Children, poverty, and health – why we need to include violence in our conversations too

Years ago, I attended the YWCA summer day camp in the inner city. My mom worked down the street at the U.S. Attorney's Office. Most of my fellow campers came from poor, inner city families. Usually there was a single mother. Often she worked two or more jobs to care for her children. I remember visiting a few of these kids at their homes. I remember talking to them about their lives and comparing notes. The differences were striking, even then.

While I didn't have a lot of money, I had nowhere near the same sense of insecurity as many of my friends. They had to think of how to navigate their route from home to school through violent neighborhoods. The girls worried about being dragged into abandoned homes and raped. The boys worried about being beaten up by gang members if they walked in the wrong place or wore the wrong colors. Many spent longer hours alone at home. More even than I did, and I spent a lot of time alone. Even then, some had experienced the loss of family and friends to violence.

Yesterday, there was a good article in the NYT examining the linkage between health and poverty for kids. But poverty not only hurts kids' – and families' – health. It raises their risk for being crime victims.

According to a report by Satyanathan and Pollack, half of homeless women and children reported being victims of domestic abuse. Further, domestic abuse drives women and kids into homelessness as they seek to escape abuse. Of course, there are lots of other crime categories that have links to poverty. We see more gang activity in the poorest neighborhoods. Poverty and drug abuse go hand in hand. Even at the country-level, poorer states tend to experience more unrest and violence than developed states. This doesn't mean that poor people are criminals. But poverty creates conditions in which crime can flourish. This goes beyond the broken windows theory. Rather, many who live in poverty are simply overwhelmed by the struggle to survive. This was the reality of my camp friends. These aren't bad people or neglectful people. They're exhausted people, on every level. And predators take advantage of vulnerability.

Given the profound effect of the economic downturn over the past few years, and the reality of a permanent underclass, we need to add to the conversation the reality of violence in the lives of these children. That violence will not only have physical implications but also psychological. It adds another dimension to the concept of “toxic stress.”

Educators and health care professionals need to add this knowledge to their training and advocacy. Evaluations for domestic violence and other types of violent victimization must be part of the dialogue between medical professionals and their youngest patients. In doing so, we not only help the child of today but the children of tomorrow.

photo credit: © diego cervo – Fotolia.com