Statement of Theo MacGregor and Jerrold Oppenheim

Investing in the eradication of poverty in America could increase the resources of American households by an average of more than $18,000 a year, equivalent to a wage increase of more than 30 percent. Investments in the eradication of poverty would:

• substantially reduce losses due to crime, a large fraction of which is caused by poverty;
• increase incomes to people now unemployed or underemployed, which would result in new expenditures (including income and sales taxes) circulating through the economy and becoming income to others;
• reduce the cost of health care, including the cost we all share of taking care of people who cannot afford health insurance or medicines;
• virtually eliminate the need for societal supports to ameliorate the most extreme manifestations of poverty.

A study conducted by the authors for Entergy Corporation found that, in the wealthiest country on Earth, more than 30 million households try to live on $26,640 or less (60% of current median income), while the rest live on incomes averaging more than $60,000. In order to make it to that $26,640 income level, a family would need two adults working full time at 1½ times the minimum wage. The average service job pays only twice the minimum wage, so there are many who earn less than that. Those folks, although working, are unable to afford the basics of food, shelter and medicine. And the buying power of the minimum wage is at its lowest in 50 years. For the poor, there is not enough income to heat and/or cool their homes, feed their children, and afford medical care. This discrepancy in incomes, as well as poverty itself, leads to real and growing costs.

What makes poverty expensive to the rest of us is not social supports but rather its large but indirect costs, especially in health care, crime, and lost productivity. Indeed -- middle-income supports – such as Medicare, social security, and income tax breaks – cost the average family about four times as much as do low-income supports such as homeless shelters and food. Eliminating the indirect costs of poverty in the simplest way – directly raising incomes to a low but decent level (60% of current median income) – would cost $12,047 per low-income household, or $397.2 billion per year, but would return almost four times the investment. In other words, the annual cost of eliminating poverty would be no more than about a quarter of the annual savings for the average non-low-income family. These calculations are conservative and leave out many benefits of eradicating poverty, such as the savings of increased preventive health care and the productivity lost due to underemployment (employment below skill level).

How do people cope with skyrocketing prices and incomes that are not keeping pace? American low-income households are the best money-managers there are. But that is not enough. A study by the National Bureau of Economic Research shows that, in extreme weather, low-income families actually eat less – about ten percent less. Other studies show that another strategy is to skip needed medicines or forego medical care.

We do not, however, propose simply raising incomes because, as we will explain, we think more targeted investments will have even larger payoffs.

Health Care.  For example, increasing health care coverage. Studies show that the health of individuals in society is strongly and inversely correlated with inequality of income. The US is the wealthiest nation on earth – ever – but people live longer in Sweden and Norway, where incomes are more equal. Japan, which has the longest life expectancy in the world, also has among the narrowest of income distributions.[2] People lower down the income scale in rich, developed countries have death rates two to four times higher than those nearer the top of the scale; and the greater the extremes between wealth and poverty, the greater the health differences.[3] Economic equality is thus more important to health than wealth is.

Poverty carries with it a much higher risk of illness. The Census Bureau recently reported that 47 million Americans have no health insurance at all, and as our study shows, the number with only partial insurance is about double that. Even the Census Bureau figure is almost 16 percent – a fraction that has been steady or rising steadily in every year but two of the last 18. Poor uninsured individuals often defer seeking out care when they are ill. As a result, their illness progresses and can become needlessly severe. They then require more expensive care, often through the emergency room or hospitalization.[4] An estimate from the National Academy of Sciences puts the number who die each year because they lack health insurance at 18,000.[5] More than half of the bankruptcies in the U.S. are now due to medical expenses, even though a large majority (75.7 percent) had insurance at the onset of the illness that contributed to the bankruptcy.[6]

Medicaid served 38 million people in 2005,[7] yet “more than eight in ten low-income, uninsured adults do not qualify for Medicaid or other public health coverage because their incomes are too high….In 42 states, unless they are severely disabled, they are ineligible for Medicaid regardless of their income.”[8] In addition, most of the care provided through the Medicaid program goes to low-income elderly or seriously disabled people who are also covered under Medicare. Only 30 percent of Medicaid costs go to cover low-income children and pregnant women.[9]

In addition to all of the uninsured Americans, many more are “underinsured.” Nearly two million people under 65 spent more than 10 percent of their pre-tax income on health care.[10]. A Kaiser Commission study found that uninsured hospital services alone would cost $41 billion.[11] The same study estimated total costs to be spent on healthcare for the uninsured came to $125 billion.[12] Investing in adequate healthcare coverage for all Americans would eliminate these costs to society.

