Health Care Poverty Homelessness Housing and Employment - Poverty

The U.S. Census Bureau first began tracking poverty data in America in 1959. The following year it counted 39.9 million Americans, or about 22.2% of the population, living below the poverty level. Changes in the definition of poverty levels over the years make pre-1980 comparisons difficult, but the percentage fell to 12.3% in the mid-1970s and fluctuated over the next two decades, hitting 14% in 1985. In 2001 the poverty rate stood at 11.7% and rose to 12.1% in 2002 and 12.5% in 2003. While the poverty rates for adults and senior citizens hovered around 10–11%, the poverty rate for children under age eighteen rose almost a full percentage point from 16.7% to 17.6% between 2002 and 2003. (See Table 5.1.)

Minorities in America have historically experienced higher rates of poverty. In 1959 the poverty rate for African-Americans was 55%, compared to 18% for whites. The African-American poverty rate tumbled in the 1960s and made another significant decline during the 1990s. In 2001, however, the poverty rate for African-Americans was 22.7% and 21.4% for Hispanics, while the rates for Asian and Pacific Islanders, white, and non-Hispanic white populations were at or below 10%. In 2002 and 2003 the African-American poverty rate stabilized at 24.4%. Similar poverty rates were recorded for Native Americans (23.2%) and Hispanics (22.5%). (See Table 5.1.)

Between 1980 and 2003 the Census Bureau's poverty threshold for a family of four increased 125%. The Census Bureau poverty threshold for 2003 was $18,660 for a family of four that included two children. (See Figure 5.1.)

Working Poor Families

Having a job did not necessarily shield a family from poverty. In 2001 about 6.8 million people were classified as working poor. They represented 4.9% of the workforce, an increase from 4.7% in 2000.

TABLE 5.1

Poverty rates, 2002–03
(Percent)
	2002	2003
SOURCE: Adapted from Income, Poverty, and Health Insurance Coverage in the United States: 2003, P60-226, U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau, August 2004, http://www.census.gov/prod/2004pubs/p60-226.pdf (accessed September 13,2004)
National	12.1	12.5
Children under 18	16.7	17.6
Adults 18–64	10.8	10.8
Adults over 65	10.2	10.2
White, non-Hispanic	8.2	8.2
African-American	24.4	24.4
Asian	10.1	11.8
Native American	23.2	23.2
Hispanic	22.5	22.5
Foreign-born citizens	10.0	10.0
Foreign-born noncitizens	21.7	21.7

Often lacking job skills and adequate child care and health care, the working poor faced problems such as low-wage jobs (43.8%), reduced hours of work (1.7%), and periods of unemployment (10.4%), according to 2004 data from the U.S. Department of Agriculture. (See Figure 5.2.) Only 2.6% of those who worked full-time year-round were below the poverty level, but 11.8% of those who either worked part-time, seasonally, or intermittently fell below the poverty mark.

Food Stamps

The Food Stamp Program was established in 1964 as part of the Lyndon Johnson administration's "War on Poverty." The program helps needy families and individuals pay for enough food to live on. The U.S. Department of Agriculture reported that in an average month in 2002, 8.2 million households received food stamp benefits. Fifty-four percent of these households included children,

FIGURE 5.1

and most were headed by a single female. Nineteen percent of households receiving food stamps were elderly people, most living alone. Twenty-seven percent of food stamp households were persons with disabilities, and more than half lived alone. The average monthly food stamp benefit in 2002 was $173.00. A household with children (average 3.3 people) received $254.00, compared to a two-person household with one or both persons disabled receiving $64.00 per month.

Increased Requests for Food Assistance in Cities

In The U.S. Conference of Mayors—Sodexho Hunger and Homelessness Survey 2003, an average of 39% of adults who requested food assistance were employed. Working parents in Charleston, South Carolina, had difficulty getting to the Food Stamp Office during business hours. San Antonio, Texas, reported a 30% child poverty rate and noted that many clients lost their food stamp eligibility due to welfare reform but were unable to provide adequate food for their families. In Portland, Oregon, 55% of households served with emergency food included children. The Greater Boston Food Bank reported a 50% increase in requests for milk, cereal, and nutritious snacks for children. Louisville, Kentucky, reported a 20% increase in distribution of baby formula.

Thirteen percent of requests for food assistance recorded in the survey came from the elderly. Many cities reported the elderly and disabled on fixed incomes struggled with the rising cost of prescription medications and

FIGURE 5.2

rising utility bills. The increase in senior citizen requests for assistance in Louisville, Kentucky, was proportional to the financial cuts in Medicare and Medicaid. Food resources were an issue for grandparents in Philadelphia, Pennsylvania, who were taking care of grandchildren while trying to remain healthy themselves. An estimated 14% of requests for emergency food went unmet. In addition to lack of agency resources, cities reported that some families were too proud to ask for help and some frail elderly people were unable to get to food pantries.

