something out of a documentary on battered wives. We spy them when Mrs. Piggle happens by. “An’t my place dirty? Yes, it is dirty—it’s nat’rally dirty, and it’s nat’rally onwholesome,” boasts the father. “And we’ve had five dirty and onwholesome children, as is all dead infants, and so much the better for them … And how did my wife get that black eye? Why, I giv’ it her; and if she says I didn’t she’s a Lie!” Today, when many liberals still romanticize the poor, Dickens’s ability to distinguish poverty from nobility is well worth remembering.

Dickens understood that there were good and bad individuals within every class. But he rarely saw the individuals who were a mixture of good and bad. His heroes and heroines don’t whine, don’t curse, and even though they’re raised in the company of foul-mouthed, cockney villains, they speak the King’s English. To be sure, his supporting cast could include people like the Peggottys in David Copperfield, who were not so well-spoken. But they, too, were practically flawless. This strict division between the worthy and the unworthy poor is more than an aesthetic flaw. It limits Dickens’s relevance today.

Dickens makes his readers want to help the deserving poor. And, indeed, the Victorian (and New Deal) reforms that were, in part, inspired by Dickens focused on these able-to-help-themselves characters. Kids who’d be okay if child labor was abolished; workers who’d prosper with a union. This is the story of America through the 1950s: The New Deal and rising prosperity catapult the “worthy” poor into the middle class. Oliver goes to Levittown.

This left behind an underclass that seemed short on lovable Cratchits and long on pregnant teens, drug addicts, and gang members. What we don’t have is the popular literature that will jar the affluent into caring about these less savory characters. We don’t have the literature that will condemn their faults and recognize that these are people who can be helped. When I worked in a Big Brothers program in New York City, I remember noticing that there was no novel or film that got at the downright weird complexities of those tenements I visited on 102nd Street. I couldn’t point to any book that explained how those kids could be such utter failures in school, unable at age 15 to write a single sentence, and still be as sharp and savvy and as alert as any kids I had known growing up in the New Jersey suburbs. There was no film that I could tell my friends about that captured the complexity of those mothers I would meet who’d blow much of their money on VCRs and HBO but who were also selfless when it came to helping their kids. There was—and still is—no writer who combines great talent and great popularity and who captures that bizarre marriage of sin and decency I saw in those tenement families.

The Dickens character who most reflects our dilemma is the Artful Dodger, the young pickpocket who befriends Oliver Twist. He’s engaging, to be sure. The first thing we see him do is take Oliver drinking; by the end, he’s in court, trying to sweet-talk a magistrate into pardoning him. But he’s a side dish. We never understand or care about him the way we care about Oliver. The next Dickens needs to put us not in our Olivers’ shoes but in those of our own Artful Dodgers.

While a new Dickens couldn’t cure poverty, he could inspire personal commitment from the middle class. I don’t mean the anesthesia of paying for yet another government program, but involvement. And that takes understanding. Public health care won’t improve unless talented doctors and nurses want to choose Harlems over Humanas, at least for a few years. We won’t really become a kinder, gentler nation unless our leaders know something that’s true about those on the bottom. But working with or for the poor requires inspiration; it doesn’t come naturally. Individuals disappoint. Projects collapse. Easier lives beckon. Great art, as opposed to Brookings reports, can be the spur we need.

In 1945, Lionel Trilling lamented that no writer in his day had done what many of the leading Victorian writers had done—combine great literature and social concern. “In three-four decades, the liberal progressive has not produced a single writer that itself respects and reads with interest. A list of writers in our time shows that liberal progressivism was a matter of indifference to every writer of large mind—Proust, Joyce, Lawrence, Eliot, Mann, Kafka, Yeats.” The absence of such a writer may have been a marginal loss in the middle of this century, when the politics of the time were liberal even if the great novelists were not or when poverty seemed like it could be erased simply through economic expansion and a few social reforms. Today when politicians are retreating from helping the poor and growth offers no panacea, we need another Dickens to inspire each of us to help.

I don’t know if there will be a single figure—be it a novelist filmmaker, or journalist—who can animate a nation’s imagination the way Dickens did or whether it may take a disparate group or even an artistic movement. But I’m certain those Dickens-like qualities will not be had by some writer-in-residence strolling the hallowed halls of Haverford. The Dickens mantle demands a life outside the academy, exposed to the real world. It belongs to the writer who can make us care not only about our Tiny Tims but about our Artful Dodgers, too.

The post Why We Need a New Dickens appeared first on Washington Monthly.

Note: In 1988, I wrote this article, and it appeared as a cover story in the Washington Monthly. There have been myriad changes in public policy toward poverty in the intervening 35 years, including the enactment of welfare reform and the short-lived expansion of the child tax credit during the pandemic. Republicans have expressed interest in work requirements for SNAP, widely known as food stamps, and Medicaid. But I wanted to republish it on Christmas last year and this because it remains, I think, relevant. We have had great works of art that focus on the poor in the years since. HBO’s The Wire is often and rightly called Dickensian. Its societal indictments, moral complexity, attention to personal agency, and riveting installments over the years echo Dickens, whose novels were serialized. But with due respect to David Simon, the show’s creator, I’d argue that we still need a new Dickens, an artist who commands global fame and unalloyed praise and whose work helps those who need help the most. That’s a lot to ask for this troubled and war-torn Christmas, Hanukkah, and Kwanzaa, but we can hope as 2025 approaches.

Matthew Cooper
Christmas Day, 2024

Christmas is always the busy season for Charles Dickens, but this year there’s more going on than usual. There’s a Bill Murray remake of A Christmas Carol (playing the perfect ’80s Scrooge—a TV exec too busy to do lunch with his ghost) and, for the truly sturdy, a two-part, six-hour film of Little Dorrit. Coming soon: Disney’s Oliver Twist. And a new biography of Dickens is getting prominent reviews, including front-page billing in The Washington Post Book World.

But what’s been missing from the articles I’ve read about these works is the recognition of Dickens’s central accomplishment: He prodded (and entertained) millions of readers into caring about the poor. Instead of seeing the poor, as Malthus did, as some abstract, seething mass of “surplus population,” Dickens saw them as individuals, engaging enough to merit novels of 700, 800, and 900 pages. He made his readers see them that way too. And that was a revolutionary accomplishment.

One indication of his influence lies in numbers. He was the best-selling author in Victorian England, writing novels that became standard household items, as common as candles and brooms. In the 12 years after he died, nearly 4 million copies of his books sold in Britain alone—an amazing feat even by Stephen King standards. When it came to influence, Daniel Webster argued that Dickens had “done more to ameliorate the condition of the English poor than all the statesmen Great Britain had sent into Parliament.” Even the conservative Economist conceded that Dickens fueled “the age’s passion—we call it so designedly—which prevails to improve the condition of the working classes.” Queen Victoria hailed his humanizing influence on the nation and his “strongest sympathy with the poorer classes.”

As for the poor themselves, they not only saw Dickens as their champion, they read him. Journals of the period are filled with accounts of chimney sweeps and factory hands captured by his work. And when they couldn’t make out all the words, there were plenty of illustrations to help them along. The working classes responded by deluging Dickens with invitations to speak before their guilds. “Ah! Mr. Dickens!” shouted a carriage driver to Dickens’s son, on the day of the novelist’s funeral. “Your father’s death was a great loss to all of us—and we cabbies were in hopes that he would be doing something to help us.”

It was not without reason, then, that Dostoevsky called Dickens “the great Christian.’” Characters like Oliver Twist and Mr. Bumble, who ran the infamous workhouse, carry lessons as old as the New Testament. When Mr. Bumble terrorized Oliver for asking for a second helping of gruel, even affluent Englishmen knew how the orphan felt. They knew, too, that they had an obligation to help. That kind of empathy stoked the era’s major reform movements. The resulting bouquet of triumphs included everything from fewer working hours to free education and universal suffrage.

There’s more to Dickens, though, than misty-eyed sentiment. His was a subtle and muscular vision that recognized (and condemned) the sins of impoverished individuals as well as the collective guilt of society. Dickens gives us not only Oliver Twist but also Fagin, the criminal ringleader who press-gangs Oliver into service. He’s no victim of society. Fagin’s problem is Fagin.

Is there any relevance in this today? After all, the sprawling squalor of Victorian Britain has gone the way of the workhouse. The laissez-faire liberalism that Dickens deplored is light-years away from today’s social welfare state. (No food stamps had Oliver. No caseworker.) But America today is in at least one way like the England of the 1830s: Most of us see the underclass as a seething, abstract mob. Of course, it’s not just our artists who’ve failed us, but our politicians, too. And it’s too much to expect all art to serve as social glue, binding each of us to the concerns of the less fortunate. But today, when so much fiction is either mired in minimalist ennui or panting with the lifestyles of the rich and promiscuous, we need someone who can animate our social concern. We need a new Dickens.

