Introduction
When Americans want to "do something" about poverty, we usually set about "improving poor people."1 We may

• offer education or job training,
• attempt to improve the parenting skills of young mothers,
• require addiction treatment as a condition of receiving housing,
• put a time limit on welfare benefits in order to motivate poor people to work, or
• limit welfare benefits to discourage additional childbearing.

The practice of improving poor people ha a long history in the United States. Early reformers traced extreme poverty to intoxication, laziness, and other kinds of unacceptable behavior, so they tried to use public policy and philanthropy to elevate the character of poor people, hoping to change the unacceptable behavior. Later reformers emphasized evangelical religion, temperance legislation, punitive conditions for relief, the forced breakup of families, and threats of institutionalization … all with the purpose of "improving poor people."

This approach rests in the belief that the primary causes of poverty are the individual characteristics of the poor themselves: ignorance, lack of training, addiction, laziness, poor character, sexual promiscuity, too many children, and so on. It's not surprising, of course, that a nation so strongly committed to individualism should also find the roots of poverty in individual characteristics.

In this brief book I want to look from a different point of view. I want to suggest that the primary causes of poverty lie not so much in individual behavior but in social structures, in forces outside of the individual's control. This is not to deny that some poor people could use some improving (as could most of us), but it is to suggest that the primary causes of American poverty lie elsewhere: in segregation, the lack of jobs on which one might support a family, inadequate access to health care, inadequate education, non-existent vocational training, particular historical realities, and so forth.

I am a physician. In 1983, after seven years as a Minnesota country doctor, I moved to Washington DC to practice medicine in the inner city. For five of those fifteen years my family and I lived in Christ House, a medical recovery shelter for homeless men. In 1990 we started Joseph's House, a community and hospice for eleven formerly homeless men dying with AIDs, where we also lived for three years.

So, I am no stranger to the individual weaknesses of poor people. It is the nature of a doctor's work to see people in trouble, and it often seemed that the immediate causes of my patients' poverty lay in their own behavior. For some, addictions consumed their time and energy. Others couldn't (or wouldn't) cooperate with my medical treatment plans. Still others lacked parenting skills or had no discernible job skills. And some didn't seem to want to work.

But the longer I worked with my patients the more obvious it became that virtually all of them were doing the best they could in the overwhelming environment they inhabited. The odds against which they were struggling, however, were overwhelming. In New American Blues,2 Earl Shorris writes about the "surround of force" confronting poor people. Living in the ghetto, one faces the drug trade, the problems within public housing, family violence, abuse, graffiti, landlords, criminals, illness, meanness, bad luck, guns, isolation, hunger, ethnic antagonisms, racism, and other obviously "bad" forces. But there are also some seemingly "good" forces that can make life miserable for the poor: the law, the media, government, helpers, merchandising, neighbors, police, and so on. And one has to contend with all of these forces—any one of which would be overwhelming—all at one time, without a break. When one problem is solved, three take its place. The cumulative effect of the "surround" is more than the sum of individual forces. There is no space to breathe.

After fifteen years in the inner city, I no longer believe that poverty should best be attacked by improving poor people. The argument that inner-city poverty comes primarily from the individual weaknesses of poor people simply cannot be sustained. Among African-American children in this country, half live in poverty. Among African-American males between the ages of eighteen and thirty-four in the city of Washington, half are in the criminal justice system. There are only two forms of explanation for these (and many other similar) statistics. Either African-American people are genetically predisposed to poverty or something has happened to them! Charles Murray's arguments in The Bell Curve notwithstanding, the scientific consensus offers no support to genetic inferiority as a cause of poverty. In this book I will argue what should by now be obvious: something awful has been done to poor people in this country.

But how does one explain, then, what appear to be significant rates of personal weaknesses among poor African Americans (and other groups of Americans in poverty)? How does one account for the extraordinarily high rates within the black ghettos of single parenthood (which is highly correlated with poverty), widespread substance abuse, poor parenting, criminal behavior? Where did it all begin? How did it perpetuate itself?

Even after fifteen years of urban medical practice, I could not have said. So, I decided to find out. I volunteered to teach a course on the causes of urban poverty and began to read. I was often shocked at how little I had known. This is a brief summary of what I've learned.3

Although this book is specifically about black, urban, ghetto poverty, it is important to remember that most poor people in the United States are neither black nor urban. The poor in our country are split pretty evenly between white, black, and Latin American, and the majority lives in rural areas or, increasingly, in the suburbs.

