My good friend, Charles Senteio possesses a wisdom far beyond his years. If you asked him where he received such a gift, we likely would begin talking about his parents.
Charles is program director for Central Dallas Ministries' Institute for Faith Health Research Dallas. He leads our efforts at community-based research, education and advocacy around health and wellness issues here in inner city Dallas.
We are very fortunate to have him.
He comes from a strong business and consulting background both academically and professionally. He is on his way to medical school. We will have him here with us for about another year. We are blessed as a result.
Just last week during one of our regular, weekly "core dumps" with our mutual friend, Dr. Jim Walton, Charles made a statement that caused me to pull out my journal and start writing--not what I normally do on social occasions when relaxation is the agenda!
"The health care problem of the poor is that they feel like they don't matter," Charles declared.
We sat in silence for a bit.
Let that assessment soak in for a moment.
When I feel as if no one cares about my issues, my situation, my problems, my life, my well-being, my survival. . .the impact on my soul can be profound. Such an evaluation creates a personal, psychic context, a self-understanding that takes on a power all its own--a negative power.
If I truly believe no one cares, that belief system begins to affect my behavior. It directs my use of scarce resources.
It may lead me to make negative choices.
My acts of self-determination may seem erratic, ill-advised or irrational to those who don't understand my starting point.
Media may then begin reporting on my life, my choices and my actions. The result can then become a self-perpetuating "feedback loop" of sorts, making certain that negative outcomes continue to "justify" the obvious lack of concern for my health and well-being since I don't make good choices myself.
Discussions about the importance of "personal responsbility" now become code for the "undeserving among us."
Research tells us that factors such as choice, opportunity, collective efficacy and control are all key determinants for a healthy life and community.
When I really feel as if I don't matter, the intangible forces that accompany a sense well-being and personal control simply elude me.
Far too often the results are negative from a health outcomes perspective.
At another time, in a future post, I'll discuss a recent essay I read about health disparities and race. The writer's thesis is shocking, but statistically verifiable: race can be a cause of death. This particular analysis points back to some of the same factors Charles raises with his simple statement about the number one health issue facing poor folks.
Charles' personal, life mantra is very simple: "Everybody matters!"
Our job now is to convince everyone, including policy makers, that this is an absolute truth.
You and I don't agree here, Justin. The way you characterize government involvement is inaccurate, especially now. We receive government funding for our programs and I can assure you what you say in your post is not our message to our neighbors at all.
ReplyDeleteGovernment supported health care, housing, education, and employment programs would not have to convey such a negative message. Adequate expressions of such public efforts would and do convey a positive message about the human worth of those who receive such opportunities. I have observed that most of the negatives come from those who sit in judgment of hte poor and from actions that cut or all but eliminate funding for the benefit of those at the bottom.
Here in Dallas the work of the Dallas Housing Authority is sending very strong, positive messages to the community about the value of all of our citizens. Our public hospital system does the same.
It seems to me that your comments reflect a very one-sided view of government involvement. Of course, currently the government programs are being cut back even further. I could go on with much more here, but Google my blog on topics like the war on poverty, food stamps, public health and community development and you will get more of my viewpoint.
I grew up in the same church tradition as you, I expect. That has played a huge part in shaping anti-government perspective, especially in the South. I reject almost all of that thinking.
Thanks for your post.
Even if it doubled -- no, tripled -- philanthropy would still be no match for government support. When fighting something as entrenched and systemic as poverty, how can churches compete?
ReplyDeleteImagine saying that the government should stop paying for a military, and we should rely on privately funded militias to defend our country. I assume you would laugh at such an idea. Why, then, would you not expect that we need an attack of equal force against poverty?
Poverty claims far more lives each year than terrorism ever will.
To put it into comparison: thanks to the recent Warren Buffett donation, the Bill & Melinda Gates Foundation now has nearly $50Billion in assets -- roughly five times the amount of the second largest foundation (Ford). Despite this amazing generosity, the annual expenditure of these foundations still pale in comparison to the support provided by governments of the world. I believe, for example, that the NIH (National Institutes of Health) actually awards more research grants than the Gates Foundation.
Furthermore, equating communism with American social programs is ridiculous. Social programs are not about abolishing capitalism: they are about supporting the very heart of the American ideal, that the government should provide for the general welfare of the people and allow us to achieve our potential.
Poverty crushes potential. This is not about personal responsibility; this is about systemic reality.
If you look at the impact of American social programs, they have a positive effect on communities and eliminate poverty. As Larry frequently reminds us, LBJ's War on Poverty dramatically decreased poverty (particularly among minorities).
It all comes back to Larry's post, and Charles' comment: The poor do not matter to the rich.