A street-walking man

Where to find one? My guess is that it can only be someone who has seen poverty up close; perhaps a journalist. Dickens himself became acquainted with the poor as what today’s social scientists would call a “participant observer.” He was one of them.

His father, John Dickens, tried to give his children a life of parlors and singing lessons on the paycheck of a Navy clerk. As a result, like so many working people of the time, the Dickens family floated in and out of debtors’ prison (bringing their servant with them, as was the custom of the day). By 1822, when Charles was 10, debt’s constant tug forced his family to yank him out of school and place him in a factory pasting labels on pots of shoe polish. When not at work, he spent long days wandering the alleys of work-weary London. With his parents often imprisoned, describing what he saw became a way of mastering a hostile world. He’d jot down dozens of “sketches,” detailed descriptions of just about anything he’d run into. They captured not only turmoil and toil but character, as well. Typical was the one about his uncle’s Soho barber, a man who, playing Monday-morning quarterback, recounted how he would have guided Napoleon’s troops at Waterloo.

Eventually, his family earned its freedom, and Dickens became a law clerk, allowing him to tame “the savagery of stenography,” as he put it, and later become a reporter. At the time, reporting mostly meant taking shorthand, but Dickens was so talented one editor called him “the most rapid, the most accurate, and the most trustworthy reporter then engaged on the London press.”

With his star rising, Dickens didn’t leave the poor behind. Instead, he sketched them. Under the pseudonym “Boz,” he churned out copy about vulgar vendors, ragged children, and raging arguments. In “The Pawnbroker’s Shop,” Dickens presented his comfortable readers with a prostitute: “The lowest of the low; dirty, unbonneted, flaunting and slovenly.” In his “Visit to Newgate,” he took them inside a prison that housed children. “Fourteen terrible little faces we never beheld. There was not one redeeming feature among them—not a glance of honesty—not a wink expressive of anything but the gallows and the hulks, in the whole collection.”

This kind of firsthand experience became central to Dickens’s fiction. To write Hard Times, for instance, he traveled to the north to cover a workers’ strike. He was no sit-in-the-study author. After writing in the mornings, Dickens would take afternoon walks of 10 miles or more that returned him to the streets that powered his prose.

Obviously, it wasn’t just the reporting that made Dickens Dickens. It takes a little more than stenography, and a lot of something called imagination, to spin a 900-page novel. But Dickens’s immersion in street life made his novels richer. When a barrister picked up Dickens’s work, he saw his servants and his slums. He saw his London.

The stenographer’s eye and the novelist’s mind gave Dickens the ability—virtually unprecedented—to make the poor seem real. As Gertrude Himmelfarb explains in The Idea of Poverty, this was a time when servants were invisible, even to their masters. When a contemporary critic hailed Dickens’s talent for making a “washerwoman as interesting as a duchess,” it was a tribute not only to Dickens’s wonderful prose, but also to his new vision.

After all, one of the main characters in his first lengthy work of fiction, the serial Pickwick Papers, is Sam Weller, a servant. He not only fails to remain invisible; more often than not he seems a good deal wiser than his master. When he first signs on as Pickwick’s valet, the negotiations turn into a “Who’s-on-first?” routine that sounds like Weller is hiring Pickwick. Weller still seems in control when Pickwick checks into an inn. After Pickwick stumbles into the wrong bedroom, only to be kicked out by a very unhappy woman, it’s Weller who rescues him and guides him to his room. “You rayther want somebody to look arter you, Sir, when your judgment goes out a wisitin’,” Weller chirps. The servant’s introduction in the serial’s fourth issue sent sales surging.

In his next book, Oliver Twist, and throughout the other novels he was to write until his death in 1870, Dickens stuck to the simple proposition that no class had a monopoly on smarts or morality or decency or humor. This was a revolutionary creed at a time when the affluent saw the poor as a mob—to be feared or appeased, perhaps, but definitely not to be considered as individuals. And the rich were scarcely alone in their class-bound vision. As Dickens was spinning novels, the history of the working class in Manchester was being written by a German emigré named Friedrich Engels.

The idea of Jacobin-style revolution haunted Dickens, who poured his fears into prose in A Tale of Two Cities. In our century of failed revolutions, there’s no more haunting or timely image than Dickens’s Madame Defarge, knitting by the guillotine. He recognized that, just as the poor weren’t all good, the rich weren’t all bad. His pages brim with venal landlords, nasty bankers, and callous captains of industry; but good-guy capitalists pop up too. A product of the streets himself, Dickens saw no romance in revolution. It’s not the proletariat who overthrew Scrooge, but his conscience.

If Dickens feared revolution, he didn’t fall into the opposite trap of forgetting why mobs charged the barricades. He understood that the capitalist society was rife with institutions that kept the poor down. The villains of Hard Times aren’t just bad apples but overlords of a cruel factory system, dehumanizing in the monotony of its work. The tragedies of Bleak House, one of his last and gloomiest books, are found in the systematic injustice of the courts. By challenging these institutions, he made the lawyer or factory owner see that they shared responsibility.

The idea of poverty

And when Dickens trained his guns, liberals weren’t exempt. The workhouse that Dickens took on in Oliver Twist was one of the most prominent liberal programs of his day. Today it’s hard to think of the book’s cruel overseers as being progressive. But the Poor Law of 1834 was considered a great liberal victory, one that would segregate the indebted poor and prevent them from dragging their fiscally responsible neighbors into the red. (Talk about the unintended consequences of liberal reform.) When Oliver meekly seeks a double dose of gruel, we see unbridled cruelty. “Enlightened” Victorians saw themselves.

And what they saw was folly. Consider the way that Mr. Bumble—who runs the “progressive” workhouse—understands Oliver’s revolt.

“It’s meat.”

“What?” exclaimed Mrs. Sowerberry.

“Meat, ma’am, meat,” replied Bumble, with stern emphasis. “You’ve over-fed him, ma’am. You’ve raised a artificial soul and spirit in him, ma’am, unbecoming a person in his condition.”

The humor of the scene helps carry its meaning. Had Dickens’s criticisms been heavy-handed, as [the late scholar of the Victorian Era] Steven Marcus points out, middle-class readers wouldn’t have touched his works. Instead of promoting a specific alternative to the workhouse, he satirized it, appealing to his readers’ Christian charity. A second key to Dickens’s success is his choice of the symbol of the good child, in Oliver Twist or Little Dorrit or David Copperfield. He tapped the wellsprings of protectiveness that cultures can be made to feel for the young. Martin Luther King Jr. put that same insight into action when Birmingham schoolchildren stared down firehoses and police dogs, leaving us with one of the most arresting images of the civil rights movement.

But even as he skewered institutions, Dickens understood that the poor were often in the wrong themselves. If anything, there’s a schism in his writing, dividing what you might call, for lack of better terms, the worthy poor from the unworthy—between those who merit our admiration and those who don’t.

Winning hands down in the Worthy Category, family division, are the Christmas Carol’s Cratchits. It’s not just their “conditions” that make them sympathetic—the fact that they’re poor or that Bob Cratchit has a boss like Scrooge or that Tiny Tim needs crutches. It’s the family’s own nobility that lends the story such power, remake after remake. One clear signal to Victorian readers was the Cratchits’ white-glove cleanliness—a paramount virtue at a time when filth was almost always followed by disease. The Cratchits were “darned and brushed” before the Christmas feast. After supper, “the cloth was cleared, the hearth swept.” In the Cratchits, like Oliver Twist, David Copperfield, or Little Dorrit, respectable British middle-class readers found an ideal of themselves.

Meanwhile, a first in Unworthiness might go to the brickmakers of Bleak House, who seem like something out of a documentary on battered wives. We spy them when Mrs. Piggle happens by. “An’t my place dirty? Yes, it is dirty—it’s nat’rally dirty, and it’s nat’rally onwholesome,” boasts the father. “And we’ve had five dirty and onwholesome children, as is all dead infants, and so much the better for them … And how did my wife get that black eye? Why, I giv’ it her; and if she says I didn’t she’s a Lie!” Today, when many liberals still romanticize the poor, Dickens’s ability to distinguish poverty from nobility is well worth remembering.

Dickens understood that there were good and bad individuals within every class. But he rarely saw the individuals who were a mixture of good and bad. His heroes and heroines don’t whine, don’t curse, and even though they’re raised in the company of foul-mouthed, cockney villains, they speak the King’s English. To be sure, his supporting cast could include people like the Peggottys in David Copperfield, who were not so well-spoken. But they, too, were practically flawless. This strict division between the worthy and the unworthy poor is more than an aesthetic flaw. It limits Dickens’s relevance today.

Dickens makes his readers want to help the deserving poor. And, indeed, the Victorian (and New Deal) reforms that were, in part, inspired by Dickens focused on these able-to-help-themselves characters. Kids who’d be okay if child labor was abolished; workers who’d prosper with a union. This is the story of America through the 1950s: The New Deal and rising prosperity catapult the “worthy” poor into the middle class. Oliver goes to Levittown.

