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But just as important—especially in the age of data-driven decision making—he inspired a flood of research. These studies raise a variety of questions and come to a variety of conclusions about poverty.

But on this they all agree: There is no such thing as a culture of poverty. Differences in values and behaviors among poor people are just as great as those between poor and wealthy people. In actuality, the culture of poverty concept is constructed from a collection of smaller stereotypes which, however false, seem to have crept into mainstream thinking as unquestioned fact. Let's look at some examples. Although poor people are often stereotyped as lazy, 83 percent of children from low-income families have at least one employed parent; close to 60 percent have at least one parent who works full-time and year-round National Center for Children in Poverty, In fact, the severe shortage of living-wage jobs means that many poor adults must work two, three, or four jobs.

According to the Economic Policy Institute , poor working adults spend more hours working each week than their wealthier counterparts. Poor parents are uninvolved in their children's learning, largely because they do not value education. Low-income parents are less likely to attend school functions or volunteer in their children's classrooms National Center for Education Statistics, —not because they care less about education, but because they have less access to school involvement than their wealthier peers.

They are more likely to work multiple jobs, to work evenings, to have jobs without paid leave, and to be unable to afford child care and public transportation. It might be said more accurately that schools that fail to take these considerations into account do not value the involvement of poor families as much as they value the involvement of other families.

What often are assumed to be deficient varieties of English—Appalachian varieties, perhaps, or what some refer to as Black English Vernacular—are no less sophisticated than so-called "standard English. Poor people are no more likely than their wealthier counterparts to abuse alcohol or drugs. Chen, Sheth, Krejci, and Wallace found that alcohol consumption is significantly higher among upper middle class white high school students than among poor black high school students.

In other words, considering alcohol and illicit drugs together, wealthy people are more likely than poor people to be substance abusers. The myth of a "culture of poverty" distracts us from a dangerous culture that does exist—the culture of classism. This culture continues to harden in our schools today.

It leads the most well intentioned of us, like my friend Janet, into low expectations for low-income students. It makes teachers fear their most powerless pupils. And, worst of all, it diverts attention from what people in poverty do have in common: The most destructive tool of the culture of classism is deficit theory.

In education, we often talk about the deficit perspective—defining students by their weaknesses rather than their strengths. Deficit theory takes this attitude a step further, suggesting that poor people are poor because of their own moral and intellectual deficiencies Collins, Deficit theorists use two strategies for propagating this world view: The implications of deficit theory reach far beyond individual bias.

If we convince ourselves that poverty results not from gross inequities in which we might be complicit but from poor people's own deficiencies, we are much less likely to support authentic antipoverty policy and programs. Further, if we believe, however wrongly, that poor people don't value education, then we dodge any responsibility to redress the gross education inequities with which they contend.

This application of deficit theory establishes the idea of what Gans calls the undeserving poor —a segment of our society that simply does not deserve a fair shake. If the goal of deficit theory is to justify a system that privileges economically advantaged students at the expense of working-class and poor students, then it appears to be working marvelously.

In our determination to "fix" the mythical culture of poor students, we ignore the ways in which our society cheats them out of opportunities that their wealthier peers take for granted. We ignore the fact that poor people suffer disproportionately the effects of nearly every major social ill.

They lack access to health care, living-wage jobs, safe and affordable housing, clean air and water, and so on Books, —conditions that limit their abilities to achieve to their full potential. Perhaps most of us, as educators, feel powerless to address these bigger issues.

But the question is this: Are we willing, at the very least, to tackle the classism in our own schools and classrooms? This classism is plentiful and well documented Kozol, For example, compared with their wealthier peers, poor students are more likely to attend schools that have less funding Carey, ; lower teacher salaries Karoly, ; more limited computer and Internet access Gorski, ; larger class sizes; higher student-to-teacher ratios; a less-rigorous curriculum; and fewer experienced teachers Barton, The National Commission on Teaching and America's Future also found that low-income schools were more likely to suffer from cockroach or rat infestation, dirty or inoperative student bathrooms, large numbers of teacher vacancies and substitute teachers, more teachers who are not licensed in their subject areas, insufficient or outdated classroom materials, and inadequate or nonexistent learning facilities, such as science labs.

