The Working Poor (39 page)

Many parents of asthmatic children are unaware of the triggers because doctors don’t bother to tell them. That was the experience of the Baltazars, a struggling family of Mexican farmworkers in Ivanhoe, North Carolina. Although cockroaches infested their small frame house, the specialist who treated the father, Agustin, and two of their children for asthma never asked about housing, never mentioned roaches as a factor. He once called to invite them to a conference on asthma, said Agustin, “and they would give me some kind of machine, an apparatus for my asthma. But I couldn’t go. You had to pay $15 to get into it.”

Most doctors don’t explore problems that they can’t address, but that overly narrow focus has been discarded at the Boston Medical Center. There, knowing that lawyers and social workers are available, pediatricians
and emergency room staff ask the larger questions. “I’ve received zillions of referrals of kids who live in poor housing conditions,” said Jean Zotter, one of the attorneys in the pediatrics department. “A kid will show up with an asthma attack, and they’ll start asking about the housing, and it turns out there’s mold growing on the wall. They’ve refused to let kids go home. They’ve wanted to keep them there and advocated with the health insurer to keep them there because sending them home would be exposing them to the things that would make them sick again.” Insurers won’t pay for hospitalization if they know it’s because of the housing.

A lawyer’s phone call can usually get the Housing Authority to move tenants from moldy apartments into other public housing units, Zotter said, and private landlords often respond to a firm nudge as well. But sometimes it takes more muscle: a demanding letter, a city inspector, a threat of legal action, or even a lawsuit. That’s what happened in the case of a nine-month-old boy with pulmonary stenosis, which restricted blood flow to his lungs. He had surgery but then remained dangerously ill in a house whose furnace was blowing toxic fumes and black dust into the air. The landlord, who lived modestly in the same neighborhood, “refused to even look at the furnace,” Zotter said.

She used Boston’s strong tenant protection laws and called for an inspector, who cited the owner for many violations. A hearing was held, the landlord failed to appear, he was given fourteen days to replace or repair the hot-air furnace, and he did nothing. Zotter then went to court, where the owner claimed that he could fix the furnace himself. Over her objection, the judge gave him two weeks to do so, after which she went back into court, and got a different judge, who ordered the landlord to replace the furnace. He finally complied, “but that whole process took a month and a half,” she said, “and in the meantime the nine-month-old baby was in and out of the hospital.” Five months later, the boy died from an infection he could probably have fought had his immune system not been so compromised. Although Zotter considered suing the landlord for damages, a clear connection between the furnace and the death would have been hard to prove. The mother, devastated and angry, moved out.

The pathway from poor housing to poor health does not always run in a straight line. One little girl in the intensive care unit, Megan Sandel remembered, had an extreme allergy to cats. The family had a cat. “We said, ‘Oh, you really need to get rid of the cat. The child’s really allergic to the cat, and we think that’s part of the reason why she had this really bad
asthma attack,’ ” Dr. Sandel recalled. “And the parents looked at me dead on and said, ‘But the cat kills the mice.’ Clearly the house was the problem, and the solution was part of the problem.”

When she and Dr. Joshua Sharfstein, also a pediatrician, did a study asking poor parents being offered housing assistance how they thought their previous housing had affected their children’s health, the words “emotionally” and “mentally” were spoken again and again. “Emotionally, no space. Too much noise in the house for homework,” said the notes from one interview. “Emotionally. Domestic violence, and also the apartment is very cold,” said another parent. “Emotionally. We can’t be together all the time.” “Mentally. Can’t go outside to play or do anything [because of street crime].” “Mentally. He needs his own room. He still has to sleep with me.” “Mentally. Grandfather is alcoholic and screams. A move is better so the kid won’t be scared of grandfather. Sister is mentally sick.”