This left behind an underclass that seemed short on lovable Cratchits and long on pregnant teens, drug addicts, and gang members. What we don’t have is the popular literature that will jar the affluent into caring about these less savory characters. We don’t have the literature that will condemn their faults and recognize that these are people who can be helped. When I worked in a Big Brothers program in New York City, I remember noticing that there was no novel or film that got at the downright weird complexities of those tenements I visited on 102nd Street. I couldn’t point to any book that explained how those kids could be such utter failures in school, unable at age 15 to write a single sentence, and still be as sharp and savvy and as alert as any kids I had known growing up in the New Jersey suburbs. There was no film that I could tell my friends about that captured the complexity of those mothers I would meet who’d blow much of their money on VCRs and HBO but who were also selfless when it came to helping their kids. There was—and still is—no writer who combines great talent and great popularity and who captures that bizarre marriage of sin and decency I saw in those tenement families.

The Dickens character who most reflects our dilemma is the Artful Dodger, the young pickpocket who befriends Oliver Twist. He’s engaging, to be sure. The first thing we see him do is take Oliver drinking; by the end, he’s in court, trying to sweet-talk a magistrate into pardoning him. But he’s a side dish. We never understand or care about him the way we care about Oliver. The next Dickens needs to put us not in our Olivers’ shoes but in those of our own Artful Dodgers.

While a new Dickens couldn’t cure poverty, he could inspire personal commitment from the middle class. I don’t mean the anesthesia of paying for yet another government program, but involvement. And that takes understanding. Public health care won’t improve unless talented doctors and nurses want to choose Harlems over Humanas, at least for a few years. We won’t really become a kinder, gentler nation unless our leaders know something that’s true about those on the bottom. But working with or for the poor requires inspiration; it doesn’t come naturally. Individuals disappoint. Projects collapse. Easier lives beckon. Great art, as opposed to Brookings reports, can be the spur we need.

In 1945, Lionel Trilling lamented that no writer in his day had done what many of the leading Victorian writers had done—combine great literature and social concern. “In three-four decades, the liberal progressive has not produced a single writer that itself respects and reads with interest. A list of writers in our time shows that liberal progressivism was a matter of indifference to every writer of large mind—Proust, Joyce, Lawrence, Eliot, Mann, Kafka, Yeats.” The absence of such a writer may have been a marginal loss in the middle of this century, when the politics of the time were liberal even if the great novelists were not or when poverty seemed like it could be erased simply through economic expansion and a few social reforms. Today when politicians are retreating from helping the poor and growth offers no panacea, we need another Dickens to inspire each of us to help.

I don’t know if there will be a single figure—be it a novelist filmmaker, or journalist—who can animate a nation’s imagination the way Dickens did or whether it may take a disparate group or even an artistic movement. But I’m certain those Dickens-like qualities will not be had by some writer-in-residence strolling the hallowed halls of Haverford. The Dickens mantle demands a life outside the academy, exposed to the real world. It belongs to the writer who can make us care not only about our Tiny Tims but about our Artful Dodgers, too.

The post Why We Need a New Dickens appeared first on Washington Monthly.

In her brilliant new book Poverty for Profit, reviewed here, Washington Monthly Contributing Editor Anne Kim pulls back the curtain on a vast, predatory corporate sector that few middle-class Americans know anything about.

Over the past few decades, she explains, government has increasingly handed off the delivery of safety net programs—in health care, housing, criminal justice, and nutrition—to large for-profit companies that promised better, more efficient services. Instead, Kim reveals, these businesses cut corners, deliver poor results, systematically abuse their clients—and lobby politicians to keep their taxpayer-subsidized rackets going.

On July 15th Editor-in-Chief Paul Glastris joined Kim at Politics and Prose for an in-depth discussion of Poverty for Profit. You can watch their conversation by clicking here.

The post VIDEO: Anne Kim Discusses “Poverty for Profit” with Paul Glastris appeared first on Washington Monthly.

Walk down the eastern steps of the U.S. Capitol and follow Pennsylvania Avenue for several miles, and you’ll find yourself in District Heights, Maryland. Even without knowing much about the majority-Black suburb, you will quickly get the sense that District Heights is poor. Instead of shopping centers with Panera and Starbucks, you see names like Ace Cash Express, the nation’s largest check-cashing chain, and dd’s DISCOUNTS, a bargain clothing outlet. Alongside them is another class of business you might not notice, less obviously low-rent but still very much dependent on poverty. There’s Liberty Tax, a nationwide franchise operation that helps residents file for low-income tax credits; Pine Dentistry (formerly “Kool Smiles”), which serves patients on Medicaid; and Woodland Springs, an apartment complex that welcomes tenants with housing vouchers. These are private businesses, but they deliver public services using taxpayer dollars. And as the journalist Anne Kim argues in Poverty for Profit, these storefronts are more than just a signal of race and wealth. They are signposts of exploitation.

Kim, a Washington Monthly contributing editor, opens her book with a drive through District Heights, taking us inside each of these establishments to reveal how, here and across America, they serve as middlemen between government benefits and the poor. Over the past few decades, she reveals, a vast corporate ecosystem has grown to monopolize and extract enormous profits from various “markets” for social services: dentistry, dialysis, tax credits, job training, housing, and more. 

In theory, a private company could provide these services just as well as a government agency could—perhaps even better. But time and again Kim shows how these businesses cut corners, deliver poor results, and systematically abuse their clients, all in the name of profit. Both sides of the political divide have failed to police or even to comprehend this growing industry, and as a result are failing to address the issue. Liberals focus on increasing funding, not recognizing that these companies will eagerly siphon it away. Conservatives want more accountability for beneficiaries, even though such demands make the programs more complex, thereby giving private corporations opportunities to step in and drain away more taxpayer money. To truly fix the problem, Kim argues, you need to understand the poverty-for-profit industry.

Kim’s first chapter takes us to Rogers, Arkansas, where at Rogers Car-Mart you can get your taxes done and buy a used car at the same time. Businesses like this one have sprung up all over the country to take advantage of the Earned Income Tax Credit, a broadly popular policy that lifted 7 million above the poverty line in 2022. The EITC is the primary tax benefit for low-income workers, and serves as a critical chunk of annual income for many households. But the complexity of claiming it—multiple formulas, dozens of pages of reading—is a lure for predatory practices. 

When Kim visited Rogers Car-Mart in spring 2022 and asked for an estimate for herself, the business quoted her $198 to file a federal and state return. The preparer would tack on a $93 charge if Kim received a refund, along with a $27 “check printing fee” for an advance on the money. These costs add up to about 15 percent of the average federal refund in 2022. She could then use the rest of her refund as part of a down payment on a used car. Kim could have walked into Rogers Car-Mart expecting a $2,000 refund—the average amount that EITC-claiming families receive annually—and walked out of there with every penny going to this hybrid tax preparer/car dealer. “That, of course, is the idea,” Kim writes. Tax-time retailers will sell you discount shoes, pawned jewelry, and a rent-to-own TV along with your fee-laden return—all in order to capture as much of your refund as possible.

What lures the working poor into these exploitative businesses is that they need help filing their taxes to get the EITC benefit. When policy makers devised the program in the 1970s, they were adamant that it should benefit working families who have income to report, rather than nonworking people. Over the years, lawmakers have demanded more and more layers of reporting to police that distinction, resulting in an ever more complex process for filers. The IRS instructions for the EITC are three times longer than instructions for the alternative minimum tax, a similar tax break that almost exclusively benefits the wealthy, and use eight different formulas to calculate eligibility for filers and their dependents.  

As strange as it may sound, Kim’s $318 quote at Rogers Car-Mart was a relative bargain. An investigation by a Washington, D.C., antipoverty nonprofit revealed that tax prep for EITC filers can run from $400 to as high as $1,200. To make matters worse, low-income workers often get subpar service from these largely unregulated preparers. An investigation by the Government Accountability Office in 2014 found that only two of 19 companies did a tax return correctly, and the Treasury Department found that in 2017 one-quarter of EITC dollars were issued improperly. Some outright fraudulent companies falsely inflate clients’ refunds and then pocket the difference. The IRS audits low-income filers five times as often as everyone else. When that happens, it’s the families, not the preparers they paid, who are on the hook. 

Meanwhile, the IRS is well aware that this needless complexity leads to waste and fraud and that the agency could easily solve this problem. The IRS already has all the wage and income information it needs to determine a filer’s EITC eligibility; it could automatically fill out and mail them their tax returns. (It could do the same for most middle- and lower-income Americans, who don’t have lots of complicated investments and deductions.) Democrats have long urged such reforms. Yet tax prep companies have spent millions on lobbying—up to $5 million in 2016 alone, according to a report by ProPublica—to stop the IRS from implementing this “return-free” filing, and they’ve found ready allies among Republicans in Congress. 