Here in Minnesota, several school districts offer universal half-day kindergarten but allow those families that can afford to do so to pay for full-day services. Our poor students scarcely make it out of early childhood without paying the price for our culture of classism. Deficit theory requires us to ignore these inequities—or worse, to see them as normal and justified. What does this mean? Regardless of how much students in poverty value education, they must overcome tremendous inequities to learn.

Perhaps the greatest myth of all is the one that dubs education the "great equalizer. The socioeconomic opportunity gap can be eliminated only when we stop trying to "fix" poor students and start addressing the ways in which our schools perpetuate classism.

This includes destroying the inequities listed above as well as abolishing such practices as tracking and ability grouping, segregational redistricting, and the privatization of public schools. We must demand the best possible education for all students—higher-order pedagogies, innovative learning materials, and holistic teaching and learning.

But first, we must demand basic human rights for all people: Of course, we ought not tell students who suffer today that, if they can wait for this education revolution, everything will fall into place. So as we prepare ourselves for bigger changes, we must Educate ourselves about class and poverty.

Reject deficit theory and help students and colleagues unlearn misperceptions about poverty. Make school involvement accessible to all families. Follow Janet's lead, inviting colleagues to observe our teaching for signs of class bias. Continue reaching out to low-income families even when they appear unresponsive and without assuming, if they are unresponsive, that we know why.

Respond when colleagues stereotype poor students or parents. Never assume that all students have equitable access to such learning resources as computers and the Internet, and never assign work requiring this access without providing in-school time to complete it. Ensure that learning materials do not stereotype poor people. Fight to keep low-income students from being assigned unjustly to special education or low academic tracks.

Make curriculum relevant to poor students, drawing on and validating their experiences and intelligences. Teach about issues related to class and poverty—including consumer culture, the dissolution of labor unions, and environmental injustice—and about movements for class equity.

Teach about the antipoverty work of Martin Luther King Jr. Fight to ensure that school meal programs offer healthy options. Examine proposed corporate-school partnerships, rejecting those that require the adoption of specific curriculums or pedagogies. Most important, we must consider how our own class biases affect our interactions with and expectations of our students. And then we must ask ourselves, Where, in reality, does the deficit lie? Does it lie in poor people, the most disenfranchised people among us?

Does it lie in the education system itself—in, as Jonathan Kozol says, the savage inequalities of our schools? Or does it lie in us—educators with unquestionably good intentions who too often fall to the temptation of the quick fix, the easily digestible framework that never requires us to consider how we comply with the culture of classism. Do the differences make a difference? An empirical evaluation of the culture of poverty in the United States. American Anthropologist, 6 3 , — Why does the gap persist?

Educational Leadership, 62 3 , 8— Culture and poverty in Appalachia: A theoretical discussion and empirical analysis. Social Forces, 53 2 , — Miseducating teachers about the poor: A critical analysis of Ruby Payne's claims about poverty. Teachers College Record, When unmet basic needs and poverty-associated risks are identified, pediatricians can refer families to appropriate community services and public programs. Key partners may include local and state public health departments, legal services, social work organizations, food pantries, faith-based organizations, and community development organizations.

Some communities also may have innovative financial literacy programs that are helpful. Engage with early intervention programs and schools to promote learning and academic achievement. Education professionals are often very involved in efforts to help children from low-income backgrounds with academic achievement and also may participate in initiatives focused on basic needs, such as feeding programs, clothing drives, and health screenings.

Pediatricians can actively participate with these efforts as well as early intervention programs, after-school programs, tutoring programs, and social services provided through the school district. Pediatricians should be familiar with local MIECHV programs and how to connect their patients with home visiting programs on the state and local levels.

Opportunities for enhanced communication between the FCMH and home-visiting programs may be explored, including the possibility of collocation of visitors in the FCMH as an integrated service model. Support community programs that enhance the involvement of fathers in the lives of their children.

Pediatricians can be an important support resource and advocate for community-based fatherhood initiatives. When possible, nonresidential fathers should be involved in all aspects of pediatric care. Advance strategies to address family and child mental health and development. Pediatricians are strongly encouraged to include routine screening for maternal depression at every health supervision visit during the first year of life and to be able to provide an appropriate referral for treatment when depression is suspected.