"For the poor will never cease to be in the land; therefore I command you, saying, 'You shall freely open your hand to your brother, to your needy and poor in your land.'" Deut.15:11
ReplyDelete"Give to him who asks of you, and do not turn away from him who wants to borrow from you." Matt. 5:42
"Is this not the fast which I choose, to loosen the bonds of wickedness, to undo the bands of the yoke, and to let the oppressed go free and break every yoke? Is it not to divide your bread with the hungry and bring the homeless poor into the house; when you see the naked to cover him, and not to hide yourself from your own flesh?" Isa.58:6-7
"Whoever has the world's goods, and sees his brother in need and closes his heart against him, how does the love of God abide in him?" John 3:17
Jesus said, "Whatever you have done to the least of these my brothers, you have done unto me." Matt. 25:40
"The health care problem of the poor is that they feel like they don't matter"
ReplyDeleteThis statement is indeed chilling, especially as a medical student. I fear that I am entering a profession that has slowly transitioned from its roots in compassion and caring into the great mess of market based medicine that nearly makes these two things impossible for the physician to practice. Because the poor cannot participate within the market, the quality of care by physicians is doubly compromised, which continues the loop. It is impossible to have a healthy individuals when there are rampant socal injustices.
http://amberlehmann.blogspot.com/2006/02/choices-and-health.html
Larry,
ReplyDeleteI work for Harding University's Physician Assistant Program and we are working to expand our sites for clinical rotations--especially those in underserved settings. Who should we contact to see about sending some of our students to work with the clinic? My email address is jaedwards(at)harding.edu
Justin,
ReplyDeleteHey, gotta agree with Larry here, as an actual social worker.
Used to be, welfare could and sometimes did perpetuate poverty - but with the welfare reform that turned AFDC into TANF, there are measures put into those programs which teach self-sufficiency, and there is FAR more accountability than used to be.
Government sources help FAR more than they hinder with respect to the war on poverty.
There are grant funds available from SAMHSA, HUD, Domestic Violence-specific funds, Faith-Based and Community Initiatives, etc etc, that help ALL of our local "private" non-profit agencies, as well as State, County, and Municipal grant dollars that keep their doors open. Ask a human services provider with 501 (c) 3 status (non-profit) if they can do what they do without ANY gov't funding - the answer will be a resounding NO.
Thanks again Larry for illuminating very important issues. As I re-read the comments I am struck at how the dialogue very quickly went to the government policy. I may be exposing my naiveté here but aren’t we supposed to be the government? Isn’t the government supposed to represent what we think? Call me crazy but I think it does, we don’t care at the level that we sometimes think we do. The point here is that the spirit of the comment says more about me (us) than it does about the poor (them).
ReplyDeleteEssentially our very human actions of devaluing some lives and valuing others is at the heart of the root cause. I believe a solution requires a mirror much more than it does an examination of social policy.
My quote was incomplete in that it only captures part of the issue, in order for us to work towards meaningful and sustained solutions we MUST come to grips with the notion that the poor, at least in some circumstances, were not born with these feelings …. We in large part gave it to them and continue to do so.
"The health care problem of the poor is that they feel like they don't matter, our inaction reinforces those feelings."
The poor don’t feel like they matter because I am doing nothing to let them know that they do. We must individually examine ourselves and understand if, and to what degree, we feel connected to our fellow man. I love to have conversations with religious folk who will go to far away lands and get potable water for the ‘natives’ and talk to them about Jesus. Is water what they need from you? Did you ask them? What do you need from them? Well, what about the poor, disenfranchised folk that live among us? Why are we so willing to travel to far away lands, or even outside of Searcy, to dispatch people and resources that may be afflicted with the apathy bug to the degree that the change they profess to catalyze is over before they even land back home? Did the desired reaction even start? Let’s see about putting more energy in examining ourselves and digesting what Dr. King so eloquently wrote about mutuality and reciprocity. Do we really care? Do I believe that we are all connected in a web of mutuality, that affects one of us directly affects all of us indirectly? It is OK not to and work with that, but don’t profess to care at a level that is not consistent with your actions. Prayer without deeds is indeed dead.
Jeremy included some very familiar passages that are dear to me, in fact I’ve shared some with the incarcerated fellas I go to visit. My effectiveness with them, and theirs with me, started to kick in when I digested – really digested – that my success was tied to theirs, and theirs to mine. That is what my God is trying to say to me, and I have to work daily to listen and act on those messages. A few months back I was invited to speak to a health care policy class at the University of Texas at Dallas, most of them were doctoral students who were curious about how to be ‘effective’ in making positive change in poor communities. They wondered how I did this. I told them that the first step was to, before you leave the house, try and understand if and to what degree you are connected to the people you are professing to help. Until you get to this point you will not be as effective as you could be. Those people that catalyze change in my own life do so through deeds, deeds that reinforce our connection. They kick my ass when I’m doing bad and pat me on the back when I’m doing good. These two expressions of connectively are only 18 inches apart, they are very similar acts. This ‘caring’ requires a large emotional investment which sets the stage for connectivity. I am still very early on this journey but I strongly believe that a deep notion of connectivity is where it starts. Go back and read the passages Jeremy included and ask yourself to what degree you believe them, then ask to what degree you live them. JFK said it very well in his inaugural speech, “…here on earth God’s work must truly be our own.”
