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.


Footnotes
¹ Katz, Michael, Improving Poor People