The meaning of the word "poverty," of course, is relative. For the purposes of simplicity, I will use the term "poor people" to refer to the economically poor, defined as those who live in families with incomes below the Federally determined poverty level. Although this definition of poverty is the most widely used in the United States, its history suggests that it probably understates the number of people who live in what most Americans consider poverty.

The "official poverty level" first seeped into government parlance in 1961 when the Social Security Administration needed an objective measure of poverty for statistical purposes. A staff economist chose to develop a standard based on the cost of food. Since it was estimated at the time that the average American family spent about a third of its income on food, the poverty level was defined as the cost of a minimum adequate diet multiplied by three. The poverty levels (which increase with increasing family size) have subsequently been updated annually for price inflation. To determine a family's poverty status, its resource—defined as cash income before taxes—are compared with the appropriate threshold for its size. In 1998, the poverty level for a single individual was an income of $8,050 per year; for a family of four, the level was $16,450.

The poverty level has been criticized both for being too low and too high. Because it excludes non-cash income (most importantly food stamps and housing subsidies), it can be criticized as too high for those who receive those benefits. On the other hand, the average American family in 1999 spends closer to one-fourth of its income on food than the one-third estimated in 1961, so it would be reasonable to reset the level by multiplying the least expensive food plan by four rather than by three. From a more practical point of view, the government fair market rent of $692 for a one-bedroom apartment is over 60% of the poverty level for a family of three. If food should cost 33% of that budget, that leaves 6% or $68 a month for all other expenses, including childcare and health care.

In 1998, after almost a decade of economic boom times, when unemployment was at its lowest level in decades, 13.3% of all Americans, more than one out of every eight people lived below a poverty level that underestimates what most of us would consider poverty. Almost 20% of all American children (and over 50% of African-American children) live in poverty. Why?

In the next pages, we will look at some answers.


Chapter I: The Formation of the "Black Ghetto"

By the early 1950s, the black, inner-city ghetto was already well formed. African Americans already lived in highly segregated, densely concentrated urban areas. These ghettos, however, differed significantly from their modern counterparts. Their levels of "social organization" were intact, that is to say, informal social networks kept neighbors in touch with one another, formal social networks (churches, fraternal organizations, and volunteer organizations) brought people together, and institutions such as businesses and schools made community viable. Most people worked. Single-parent families were a distinct minority (about 17%). Levels of violence were low. Education were "integrated vertically," meaning that affluent, middle-class, working-class, and poor people all lived in relatively close proximity. This is not to overlook the often severe poverty (with its related conditions) that existed, but the social organization still present made these ghettos vastly different from their modern counterparts. They were societies unto themselves that mirrored the larger society.

The seeds of the black ghetto's current problems had, however, already been planted. Most importantly, these areas were highly segregated. It had not always been so. Prior to the late 1800s, urban rich and poor, white and black lived in relatively close proximity, (whether they wanted to or not). The poor were often servants (or, previously, slaves) of the rich and so lived close by, and the still primitive modes of transportation made living close to the centers of business and commerce necessary for everyone.

With the coming of large manufacturing factories to northern cities during the industrialization of the late 1800s, however, workers were needed and wages were unprecedented, so immigrant workers flocked to the United States from Europe, Asia, and every other area of the world. At the same time, efficient modes of transportation were coming into use, so the affluent were able to avoid this onslaught of "undesirables" by moving from the central cities. It was, in some ways, the beginnings of American suburbanization. Most immigrants could not afford to move away from the places where they worked, so they lived close to the factories and tended to live together in the same neighborhoods, choosing to live in a culture familiar to them. These were the first American urban ghettos.

But foreigners were not only "immigrants." African-American agricultural workers from the South also poured into the northern industrialized cities. They were not only pulled into the North by the lure of decent wages but also pushed out of the South because of the joblessness due to the mechanization of southern agriculture. Like other immigrant groups, they settled in ghettos near their jobs. Unlike other immigrant groups, however, they stayed there. As workers from the white ethnic ghettos became more affluent over the course of one or two generations, they gradually moved out from their ghettos and dispersed into the general population. We don't speak of "Finnish ghettos" or "German ghettos" anymore. Segregation, of course, did not allow black people into white areas. Even those African Americans who became affluent were confined to black ghettos.