Low-Income, Female-Headed Families

In 1947 the median family income was $3,031. The median income for a similarly situated family in 2001 was $51,407. The value of a dollar, however, changed over the years with inflation. For a more equitable comparison, Table 5.2 shows actual dollars converted to "constant" dollars (adjusted for inflation). The $3,031 family income from 1947 would be worth $20,402 in 2001 dollars. In 1947 the median family income for a female householder with no husband present was 72% of that earned by the average family, but declined by 1950 to 58%. The decline in family income for female-headed families continued downward to a low of 48% of average family income in 1990. In a slight upturn, however, female-headed families had median 2001 income equal to 50% of the average family income.

Health Insurance Challenges

The availability of affordable health insurance became a serious national concern as costs of health care rose in the

TABLE 5.2

Median family income by race and type of family, 1947–2001
	Median income in current dollars						Median income in constant (2001) dollars
				Married-couple families		Female house–holder, no husband present				Married-couple families		Female house–holder, no husband present
Year	All families1	White	Black2	Total	Wife in paid labor force		All families1	White	Black2	Total	Wife in paid labor force
NA Not available.
1Includes other races not shown separately.
21947–1966, Black and other races.
SOURCE: Adapted from "No. HS-25. Money Income of Families—Median Income in Current and Constant (2001) Dollars by Race and Type of Family, 1947–2001," Statistical Abstract of the United States, 2003, U.S. Census Bureau, September 30, 2002, http://www.census.gov/statab/hist/HS-25.pdf (accessed August 2,2004)
1947	3,031	3,157	1,614	3,109	(NA)	2,172	20,402	21,250	10,864	20,927	(NA)	14,620
1948	3,187	3,310	1,768	3,272	(NA)	2,064	19,846	20,612	11,009	20,375	(NA)	12,853
1949	3,107	3,232	1,650	3,195	3,857	2,103	19,584	20,372	10,400	20,139	24,311	13,256
1950	3,319	3,445	1,869	3,446	4,003	1,922	20,668	21,452	11,638	21,458	24,927	11,968
1951	3,709	3,859	2,032	3,837	4,631	2,220	21,391	22,256	11,719	22,129	26,709	12,803
1952	3,890	4,114	2,338	4,061	4,900	2,235	22,040	23,310	13,247	23,009	27,763	12,663
1953	4,242	4,398	2,466	4,371	5,405	2,455	23,825	24,702	13,850	24,550	30,357	13,789
1954	4,167	4,338	2,416	4,333	5,336	2,294	23,252	24,206	13,481	24,179	29,775	12,801
1955	4,418	4,613	2,544	4,599	5,622	2,471	24,706	25,797	14,227	25,718	31,439	13,818
1956	4,780	5,002	2,632	4,973	5,957	2,754	26,387	27,613	14,530	27,453	32,885	15,203
1957	4,966	5,168	2,763	5,157	6,141	2,763	26,506	27,584	14,747	27,525	32,777	14,747
1958	5,087	5,300	2,715	5,315	6,214	2,741	26,387	27,492	14,083	27,570	32,233	14,218
1959	5,417	5,643	2,915	5,662	6,705	2,764	27,930	29,095	15,030	29,193	34,571	14,251
1960	5,620	5,835	3,230	5,873	6,900	2,968	28,464	29,553	16,359	29,746	34,947	15,032
1961	5,735	5,981	3,191	6,037	7,188	2,993	28,764	29,998	16,005	30,279	36,052	15,012
1962	5,956	6,237	3,328	6,263	7,461	3,131	29,585	30,981	16,531	31,110	37,061	15,552
1963	6,249	6,548	3,465	6,593	7,789	3,211	30,627	32,093	16,982	32,313	38,175	15,738
1964	6,569	6,858	3,838	6,932	8,170	3,458	31,773	33,171	18,564	33,529	39,516	16,726
1965	6,957	7,251	3,993	7,265	8,597	3,532	33,152	34,553	19,028	34,620	40,967	16,831
1966	7,532	7,825	4,691	7,838	9,246	4,010	34,861	36,217	21,712	36,277	42,794	18,560
1967	7,933	8,234	4,875	8,441	9,956	4,294	35,629	36,981	21,895	37,911	44,715	19,286
1968	8,632	8,937	5,360	9,144	10,686	4,477	37,275	38,592	23,146	39,486	46,145	19,333
1969	9,433	9,794	5,999	10,001	11,629	4,822	39,034	40,528	24,824	41,385	48,121	19,954
1970	9,867	10,236	6,279	10,516	12,276	5,093	38,954	40,411	24,789	41,516	48,465	20,107
1971	10,285	10,672	6,440	10,990	12,853	5,114	38,878	40,341	24,344	41,543	48,585	19,331