The psychological toll on children was the concern most mentioned by parents, Dr. Sharfstein said. “A lot of families are living with friends or relatives who really don’t want them there, and the parents have to share bedrooms with the kids, and the kids have no space, and some of the parents say they can’t do their homework because there’s no quiet, they’re crying all the time, or, ‘They hate my aunt.’ People fighting in the house. I’ve heard a couple of horror stories about kids who were abused by people in the house.”

And the rats. “The kids are just terrified of rats,” he said. “One woke up with rats on him and won’t go to sleep, is having trouble in school.” The boy is caught in the unbroken cycle: Poverty leads to health and housing problems. Poor health and housing lead to cognitive deficiencies and school problems. Educational failure leads to poverty.

In a tight housing market with high rents, low incomes, and inadequate government assistance, the goal of improving conditions often means getting working poor families the subsidies they have been illegally denied. That occupies the lawyers and social workers in the pediatrics department, which treats many children who should be benefiting from food stamps, welfare payments, and Section 8 housing vouchers. The vouchers, which are federally funded, pay at least part of the rent for privately owned houses and apartments, but there is not enough money or housing in the program, and the waiting lists are long in most areas. With rising wealth driving up housing costs, the working poor have been left practically helpless, unable
to get into the market and unserved by underfunded federal and state housing programs.

The system is also plagued by welfare cheats. They are not people who receive welfare illicitly. The more damaging welfare cheats are the caseworkers and other officials who contrive to discourage or reject perfectly eligible families. These are the people who ask a working poor mother a few perfunctory questions at the reception desk, then illegally refuse to give her an application form, despite the law’s provision that anyone of any means may apply. It is a clever tactic, say the lawyers, because they cannot intervene on behalf of a client who has not applied.

The welfare cheats are the officials who design Kafkaesque labyrinths of paperwork that force a recipient of food stamps or Medicaid or welfare to keep elaborate files of documents and run time-consuming gauntlets of government offices while taking off from work. “I have clients with daily planners that are filled more than mine are,” said Ellen Lawton, an attorney at the clinic.

If you want to stay on welfare, you have to provide pieces of paper proving that your children have been immunized and are attending school. If you want food stamps, you have to deliver pay stubs and tax returns. If you want a job, you need day care for your children, and if you can’t afford it, you have to get a day-care voucher, and if you want a voucher, you have to prove that you’re working. Getting a voucher involves multiple visits to multiple offices—during working hours, of course. Caught in this Catch-22, one mother put herself on waiting lists at infant day-care centers all over the city; meanwhile, her caseworker told her that she had to get a job before she could get day care paid for. Lawton quoted the caseworker: “So if you’re on a waiting list, you need to find somebody who’s gonna watch your kid.”

Every demand for a document provides an opportunity for a cutoff, because no matter how meticulous a recipient may be, pieces of paper seem to get lost in the bureaucracy. “I just had a client like this last week,” said Lawton. “She had received three different notices informing her in three different ways that she was being cut off. One of the issues was that she hadn’t provided a certain piece of paper about her attendance at a [job-training] program. And she said she had provided the paper, but they lost it. Fine, we provided another piece of paper. She receives another notice that she’s going to be cut off. Well, it’s actually a different computer system
that’s generating that notice, so she has to take time off from her program to go and get another piece of paper, bring it to the office.… Being poor is a full-time job, it really is.”

It also promotes absurdity. One mother, desperate to get her asthmatic child out of a harmful apartment, obtained a letter from her pediatrician saying the house was making the child sick, which technically qualified her for emergency assistance, Zotter said. But the welfare department’s receptionist turned her away three times, telling her that she already had housing and couldn’t even apply for temporary shelter as long as she wasn’t homeless. The mother seriously considered moving out and making herself homeless to qualify. As the lawyer was explaining forcefully to a caseworker how the welfare department had broken the law, “she gave up and she moved to Atlanta, because she said she didn’t feel like the system was helping her.”