Education.  “Poverty prevention is more dependent on education than on any other factor, as is escape from poverty.”[13] Education is the primary means by which people can lift themselves out of poverty, yet the amount spent on education targeting low-income children falls far short of the need. Educating all of our people so that people can take jobs at higher skill levels would increase the money circulating throughout our economy. “The achievement gap between poor and non-poor children is well-documented. Low-income children consistently fall behind their peers in test scores, graduation rates, college enrollment, and other measures of academic success.”[14] Head Start has enrolled over 20,000,000 low-income children since its inception as a summer program in 1965.[15] Long-term follow-up studies on a number of these children have shown that Head Start participants achieve greater school success and avoid crime as they grow.[16]

In an earlier study for Entergy, Oppenheim and MacGregor found that educating low-income children when they are very young returns about $9 for every dollar spent. Benefits include children staying in school through high school, developing a work ethic, and getting and keeping better jobs, with the commensurate rise in pay and associated income taxes, along with the multiplier effect of putting more money in the economy.[17]

Employment.  Unemployment is devastating for the family depending on a breadwinner to pay the rent and put food on the table. Underemployment is also difficult for families in today’s economy, where two full-time salaries at one-and-a-half times the minimum wage[18] just make it to the poverty cut-off of 60 percent of median income.[19] Almost half of the prisoners in the US are unemployed when they’re arrested, and 70% are functionally illiterate.  After release from prison, they face a wage penalty of as much as 12% for longer than 8 years.  So the cycle continues: low wages, low self-esteem, more crime. The cost of our judicial, correctional, and security systems could be substantially reduced by removing the desperation of unemployment that causes a substantial fraction of crime.

Unemployment and underemployment push families into poverty. Families falling into poverty are costly to the nation because of the increased costs they cause of crime, healthcare, and social services. Thus, as difficult as unemployment and underemployment are for the families that experience them, unemployment and underemployment are costly drags on the economy that affect everyone. Some of the costs that could be avoided by reducing unemployment and underemployment are taxpayer-financed social supports such as unemployment compensation, job training, and retraining. In addition, unemployed and underemployed persons pay less in taxes than if they were fully employed. They also spend less on job-producing goods and services – the so-called multiplier effect.

Crime.  In societies where inequality of income prevails, violence is more prevalent than in more equal societies, and the poor are more likely to commit crimes than the wealthy. During the past 25 years, the population of people convicted of criminal activity in the U.S. rose from 1.8 million to 6.3 million – with over two million in prison and another four million on probation, the highest per capita incarceration rate in the world.[20] With more money from full employment at decent wages, people are less likely to commit crimes, saving society costs of the judicial system, police, corrections facilities, and security systems. Added to these costs are the enormous costs to victims, both persons and businesses.

The total net burden of crime in the United States is estimated to be $1 trillion annually, or $4,118 for every U.S. resident.[21] According to The National Center for Victims of Crime, in 2002, crime was estimated to create $105 billion in medical expenses, lost earnings, and costs for victim services. Including intangible costs, such as pain and suffering and a reduced quality of life, brought the estimated cost of crime to victims to $450 billion annually.[22] The costs to society of incarcerating criminals are almost as staggering. Recent estimates put the cost at $38 billion annually.[23] The costs of police and the judicial system at the federal, state and local levels add another $110 billion.[24] The vast majority of prisoners are poor, but even attributing only 50 percent of crime to poverty and its effects results in a cost to society from crime committed by poor people of nearly $661 billion a year. Saving one child from a life of crime can save society around $2 million. Providing full employment at a living wage, with health and other benefits, can reduce crime and save society an estimated $661 annually.

Housing.  Homelessness exploded in the 1980s. Yet current federal spending on housing assistance programs targeted at low-income populations is less than 50 percent of 1976 spending levels.[25] More than 3.5 million Americans are affected by homelessness for at least part of the year each year. On any given day, at least 840,000 people in the United States are homeless -- nearly 40 percent of them children. Over 40 percent of homeless persons are eligible for disability benefits, but only 11 percent actually receive them. Most are eligible for food stamps, but only 37 percent receive them. Most homeless families are eligible for welfare benefits, but only 52 percent receive them.”[26]

More than one in eight households pay more than 50 percent of their income for housing, and another 2.5 million live in over-crowded or severely inadequate housing.[27] These factors contribute to interrupted educations, lack of adequate health care, persistent hunger, and higher crime rates. Children living with families that are homeless attend school less frequently, score lower on standardized tests, are less likely to graduate from high school and become productive members of society.[28]

Homelessness can both cause and result from serious health care issues. Homelessness can exacerbate drug and alcohol addictions. Other major causes of homelessness are unemployment or underemployment; high housing costs, including rising utility bills; domestic abuse; mental illness and substance abuse, with lack of treatment services; cuts in public assistance; and the general state of the economy. The study calculates the costs of homeless shelters, public housing, and public subsidies to private housing (including tax expenditures) at $69.1 billion.

