Imagine an infant born into poverty. this child is statistically at greater than normal risk for every bad social outcome in later life associated with early chronic trauma. As the infant grows into a toddler, the child is more likely to have poor cognitive and emotional skills; later on, to do poorly in school; to have poor eating and exercise habits, to use drugs and excessive alcohol, to become pregnant as a teen, to drop out of school. As an adult, this grown child is more likely to suffer physical and mental illnesses, to have difficulty forming secure attachments to a life partner, to get into trouble with the law, to be incarcerated, and to die prematurely. Add other factors highly correlated with extreme poverty in children, such as severe depression in mothers, and the odds worsen. Some remarkable individuals surmount these odds, but to be poor is to be at greater risk.
The phrase that famously got Daniel Patrick Moynihan into such trouble four decades ago in his report "The Negro Family" -- "tangle of pathology" -- is an accurate description not of race but of extreme poverty. Pathology was taken to imply blame. Yet no newborn baby is responsible for its own behavior. And while some poor parents do make poor choices, as Dorothy Day of the Catholic Worker Movement observed, to be poor is often not just to be poor in money but poor in spirit and other human resources. To be born into such an environment is not good for children.
There will never be enough money to treat all the casualties of early trauma and poverty after the fact. Simple humanity tells us that we need a broad range of early-childhood interventions to save the next generation. The psychologist George Albee, who died last year, advocated what he termed "primary prevention" of mental illness. Albee was not talking about counseling; he had in mind removing the economic assaults of inequality. "Stress, abuse, violence, sexism, exploitation, poverty are all noxious agents," he wrote, and "unhealthy for children."
Richard Rothstein, the former New York Times education columnist, argues that if we want poor children to do better in school, a marginal dollar invested in medical and dental clinics may be more effective than a marginal dollar spent on schooling.
Infants come attached to mothers. The British psychiatrist Donald Winnicott liked to say that there's no such thing as a baby -- meaning that it's impossible to imagine an infant without a parent. For babies to thrive, their parents need to thrive. Yet our society makes the enterprise of healthy mothering far more arduous than it could be, by failing to provide social supports and by punishing families economically, especially women, if they choose to have children.
Contemplating the casualties of extreme poverty, every human impulse prompts us to call for a massive infusion of resources to alleviate poverty, mitigate its toll, and rescue the next generation. Poverty is toxic for children. To break the cycle, we need an antipoverty superfund.
Yet everything we know about the logic of social investments and political coalitions also suggests that we can't effectively address poverty alone. When a candidate like John Edwards speaks a moral language about poverty, he wins admiration for his political bravery and conscience. When he talks about the economic vulnerability of three Americans in four, you start thinking that he might be elected president.
Extreme poverty is a special case of an America that fails to deliver economically for ordinary working families. And if you look at the programs and political coalitions that have made a real difference in alleviating poverty, you quickly appreciate the wisdom of the old line that programs for the poor alone are poor programs. Social Security, by being a program for everybody, keeps tens of millions out of poverty -- and redistributes more money to the poor than all poverty programs put together. As such, it is better defended politically than any explicitly antipoverty program.
Medicare, another widely esteemed universal program, allows the poor to be instantly treated like the middle class, at least for medical purposes, upon turning 65. The Earned Income Tax Credit has alleviated a lot of poverty by reaching well into the lower middle class. Targeted Head Start helps many low-income children, but universal public prekindergarten would do even more. Universal early education would also energize coalition politics and cultivate social compassion, by reminding us of the common needs of all children. The children of the working middle class may not face the same profound risks as the children of the poor. But there has not been a time since the Great Depression when the American middle class had more economic vulnerabilities in common with the poor. Politically, the way to find the resources to alleviate poverty is to create a broad coalition of all Americans who are a few paychecks away from poverty, with good social investments that are universal. To end poverty, we need to imagine a middle-class America, where to work is to earn a decent living, and to be born is to have decent life chances.
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