The second great migration of African Americans from the South into northern cities occurred in the 1940s or 50s. Once again, they were pushed out of the South by increasing agricultural mechanization (especially the introduction of the mechanical cotton picker), and they were pulled north by decently paying jobs in the manufacturing centers of the cities. Because of continuing segregation, however, the geographical area of the black ghetto could expand only slowly and these new immigrants had few options. Population density increased constantly. By the 1950s, black people in the least segregated cities of America were more segregated than any other ethnic or racial group had ever been in any city in the United States.

The second factor that would play increasing prominence in the formation of the modern black ghetto was the relative poverty of African Americans compared to European Americans. Discrimination in education, employment, and housing was, of course, legal, but there were other, less well-known causes of the relative poverty of black Americans.

Poverty had been widespread among all ethnic groups during the Great Depression, but many Federal programs had helped to alleviate that poverty. Unfortunately, African Americans were often left out of those efforts. Two of the most important elements of social insurance introduced during the Depression, for instance, were Social Security and mandatory unemployment insurance, but they specifically excluded domestics and agricultural workers. Since two-thirds of employed blacks were, at that time, either domestics or agricultural workers, most black people were not eligible for benefits. While the rest of the country was receiving significant Federal help in moving out of poverty, African Americans were left out.

The Federal Housing Administration (FHA) was another important anti-poverty program developed during the Depression to guarantee mortgages for the purchase of homes. This not only allowed families to become homeowners (and thus accumulate wealth) but also created jobs and provided investment in the community. Citing concerns that the poorer black neighborhoods were not good financial risks, however, the FHA "redlined" almost all black areas, refusing to guarantee mortgages there. Private lenders followed suit. These FHA policies lasted well into the 1960, and redlining by private institutions is still in unofficial practice today.

Finally, cities had frequently used zoning requirements (first initiated in the United States in the early 1900s) to zone poor neighborhoods as "industrial," prohibiting not only new residential construction but also frequently the improvement of old residential buildings. The quality of life in these areas was already lower because of neighboring industry, and the housing stock tended to deteriorate easily. Other poor people could move out to other areas, but the reality of segregation forced African Americans to stay in these increasingly industrialized areas of the cities.

Despite the segregation, crowding and poverty, however, the black ghettos of the early 1950s were viable neighborhoods, primarily because of the intact social organization. A series of events over the next three decades, however, was to change that situation markedly.

The first event was the wholesale destruction of black neighborhoods by the Federal Urban Renewal and Federal Interstate Highway programs. Urban renewal was an attempt to improve decaying center cities by transforming them into new, architecturally pleasing areas. Because of the minimal political power held by African Americans at that time, black ghettos (and other poor areas) were usually chosen as sites for urban renewal. Large, inner-city black ghettos were razed. Some of the poorer people from the "renewed" areas were moved into public housing, but these were usually large apartment buildings reserved only for the poor. But the rest simply squeezed into remaining ghettos areas.

The same phenomenon occurred when the Interstate Highway Program started during the Eisenhower administration. When these superhighways went through cities, poor black areas were usually the ones disrupted. Either the area was simply razed and the former inhabitants moved into public housing or the highway was placed so as to create a physical boundary between the black ghetto and other areas of the city, effectively isolating the inhabitants.

A second event facilitating the disintegration of the ghettos was the gradual loss of jobs that paid a living wage. The major structural changes in the American economy over the last four decades have almost all been detrimental to poor people. By the middle of the 20th century, the United States had become the overwhelming leader in worldwide manufacturing, and many of these factories were located in the large cities of the North. They offered good employment for workers who entered the job market with little education and few skills. High levels of unionization meant that the jobs were secure, wages were relatively high, and the chances for advancement were good if one stayed with the company. Blue-collar jobs were a primary way out of poverty for many African Americans.

But soon Europe and Japan had rebuilt themselves after the destruction of World War II, and their manufacturing competed, often quite successfully, with American companies. Later on, less developed countries, such as Korea and Taiwan, expanded their manufacturing, too. More recently, the globalization of the economy and the development of large, multinational companies have led to the loss of manufacturing in the United States as plants have moved to the Third World, where salaries are lower, environmental regulations are few, and expensive regulations for worker protection almost non-existent.

