America's Poorest Cities

After reading this wonderfully uplifting (-__-) article about the financial troubles that Detroit is facing, I wondered what other U.S. cities are facing similar rates of extreme poverty.

Per the New York Times, these are the 10 cities with the highest poverty rates in 2010.

1. Reading, PA
Percentage below poverty line: 41.3%

2. Flint, MI
Percentage below poverty line: 41.2%

3. Bloomington, IN
Percentage below poverty line: 39.9%

3. Albany, GA
Percentage below poverty line: 39.9%

5. Kalamazoo, MI
Percentage below poverty line: 38.8%

6. Brownsville, TX
Percentage below poverty line: 38.6%

7. Gary, IN
Percentage below poverty line: 38.3%

8. Detroit, MI
Percentage below poverty line: 37.6%

9. College Station, TX
Percentage below poverty line: 37.3%

10. Pharr, TX
Percentage below poverty line: 37.1%

Cities with some of the highest unemployment rates in the country include El Centro, CA (29.6%), Yuma, AZ (27%), Yuba City, CA (16.5%) and Merced, CA (16%) (US Bureau of Labor Statistics).

While publications like the Wall Street Journal are reporting that the US recession scare has passed, there still seems to be many Americans across the country who are struggling to survive financially.

American Indians/Alaska Natives & Mental Health: Some Facts

This post about mental health issues related to American Indians and Alaskan Natives was precipitated by the 20/20 special called Hidden America: Children of the Plains which was hosted by Diane Sawyer (see here). During the program, Sawyer explored the multitude of issues that children of the Oglala Lakota  Sioux tribal nation living on the Pine Ridge Reservation in South Dakota face including extreme poverty and alcoholism. According to some estimates, unemployment on the Pine Ridge Reservation ranges from 83-85% and can be higher during the winter months when it is difficult to travel. As a result, the median income on the Reservation is $2,600 to $3,500 per year and approximately 97% of the population lives below federal poverty lines. The nearest town that could potentially offer employment for those with the ability to travel is Rapid City, South Dakota, which is 120 miles away from the Reservation. Likely due to the lack of opportunity, many on the Pine Ridge Reservation either turn to alcohol or become severely depressed and/or suicidal. On this Reservation alone, alcoholism affects 8 out of 10 families; the death rate from alcohol-related problems is 300% higher than the remaining population. Rampant medical problems among the population including high rates of diabetes, heart disease, and cancer in addition to substance abuse and poor nutrition have resulted in a life expectancy of 48 years for men and 52 years for women (compared to 77.5 years for the US population as a whole).

Because of the serious social and economic difficulties they face, Native American populations like the Oglala Lakota Sioux are more susceptible to mental illnesses. Here are some facts regarding mental health and Native American communities gathered from the National Alliance on Mental Illness (NAMI). 

• Approximately 26% of American Indians/Alaska Natives live in poverty compared to 13% of the general population and 10% of Caucasian Americans.
• The American Indian and Alaska Native populations report higher rates of frequent distress than the general population.
• Alcohol abuse is a problem for a substantial portion of the American Indian adult population, but widely varies among different tribes.
• A study of Alaska Natives in a community health center found that substance abuse was the reason that 85% of men and 65% of women seek mental health treatment. 
• Native Alaskan males have had one of the highest documented suicide rates in the world. Suicide rates are particularly high among Native American males ages 15 - 24 who account for 64% of all suicides by American Indian/Alaska Native individuals.
• The words "depressed" and "anxious" are absent from some American Indian and Native Alaskan languages. Culturally different expressions of illness ("ghost sickness" or "heartbreak syndrome") do not easily correspond to Western psychiatric diagnosis criteria.
• In a Northern Plains study, 61% of children had experienced a traumatic event.
• Compared to the general population, American Indians and Alaska Natives tend to under-utilize mental health services, have a higher therapy dropout rates and are less likely to respond to treatment. This may derive from the fact that individuals tend to have negative opinions of non-Indian health providers and that traditional healing is used by a majority of Native Americans.
• Mental health services are available for the American Indian/Alaska Native communities, such as the services provided by the Indian Health Service (IHS), but they are in need of improvement. Currently only 7% of IHS' s budget is allocated for mental or behavioral health and substance abuse treatment services combined.

Citations:

Gone, J.P. (2004). Mental health services for Native Americans in the 21st century United States. American Psychological Association, Vol. 35, No.1, 10-18.