Pediatricians can advocate for increased resources to address mental health and behavioral issues in poor communities, including separate payment for screening for parental depression and for care coordination activities. Advocate for public policies that support all children and help mitigate the effects of poverty on child health. Pediatricians can serve as important advocates for policies that help children and families in poverty.

Pediatricians can add a unique voice to poverty-related advocacy by reframing poverty as an evidence-based health concern with lifelong health, social, and economic consequences. Poverty and other adverse social determinants have a detrimental effect on child health and are root causes of child health inequity in the United States. Knowledge is expanding rapidly, especially regarding the neurobiological effects of poverty and related environmental stressors on the developing human brain as well as the life course of chronic illness.

Understanding the causative relation between early childhood poverty and adult health status should inform and influence the decisions of policy makers, researchers, and community pediatricians. The evidence strongly suggests that the FCMH with its enhanced capabilities is an essential asset in efforts to ameliorate the adverse effects of poverty on children. The AAP considers child poverty in the United States unacceptable and detrimental to the health and well-being of children and is committed to its elimination.

The AAP calls for concerted action by its state chapters as well as governmental, private, nonprofit, faith-based, philanthropic, and other advocacy organizations to reduce child poverty by supporting and expanding existing programs that have been shown to work and to make efforts to develop, identify, and promote other potentially effective policies and programs.

Together, these 2 pieces of legislation have greatly reduced and nearly eliminated poverty in the elderly. It is time to enact similar reforms to eliminate child poverty. By embracing the policies and enacting the recommendations in this statement, the AAP joins with governmental, philanthropic, private, and other health care organizations in a concerted and dedicated effort to eliminate child poverty in the United States.

We acknowledge the following University of California—Los Angeles pediatric and med-peds residents for their research contributions to this policy statement: Klein, MD, Ashley E. Maufe, MD, Colin L.

A companion to this article can be found online at www. This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics.

Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

Policy statements from the American Academy of Pediatrics benefit from expertise and resources of liaisons and internal AAP and external reviewers. However, policy statements from the American Academy of Pediatrics may not reflect the views of the liaisons or the organizations or government agencies that they represent. The guidance in this statement does not indicate an exclusive course of treatment or serve as a standard of medical care.

Variations, taking into account individual circumstances, may be appropriate. All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time. This measure does not take into account government benefits eg, SNAP , income tax credits, or family expenses eg, child care, income taxes and has not fundamentally changed since except for annual adjustments for food price inflation.

The SPM includes the value of certain federal in-kind benefits, federal tax benefits, and family expenses. We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Skip to main content. Search for this keyword. From the American Academy of Pediatrics. Abstract Almost half of young children in the United States live in poverty or near poverty. Statement of the Problem Poverty is an important social determinant of health and contributes to child health disparities.

What Works To Ameliorate the Effects of Child Poverty Programs that help poor families and children take many forms and often involve stakeholders from multiple communities, including governmental, private nonprofit, faith-based, business, and other philanthropic organizations. Early Childhood Education Early Head Start and Head Start are federally funded, community-based programs for low-income families with young children.

Nutrition Support The Supplemental Nutrition Program for Women, Infants, and Children WIC is a federal assistance program of the US Department of Agriculture that was first established in with the aim of improving the health of low-income women, infants, and children. Family and Parenting Support in the Medical Home Programs designed for the pediatric medical home provide opportunities for low-cost, population-based preventive intervention with low-income families.

Early Identification of Families in Need of Services To link families to services as early as possible, pediatricians can use screening tools that have high sensitivity and specificity. Recommendations As the health care system increasingly focuses on efforts to improve quality and contain costs, there may be new opportunities to restructure the health care delivery system in ways that can improve care for children in low-income families.

Opportunities for Public Policy Advocacy Public policy efforts are needed to protect the health of children affected by poverty and to help families become economically secure. Opportunities for Community Practice The following recommendations address how individual pediatricians can support the health and well-being of children living in poverty.

