Race, Poverty, and Disability: Three Pillars of Need in Health Promotion
Five years ago, Hurricane Katrina devastated one of the largest and poorest sections of any city in this nation. New Orlean's Ninth Ward and other areas of the city have not been the same. Tens of thousands of people were left homeless and several thousand people died. The city is still trying to revamp itself, but as it does so, the state of health among the people most severely hit by the ravages of the storm remains strikingly and disappointingly poor.
What Katrina did was expose the world to a pocket of poverty that rarely seen on the front pages of major newspapers. While visitors from around the world flocked to New Orleans for fun and relaxation, just a few blocks from the French Quarter was the underbelly of the city, a place marked with poverty, crime, and poor health. It was far enough away from the city's lifeblood of tourism to not disturb the profit margin.
The Ninth Ward is just one example of how people in poverty live. There is extreme poverty across the globe and caught in its web of destruction and despair are people of color, the elderly, and children, adults, and seniors with disabilities. When you can't afford to live anywhere else, you live in poverty.
In a front-page story that appeared in The New York Times a few weeks ago, two families who were displaced after losing their homes were interviewed about where their lives are today. One family was relocated to Mississippi and the other to Kentucky. The photos portray the grim reality that when you're born into poverty, very little changes other than your zip code. Uncovered floors, debris inside and outside the home, beds with no sheets, children and teenagers with blank stares, parents smoking, poor food choices, and obesity fill the photos. The more things change, the more they stay the same.
Who are the people who get caught in this web of despair? It's often those with the least amount of education who leave the school system early because of a lack of success. An unscientific observation is that many fail in school because of diagnosed or undiagnosed learning disabilities, emotional disorders, mental health issues, or mild intellectual disabilities. Once the support is pulled out from under them, which is usually at age of 21, if they are eligible for special education, they enter society ill-prepared for maintaining a sense of balance in their life. Unhealthy behaviors are a way to deal with the harsh realities of life.
All hope is not lost. There are ways to rebuild the core foundation of communities living in poverty and the effort needs to start with good health. We need a new national service system like the Peace Corps that can reach out to people on Medicaid and other public aid programs through the phone, followed by a community support system similar to what we have for national emergencies - where to go and what to do when you're in the crossfire. College students in health/wellness programs should be taught about the sociocultural effects of poverty, understand its impact on health, and after graduation, be prepared to work in communities with the greatest need.
It's easy to assume that everyone knows how to be healthy, but that may not be the case for the millions of young people who leave the educational system with a diagnosed or undiagnosed learning, emotional, intellectual, or mental health disability and enter a society where the incentive to exercise regularly, eat healthy, and avoid tobacco must compete with the culture of poverty and the unhealthy practices that go with it.
It is time for a new Peace Corps, one that targets health promotion to those with the greatest need - people with disabilities and people of color who live in poverty, but don't necessarily need to live in poor health.