Next, Kim moves us to East Los Angeles, California, where 96 percent of residents are Hispanic and more than a quarter of children live in poverty. With only 11 percent of the population holding a bachelor’s degree (compared to 36 percent statewide), International College, a local job training program, would seem to offer a way up. But the for-profit school has only five courses, including a cake decoration class that promises to teach students “how to properly bake and ice a cake.” The course is online, and costs $5,100. Less than half of students who enrolled at International College in 2020 finished their classes—that is, except for cake decoration, which three students took and completed that year. 

There’s no evidence that anyone who graduated landed a job, because the school didn’t bother to fill in the job placement data required by the state, which covers the tuition for many of the students through the federally funded, state-administered Workforce Innovation and Opportunity Act (WIOA). Yet despite the school’s refusal to even try to justify its government subsidies, it remains on California’s approved list of workforce training providers. That list includes some high-performing institutions, but job seekers have no way to distinguish them from the reams of low-performing and sometimes shady options. The situation is hardly better in other states. Nationally, WIOA participants earn less per year than the typical worker who lacks a high school degree. 

A similar lack of oversight plagues Job Corps, the government’s largest education and training program for low-income people, with an annual budget of $1.7 billion. The program is mostly run by a duopoly of for-profit government contractors, with perennially poor results. A report by the inspector general in 2018 found that the program did not place students in “meaningful jobs appropriate to their training” and the majority of graduates made less than the median income for workers without high school diplomas. 

Yet money continues to flow to these programs, thanks to a combination of aggressive lobbying by the companies that profit, and good old-fashioned pork barrel politics. Job Corps participants are required to live in residences that require staff. These centers can provide quite a few jobs for some communities that desperately need employment, which makes closing the centers politically unpalatable. Job Corps contractors are not shy about reminding politicians how unpopular it would be to cut jobs in their own districts. This prevents government funding from going to better-performing programs, such as Year Up, a nonprofit that since 2000 has trained more than 29,000 people for jobs in IT, software development, and more. 

Kim credits much of the shift toward the corporate takeover of social services to Emanuel Savas, an academic and public administrator who is widely acknowledged as the father of “privatization.” His work fueled the conservative campaign in the 1980s to take government services away from unaccountable bureaucracies and entrust them to efficient, competitive entrepreneurs. Ronald Reagan embraced Savas’s ideas and appointed him as an assistant secretary at the Department of Housing and Urban Development. There, Savas championed the policy of moving public housing recipients out of government-run high-rises into private apartments by providing them with what were then called “Section 8” housing vouchers. Future presidents, including Bill Clinton, accelerated that policy. 

Kim acknowledges that many public housing projects were hellish places to live. But she also makes clear that housing vouchers haven’t lived up to their promise either. Advocates envisioned that vouchers would help the poor escape high-poverty neighborhoods. Yet the dearth of affordable housing generally, combined with the fact that landlords in most states aren’t required to rent to voucher recipients, means there is a great undersupply of apartments recipients can rent, and the vast majority that are available are in poor neighborhoods, with their attendant high crime and substandard schools. This gap between supply and demand also allows unscrupulous landlords to profit off the voucher holder’s limited options by providing substandard homes at inflated prices. An investigation by The Washington Post found that the city of D.C. was paying $2,467 per month for an apartment for an elderly resident when the market rate for a similar apartment was $1,613 per month.

In the criminal justice realm, the most infamous example of privatization is the for-profit prison industry. So tempting are the potential returns that some private companies have been known to build “speculative” prisons in rural areas with high unemployment, and then encourage local leaders to secure a contract. This works. 

But profiteering isn’t limited to for-profit incarceration. It’s rife in state-run institutions, too, which contract with outside vendors that charge inmates exorbitant fees for food, toiletries, health care, and other services. Some prison telecom vendors demand nearly $25 for a 15-minute in-state call, and companies like Western Union will charge up to $12 to transfer $25 into an inmate’s phone account. The disproportionately Black prison population performs forced labor for pennies an hour, a practice that civil rights advocates often compare to slavery. State prisons even bill inmates for their incarceration. One man in Florida was charged $50 per day for his nearly three-year stay in state prison (about $55,000 total). In Connecticut, the daily rate is $249. 

These and other exploitative arrangements continue in large part because state prison systems, at the behest of governors and legislatures, receive a cut of the profit. Essentially, state policy makers have decided to soak the families of inmates (because that’s who mostly pays these fees) to relieve themselves of having to ask taxpayers to shoulder more of the financial burden of administering public prisons.

Incentive structures are also to blame in other policy realms, like health care. Kim shows how many Medicaid programs use fee-for-service models that reward companies for performing more procedures rather than for providing better care. The average Medicaid reimbursement for child dental services is just 61 percent of the fees paid by private insurance. Most dentists refuse to take Medicaid patients for this reason. For those that do take Medicaid patients, many of them corporate-owned practices, this payment model encourages providers to cram as many bodies into a room as possible. Children get dental work with their heads barely a few feet apart. 

These providers also pressure parents to allow costly and unnecessary dental work on their children, for which reimbursements are much higher than for routine procedures like dental cleanings. Kim recounts instances of young children getting as many as 17 root canals and caps. An article published in 2022 by the Journal of the American Dental Association found that children on Medicaid were more likely to have multiple root canals than children with private insurance.

To perform these procedures on small children, many clinics have resorted to cruel tactics that are frowned upon elsewhere in commercial dentistry. A Kool Smiles clinic in Connecticut wrapped children in cocoon-like structures called “papoose boards” to keep them from squirming during long and painful procedures, according to a whistle-blower. The same whistleblower reported that the clinic kept a hair dryer for children who wet themselves from fear and pain. In Maryland, a Kool Smiles dentist propped open a patient’s mouth so painfully wide for a “baby root canal” that she vomited halfway through the procedure. The dentist turned the patient on her side and suctioned her mouth and throat so she would not choke. The Justice Department reached a $23.9 million settlement in 2018 with Benevis and its affiliated Kool Smiles dental clinics for submitting false claims and performing medically unnecessary procedures for children on Medicaid. Investigations of other Medicaid providers have revealed similarly horrifying dental practices and overtreatment. 

Kim also shows that things are no better in the private dialysis market, which is largely controlled by two companies—DaVita and Fresenius Medical Care. To maximize profits on Medicaid’s low reimbursement rates for blood transfusions, these firms rush patients through dialysis in their factory-line centers, where people are regularly carted away with extreme exhaustion and sometimes heart failure after having the blood pumped through their bodies at dizzying speeds. Simply raising reimbursement rates is not the answer, Kim notes. Only months after Connecticut raised fees for Medicaid dentists in 2008, it saw a spike in expensive dental work as profiteers capitalized on the higher rates. 

As the Connecticut experience shows, these can be thorny issues to solve, but Kim outlines several steps that the government can take. To start off, she calls for the federal government to conduct a comprehensive “census” of privatized social services, which operate largely in the dark. With more information, policy makers can craft wiser solutions and conduct more effective oversight, which is badly needed, given the billions wasted and defrauded across the industry each year. Governments should follow up by exercising their policing powers—for instance, by kicking poorly performing colleges off their list of approved workforce training providers. 

Changing the incentive structure could also help. Kim laments how fee-for-service medical care leads to abuse, but she does not mention by name the leading alternative, value-based care, which rewards providers for delivering better health outcomes. Medicare, a handful of states, and countries like Germany, France, and the United Kingdom have adopted variants of this model, also known as “pay for performance,” with moderate success. The government could also leverage its huge buying power to improve what’s available to low-income families, similar to how big public health programs like the VA negotiate lower prices for prescriptions and medical care. 

More fundamentally, state and federal authorities should consider clawing back some of the responsibilities they have handed to private corporations. In many cases, government bureaucracies are better at delivering public services—for example, the most successful Job Corps programs, Kim notes, are run by the U.S. Forest Service. If the IRS can eliminate the need for EITC recipients and other Americans to rely on a predatory tax prep industry, why not empower it to do so? The Biden administration took a big step forward this year with a pilot project that allowed taxpayers in 12 states to file electronically for free with the IRS. In late May, the IRS announced that it would make the program permanent and expand it to all 50 states and the District of Columbia. State governments, too, can be more assertive—for instance, by narrowing their contracts with the managed care companies that handle Medicaid plans, taking decisions about granting care out of their hands. In all, Kim argues that America needs more governance, not less.