With the increasing computerization and mechanization of manufacturing worldwide, moreover, the well-paying jobs that remained wen to those whom William Julius Wilson calls the "symbol manipulators," those who analyzed data, wrote computer programs, managed people, administered organizations, or performed other tasks for which higher degrees of formal education were required. Increasingly, the only jobs remaining for poorly trained or educated people were in the service sector—as domestics, janitors, clerks, salespeople, nursing aides, and so on—where wages had historically been low and benefits poor. To make matters worse, the wages in the service sector were declining even further relative to other sectors of the economy, so even full-time workers were finding it difficult to stay out of poverty.

Segregation, of course, made it difficult to find well-paying jobs outside of black areas.

The third event was integration itself. With the coming of integration, affluent and middle-class African Americans could now find housing outside the crowding of the black ghetto. Only those who could not afford to move out—that is, the poorest—were left, often crowded together in high-rise public housing.

What had been poor but vertically integrated neighborhoods—where most people worked, social networks were intact, and institutions functioned—were now extremely poor areas where only poor people lived with few or no social networks, no institutions of support, no jobs, and large numbers of people who did not work. Under such conditions, the results are predictable. The "surround of force" that people experience leads to despair, inertia, and increasing anti-social behavior.

By the 1960s, the wider society had begun to notice the changes occurring in the inner city. As always, there were analysts eager to blame the poor themselves for their poverty, but the political tenor of the times (as a society, we believed much more strongly then in structural causes of poverty than we do now) made it unfashionable to criticize poor people, and the structuralist view dominated. Due in part to the publication of Michael Harrington's The Other America, the country was rediscovering poverty and wanted to do something about it.

In 1964, Daniel Patrick Moynihan, then a young advisor to President Johnson, wrote what was supposed to be a confidential memo to the President. Although the report, The Negro Family: The Case for National Action, stressed male unemployment as the primary cause of black poverty, Moynihan also documented dramatic increases in single-parenthood among black families4 and expressed concern about its impact on black poverty. The report was leaked, circulated widely, and the issue of single-parenthood was sensationalized by the press, causing a firestorm among liberals.5 Black activists (their influence nearing its apex in the liberal community) interpreted the report as humiliating to blacks at a time when they were trying to support black strength and identity. More radical Black Power advocates condemned the report as another racist attempt to discredit black people. What right did this white man have even to write such a report about black people? Other (white) liberals didn't like it either, since it seemed to blame black people for their plight.

The condemnation of the Moynihan Report was so severe that liberals, sociologists and researchers responded by

• avoiding even mentioning race when discussing behavioral problems among the poor,
• emphasizing racism as the cause of any such behavior,
• denying that the behavior (e.g., decreased labor-force attachment, increase in single-parenthood, even the increase in drug use) was inappropriate, or even
• denying that the behavior existed.

Anyone who dared talk about a "culture of poverty"6 was so viciously attacked that research simply stopped.

Lyndon B. Johnson declared a "War on Poverty" early in his presidency, significantly increasing public spending on poverty, availability of services, and growth in benefits available to the poor, especially to the elderly poor. In today's political climate, the War on Poverty is vilified as an utter failure, but many of its programs—Headstart, food stamps, Medicaid, Medicare, higher social security benefits, increases in disability benefits, Legal Aid, the Job Corps and others—were much more successful than is commonly realized. Between 1959 and 1979, the poverty rate among fully employed blacks went through 43% to 16%. The War on Poverty was especially successful among the elderly as their poverty rate was cut by two-thirds.

But the War on Poverty was stunted and ultimately cut short by the War in Vietnam. Few poverty programs were fully implemented and funding was curtailed in almost all programs. Despite the success with the elderly, overall poverty increased during the next two decades, primarily due to the major economic changes occurring worldwide.

During the seventies, the forces within the now-fully-formed black ghetto intensified. Since there were no jobs, the illicit drug industry found a fertile field in which to grow new employees. And with the drugs came the violence, especially with the rise of gun sales in the 1980s.