Jacob, thanks for your post! I have referred your message to Keith Ackerman, our COO and to Marcus Bryd, our medical practice administrator. They will be in touch!
ReplyDeleteJohn, thanks for the statistical documentation. I felt like it would be coming.
Justin, I do believe you, like many really fine people, buy into the myths that have been perpetrated since 1980 on the voting public. Everything from Mr. Reagan's "welfare Cadillac" to supply-side economic theory has shaped our public policy in a very bad way for low-income Americans.
A couple of additional facts. The most efficient "insurance company" in America is Medicare in terms of administrative costs. If we shifted from private insurance to a single-payer system we would save a minimum of $45 billion annually in admin costs. Public insurers such as Medicare and Medicaid don't enjoy richly appointed offices, stockholder demands, etc.
Why do we look to government for solutions to middle and upper class problems, but not under class issues? The G.I. Bill educated and launched America's middle class after WWII. Why wouldn't such a plan help with American poverty? Cutting capital gains taxes, cutting income taxes and eliminating the estate tax are actions aimed at "helping" the upper classes, often at the expense of those at the bottom.
Finally, I don't think we can be taken seriously by continuing to talk as if the church will 1) really step up the plate with great passion and creativity to address the issues associated with poverty or 2) act as if the church, even if it were committed to engage, has the capacity to address problems of this scale.
In short, Justin, I think you have been unduly influenced by the dominant political culture of your denomination.
Charles, thanks for your words. I wish everyone who visits this site could meet you. Your words help make that a virtual reality!
ReplyDeleteLibertarian. Oh, now we all understand.
ReplyDeleteJustin, not talked "down to," just given some facts. When you spout off stats about govt failure that are untrue, you can expect to be corrected.
ReplyDeleteLook at what churches are actually doing in this country. Case closed.
Anonymous, correct! Look at Memphis, TN and its current racial climate in the churches, forget the city. Some folks with power and privilege just want to keep it no matter who is hurt or how many.
ReplyDeleteThis comment has been removed by a blog administrator.
ReplyDeleteJustin, the Laffer curve's theory relies on tax cuts to the majority (i.e. mid and lower incomes), those folks generally spend almost all of the money that they earn (therefore transfering income tax to sales, property and other "consumption" taxes).
ReplyDeleteCutting taxes to the wealthy only results in more money locked out of the system, since the rich generally invest or save their "net."
Investing in the poor is investing in the community.
As far as your question about why Jesus did not overtake Rome, I think he said it best when he said "render unto Caesar what is Caesar's."
Governments are worldly institutions created to address worldly concerns. Poverty is the most significant concern in our community, as it is directly related to the other problems that we all acknowledge governments should address (health, crime, etc.).
On a related note, you should read this interesting story about the loss of hope (from The Dallas Morning News).
No insinuations about character needed!
ReplyDeleteHowever, I do question the idea that the removal of US taxes would result in the rich moving their money back into the US. The more you have, the tighter you squeeze.
Justin, thanks for your comments. They are appreciated, even when I strongly disagree.
ReplyDeleteThe intention of this site is not to judge you. The intention is to focus on the enormity of the challenge and the depth of the problems of the poor.
We disagree in approach.
The church in its status quo is not up to the challenge. The people still suffer. The government is not doing what it could and should in my opinion. So, I speak out.
Cutting good, solid, useful programs--like Medicaid and housing--to pay for only a part of an irrational tax cut for the wealthiest is not only bad public policy, it is a moral issue. And not just to the "social justice/Sojourners crowd," as you call us. As I said earlier, Amos, Isaiah, Micah, and even Jesus would have something to say to this situation (see Luke 20:45-47 where Jesus blasted the wealthy religious leaders who exploit and grow wealthy at the expense of the poor widow to whom he turns in the next paragraph at Luke 21:1-4; then take a look at the very surprising word at Luke 11:39-41--he gets his points in everywhere!).
I don't see how we can ignore the amazing scale of the problem of poverty or the clear mandate of scripture on the subject.
Thanks for the post, Justin.
ReplyDeleteI agree with have to teach and persuade.
I just don't have time, from where I sit daily (and that is part of my problem), to wait on people to have a change of heart and "get it." Why do people deserve that luxury when so many suffer and die?
Had we waited on "hearts to change" there would have been no Civil Rights Movement--I think here of Dr. King's "Letter from a Birmingham Jail.'
And then, there is the continuing reality of the sheer scale of the problem.
Thanks, John. Your factual approach is indisputable.
ReplyDeleteThe sad reality is people are not passionately concerned, either in churches or in the political arena, to really take serious action or make sustantive progress on poverty in this nation or around the world.
"Of course, none of that is going to happen, and probably shouldn't."
ReplyDeleteHmmm... I might actually be pretty happy if all of that DID happen -- Not that it would solve much of anything, I'm just not too big on a lot of things "church" spends its money on. Maybe it would at least get churches more outward focused.
Good financial point, though... helps put it in perspective how dwarfed the church is compared to government spending.