Conclusions Poverty and other adverse social determinants have a detrimental effect on child health and are root causes of child health inequity in the United States. Lead Authors James H. Staff Camille Watson, MS. Acknowledgments We acknowledge the following University of California—Los Angeles pediatric and med-peds residents for their research contributions to this policy statement: The effects of poverty on children.

Salivary cortisol mediates effects of poverty and parenting on executive functions in early childhood. Early childhood adversity, toxic stress, and the role of the pediatrician: Trends in the prevalence of developmental disabilities in US children, The Price We Pay: Economic and Social Consequences of Inadequate Education. Brookings Press ; The lifelong effects of early childhood adversity and toxic stress.

The economic costs of childhood poverty in the United States. The economic value of opportunity youth. Corporation for National and Community Service ; Accessed January 11, Innocenti Report Card Organization for Economic Cooperation and Development.

Current population reports, P, income and poverty in the United States: US Government Printing Office; One in five children receive food stamps, Census Bureau reports. Accessed September 28, Kids Count Data Center. Accessed July 31, International comparisons of economic mobility. Getting ahead or losing ground: The Brookings Institution ; Economic mobility in the United States. Accessed December 27, University of California Berkeley ; The state of working America: Childhood and intergenerational poverty.

National Center for Children in Poverty ; The geography of despair. Confronting Suburban Poverty in America. Building stronger communities for better health. Accessed December 28, Council on Community Pediatrics. Providing care for children and adolescents facing homelessness and housing insecurity. Mediators and adverse effects of child poverty in the United States. Waging War on Poverty: National Bureau of Economic Research ; Center on Budget and Policy Priorities.

The impact of the earned income tax credit on incentives and income distribution. Poterba JM , ed. Tax Policy and the Economy. MIT Press ; TANF weakening as a safety-net for poor families. Declining fortunes of children in middle-class families: Foundation for Child Development ; Minimum wages and the distribution of family incomes.

UMass Amherst Working Paper. Issacs JB , Magnuson K. Brookings Institute ; Early-childhood poverty and adult attainment, behavior, and health.

Welfare reform, work, and child care. Cohen J , Ewen D. Infants and toddlers in child care [policy brief]. Zero to Three ; Economic Policy Institute; MacGillvary J , Lucia L.

Economic impacts of early care and education in California. Taxation and the family. How does the tax system subsidize child care expenses? Abdus S , Selden TM. Adherence with recommended well-child visits has grown, but large gaps persist among various socioeconomic groups. Preventive care for children in low-income families: Med Care Res Rev.

Head Start Program facts fiscal year Learning, thriving and ready to succeed. Zero to Three; Accessed January 19, Proven benefits of early childhood interventions [research brief]. Rand Corporation ; The case for investing in disadvantaged young children.

Big Ideas for Children: First Focus ; Prepared by Insight Policy Research under contract no. Early childhood WIC participation, cognitive development and academic achievement. Executive Office of the President of the United States. Long-term benefits of the Supplemental Nutrition Assistance Program. SNAP benefits alleviate the intensity and incidence of poverty. National School Lunch Program. A New Majority Research Bulletin: Southern Education Foundation; Changes in body mass index associated with head start participation.

Health Resources and Services Administration. Home visiting evidence of effectiveness review: Accessed January 3, Infant Ment Health J. Promoting early literacy in pediatric practice: Fostering early development and school readiness in pediatric settings. Dickinson D , Neuman SB , eds. Handbook of Early Literacy Research. Healthy Steps for Young Children: Improving parenting skills for families of young children in pediatric settings: Prevention of behavioral disorders in primary care.

Kindergarten readiness and performance of Latino children participating in Reach Out and Read. J Community Med Health Educ. The impact of a clinic-based literacy intervention on language development in inner-city preschool children.

Pilot study of medical-legal partnership to address social and legal needs of patients. J Health Care Poor Underserved. Vasan A , Solomon BS. Use of colocated multidisciplinary services to address family psychosocial needs at an urban pediatric primary care clinic.

Council on Community Pediatrics Committee on Nutrition. Promoting food security for all children. Development and validity of a 2-item screen to identify families at risk for food insecurity.

Development of a tool to identify poverty in a family practice setting: Int J Family Med. US housing insecurity and the health of very young children. Am J Public Health. An integrated scientific framework for child survival and early childhood development.

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