Liberals were in denial, refusing even to notice this new phenomenon in the cities for fear of criticizing African Americans. Middle America, of course, was watching television and reading the newspapers, and the behavior changes in the black ghetto were not only obvious but also frightening. Since liberals wouldn't acknowledge those changes, they were marginalized in the debate and the only voices average Americans heard were those who blamed the poor for their poverty. So, the conservative view (that focused almost exclusively on individual characteristics as a cause of poverty) was essentially unopposed until the black sociologist William Julius Wilson began writing in the mid-80s.

The conservatives (most importantly, Charles Murray in Losing Ground7 in 1983) also added the new argument that the liberal welfare policies of the Great Society programs had worsened poverty. Given that one couldn't do much about cultural traditions, family structures, or individual character, their arguments strongly bolstered the conservative attack of social spending in the 1980s, which has continued in the 90s as "welfare reform."

The mood of the country hardened against the ghetto. Poverty was increasing and the War on Poverty was declared a failure, forgetting that it had been more a skirmish than a war. By the 1980s, government programs for the poor were being drastically curtailed, and society was moving toward controlling the ghetto rather than helping it.

The "black ghetto" that we know today had been found.


Chapter II: Specific Causes

Causes of poverty are always multiple, interrelated, and mutually reinforcing. As we examine some of the other forces that have shaped the black, inner-city ghetto, it is important to remember that a written description cannot adequately convey the full impact of the multiple forces, for each affects the other, increases the complexity, multiplies the difficulty, pulls the web tighter, adds to the surround of force. It is the combined, intertwined effect of these various factors that is so intractable.

Racial Discrimination
Discrimination based on skin color is still widespread in the United States. While there has undoubtedly been progress in the last half century, discrimination against African Americans remains a persistent cause of inner-city poverty.

Until relatively recently in our history there has been little effort to treat African Americans equally. Well into the middle of this century, federal government policies made social security, FHA loans, and unemployment insurance virtually impossible for most blacks to obtain. Job and housing discrimination have been both legal and overt. Educational opportunities have been restricted. Some of these conditions have improved, but the history of discrimination helped to create the ghetto environment. Even past discrimination, therefore, remains a potent cause of contemporary inner-city poverty.

And discrimination itself persists, most notably in housing and employment. In study after study, when paired couples, similar to one another in every respect except color, are sent out to purchase homes or rent housing, white couples will be shown housing that black couples were told was unavailable, black couples will be steered to black neighborhoods. It is still more difficult for African Americans—especially those living in the city—to obtain mortgage loans.

William Julius Wilson has studied the attitudes of employers toward young, black men in the city of Chicago.8 It is quite clear that employers are more reluctant to hire young, black men9 from the inner city. It is hard to determine, however, whether this results from racial bias or an objective assessment of worker qualifications, a point underscored by the fact that black employers viewed young men from the ghetto just as harshly as white employers, tending to view them as uneducated, unstable, uncooperative, and dishonest.

Many employers screen out black, inner-city applicants by

• not using employment ads in city-wide newspapers (when ads are used, they appear in ethnic, neighborhood, or suburban newspapers),
• screening out applicants from urban public schools,
• avoiding welfare programs or state employment services as sources of referral, and
• relying on informal job networks. Employers are especially likely to hire their unskilled workers by getting recommendations from current employees, which means that job hunters who live in areas of high poverty where few people work face an almost insuperable barrier in simply getting an interview.

Wilson writes,

Inner-city black job seekers with limited work experience and little familiarity with the white, middle-class world are also likely to have difficulty in the typical job interview. A spotty work record will have to be justified; misunderstanding and suspicion may undermine rapport and hamper communication. However qualified they are for the job, inner-city black applicants are more likely to fail subjective "tests" of productivity during the interview.10

The dialect of the black ghetto, "Black English Vernacular," can also lead to problems. Not only is the ability to speak, write, and communicate effectively in standard English essential for employment in most white-collar jobs (meaning that most ghetto residents will be considered only for the blue-collar jobs) but even blue-collar employers also make frequent use of language as a screening device. Prospective employees may fail the "telephone test" because they do not speak Standard English well, never even making it to the initial interview.

While it may be easy to sympathize with employers looking for qualified applicants, from the point of view of the man looking for a job, this form of discrimination is just as virulent as if it were due purely to prejudice against African Americans.


Segregation
Continuing, imposed, severe segregation of African Americans from the rest of society is the single most important cause of urban black poverty.11 The ghetto itself is the problem.