National Alliance on Mental Health: American Indian and Alaska Native Communities Mental Health Fact Sheet       http://www.nami.org/ContentManagement/ContentDisplay.cfm?ContentFileID=79888

Schwartz, S.M (2006). The arrogance of ignorance: hidden away, out of sight, out of mind. Regarding life, conditions and hope on the Oglala Lakota (Sioux) Reservation of SD. http://www.nativevillage.org/Messages%20from%20the%20People/the%20arrogance%20of%20ignorance.htm

Drug Related Convictions & the FAFSA: The Aid Elimination Provision

In 1998, the Higher Education Act (HEA) was reauthorized with what, at the time, was a little known or debated provision called the Aid Elimination Penalty (also known as the Drug-Free Student Loan Amendment). Added by then Indiana Representative Mark Souder (R), the Aid Elimination Act automatically disqualified students who had any drug convictions (except juvenile convictions) including misdemeanor marijuana possession from receiving federal financial aid regardless of when the conviction occurred. Specifically, the amendment states:

A student who is convicted of any offense under any Federal or State law involving the possession or sale of a controlled substance shall not be eligible to receive any grant, loan, or work assistance under this title during the period beginning on the date of such conviction and ending after the interval specified...

The intervals originally set forth for aid ineligibility depended on the whether the charge was the possession or  sale of a controlled substance and whether it was the person's first, second or third offense. For possession, the period of ineligibility is one year for the first offense, two years for the second offense and indefinitely for the third offense. For sale, ineligibility for financial aid lasts two years for the first offense and indefinitely for the second offense.

Additionally, the amendment states that

A student whose eligibility has been suspended under paragraph 1 (see above) may resume eligibility before the end of the eligibility period determined under such paragraph if 

(A) the student satisfactorily completes a drug rehabilitation program that - 

     (i) complies with such criteria as the Secretary shall prescribe in regulations for purposes of this paragraph; and

    (ii) includes two unannounced drug tests; or

(B) the conviction is reversed, set aside or otherwise rendered nugatory.

So, why was this provision added?

Former Rep. Mark Souder, who authored the Aid Elimination Penalty, was huge proponent of the so-called "War on Drugs." Souder had previously supported foreign drug war adventures in places like Colombia and Mexico and was a staunch opponent of softening marijuana laws even for medical uses. In 1998, as amendments were being added to the original Higher Education Act of 1965, Souder included the Aid Elimination Penalty in these changes. Interestingly, the amendment only refers to drug convictions; convicted murderers, rapists, burglars, child molesters and other criminals are still eligible for financial aid without conditions.  Though the provision was added as an attempt to curb drug use among young people, the Government Accountability Office recently indicated that it could find no evidence that the penalty "actually helped to deter drug use."

Since the provision was added over 10 years ago, 200,000 students have been denied aid because of the provision; it has been estimated that thousands of other prospective college students did not even apply for aid because they believed their application would be denied. Additionally, the amendment has been found to especially hurt low- and middle-income families as students from wealthy families often attend college without public aid. Additionally, due to the discriminatory enforcement of drug laws, the Aid Elimination Penalty tends to keep people of color out of school at a much higher rate than the general public.

Due in  large part to external pressure, the law was actually scaled back in 2006 such that only people who were convicted of a drug related offense while receiving financial aid would be stripped of their ability to receive federal money for their schooling. The law was further amended in 2008. During the Higher Education Reauthorizaton process, Congress made it much easier for those convicted of drug-related offenses to regain their financial aid eligibility. Now in order to regain their aid eligibility, students would have to pass two unannounced drug tests administered by a government-approved treatment program without having to complete the program itself which the law initially required. 

Still, more than 325 groups and organizations including the National Education Association, the ACLU and Students for a Sensible Drug Policy (SSDP) have called for the law's repeal, but with little progress made. In 2008, the ACLU along with SSDP sued for an injunction against the law calling it "unconstitutional because it violates the Fifth and Eight Amendments to the United States Constitution." Groups such as these are of the opinion that the law allows students to be effectively punished twice for the same transgression. Also, some believe that forcing students with drug convictions out of school makes them more likely to abuse drugs or engage in criminal activity and less likely to become productive taxpaying citizens. The Court, however, ruled against the SSDP stating the denial of financial aid based on prior drug convictions did constitute cruel or unusual punishment and did not violate double jeopardy laws. As it stands today, the Aid Elimination Penalty, albeit in its amended form, is still on the books with groups like the SSDP continuing to fight for its complete repeal.