Kim concludes that the privatization experiment of the past 40 years has failed. For decades the federal government’s antipoverty programs have enabled corporations to profit off the backs of the poor and the taxpayers who support them. Yet politics on both sides prevents improvement because it misses the real problem. Politicians, especially conservatives, focus their accountability on the recipients of the services (by ensuring that welfare recipients are working, for example) rather than on the people doling out those services. Liberals and progressives tend to throw more money into these programs rather than evaluating them, out of fear that such evaluations might result in budget cuts or more privatization. And so the process continues, with government programs benefiting the people who need government help the least. Transparency is the first big step, and in exposing the inner workings of these private industries profiting from public money, Kim’s book is an important move toward reform.

The post Poverty, Inc. appeared first on Washington Monthly.

In 1962, Michael Harrington’s The Other America shocked the national conscience with its      portrait of American poverty. In the midst of post–World War II plenty, Harrington wrote, as many as 50 million people—or one in three Americans—lived in a “subculture of misery,” unable to afford the basics of food, shelter, and clothing “necessary for human decency.” “If these people are not starving, they are hungry, and sometimes fat with hunger, for that is what cheap foods do,” he wrote. “They are without adequate housing and education and medical care.” 

Harrington’s book was an instant sensation. Devoured nationwide, it was well thumbed in the Kennedy administration and, later, an inspiration for the Johnson White House as well. “This administration today, here and now, declares unconditional war on poverty in America,” President Lyndon B. Johnson proclaimed in 1964. Buoyed by broad public support for his cause, Johnson and a Democratic Congress enacted the Great Society programs of the 1960s that still make up the backbone of the federal safety net—Medicaid, Medicare, Head Start, and food stamps (now SNAP).

It’s hard to imagine that kind of bold action on poverty today. If anything, the nation has slipped backward. 

Earlier this year, Congress let lapse the child tax credit included in last March’s coronavirus relief bill, which sentmonthly payments of up to $300 per child to an estimated 35 million families. In September alone, the credit pulled 3.4 million children over the poverty line, according to Columbia University researchers, and slashed the child poverty rate by more than 25 percent. Calling the credit “the biggest investment in American families and children in a generation,” a group of Democratic senators recently urged its permanent extension as part of President Joe Biden’s Build Back Betterplan (BBB) and warned of dire impacts from its expiration. “Raising taxes on working families is the last thing we should do during a pandemic,” wrote Democratic Senators Michael Bennet, Sherrod Brown, Cory Booker, Raphael Warnock, and Ron Wyden in a letter to Biden.

BBB, however, seems doomed at this point, as does the child tax credit. Both measures face unified hostility from the GOP, plus opposition from Democratic Senator Joe Manchin. Manchin has not only balked at Build Back Better’s hefty price tag ($2 trillion+ in its original formulation), he’s also demanded that the child credit include a work requirement that most congressional Democrats find unacceptable. 

But as easy as it is to blame Joe Manchin for the stalling of BBB and the potential death of the child tax credit, the real obstacle is the current politics of poverty—a toxic stew of Americans’ indifference, lack of trust in government, and long-standing biases against the poor. Decades of conservative assaults on means-tested programs like SNAP as well as large and popular entitlement benefits like Medicare have hardened Americans’ views of who should benefit and who is “deserving.” 

Despite the inequities exposed by the coronavirus pandemic, the Black Lives Matter movement, and the social justice protests of 2020, today’s political environment is deeply hostile to antipoverty efforts. BBB and the child tax credit, unfortunately, are the casualties of this antipathy. 

Over the past four decades, conservatives have successfully reinforced and exploited long-standing historical biases against poor Americans. In the 1980s, President Ronald Reagan popularized the myth of the “welfare queen,” a racist trope designed to invoke white outrage over Black single mothers living lavishly on government benefits even though then—as now—the overwhelming majority of poor Americans are white. 

At the same time, conservative writers such as Charles Murray and Lawrence Mead began promoting a starkly punitive approach toward the poor. In 1984, Murray’s Losing Ground blamed federal welfare programs for fostering a “culture of poverty” that encouraged “dependency” and the breakdown of social norms. As the historian Michael Katz chronicled in The Undeserving Poor, Murray’s book bolstered the notion that poverty was the result of individual choices, not systemic barriers to opportunity, and that government programs coddle beneficiaries, causing more harm than good. Despite its many factual and analytical flaws, Losing Ground became the “authoritative rationale for reducing social benefits,” Katz wrote, and laid the groundwork for “personal responsibility” as the fulcrum of 1990s welfare reform. 

Mead’s Beyond Entitlement, meanwhile, introduced the idea of work requirements as a condition of getting government help. Building on Murray’s argument of poverty as an individual pathology, Mead argued that federal programs were too “permissive,” “expecting next to nothing from the beneficiaries in return.” Jobs, he argued, were available for anyone who wanted one, and unemployment “has more to do with functioning problems of the jobless themselves than with economic conditions.” The purpose of federal programs, Mead wrote, was to “affirm the norms for functioning on which social order depends,” such as by requiring work. 

In 1996, the passage of welfare reform cemented these ideas into law, essentially redefining the “deserving” poor as those who work. The legislation replaced the old welfare entitlement with Temporary Assistance for Needy Families (TANF), which imposed a five-year time limit on benefits as well as a work requirement on recipients. (Its immediate impact was a 58 percent drop in caseloads by 2000.) The 1996 law also enacted work requirements for “able-bodied” SNAP beneficiaries, which led to steep declines in the number of Americans receiving benefits. Acceding to the politics of the time, President Bill Clinton signed welfare reform into law, albeit with bipartisan support and after rejecting earlier, even more punitive versions of the bill. Clinton also managed to parlay public support for working families into historic new investments in child care and an expansion of the Earned Income Tax Credit. The consequence, however, has been a calcification of public policy and public attitudes toward the poor. 

Despite abundant empirical evidence of poverty’s structural causes and the failures of welfare reform, current public opinion still reflects the ascendancy of conservative social policy. While it’s an article of faith among liberals that poverty’s primary causes are structural—that is, the result of racial segregation, substandard schools and transit, low wages, labor market dislocations, and other factors—many Americans still hew to a naive, Horatio Alger view that poverty and wealth are determined largely by individual behavior. (Of course, both culture and choices matter. “The central conservative truth is that it is culture, not politics, that determines the success of a society,” Daniel Patrick Moynihan once wrote. “The central liberal truth is that politics can change a culture and save it from itself.”)

Seventy percent of Americans, for instance, believe they can achieve the “American Dream” if they “work hard and play by the rules,” according to Gallup. Likewise, 61 percent of Americans say “most people who want to get ahead can make it if they’re willing to work hard,” according to the Pew Research Center, while just 36 percent say “hard work and determination are no guarantee of success.” 

Many Americans are also resistant to the idea of systemic racism as a root cause of poverty, despite an abundance of evidence to the contrary. In a 2021 survey by the Pew Research Center, just 31 percent of Americans—including only 6 percent of Republicans—said that white people “benefit from advantages in society that Black people do not have.” Likewise, a 2020 Gallup poll found that 67 percent of whites believe “blacks have as good a chance as whites to get any kind of job for which they are qualified.” (Only 30 percent of Black respondents feel the same.) 

Work requirements, in the meantime, have become an accepted feature of social programs, which likely explains why Manchin has called for work requirements for the child tax credit. Work requirements for Medicaid was one of the top priorities of President Donald Trump, which Biden is now working to unwind. 

Build Back Better pushes against the headwinds of public opinion. It tackles the structural sources of poverty and inequality with investments in education, housing, health care, and social services to correct historical injustices. It proposes unconditional cash transfers through the child tax credit (whether parents are working or not). It argues for major investments in racial justice at a time when Republicans are weaponizing white grievance. Its greatest strengths as legislation are also its most significant political weaknesses. 

Moreover, the bill is huge. Low levels of trust in government mean little appetite for sweeping federal efforts. Despite the pandemic’s continued hardships, 52 percent of Americans say government is “doing too many things that should be left to individuals and businesses,” according to Gallup, while 43 percent want the government “to do more to solve the country’s problems.” And while a majority of Americans agree that there is “too much inequality” in the U.S., relatively few call it a “top priority” for the government, according to the Pew Research Center. 

Build Back Better, however, is an LBJ-style bill in a Biden era, and the White House insistence on using hyperbolicdescriptors to emphasize the package’s immense scope does not help matters. Not only is it “historic,” it includes “the most transformative investment in children and caregiving in generations,” the “single largest and most comprehensive investment in affordable housing in history,” and the “biggest expansion of affordable health care coverage in a decade.” These phrases, meant to rally liberals, are at odds with public demand (or, rather, lack thereof) for significant government intervention. 

The galvanizing impact of Michael Harrington’s seminal book is proof that a nation can be inspired to act. Antipoverty advocates, however, need to reset the stage of public opinion—which browbeating Joe Manchin won’t accomplish. 