The effect of segregation on black well-being is structural, not individual. Residential segregation lies beyond the ability of any individual to change; it constrains black life chances irrespective of personal traits, individual motivations, or private achievements.12

Although the degree of black segregation has declined somewhat in the last decade, African Americans today are still far more segregated than any ethnic group has ever been segregated in America, excluding Native Americans living on reservations.

The history of the American segregation of African Americans is complex, and it does not make for pleasant reading. Although this century's use of violence as a means of maintaining the color line crested in the 1920s, its use declined only gradually and the fear of violence is still, according to polls, a major deterrent keeping black people from moving into white neighborhoods. Earlier in this century violence against black people occurred regularly at the borders between white and black neighborhoods, keeping black areas from expanding. Although overt violence is less common, its threat—especially the threat that one's children will be harassed or harmed—remains important.

Earlier in the century, groups of white neighbors sometimes organized themselves to keep their neighborhoods white. Forming as "Neighborhood Improvement Associations," these groups:

• lobbied for local zoning restrictions to close hotels and rooming houses that attracted African Americans,
• gave cash bonuses to black renters as incentives to leave the area,
• boycotted real estate agents who sold to blacks,
• boycotted white establishments that catered to blacks,
• lobbied for public investments in the area to keep property values up and thus create economic barriers to African Americans, and
• created funds to buy property back from black buyers or to buy vacant houses to prevent them from being sold to black homebuyers.

One of the most effective methods used by the improvement associations was the Restrictive Covenant, a legal agreement forbidding signers to sell their property to African Americans. Although Restrictive Covenants were declared unconstitutional by the Supreme Court in 1948, the Federal Housing Administration—claiming an interest in maintaining the economic viability of neighborhoods in which it was guaranteeing mortgages—continued to recommend their use until 1950. Restrictive covenants continued to be used covertly for decades until the Federal government began enforcing the law in the 1980s.

As more African Americans moved into northern ghettos, the fixed size of the areas in which they were allowed to live naturally increased property prices within them, leading to pressure for expansion. Since whites would ultimately move out of neighborhoods if enough (or any) black people moved in, unscrupulous realtors developed the practice of "block busting." As middle-class blacks began to move in, property values would fall as whites hurried to sell and leave. Often spreading rumors about the "invasion," "developers" bought up property, divided it up, and rented to poorer blacks from the ghettos at inflated rates. It was often true both that property values fell and that poverty developed when black people moved into an area, but these changes had to do with white flight and realty practices, not any inherent characteristic of African Americans.

The intensification of the black ghetto in the middle of this century caused a breakdown in the politics of integration. Traditionally, immigrants have almost always been in the minority even in the political districts in which they lived. If they were to succeed politically, therefore, they had to develop coalitions across ethnic lines. These coalitions led to other kinds of mutual cooperation and increased the pace of their integration into the mainstream. By the 1940s, however, black people had been highly segregated. As opposed to other minorities, therefore, their political power came from their ability to vote as a block, under the leadership of powerful black politicians (who then had a stake in the area remaining segregated). In effect, if African Americans wanted political power, they had to "take over" a particular area and dominate its politics. Even today, much of African American political power lies in black segregation. Rather than lead to coalitions, this side effect of segregation leads to mistrust and, ultimately, political marginalization of African Americans.

In the 50s and 60s, the federal government subsidized suburbanization in various ways. Road construction made easy commuting from suburban residence to urban jobs possible. FHA policies guaranteed mortgages and made owning homes in the suburbs possible while (until the mid-60s) discouraging mortgages to inner-city areas. Tax breaks on home mortgages made home owning even easier. While this relieved housing pressure in the cities and therefore allowed for physical expansion of ghettos, the color line was maintained despite massive population shifts to the suburbs. At each point between 1940 and 1970, whites and blacks lived in essentially separate worlds. Due in part to FHA policies and in part to racism, discrimination by realtors and bankers was institutionalized and—as mentioned above—continues into the present (although there has been some improvement in the 1990s).

Finally, of course, white people just move out. Studies have shown that while the vast majority of African Americans desire to live in integrated neighborhoods, they would not choose to be the only black family or one of very few black residents in an otherwise white neighborhood. There is still a very real fear of harassment and violence. African Americans tend to see the most desirable mix, therefore, as something approximating 50-50. Most whites, on the other hand, will not choose to move into integrated neighborhoods. Studies have shown, in fact, that whites begin to move out of their own neighborhoods once the percentage of black residents grows above 10%. To over-simplify, once the percentage of black residents is enough that blacks can feel comfortable living there, white people move out.