Citations:

Students for Sensible Drug Policy: http://ssdp.org/campaigns/the-higher-education-act
1998 Amendments to the Higher Education Act of 1965: http://www2.ed.gov/policy/highered/leg/hea98/sec483.html

Poverty Matters: The Effects of Being Poor On Children

A recent national study revealed that 1 in 5 U.S. children lives in poverty which has largely been attributable to the recession and represents an increase of nearly 2.5 million children since 2000. Given the number and the scope of the negative effects associated with poverty, increasing poverty rates among U.S. children have the potential to inflict severe psychological, emotional and economic damage on the next generation of young people. This issue is particularly pertinent for me living in Lynn, MA, a city where nearly a quarter of children (under age 18) live below the poverty line; other cities in Massachusetts have as high as 42% of children living below the poverty line (Danzing & Bernier, 2008). In Chelsea, MA, 97.4% of children under age 18 live in a neighborhood 20% of more of population is living below the poverty line (Danzig & Bernier, 2008). Furthermore, the Massachusetts Citizens for Children found that on any given day 50,000 school aged children and youth as well as 50,000 younger children are homeless in Massachusetts (Danzig & Bernier, 2008); at the Whitney Elementary School in Las Vegas alone 85% of the 610 students are homeless (see here). Knowing the numbers is important, but what about the specific consequences of both short-term and persistent poverty? What are some of the far-reaching effects of childhood poverty?

Jeanne Brooks-Gunn and Greg Duncan published a study in 1997 detailing the toll that poverty can take on children. Specifically, Brooks-Gunn and Duncan (1997) found that poor children suffer higher incidences of adverse health, developmental, and other outcomes than non-poor children. In terms of physical health, poor children are 1.7 times more likely to be born with a low birth rate than non-poor children.  This is likely because poor pregnant women have less access to adequate nutrition and prenatal care; in Lynn, nearly 29% of pregnant women receive NO prenatal care within the first trimester (Torname, 2011). Low birth weight has been associated with an increased likelihood of cognitive and emotional problems that can persist through childhood and adolescence (Brooks-Gunn & Duncan, 1997). Learning disabilities, physical disabilities, and grade repetition as well as lower levels of math and reading achievement are also more prevalent among children who were low birth weight as infants (Brooks-Gunn & Duncan, 1997). This information is particularly disheartening given that in my hometown (Lynn, MA) 8.7% of children are born with a low birth rate (Torname, 2011). Additionally, poor children are only 66% as likely to be in excellent health and almost twice as likely to be in poor or fair health compared to non-poor children (Brooks-Gunn & Duncan, 1997). Poor children are also twice as likely to experience growth stunting (low height for age), spend almost 1.5 times as many days in bed, and have twice as many short-stay hospitalizations than non-poor children (Brooks-Gunn & Duncan, 1997). 

In terms of cognitive abilities, children living below the poverty line are more likely to experience learning disabilities and developmental delays (Brooks-Gunn & Duncan, 1997). One study found that poorer children scored between 6 and 13 points lower on various standardized tests of IQ, verbal ability, and achievement (Brooks-Gunn & Duncan, 1997). This difference between poor and non-poor children was still present even when controlling for maternal age, marital status, education and ethnicity. The 6- to 13-point difference on these types of measures, for some, could mean the difference between being placed in a special education class or not (Brooks-Gunn & Duncan, 1997). Findings suggest that the effects of poverty on children's cognitive development occur early, but also that the effects of long-term poverty were significantly greater than the effects of short-term poverty (Brooks-Gunn, 1997).  What is the reason for this? Poverty has been found to affect children's brain development as children growing up in poor families tend to experience unhealthy levels of stress hormones. Excessive levels of stress hormones disrupt the formation of synaptic connections between cells in the developing brain and affect its blood supply. The result is impaired language development and memory (Danzig & Bernier, 2008). 

Fortunately, a comprehensive review of the literature did find that the effect of poverty on the number of school years completed was small (Brooks-Gunn, 1997). The observed relationship between income and educational attainment seems to be related more so to confounding factors such as parental education, family structure, and neighborhood characteristics as opposed to just family income (Brooks-Gunn, 1997). Research does suggest, however, that family income averaged from birth to age 5 had a much more powerful effect on the number of school years a child completes than family income measured between ages 5 and 10 or between ages 11 and 15 (Brooks-Gunn, 1997). Specifically, for low income children a $10,000 increase in mean family income between birth and age 5 was associated with almost a full year increase in completed schooling (Brooks-Gunn, 1997). This same increase to family income later in childhood had no significant impact suggesting that income may only be a significant  primary factor in future education attainment during the earliest childhood years (Brooks-Gunn, 1997). In terms of other academic related outcomes, poor children were twice as likely to repeat a grade, be suspended or expelled and dropout of high school (Brooks-Gunn, 1997).