Hunger.  In addition to being homeless, too many Americans are hungry. An estimated 14 million American children live in homes where there is not enough food.[29] Bread for the World reported that 35 percent of Americans had to choose between food and rent, while 28 percent had to choose between medical care and food, in the first half of 2004.[30] Other studies show that money devoted to food by families is typically the first to be sacrificed. Families will often pay their fixed payments first, such as rent and utilities, rather than pay for food.[31] The direct cost to other Americans to provide food for hungry people includes: food grants from non-governmental food pantries ($2.3 billion); the federal Women, Infants and Children (WIC) program ($5.2 billion); Food Stamps ($27.2 billion in 2004); school and other child nutrition programs ($11.9 billion); and other food assistance ($300 million), for a conservative $46.9 billion.

Energy.  Poor people cannot afford the full cost of heating and lighting their homes. Utilities, governments, and social service agencies have long assisted low-income ratepayers in paying their bills through such programs as the Low-Income Home Energy Assistance Program (LIHEAP), charitable fuel funds, levelized billing, discounts, home weatherization, energy efficiency, energy usage education, and arrearage forgiveness/debt management. Nevertheless, utility bad debt costs around $1 billion annually.[32] American utilities, through their ratepayers, paid an average of $3 per customer to collect bad debt and, in some cases, the cost was as high as $10.[33] If all Americans lived in weatherized and energy efficient homes, and had the income to pay their full share of utility bills, all other ratepayers would save nearly $6 billion in poverty costs, including fuel assistance, lifeline and other rate assistance; weatherization and efficiency costs; and the costs of late and unmade payments, such as service disconnections.[34]

Other Social Services.  Some additional anti-poverty programs and initiatives for which the average non-low-income household contributes, and which are not detailed above but are included in the total estimate of the cost of poverty, include the following:

• Legal Services and other civil legal aid -- $573 million;
• Transitional Aid to Needy Families (TANF) -- $27.5 billion, federal and states combined;
• Supplemental Security Income (SSI) -- $42.6 billion;
• Earned Income Tax Credit (EITC) -- $36.7 billion;
• Services to low-income seniors -- $1.830 billion;
• Other social services -- $2.673 billion;
• Community Services Block Grants -- $636.8 million; and
• Community Development Block Grants -- $4.116 billion.[35]

INVESTMENT NEEDED TO ELIMINATE POVERTY

The maximum investment needed to eradicate poverty in the United States is an amount that would raise the income of every low-income household to the minimum income required to be a non-low-income household. As explained above, there are investments that are more effective, as well as more cost-effective, than cash transfers to eradicate poverty – such as education, job training, nutrition, housing, and health care.[36] But even paying people directly to eradicate poverty is considerably less than the annual benefit that it would achieve by reducing the costs of crime, healthcare, unemployment and underemployment, and transfers and other current investments in low-income families.

Such investment would not even come close to raising incomes to the self-sufficiency income standard.[37] These are very detailed calculations, usually done on a county-by-county, state-by-state basis that take into account actual expenditures necessary to live a basic life in various family configurations. Bare bones budgets for a working family are calculated to include housing, child care, food, transportation, health care, clothing, household items, and taxes – no recreation, entertainment, or savings.[38] In particularly costly locales, such as along the two ocean coasts, self-sufficiency incomes can be as high as a state’s median income, as, for example, in Boston.[39] However, even in Atlanta, the self-sufficiency requirement for such a family is 90 percent of the state’s median income.[40]

Avoidable annual costs of poverty are described in the full report and fall into four broad categories. These are costs to the society at large that are caused by the existence of poverty and do not include the substantial costs to low-income households themselves.

Costs of criminal activity, including property losses, costs of the judicial and correctional system, and security costs;

Costs of healthcare, including costs that are preventable by improving healthcare and costs of low-income healthcare that are spread through the society;

Costs of unemployment and underemployment, including unemployment compensation, job training, and the multiplier effect of lost economic activity;

Costs of current anti-poverty investments, including costs for social services, elderly services, income supports, affordable housing, food, education, energy and utility supports, and block grants for community services and community development.

As substantial as these avoidable costs are, they are significantly understated. For example, this study conservatively did not include:

• many state expenditures;
• most non-governmental expenditures;
• increased risks of damage from fire caused by inadequate housing;
• increased pressure on energy prices caused by energy waste in leaky homes;
• increased property tax receipts caused by needed property improvements;
• increased borrowing costs caused by bad debt and slow payments of low-income consumers; and
• increased vulnerability to disasters such as hurricanes, causing additional requirements for disaster relief.