1972	11,116	11,549	6,864	11,903	13,897	5,342	40,764	42,352	25,171	43,650	50,962	19,590
1973	12,051	12,595	7,269	13,028	15,237	5,797	41,590	43,467	25,086	44,961	52,585	20,006
1974	12,902	13,408	8,006	13,923	16,221	6,488	40,513	42,102	25,139	43,719	50,935	20,373
1975	13,719	14,268	8,779	14,867	17,237	6,844	39,784	41,376	25,458	43,113	49,985	19,847
1976	14,958	15,537	9,242	16,203	18,731	7,211	41,023	42,611	25,347	44,438	51,371	19,777
1977	16,009	16,740	9,563	17,616	20,268	7,765	41,271	43,156	24,653	45,414	52,251	20,018
1978	17,640	18,368	10,879	19,340	22,109	8,537	43,601	45,400	26,890	47,803	54,647	21,101
1979	19,587	20,439	11,574	21,429	24,861	9,880	44,255	46,180	26,151	48,417	56,171	22,323
1980	21,023	21,904	12,674	23,141	26,879	10,408	42,776	44,569	25,788	47,086	54,691	21,177
1981	22,388	23,517	13,266	25,065	29,247	10,960	41,642	43,742	24,675	46,622	54,400	20,386
1982	23,433	24,603	13,598	26,019	30,342	11,484	41,151	43,206	23,880	45,693	53,285	20,167
1983	24,580	25,757	14,506	27,286	32,107	11,789	41,444	43,428	24,458	46,006	54,135	19,877
1984	26,433	27,686	15,431	29,612	34,668	12,803	42,858	44,890	25,020	48,012	56,210	20,759
1985	27,735	29,152	16,786	31,100	36,431	13,660	43,518	45,742	26,339	48,798	57,163	21,434
1986	29,458	30,809	17,604	32,805	38,346	13,647	45,393	47,475	27,127	50,551	59,089	21,029
1987	30,970	32,385	18,406	34,879	40,751	14,683	46,151	48,259	27,428	51,976	60,726	21,880
1988	32,191	33,915	19,329	36,389	42,709	15,346	46,285	48,763	27,792	52,321	61,408	22,065
1989	34,213	35,975	20,209	38,547	45,266	16,442	47,166	49,595	27,860	53,141	62,404	22,667
1990	35,353	36,915	21,423	39,895	46,777	16,932	46,429	48,480	28,135	52,394	61,432	22,237
1991	35,939	37,783	21,548	40,995	48,169	16,692	45,551	47,888	27,311	51,959	61,052	21,156
1992	36,573	38,670	21,103	41,890	49,775	17,025	45,221	47,814	26,093	51,795	61,544	21,051
1993	36,959	39,300	21,542	43,005	51,204	17,443	44,586	47,410	25,987	51,880	61,771	21,043
1994	38,782	40,884	24,698	44,959	53,309	18,236	45,820	48,304	29,180	53,118	62,984	21,546
1995	40,611	42,646	25,970	47,062	55,823	19,691	46,843	49,191	29,956	54,284	64,390	22,713
1996	42,300	44,756	26,522	49,707	58,381	19,911	47,516	50,275	29,792	55,836	65,580	22,366
1997	44,568	46,754	28,602	51,591	60,669	21,023	49,017	51,421	31,457	56,741	66,726	23,122
1998	46,737	49,023	29,404	54,180	63,751	22,163	50,689	53,168	31,890	58,761	69,142	24,037
1999	48,950	51,224	31,778	56,676	66,529	23,732	51,996	54,411	33,755	60,202	70,668	25,209
2000	50,890	53,256	34,192	59,184	69,463	25,794	52,310	54,742	35,146	60,836	71,402	26,514
2000	50,732	53,029	33,676	59,099	69,235	25,716	52,148	54,509	34,616	60,748	71,167	26,434
2001	51,407	54,067	33,598	60,335	70,834	25,745	51,407	54,067	33,598	60,335	70,834	25,745

FIGURE 5.3

1990s. The percentage of the nation's population without coverage grew from 15.2% in 2002 to 15.6% in 2003. Among people who were employed in 2003, 60.4% had some type of employment-based health insurance, but this figure was a decrease from 60.3% in 2002. For people in poverty who could least afford medical expenses, obtaining adequate health coverage was a significant challenge. The percentage of people on government insurance plans rose from 25.7% in 2002 to 26.6% in 2003. (See Figure 5.3.)

"Since 2000, the cost of health insurance has risen 59%, while workers' wages have increased only 12%," said Jon Gabel of the Health Research and Educational Trust in September 2004. "Since 2001, employee contributions increased 57% for single coverage and 49% for family coverage, while workers' wages have increased only 12%. This is why fewer small employers are offering coverage, and why fewer workers are taking up coverage."

While the number of people with health insurance grew by one million from 2002 to 2003, the number of uninsured increased by 1.4 million. The largest increase among Americans without insurance was primarily among white, non-Hispanic residents.