Poor children also suffer from emotional and behavioral problems more frequently than non-poor children exhibiting both more externalizing (aggression, fighting, and acting out) and internalizing behaviors (anxiety, social withdrawal, depression) than children who had never been poor (Brooks-Gunn, 1997). This may be due to the fact that poor children are almost 7 times more likely to experience child abuse or neglect and violent crime than non-poor children (Brooks-Gunn, 1997). Short-term poverty (being poor in at least 1 out of 4 years) was also associated with behavioral problems though the effects were smaller than what was found for those experiencing more persistent poverty (Brooks-Gunn, 1997). Still, parents in poor families were 1.3 times more likely to have a child who had an emotional or behavioral problem that lasted 3 or more months (Brooks-Gunn, 1997). Interestingly, persistent poverty was associated with more internalizing behaviors while current, but not persistent, poverty was associated with externalizing behaviors such as hyperactivity and peer conflict (Brooks-Gunn, 1997). 

So how and why does poverty have such a negative effect on children?

Health & Nutrition

- The cumulative health disadvantage experienced by poor children on health measures may account for as much as 13% to 20% of the difference in IQ between poor and non-poor children (Brooks-Gunn, 1997). 

-Malnutrition is associated with lower scores in tests of cognitive development (Brooks-Gunn, 1997).

-Growth stunting, which poor children are at an increased for, affects short-term memory. The effects of stunting on short-term memory is equivalent to the difference in short term memory between families that experienced poverty for 13 years and children in families with incomes at least 3 times the poverty level (Brooks-Gunn, 1997). 

Parental Interactions with Children

-Among adolescents, family economic pressure may lead to conflict with parents resulting in lower school grades, reduced emotional health, and impaired social relationships (Brooks-Gunn, 1997). 

-Other sources of conflict include economic uncertainty, unemployment or underemployment and unstable work conditions that ultimately impact the children (Brooks-Gunn, 1997). 

Parental Mental Health

-Parents who are poor are likely to be less healthy both emotionally and physically than those who are not poor (Brooks-Gunn, 1997). 

-Parental irritability and depressive symptoms are associated with conflictual interactions with adolescents, leading to less satisfactory emotional, social and cognitive development (Brooks-Gunn, 1997). 

-Poor parental mental health is associated with impaired parent-child interactions and less provision of learning experiences in the home (Brooks-Gunn, 1997). 

Neighborhood Conditions

-Low income may lead to residence in extremely poor neighborhoods characterized by social disorganization such as crime and few resources for child development such as playgrounds, day care and after school programs (Brooks-Gunn, 1997). 

-Poor children are twice as likely to report being scared to leave the house (Brooks-Gunn, 1997).

Other
-Other pathways through which poverty operates include a lack of access to and use of prenatal care, access to pediatric care, exposure to environmental toxins, household stability, quality of school attended and peer groups (Brooks-Gunn, 1997).

While poverty has the ability to negatively affect multiple aspects of both children and adults' lives, there are protective factors against a guaranteed life of misfortune. These include strong family support, religion, and positive peer relationships. Additionally, introducing learning experiences in the home has been found to aid in cognitive development and counteract poverty's influence on achievement outcomes. Unfortunately, not all children have parents or families that are willing or able to provide the necessary academic or emotional support to prevent negative outcomes. While some in the recent education reform debate may say that citing poverty is 'an excuse,' as the research here and elsewhere suggests, the effects of poverty on one's  overall emotional and physical well being and  future educational outcomes as well as on life’s trajectory in general are very real. 

Citations:

Brooks-Gunn, J. and Duncan, G.J. (1997). The effects of poverty on children. Children and Poverty, 55-71.

Danzig, B. and Bernier, J. (2008). Child poverty in Massachusetts: a tale of 2 states. Massachusetts Citizens for Children, 1-63.

Torname, J. (2011). Lynn: a little city with big potential. New Lynn Coalition Publication, 2-32.

HIV Prevalence Rates by Country

While specific discussion of the HIV epidemic seems to be nonexistent in the American media these days, it is still an issue that is affecting an astonishing number of people globally. Below is the HIV prevalence rate for people 15-49 years of age in a select group of countries.