Just under half such cases can be solved with an attorney’s phone call, Zotter estimated. One involved the mother of another patient who was denied an application for emergency food stamps. “If you’re really low income you can get food stamps within twenty-four to forty-eight hours,” Zotter said, “and then they do your verification and see if you really qualify. And they wouldn’t let her apply for it. I just called them up and said, this is her income, she has no resources, she qualifies for this, you have to give it to her. And they did.”

Blessed are the poor who have lawyers on their side.

“When I grow up,” said Shamika, age eleven, “I want to be a lawyer so I can help people.” What kind of people? I asked her. “The homeless,” she replied. “Little kids need help. That’s why I want to help the homeless.” She made her declaration with the bright certainty of a sixth-grader whose eyes still shone in the conviction that anything was possible.

In her desperate neighborhood of Anacostia, across the polluted river from Washington’s marble monuments, that clear gaze of childhood rarely survives into high school. Along the way, somehow, the visions from younger years are dulled—or distorted into fanciful notions of fame and riches on the gridiron and under the hoops.

Virtually all of the youngsters I spoke with in poverty-ridden middle schools wanted to go to college. Some of their parents were unemployed; others moved furniture, sorted library books, and cleaned government buildings. Many worked in supermarkets, factories, nursing homes, garages, hos-
pitals, and hair salons. Only a few had skilled jobs as mechanics, carpenters, electricians, and computer operators. To realize their hopes, most of their children would have to move up substantially through the social hierarchy of education, jobs, and income; they would have to fulfill the American Dream.

Three of the five sixth-graders in Shamika’s group imagined themselves as lawyers; one wanted to be an optometrist; and the fifth, Robert, saw himself “working in a office like a [corporate] president or something or a doctor.” His goal was to have the power to do good. “Like if my family hurt or something, then I can go over there and I can even help them out,” he said. Running a company, “I’d go over and help homeless people out and give them money and help out with charity and stuff.”

In a poor neighborhood of Akron named Opportunity Park, a group of sixth-graders wanted to be singers and pediatricians, a police officer and a nurse, a rapper and a mechanic. Their ambitions spilled over the brims of their young lives. Dominique, the daughter of a construction worker and a hair stylist, yearned to be “a archeologist and a pediatrician.” At the same time? I asked. “No, a archeologist when I get older and a pediatrician when I’m a little bit younger, like in my twenties and thirties.”

Blacks in seventh grade at the Akron school listed the most visible black models: football player, basketball player, and rapper. Whites mentioned artist, veterinarian, and auto mechanic. Don, who was white, explained why he wanted to pave roads for the city: “The pay is good.” At schools in two low-income Washington, D.C., neighborhoods, seventh-graders, almost all of them black, mentioned lawyer, photographer, football player, basketball player, FBI agent, policewoman, salesman, doctor, dancer, computer specialist, architect, and artist. Eighth-graders in Akron said: marine biologist, computer engineer, scientist, construction worker, lawyer, and pediatrician. Professions they happened to encounter or read about or see on television entered their hopefulness, sometimes as a passion, more often as a notion carried on a breeze of impulse. Some would realize their aspirations, if overall statistics were applied, but most would not. Many would drop out of high school; few would go to college; most would be trapped in low-wage jobs.

Their ambitions brought a sneer from Mrs. C, a veteran who had taught history for fifteen years at Shamika’s school, the Patricia R. Harris Educational Center in Washington. “They come late every day and are out every other day,” the teacher scoffed. She was black, and so were nearly all
of her students, which freed her to be tough and candid without being accused of racism. “I ask them, ‘Where are you going to be ten years from now?’ They’re gonna be doctors, they’re gonna be basketball players. They’re gonna be lawyers. They’re gonna be football players. I say, ‘How many football teams are there, and how many players on each team? What is the chance that you’ll be able to do that? And do you realize that if you’re gonna be a lawyer, that requires reading skills? If you’re gonna be a doctor, that requires math skills, reading skills? Yo u can do it, but you’ve got to get going.’ ” She was treading on dreams, and not softly, but she was trying to tell them the truth. “I want them to dream but be realistic in the process.”