In the short term, Democrats could swallow current political realities and try to pass BBB in digestible “chunks,” as Biden has suggested. The child credit—if it survives—will need to be less generous. (Democrats should not, however, add a work requirement, which is not only impractical to administer but also reinforces conservative notions of the “deserving” poor that need to be reversed.) In the long term, Democrats need a new strategy for undoing the damage done by conservative attacks on the poor. Americans need to be persuaded again that helping the “other” America helps all Americans and is a collective cause worth pursuing.

The post How America Stopped Caring About the Poor appeared first on Washington Monthly.

Nadine Shaanta Murshid, a Bangladeshi professor of social work and public policy at SUNY Buffalo,analyzed data from 5,000 Bangladeshi households who had taken out microloans and found that violence against women was actually less prevalent among the poorer families. She explained, “For families who are slightly wealthier, the ‘need’ for microfinance is not as great, so their husbands see the fact that the women ‘want’ the loans as a threat.”

The post The False Promise of Microfinance appeared first on Washington Monthly.

Let’s assume that Senators Joe Manchin and Kyrsten Sinema are decent people, not callous to children in poverty. That would mean that they’re merely clueless. They are not connecting the dots. As they insist on slashing President Biden’s proposed $322 billion in housing subsidies, they cannot possibly understand how much lifelong damage that will do to kids.

Biden and the Democratic leaders are trying to break a key link in the chain reaction of poverty. Housing is that link. Without government aid, high rents leave less money for food, leading to malnutrition, parental stress, and disrupted living, all of which can impair brain development in young children. The scientific and social research has been clear on this for decades. Yet the connections are rarely recognized by legislators and officials—and journalists, as well—who persistently treat each problem and government program as separate and distinct, with little regard for the web of interactions among the hardships that struggling families face.

In many parts of the country, the private housing market is brutal for low-wage workers. Nationwide, households in the bottom 20 percent spend a median of 56 percent of their income on rent. The rest of their monthly funds are committed to paying for electricity, water, phone, heat, car loans, and the like. What they can shrink is the part of their budget for food. And without proper nutrition during critical periods of early life, children suffer cognitive impairment that is not undone even if food security is later restored. (See my earlier story“A Hungry Child’s First Thousand Days” in these pages.)

Stress is also a factor in brain development, researchers have found. Even if a family doesn’t become homeless but lives with constant tension over paying the rent and other bills, the anxiety can be absorbed by children, both in utero and after birth. Imagine—if you can—the anxiety of parents who have too little food for their children, for feeding offspring is a most elemental instinct and duty.

Furthermore, children’s biological and mental health is damaged when families have to move repeatedly or reside in poor housing with lead in the water from old pipes, roaches, and mold that can trigger asthma attacks, and overcrowding that often causes household friction.

The study of stress has been a significant addition to the understanding of the environmental impacts on the brain, to the point where the Centers for Disease Control and Prevention devotes an entire website to updating research on risks and prevention. In its list of what scientists in a seminal study call “adverse childhood experiences,” the CDC includes housing issues along with more obvious traumas such as suffering neglect and witnessing violence or suicide.

Actual brain chemistry and architecture can be affected by “families with caregivers experiencing high levels of parenting stress or economic stress,” the CDC reports, “communities with unstable housing and where residents move frequently,” or “where families experience food insecurity.” Protective factors include “communities with access to safe, stable housing.”

It would be nice if Manchin and Sinema would read and respect their own country’s expertise. Sinema labels herself a former social worker. It’s hard to imagine any social worker with proper training and credentials failing to grasp these pernicious risks to children’s futures.

Specialists identify three types of stress: positive, tolerable, and toxic. The response to each of these determines its long-term effects. A certain amount of transitory stress is necessary to healthy development, according to Harvard’s Center on the Developing Child. “Some situations that might trigger a positive stress response are the first day with a new caregiver or receiving an injected immunization.”

Tolerable stress—a death in the family or a natural disaster—can elevate alert levels for a longer period, but “if the activation is time-limited and buffered by relationships with adults who help the child adapt, the brain and other organs recover from what might otherwise be damaging effects.”

Toxic stress, which can include prolonged economic hardship, occurs when the body’s stress response is activated for an extensive period without adequate adult support. That “can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years,” the center notes. Diabetes, heart disease, depression, substance abuse, and developmental delays may result.

The biological chemistry is no mystery. “When a child experiences toxic stress,” according to the pediatrician Kari Phang, “the Hypothalamic Pituitary and Adrenal (HPA) hormone axis is over-activated. This results in blood levels of the stress hormone cortisol being higher which can result in long term changes in inflammation and immunity. Studies have shown associations between toxic stress and changes in brain structure. The consequences of this can include more anxiety as well as impaired memory and mood control. Toxic stress responses can also include changes in gene expression, meaning which genes in your DNA are turned on or off.”

Since housing is a major factor in stress-producing hardships, increasing subsidies is an important part of the Biden administration’s proposal in its $3.5 trillion social spending bill—which won’t be enacted, thanks to Manchin and Sinema and the Senate Republicans. Of the $322 billion in proposed housing subsidies, $200 billion would go for the federal program of vouchers that about 2 million poor families now use to pay part of their rent. It is a sad but undeniable fact that America’s vaunted free market economy alone does not enable low-wage workers enough income to live healthy lives, either emotionally or physically.

Glenn Thrush reports in The New York Times that the funds would add 750,000 families to the program, going partway to alleviating a waiting list so enormous that some local authorities have stopped taking new applicants. You have to wait to get on the waiting list. But even that additional aid would barely make a dent, since limited funding leaves an estimated 16 million eligible households unable to get rental assistance, according to the Center on Budget and Policy Priorities.

Manchin, Sinema, and their short-sighted colleagues are wielding their devastating axes against the powerless people who depend on government lifelines. As Thrush points out, housing subsidies are vulnerable to cuts because they enjoy less popular support than programs benefiting the middle class as well as the poor: preschool education, health care, community college.

This blindness to the harm inflicted on children displays the country’s poverty—its poverty of understanding.

The post Biden’s Housing Plan Could Save Millions of Children’s Futures appeared first on Washington Monthly.

The Biden administration’s anti-poverty strategy is winning rave reviews from think tanks. The Urban Institute, in a projection requested by The New York Times, estimated that this year’s poverty rate will be cut from its 2018 level by 45 percent. Separately, the Urban Institute estimated that the newly expanded child tax credit, which has been touted by Democrats as a historical achievement, will cut child poverty by 40 percent. And the Niskanen Center predicted that the credit will boost consumer spending by $27.6 billion and “deliver a substantial boost to rural economies across the country.”

The White House will need those data points to help sell the expanded child tax credit, because it isn’t selling itself.

The American Rescue Plan—which sailed through Congress in March on a party-line vote—expanded the child tax credit both in size and in eligibility, and made monthly government checks the default option for receiving the credit. But those changes are temporary, expiring at the end of this year. So Democratic leaders plan to extend the credit in the next budget reconciliation bill, in hopes of embedding it in the national fabric and making any future expiration politically untenable.

But the public is not yet in sync with Democratic leaders. In a mid-July Morning Consult poll, only 35 percent of voters said the expansion should “definitely” or “probably” be made permanent, with 52 percent saying the opposite. A YouGov poll from around the same time found only 30 percent of voters favored permanent expansion; 46 percent opposed it.

These numbers probably surprised Biden and other top Democrats. They certainly surprised me. As I wrote here in February, giving people money is typically a political winner. But if the expanded credit doesn’t become one, then it may not survive budget reconciliation.

Several moderate Democrats have already proposed that, unlike in the American Rescue Plan, the expanded child tax credit—along with everything else in reconciliation—be paid for with tax increases, to avoid increasing debt and boosting inflation. Paying for the credit is difficult because it’s a very expensive policy: it will cost the Treasury about $100 billion annually through 2025, and about $190 billion annually after that (because Donald Trump did his own temporary child tax credit expansion, which expires after 2025, adding to the long-term cost of maintaining the current level of benefits.)

Democrats are looking to spend $3.5 trillion over 10 years through reconciliation; a permanent extension of the expanded child tax credit would cost $1.6 trillion over 10 years—nearly half the total, which would crowd out other priorities. So Democrats are thinking incrementally. Senator Michael Bennet of Colorado said, “I’m going to fight for as many years as we can now. And then we’ll come back and come back and come back until it’s permanent.”

But the worse the child tax cut fares in the polls, the harder it will be to preserve it. That helps explain why the White House’s National Economic Council director, Brian Deese, was quick to tout the Niskanen Center’s finding that “the CTC provides its largest relative benefit to rural communities.” To boost those poll numbers, Democrats need to impress voters beyond their own political base.

The perplexing question is: why aren’t the checks themselves breaking through the partisan divide? Why isn’t the credit selling itself?

Optimists may still believe it will. After all, the first child tax credit checks were sent out only last month. Maybe after a few more months they’ll prove popular.