Country	Percentage
Swaziland	25.9
Botswana	24.8
Lesotho	23.6
South Africa	17.8
Zimbabwe	13.5
Namibia	13.1
Mozambique	11.5
Malawi	11
Uganda	6.5
Kenya	6.3
Cameroon	5.3
Central African Republic	4.7
Nigeria	3.6
Thailand	1.3
Guyana	1.2
Russia	1
El Salvador	0.8
Honduras	0.8
Latvia	0.7
United States	0.6
France	0.4
Nepal	0.4
Belarus	0.3
United Arab Emirates	0.2
Israel	0.2
Turkey	0.1
Algeria	0.1
Germany	0.1
Slovakia	0.1
Pakistan	0.1
Afghanistan	0.01

Citation: 

CIA World Fact Book

https://www.cia.gov/library/publications/the-world-factbook/rankorder/2155rank.html#top

Homeless Youth in America: Facts & Statistics

As a result of the current economic crisis, families with children are the fastest growing segment of the homeless population. In 2007, 23% of all homeless people were members of families with children.  This number may be even higher if one considers that many homeless families move in with other family members; in terms of record keeping, homeless people who live with family are often excluded from  the statistics. Recent estimates state that 1 in 50 children in the U.S. are homeless with half of these children under the age of 5. The composition of the average homeless family is a single parent household headed by an African American female. People of color, especially African Americans, tend to be overrepresented in the homeless population - 40% are African Americans, 11% are Hispanics, and 8% are Native Americans. This is compared with 11%, 9%, and 1%, respectively, of the general population. 

There is also a growing number of homeless young people who are living completely on their own. According to the National Coalition for the Homeless (www.nationalhomeless.org), homeless youth are "individuals under the age 18 who lack parental, foster, or institutional care." These young people are sometimes referred to as "unaccompanied" youth. The most recent study estimates that there are approximately 1.7 million homeless and runaway youth. This number is equally divided between males and females, with the majority between the ages of 15 and 17. The National Network of Runaway and Youth Services estimates that 6% of homeless youth are lesbian, gay, bisexual or transgender. Additionally the number of pregnant youth is somewhere between 6 and 22% of the population. Five to seven percent of American youths are homeless in any given year (National Alliance to End Homelessness, 2007). 

Youths often leave home for a variety of reasons including physical and/or sexual abuse, addiction of a family member and parental neglect. One study found that half of the youth in a shelter reported that their parents "either told them to leave or knew they were leaving and did not care" (U.S. Department of Health and Human Services). Other young people become homeless due to family issues including a lack of affordable housing, limited employment opportunities for their parents, and no medical insurance. A history of foster care also correlates with becoming homeless at an earlier age and remaining homeless for a longer period of time. 

As a result of a lack of housing and services for homeless youth, they sometimes turn to exchanging sex for food, clothing and shelter. Because of this, they are at higher risk for contracting HIV and/or AIDS. Some estimates place the number of homeless youth with HIV at around 5%, but some studies find that the number may be as high as 17%. Additionally, homeless youth suffer from depression, anxiety, and poor health and nutrition. School attendance is also an issue due to legal guardianship requirements, residency requirements, improper records and a lack of transportation.

Due to the numerous negative consequences of homelessness for young people, more needs to be done to ensure that appropriate services are available in order to prevent these outcomes from occurring. 

Children without 'Forever' Homes

Currently, there are over 400,00 children in the United States foster care system. Each year more children become available for adoption than are adopted. For example, in 2009 over 69,000 children were up for adoption but only 57,000 were adopted. According to a November 2010 article at SFGate.com, children often wait 3 or more years to be adopted, move 3 or more times in foster care and are often separated from siblings. While the average age of a 'waiting' child is 8 years old, approximately 20,000 young people leave the foster care system each year without an adoptive family.

While in foster care, youth receive services such as food, housing, transportation and medical care. If not adopted by age 18, a young person in foster care "ages out" of the system and loses all of his or her foster care services. Many are left to fend for themselves without any support. Likely due in part to a lack of support, people who age out of the foster care system are more likely to experience negative outcomes.

• 84.8% do not have a high school diploma or GED
• 22% are homeless
• 33.2% are below the poverty line
• 25% are involved in crime
• 54.4% have behavioral/emotional issues, school problems and mental and physical health issues
• 50% experience early pregnancy
• Only 33 percent have health insurance
• Only 20% complete college

*Statistics take from:  http://cle.osu.edu/lwc-publications/youth-information-briefs/downloads/Youth-Aging-Out-of-Foster-Care.pdf

Because of the high rates of negative outcomes more needs to be done to ensure that young people who have been in the foster care system do not fall through the cracks. If this issue is ignored, the United States will continue to have a population of people with little opportunity for success.