The consequences of segregation are insidious. Because of their history, the persistent discrimination, and the fewer opportunities, African Americans are, as a group, poorer than other Americans. Segregation then forces African Americans to live in neighborhoods that are more likely to have higher than average concentrations of poor people. Segregation concentrates poverty,13 thus intensifying its force.

To take only a single example of the deleterious effect of concentrated poverty, the physical appearance of a neighborhood is thereby threatened. Individuals have fewer resources to maintain their property, and buildings will begin to show signs of physical disrepair. But, "studies suggest that property owners are extremely sensitive to [these small signs]" and will view them as a "signal that the neighborhood is going 'downhill,'"14 leading to more disinvestment, further physical deterioration, and so on in a vicious cycle.

Poverty tends to be self-reinforcing, so people born into poorer neighborhoods have a higher probability of becoming poor themselves.


Education
Segregation and the concentrating of poverty have especially pernicious effects on education. Because elementary and secondary schools are primarily funded through local taxes, cities with large numbers of poor people have fewer resources per child and are therefore less able to fund decent education. Further, because the ghettos are politically marginalized even within the city, education in the ghetto can easily be neglected. As Jonathan Kozol graphically describes in Savage Inequalities, the physical state of inner-city schools, the equipment and supplies available, the level of instruction, class size, expectations of the students and so on are markedly inferior when compared to their non-ghetto counterparts.

Concentrating poor African Americans into the ghetto, of course, means that ghetto schools will be completely black and predominantly poor. The other problems these children bring to school (hunger, homelessness, exposure to violence, and so on) demand resources that have to be pulled away from the already meager educational resources allotted. Ghetto schools should be getting far more money than suburban schools because the problems they have to deal with are worse. Instead, they get less.

One current approach to improving urban education is the "magnet school," which takes students from the districts of many schools, often to emphasize a particular area of study, such as science or the arts. These schools are better funded and have better teachers, more access to supplies, and better physical plants. They are of very significant benefit … to the children who qualify. Unfortunately, by creaming the best students, the most committed parents, the more assertive parents, and (often) a higher-than-average proportion of the school district's budget, they also weaken the schools that remain.

This creaming and consequent weakening of the remaining school system is the primary danger of the proposed educational voucher system for education. Vouchers represent a determined amount of money (usually the average that the public school system spends per student) that parents can use to pay the tuition at any school (including private schools) to which the child can be accepted. Private schools (although not all parochial schools) usually cost more than the average public school cost, so poor families that can't afford another expense will not benefit, nor will the children of parents who are not actively involved nor children who for any reason can't get accepted at a private or parochial school. Since the voucher money is withdrawn from public education (with large fixed costs in buildings, maintenance, teacher contracts, and so on), the danger is that the public schools that remain (which will have to educate many of the most difficult students who require the highest level of resources) will have even less adequate funding than they do today.

In their 1886 Plessy vs Ferguson decision, the Supreme Court created the doctrine of "separate but equal." Schools could thus be segregated as long as the education provided to black students was equal to that provided white students. In their 1954 decision, Brown vs School Board of Topeka, the Supreme Court went further to demand the integration of schools. As Jonathan Kozol has pointed out, we have not only failed to meet the conditions of the 1954 decision, we have also failed to meet the conditions of the 1886 decision.

In Washington DC approximately half of the black children will drop out of school before they graduate. Those who do graduate will, on the average, be two years behind national norms. Without a decent education, a child is handicapped for life.


Health Care
In 1999, 43 million Americans—most of them poor—do not have health insurance. We tend to assume that if people are poor enough, they are eligible for some kind of governmental health coverage. Our assumption is wrong. Less than one-third of people living in poverty are eligible for Medicaid, the primary form of health insurance available to the poor. The low-paying jobs available to poor people rarely pay for health insurance. A family policy currently costs more than $500 a month or half the total income of a family of three living at the poverty level. Poor people, therefore, cannot afford to purchase insurance on their own, so they remain uncovered, spending significant percentages of their income on doctor or emergency room visits, especially if they have young children.