Maybe. But given the dismal initial polling, Democrats shouldn’t bet on the problem fixing itself. They should develop a persuasive case to strengthen the child tax credit, and they can’t do that until they find out why support for it is so weak.

Here are a few possible explanations:

1. Not everyone gets the checks.

About 39 million households are receiving the checks. But America has about 121 million households. Most parents of young children are getting paid, but most voters aren’t parents of young children.

2. Even people who get checks believe that other people shouldn’t.

The Times piece on how Biden’s pandemic relief policies slashed poverty—driven by “stimulus checks, increased food stamps and expanded unemployment insurance”—quoted recipients of relief who were simultaneously thankful and critical.

The Times’s Jason DeParle talked to a single mother of five from Missouri:

 “In my case, yes, it was very beneficial,” she said. But she said that other people she knew bought big TVs and her former boyfriend bought drugs. “All this free money enabled him to be a worse addict than he already was,” she said. “Why should taxpayers pay for that?”

The paper also spoke with a former convict in Indiana who was able to get custody of his son with the help of stimulus checks:

…he said he distrusted “the crooked government” and urged poor people to help themselves. “If you want to change your life, you have to get up and do something — not sit home and get free money,” he said.

3. The expanded child tax credit was slipped quietly into a crisis package—perhaps too quietly

Democrats took advantage of the filibuster-proof budget reconciliation procedure to slip the expanded child tax credit into the American Rescue Plan with minimal news coverage or floor debate.

As a legislative matter, that was shrewd strategically. But as a result, the public never heard arguments for why the expanded child tax credit should extend past the pandemic.

Democrats thought cutting fat checks would cultivate political support far better than the subtler stimulus policies of the Obama administration. But Biden may have gone too far in the opposite direction. The child tax credit checks are arriving after a year’s worth of pandemic relief checks. So they feel like another round of relief checks, which may convey the shameful stigma of government welfare, not the warm glow of a tax cut.

4. Voters support crisis help more than permanent help.

In both the Morning Consult and YouGov polls, a majority supported the expanded child tax credit for this year. That majority dissolved when asked whether the extension should be permanent.

That discrepancy speaks to a potential ideological gulf that Democrats need to bridge.

Many Democrats saw opportunity in crisis: Seize the pandemic moment, send out near-universal and unconditional checks, and demonstrate that’s the most direct way to eradicate poverty.

But unpleasant though it is to consider, most voters may not aspire to slashing poverty as much as progressive Democrats do, and therefore may not want to spend huge amounts of money to that end. They may have accepted it only as a temporary necessity to survive a government-imposed economic lockdown, not as a permanent economic policy. The hope that a near-universal policy would forge an allegiance between middle-class, working-class, and poor voters has not been realized.

All these potential explanations stem from the same root cause: selfishness. Not every voter is moved by moral appeals to eradicate poverty. Not every voter feels sympathy for the poor. Most voters prioritize their own bankbook above all else. That’s where the Niskanen report can be most helpful, showing that local economies will benefit broadly from the expanded child tax credit, lifting up all voters.

Still, the Niskanen report omits mention of the dreaded I-word: inflation. There may be some fear out there that continuing past the pandemic the flood of government cash will cause a price shock that will erode the value of the checks and drag down the economy.

The White House and the Federal Reserve say they believe the recent inflation surge will ebb quickly; Larry Summers says he fears it won’t. Not being an economist, I won’t venture any economic predictions. But if the rate of inflation is still high when the reconciliation vote occurs—it’s currently expected in the fall—the Niskanen report won’t muzzle combative Republicans or calm the nerves of skittish Democratic moderates. And anyway, it’s not at all clear that a wonky report can overcome gut emotion.

Still, Democrats have to play the cards they’re dealt. If a large swath of the public doesn’t believe the expanded child credit will help them, then all rhetorical energy should be marshaled toward convincing them otherwise. Because without strong public support for an extension, we can’t assume a narrow majority will materialize in Congress.

The post The Expanded Child Tax Credit Isn’t Selling Itself appeared first on Washington Monthly.

Dr. Megan Sandel, a pediatrician, experiences a troubling revelation whenever she sees a patient in the Boston Medical Center’s Grow Clinic. The clinic seems like a normal health-care facility in an advanced country, she notes: a waiting room, a medical assistant taking a child to be weighed and measured and then into an examining room.

“But that’s where, in some ways, the picture changes,” said Dr. Sandel, the clinic’s co-director, “because when you walk into the room you see this really cute, what you think is a twelve-month old, but it turns out it’s a two-year old. It’s a two-year old who hasn’t outgrown their twelve-month-old clothes yet.”

Even more serious than what you see is what you do not see: the brain of the child during a critical window of cognitive development. And in that largely invisible universe of neurons and synapses, of myelin sheaths and the neurological connections that are supposed to be generating the abundant future of every small person, lifelong damage is being done. The medical diagnoses are “stunting” and “failure to thrive.”

That is malnutrition in America, which is chronic among the poor and has soared during the pandemic. Its long-term harm will be one of the most severe legacies of Covid-19.

The usual incidence of what the government calls “food insecurity” ranges from 13 to 21 percent of American households with children, varying with the state of the economy. Most of them are white, although Black and Hispanic families suffer at higher rates. As school meals ended and vulnerable parents lost jobs during the Covid-19 outbreak, the Grow Clinic’s caseload jumped 40 percent. Nationwide, the rate of food insecurity in families with children rose to 29.3 percent last spring and summer from 13.6 percent in 2019, before the pandemic. With the return of some jobs and bursts of government assistance, the level has gradually declined to 17.8 percent, according to a large sample of adults with children in their households, surveyed by the Census Bureau in April. Seven out of ten who reported that they “sometimes” or “often” did not have enough to eat said they simply couldn’t afford to buy more food.

The recent $1.9-trillion American Rescue Plan will help, but not sufficiently or indefinitely. It raises grants by what used to be called food stamps—the Supplemental Nutrition Assistance Program (SNAP)—by up to $100 a month per family. More significantly, the plan’s $3000 to $3600-per-child stipend for one year would re-conceptualize governmental aid if made permanent, evading bureaucratic red tape by providing direct cash payments. Medical professionals say that getting money into parents’ pockets is the best way to treat children’s malnutrition.

Without broader policy overhauls, though, food insecurity seems likely to remain both a result and a cause of hardship, a key link in the middle of a complex chain reaction. For poor families without government housing subsidies, for example, rent on the private market can soak up 40 to 60 percent of income. Paying rent is not optional. The bills for electricity, water, heat, phone, and car loans cannot be ignored. The part of the budget that can be squeezed is the part for food. And that’s what happens.

Furthermore, nutritious food is scarce in many poor neighborhoods, one reason that obesity and malnutrition can coexist. When you don’t have the resources to make rational choices, Dr. Sandel observes, you go for the less expensive soda, chips, and other junk food whose prices are lowered by government subsidies of the sugar and corn industries. And when her patients know that their SNAP and other funds are going to run out before the end of the month, they overeat when they can, stuffing their kids and using heavy cream to stretch dishes.

“Hunger” is an unscientific term that can embrace everything from starvation to passing discomfort. In deeply impoverished countries, it can kill by compromising the immune system to expose children to serious disease. In the United States, too, poorly fed kids get sick and miss school more often than their wealthier peers. When they are hungry in class—or online during the pandemic—their attention flags, they do not do well. “Learning is a discretionary activity, after you’re well-fed, warm, secure,” said Dr. Deborah A. Frank, who founded the Grow Clinic nearly forty years ago.

But something even more pernicious is happening to younger children who aren’t getting enough micronutrients during their first thousand days—the second and third trimesters in utero and the first two years after birth. For at least half a century, scientists have been documenting how the developing brain suffers from insufficient iron, iodine, folate, zinc, calcium, magnesium, selenium, and various vitamins, all found in balanced diets of fresh fruits and vegetables, meat, fish, eggs, and dairy products. The alarm is sounded in study after study, including the succinct warning in the Journal of Developmental & Behavioral Pediatrics that, after age two, “the effects of malnutrition on stunting may be irreversible, and some of the functional deficits may become permanent.”

Brain growth comes early. A newborn’s brain is about 10 percent of total body weight compared with an adult’s 2 percent. By her first birthday, her brain reaches about 70 percent of what it will be in young adulthood, and by age two, about 77 percent.

At the microscopic level, the target of malnutrition’s assault depends on the timing. Neurons, generated during the second trimester of pregnancy, are reduced in number; their maturation is impeded if inadequate nutrition occurs in the third trimester. Nutritional deficiency in that period can also lower the production of glial cells, which support and protect neurons. Midway into the first year, synapses develop in the part of the brain governing vision, a little later in the auditory and receptive language areas, and between one year and mid- to late adolescence in the prefrontal cortex, responsible for high-level cognition. The networks of synapses are generated and pruned by an interplay of genes, behavioral experience, learning, and nutrition.

