The Working Poor: Invisible in America

Sometimes as with the romantic story of Tom and Kara King, a traumatic childhood, past abusive relationships, and economic hardship do not rule out the possibilities of love. Parents to three children, Tom and Kara have a household full of love while facing problems with their health and employment: “Kinship blunts the edge of economic adversity” (179). Shipler writes that a familial bond makes the impoverished person feel less isolated, even as he or she battles hardships. As in Kara’s case, she struggles with the debt of an unpaid divorce bill from a previous marriage and an aggressive lymphoma, which she attempts to treat by becoming part of a medical trial. As Kara’s cancer advances, Tom is able to draw on the support of his friend Kurt, who goes to work in his place. Although Kara is hopeful until the end and does what she can to survive the cancer, she dies, leaving the family devastated.

A year later, Tom has adopted Kara’s boys and they are living with their animals, including rabbits and an enormous pig called Emma, in “the middle of a grown-up’s playground where […] the children were learning[…] by getting their hands dirty, by making things work, by caring for animals, by taking responsibility” (187). One of the boys, Zach, who is very artistic, likes school and wishes to be an architect. Even though he becomes Homecoming King, his SAT scores are not high enough to attend the college of his choice, and he cannot afford the courses that affluent students use to improve their scores. He therefore elects to enlist in the Air Force.

Ann Brash also nurtures close family ties with her children and chooses poverty over working numerous shifts and leaving their education unsupervised. As a result, her children do well, as her son goes to Dartmouth and her daughter to the New England Conservatory of Music. The family’s close bonds and cultural capital means they do not feel poor in the conventional sense of the word. Overall, Shipler indicates that strong family ties can make poverty bearable and can even offer opportunities to rise out of it.

Of all the expenses a poor family has, food is the most flexible and can be cut to the bare minimum. It is also difficult for disrupted families to keep track of how often and how much a small child is eating. The result of this is a number of malnourished children in America.

Services such as the Grow Clinic in Boston Medical Center aim to eradicate child malnourishment, advising impoverished parents how to better nourish their children, especially when conditions such as allergies create further challenges. Other work includes advising immigrant parents who are clueless about American food and feed their babies potato chips and soda, even though they were able to manage a competent diet in their own cultures. The degree of treatment received for malnourished children depends on the state. Boston fares better than the rural South.

Cultural clashes abound between medical professionals and African Americans and Latinos, who often feel judged by doctors. The result is that the infant mortality rate of black babies is 2.4 times higher that of white babies, owing to the mothers’ inferior medical care, untreated vaginal infections, and nutritional deficits. For Latino families, language can be a barrier to seeking the help they need.

Malnourishment leads to learning difficulties. Learning is secondary when a child is malnourished because the organism is tuned towards survival qualities first. Iron deficiency, in a pregnant woman's final trimester as well as in the baby’s first years of life, can also limit brain growth. Studies are in conflict with regard to whether intelligence is inherited or acquired through nurture, but Shipler concludes that “genetic predispositions are believed to interact with an individual’s experience to enhance or diminish not only his biological health but his intellectual success” (222). This means that poverty and lack of adequate medical care can lead to cognitive and emotional deficits. 

Poor housing is a cause of stress, and structural problems, such as dampness, can affect and trigger asthma and more severe lung problems. It is often lawyers, not doctors, who call landlords to change these adverse living conditions.