Even those few who do qualify for Medicaid can find themselves in trouble. Although patterns vary from state to state, fewer and fewer doctors and hospitals accept Medicaid, so poor people must usually go to hospital emergency rooms or public clinics for their care. Emergency rooms handle emergencies well (even for the poor), but they cannot offer much in the way of continuing care, preventive medicine, or help in routine medical problems. In fact, patients with routine problems are increasingly triaged out of emergency rooms. Public clinics can be good, but they rarely have the staff or other resources to provide good care to all who need it. Waits are usually long, one usually sees a different doctor each time, charges are made and bills are sent anyway, and there is usually no special provision for paying for other needed services—x-ray, special lab, hospitalization—which can be enormously expensive.

So, cost prevents the appropriate use of health care and drives the poor further into poverty.

We sometimes forget the other side of the equation: poor health is not only a complication of poverty but also among its causes. The health of poor people is measurably worse than average, which in turn aggravates their poverty. Poor prenatal care, inappropriate maternal drug use, and maternal malnutrition, for example, can all lead to significant learning disabilities and decreased cognitive abilities (which can lead to poor educational achievement, which further complicates poverty). Congenital disease and infant AIDS are far more common among the poor.

The chronic diseases of childhood are far more common among the poor. Asthma, lead poisoning, various anemias, malnutrition, chronic middle-ear infections are not only expensive to diagnose and treat, they can also lead to adult impairment, sometimes in surprising ways. Consider chronic middle-ear infections (otitis media). The usual acute ear infections cause pain and lead to emergency doctor visits. If these infections are (as often happens) insufficiently treated, chronic otitis media can develop which may have few noticeable symptoms. For financial reasons, a poor child is less likely to return to the doctor after her acute ear infection seems to have gotten better, so chronic otitis media remains often undiagnosed. Otitis media causes a temporary loss of hearing, which often persists through early childhood. Undiagnosed hearing loss can lead to poor school performance and permanent educational deficiencies, making it that much harder to escape poverty as an adult.

Similar stories can be told about lead poisoning, malnutrition, and many other childhood health problems. The "surround of force" seems inescapable.

The poor are much more likely to live in environmental conditions and work in conditions that are detrimental to health. A friend of mine cannot afford to move out of her damp basement apartment although the mold spores severely aggravate her daughter's asthma.

Finally, the stress of simply being poor has been documented to be a real health risk. The poor get it coming and going.


Criminal Justice System
African Americans compose approximately 12% of the American population, yet they are 45% of the combined local, state, and Federal prison population, a percentage that has approximately doubled since 1930. 40% of all prisoners awaiting a death sentence in the United States are black.

One out of every five black men in the country spends some time in jail during his life. According to the Washington Post, in 1998 over half of the black males residents of the District of Columbia between the ages of 18 and 34 are in the criminal justice system: awaiting trial, awaiting sentencing, in prison, or on parole.

Given the statistics, our recent decisions to fight crime by "getting the criminal off the street" mean that increasing numbers of poor black men will be in jail.

One can certainly argue that the increase in safety that should result from "getting the criminal off the street" makes current policies appropriate, especially for the inner-city poor who are much more often the victims of such street crime. At the same time, removing tens of thousands of young men from the cities takes potential breadwinners from their families. Since ex-cons find it much harder to get jobs, the impact of the criminal justice system on poverty is doubly harsh.

It is important to remember, too, that in computing the unemployment rates, those who are in jail are not counted as "unemployed;" they are removed from the denominator altogether, effectively lowering the real unemployment rate.

The reasons for the high numbers of African Americans in the criminal justice system are debatable and complex. Certainly, as we will see in the next chapter, proportionately higher percentages of poor black people commit crimes for which we ordinarily send people to jail (especially drug offenses but also burglary, robbery, murder, etc).15 It is also undeniable that our system of criminal justice is more willing to prosecute poor African Americans than others, especially since these prosecutions are usually resolved through plea-bargaining. The few resources at the disposal of public defenders relative to those available to private attorneys mean a further tilt toward conviction of the poor.

Whatever the reason, the result is the same: the criminal justice system impacts African Americans, especially poor African Americans, far more harshly than average.


Conclusion
Each of these factors is exacerbated by the others. The segregation of poor African Americans into ghettos is the linchpin holding it all together. As long as ghettos exist, most of the people who live there will be poor.