“The stages of development are numerous and complex,” the biologist Mohamed El Hioui wrote in a 2019 summary of research studies. “Neural cells must proliferate, migrate to the right place, establish the right connections, form the right receptors for neurotransmitters and be well covered with myelin, a protective substance essential to the proper transfer of nerve messages. This meticulous assembly of neural cells is vulnerable to environmental stressors, including of course, malnutrition.”

The process is rapid at times, always delicate, and easily disrupted. Although the brain gets first priority in harvesting scarce nutritional resources, at the expense of the rest of the body, even slight food insecurity has been shown to affect young children, and “any sustained interruption to their nutrition or to their care, if not treated early, can result in irreversible damage to their development,” warned a 2007 paper from the Drexel University School of Public Health.

For example, protein deficiency diminishes the thickness of the cerebellum and the visual cortex, among other areas of the brain. During pregnancy, inadequate choline protein may be associated with a reduced transfer of nutrients by the placenta and adverse brain structure in the child. Since chicken eggs contain high amounts of choline, undernourished children in Ecuador who were fed eggs in a study reported in 2017, the youngsters “had significantly higher concentrations of biomarkers associated with improved child development and important physiological processes in the brain.”

Some early injuries never heal. Seventy-seven infants who had been hospitalized with protein deficiency in Barbados carried the effects into adulthood, despite getting nutritious food between ages one and twelve. In their thirties, they had compromised “verbal fluency, working memory, processing speed, and visuospatial integration” compared to a healthy group from the same classrooms.

Among poor pregnant women and young children who don’t eat enough meat, poultry, fish, spinach, or beans, ruinous iron deficiency is widespread. Anemia decreases the formation of the myelin sheath, whose fatty matter insulates nerve cells and helps accelerate nerve conduction. Inadequate iron also affects the metabolism in the hippocampus, critical for memory. And it can lead to low birth weight, which is associated with cerebral palsy and other neurological problems.

Even children who get adequate iron later do not recover fully. Decades of studies following anemic infants into their school years have found them scoring lower in “arithmetic achievement and written expression, motor functioning, and . . . spatial memory and selective recall,” according to a collection of research, From Neurons to Neighborhoods, assembled by the National Research Council and the Institute of Medicine.

Low iron also makes the body more susceptible to lead from the old water pipes often found in slum housing. “Iron and lead are absorbed in the same pathway,” Dr. Sandel explained. “If you’re iron deficient, you create more receptors, you’re iron hungry, you’re looking for iron wherever you can find it,” and you absorb lead more readily as well. “So part of the treatment for kids who are lead-exposed is iron therapy.”

Research on the brain has gone far beyond the most demonstrable biological effects of malnutrition into areas of behavior and mental illness, where food deprivation is hard to isolate from such other factors as parenting, family stress, poor housing, and the myriad hardships of poverty.

It’s been established that the brain generates and whittles away synapses as the environment demands, so that emotional support during infancy can shape a person’s later ability to form attachments. And kids who don’t get enough iron and protein often lack the energy needed for curiosity and communication with others, reducing interactions essential to cognitive development. Proven remedies have included both nutrition and increased psychosocial stimulation.

The Barbados study and other research have reported correlations between early malnutrition and later attention deficit disorders. Causal relationships have been hard to establish, but children who once suffered from malnutrition have displayed hyperactivity, poor socialization, and difficulties in emotional regulation. A study that followed children in twenty American cities from 1998 to 2000 found lower self-control and higher rates of delinquency among those who had experienced food insecurity. Increased schizophrenia afflicted adults whose mothers during pregnancy had suffered in the “Dutch famine” during World War II.

A family’s anxiety over insufficient food can spread to children, with a particular neurological impact. “There is growing evidence from both animal and human studies,” a group of scientists reported in 2016, “that persistently elevated levels of stress hormones can alter the size and architecture of the developing brain, specifically the amygdala, hippocampus, and prefrontal cortex.”

Then, writing last year in The American Journal of Clinical Nutrition, a team at the Department of Medicine at the University of California, San Francisco, added together the findings of numerous studies into a devastating litany of mental health implications that are expected to outlast the pandemic: “Individuals experiencing food insecurity,” their paper concludes, are “more likely to experience symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD), as well as suicidality. Qualitative research suggests that financial and food insecurity can fuel feelings of sadness, shame, guilt, anxiety, and hopelessness.”

The Grow Clinic’s caseload might decline, and the virus might diminish quite soon. Its effects on children will not.

The post A Hungry Child’s First Thousand Days appeared first on Washington Monthly.

Imagine walking into a police station for help as a victim of crime and also getting help as a victim of poverty. Think how policing would change if, under the same roof, assistance were available for the problems of hunger, housing, health, addiction, and joblessness.

This sounds like pure fantasy, especially as unjustified police shootings continue, the country erupts in protests, and white supremacists threaten Black Lives Matter demonstrators with violence that turns deadly. In many Black neighborhoods, the police are seen as the enemy—just another gang, as some residents have said.

But the constructive reform of policing need not be lost in the fog of fury. It needs to be kept as a focused goal whose achievement will take unprecedented cooperation among community activists and law enforcement, including police leadership and officers in the ranks.

The problem has two parts. One is the use of force by cops who are scared or bigoted or poorly trained or all of the above. A great deal of study and thinking has gone into that issue, and lots of sound policies have been proposed, though too rarely adopted, in scattered jurisdictions among the nation’s 18,000 police departments.

The other part has been mostly neglected, however: the clustering of diverse services so that officers can be relieved of onerous tasks for which they have no expertise. It’s a good bet that you won’t be able to find a police officer who loves being called to a “domestic dispute,” where parachuting into a home without context can mean encountering unpredictable, split-second dangers. Nor do cops relish dealing with people suffering from mental illness, who account for a large number of encounters. In short, police are confronted by issues they cannot address, and need tools and training they do not have.

The solutions cannot be reduced to bumper-sticker slogans such as “Defund the Police.” If that implies abolishing the police, it’s a ridiculous prescription for vigilantism in neighborhoods where lawlessness would reign. On the other hand, if it means shifting some funds from policing to social services, it makes sense, especially if that assistance is readily available, and cops can refer people easily.

Police officers interact with many citizens who are in or near poverty, whether to arrest them or protect them. Poverty, for its part, is a constellation of problems that span a universe of hardships that require holistic measures. As some police departments have learned, addressing housing and other factors in the lives of those arrested for drugs, for example, can reduce recidivism. The LEAD (Law Enforcement Assistance Diversion) program, which began in Seattle, enables officers to send low-level drug and prostitution defendants into a web of services, including mental health, housing and drug treatment, instead of the normal criminal justice system. Participants are 58 percent less likely to be rearrested, according to the LEAD National Support Bureau, which is a project of the Public Defenders Association.

LEAD participants in Seattle improved their lives dramatically from before their enrollment, a 2016 evaluation found. They were “89 percent more likely to obtain permanent housing . . . 46 percent more likely to be on the employment continuum (i.e., in vocational training, employed in the legitimate market, retired),” and “33 percent more likely to have income/benefits.” Nearly fifty jurisdictions are either operating or launching the program, a good start but a tiny fraction of what’s necessary.

Americans in or near poverty who present themselves to an agency for one particular problem—at a food bank, say—invariably struggle under a broad burden of other issues. The chain reactions among them are much more extensive than popularly understood. Poor housing, for instance, is a key link to illness, especially childhood asthma, which is higher among families in poverty. Roaches, mold, and dust mites can trigger asthma attacks, which result in kids missing school and parents missing work to take them for treatment. Doctors at the pediatrics department of the Boston Medical Center learned years ago that the treatment was practically futile when the children went back to homes full of antigens, so they began to enlist lawyers to press landlords to improve conditions. The idea has caught on, and now 442 medical-legal partnerships exist in 48 states and the District of Columbia.

Some nonprofits have also established one-stop shopping for multiple services. Bread for the City in Washington, DC, began as a food pantry, established an intake procedure to identify families’ other problems, then added a medical clinic, job readiness instruction, and legal services to help people with housing, immigration, and access to government benefits.

There is a critical need across the country for such gateways through which people can pass into assistance for a range of their hardships. We already have institutions that could be gateways—in normal, Covid-free times. Schools, for example. Teachers see problems such as hunger and poor health but don’t have the tools to help families address them. So schools, with proper funding, would be natural places for counselors and others who could give assistance. Also, public and affordable housing projects, where problems of poverty are legion. Probation offices, where those convicted of crimes are required to make scheduled appearances. And, of course, police departments, which see citizens who are down and out for arrays of reasons that cannot be ignored without consequences for the entire society.

Windows of opportunity open briefly. This is one. It goes without saying that America ought to be great enough to translate the anger, the hurt, the protest into practical reforms.

The post How Police Reform Can Improve the Plight of the Poor appeared first on Washington Monthly.