Understanding the Culture of Poverty Feed My People 2018 Spring Agency Gathering April 30, 2018

“No problem can be solved from the same consciousness that created it “No problem can be solved from the same consciousness that created it. We have to think with a new mind.” ~Albert Einstein Good morning—introduction— In my role as a community health educator we assess and address the health of the communities we serve. We just completed a health needs assessment this year. The top three health needs in the counties are mental health, substance abuse and alcohol misuse. In our Catholic hospital ministry it is vital that we focus our efforts strongly on the poor and vulnerable and to look at how the social determinates of health contribute to the needs of the community.

Health Outcomes Linked to Poverty The average age of death is younger in poverty Primary care is often the Emergency Department Dental visits are fewer Obesity and diabetes rates are higher Smoking rate is higher As healthcare providers, we are also very attuned to the research on how poverty can affect health. An MIT study published in 2016 showed on average—the richest 1% of men in the U.S. live 14.6 years longer than the poorest 1% of men. Among women in those percentiles, the figure is 10 years on average. 2. Uninsured, underinsured. 3. Again, no dental insurance. This contributes to serious medical issues. 4. Twice as likely to develop diabetes and other diseases. --Chronic Stress --Difficult to access fresh and healthy foods and also programs that promote physical activities and fitness. 5. Smoking cigarettes. 2016 CDC --25 of 100 people below the poverty line smoke cigarettes --14 of 100 people above the poverty line smoke cigarettes

Poverty noun, often attributive pov·er·ty \ ˈpä-vər-tē \ a : the state of one who lacks a usual or socially acceptable amount of money or material possessions Generational Poverty Situational Poverty Working Class Poverty Immigrant Poverty Absolute Poverty Relative Poverty 1. Having been in poverty for at least 2 generations 2. Lack of resources due to a particular event. 3. Most vulnerable group—ALICE Report Asset.Limited.Income.Constrained.Employed 13% of WI households are below the poverty line 2014 29% ALICE households 2014 4. Immigrant Poverty—according to the 2010 census—16.5% of those in poverty were immigrants. Understanding the difference between generational and situational poverty is crucial for people who work with the poor. People in different types of poverty tend to approach their circumstances differently, and they may have different values or priorities. Situational poverty— Often higher educational level May be more familiar with the hidden rules and social codes of the middle class Generally has more resources in may forms to rely on.

Mental Models of Economic Environments Poverty Tyranny of the moment Middle Class Tyranny of the future Wealth Hierarchy (Past) / Connections 1. When you live in the ciaos of the moment, it is impossible to plan for the future. People caught in (especially generational) poverty are focused on surviving. They are faced with the issue or challenge of the day—money for food, housing, transportation, unresolved health issues, family members issues. This is all done is urgency and the concept of planning does not exist. HOPELESSNESS 2. STABLE Environment—Work, achievement, Decisions are made with the future in mind. *this is the model we use to design our institutions and services. 3. Wealth—Connections with the right people (socially, financially, politically). Tradition/history important. Abundant resources. When you consider the economic environments, it’s important to remember it runs on a continuum – people move on that continuum. When you look at the economic environments we tend to think that financial resources are the only thing that move people along that continuum.

RESOURCES RELATIONSHIPS/ROLE MODELS FINANCIAL EMOTIONAL KNOWLEDGE OF HIDDEN RULES RESOURCES MENTAL FORMAL REGISTER PHYSICAL There are many resources to consider. The less of these resources you have, the less stable the environment. Emotional Resources—provide the stamina to get through the difficult and uncomfortable situations-this is hard when you don’t have someone to fight for you. When present they allow people to not return to old habit patterns, i.e. Getting drunk when frustrated, angry, sad Can you translate from the personal to the issue? Mental Resources—being able to process information and use it in daily living. It is an advantage to be able to Read/Write and compute. Spiritual resources—belief that help can be obtained from a higher power and that all people have a purpose can be valuable when facing hardship. Physical Resources—having a body that works and capable and mobile. Support Systems—the people from whom we seek help. Who can take care of a sick child if you have to work. Who helps with transportation when your car is broken. Relationships/Role Models— How nurturing and appropriate are the role models? Can they parent? Work successfully? It is largely from role models that people learn to life emotionally. Formal Register— All languages have a casual and formal register. Not being able to access formal register will knock someone out of a job interview very quickly. Think about health literacy. Medical terminology is considered to be in the frozen language register— above formal. Knowledge of Hidden Rules—Hidden rules exist all along the econonmic continuum as well as ethnic groups, workplaces and other units of people. Hidden rules are unspoken understandings that cue the members of the group that the individual doesn’t fit. SPIRITUAL SUPPORT SYSTEMS

Knowledge of Hidden Rules POVERTY MIDDLE CLASS WEALTH DRIVING FORCES Survival, relationships, entertainment as a respite. Work, achievement. Financial, political and social connections. MONEY To be used, spent. To be managed. To be conserved, invested. SOCIAL EMPHASIS Social inclusion of like people. Self-governance and self-sufficiency. Social exclusion. FOOD Quantity Quality Presentation CLOTHING Valued for individual style and personality. Valued for acceptance into norm. Label. Valued for its artistic and expression. Designer. EDUCATION Valued and revered. Crucial for success. Tradition. Source: Bridges out of Poverty, Strategies for Professionals and Communities. Ruby Payne, Philip DeVol, Terie Dreussi Smith

Implications of Hidden Rules Assumptions are made about intelligence and approaches to life. Lack of resources lack of intelligence Attitudes that people have are a part of their culture and belief systems. Middle class solutions should not be imposed Understanding this will help lessen anger, frustration and prejudice felt when working with people different from themselves. Assumptions are made in every class. Why would you know how to manage something you have never had. I have never had a trust fund, nor will I ever have one. We design our schools, institutions, services with a middle class mindset—then wonder why they don’t work for people not in middle class environments. The first step in community change is knowledge and understanding as individuals.

Key Points Poverty is relative Poverty occurs in all races and all countries Generational poverty and situational poverty are different Society in general operates from middle-class norms We cannot blame the victims of poverty for being in poverty. We cannot continue to support stereotypes and prejudices. What helps people stay out of poverty? Not be born into poverty Get higher education Two income household Delay the onset of parenthood What pushes people to leave poverty— A goal or vision of something that want to have or be. A situation that is so painful that anything would be better Someone who mentors or sponsors them—shows or convinces them another way A specific talent or ability that provides opportunity

Thank you