An additional benefit of eradicating poverty not fully quantified is the increased economic activity caused by the multiplier effect of increased income.[41]

These costs are shared by all non-low-income households, the number and median income of which are derived from the US Census. From these data, it is possible to compute the annual per-household burden of poverty:

It is also possible to compute a benefit:cost ratio on the assumption that investments are made to close the income gap in order to eradicate poverty and thus eliminate the avoidable costs of poverty described above.

Conclusion.  Investments in low-income Americans are among the most cost-effective investments we can make. Simple cash payments to low-income families may be among the least cost-effective investments against poverty in the long-run. Yet, as we show above, even simple cash payments sufficient to lift all Americans out of poverty would immediately be returned almost fourfold. Yet, as we have shown elsewhere, there are investment strategies on behalf of low-income families with even greater potential payoffs. For example, investing in weatherization and installing efficient appliances in low-income homes returns at least seven times the investment.[42] Investing in the education of three-and-four-year-olds returns nine times the investment.[43] Others have shown that investments in preventive healthcare earns a positive return.[44] Additional study should confirm the economic wisdom of other investments in low-income families. Indeed, in many cases, the science is established and the political decision has been made to create a program. All that remains to do in those cases is to adequately fund the existing programs.[45]

Weatherization, Head Start, and preventive healthcare are examples of under-funded cost-effective investment opportunities that have already been mentioned. Another example is childhood nutrition. It is well established that a nutritious breakfast and lunch determines a child’s ability to learn, with significant implications for later success in life,[46] just as it is well established that nutrition during the first two years of life, as well as of pregnant mothers, has an enormous impact on later health and intellect.[47] That is why there is a successful program to provide adequate nutrition to infants and pregnant mothers.[48] Similarly, this is the basis for the free and reduced price school meal program.[49]

Later in life, effective vocational training and re-training can turn a marginal worker into an economic success.[50] Investing in decent housing provides the first prerequisite for a homeless family to even participate in the economy.[51] All are cost-effective investments in low-income families that could pay huge dividends if expanded.

It is time for America to invest in eradicating poverty for the benefit of all Americans.

[1] We appreciate the opportunity to provide this information to the Committee. For further information, see the attached full report: “The Economics of Poverty: Benefits to All Americans from Investments to Eliminate Poverty” or go to our web site: www.DemocracyAndRegulation.com. We can also be reached by telephone: 1-978-283-0897 (office), or 1-978-335-6748 (mobile).

[2] Blane, Brunner and Wilkinson, Health and Social Organization, pp. 60-61, Routledge, London and New York (1996).

[3] Richard G. Wilkinson, Unhealthy Societies: The Afflictions of Inequality, p. 54-56, 76, Routledge, London and New York (1996).

[4] Whitney W. Addington, “No Health Insurance?  It’s Enough to Make You Sick – Scientific Research Linking the Lack of Health Coverage to Poor Health,” ACP Online, http://www.acponline.org/uninsured/lack-fore.htm.

[5] Joan Gralla, “U.S. Uninsured Health Care Cost Put at $125 Billion,” Common Dreams News Center, (Reuters, May 11, 2004).

[6] Himmelstein, et al., “MarketWatch: Illness and Injury As Contributors to Bankruptcy,” Health Affairs (Feb. 2, 2005).

[7] Michelle Chen, “Poor ‘Share’ More Costs Under Medicaid ‘Cost Sharing’ Initiatives,” The New Standard, (June 3, 2005).

[8] “Working without a Net: The Health Care Safety Net Still Leaves Millions of Low-Income Workers Uninsured,” (Families USA, April 2004). Other public health services include the State Children’s Health Assistance Program and local health clinics.

[9] “Future Medicaid Growth is not Due to Flaws in the Program’s Design, but to Demographic Trends and General Increases in Health Care Costs,” (Center on Budget and Policy Priorities, Feb. 4, 2005).

[10] “PHC4 FYI – Uninsured Stats Continue to Climb,” citing Kathleen Stoll, Director of Health Policy Analysis for Families USA, (Pennsylvania Healthcare Cost Containment Council, April 2005), http:/www.phc4.org/reports/fyi29.htm

[11] “PHC4 FYI – Uninsured Stats Continue to Climb,” (Pennsylvania Healthcare Cost Containment Council, April 2005), http:/www.phc4.org/reports/fyi29.htm; May 2004 report projecting 2005.

[12] Joan Gralla, “U.S. Uninsured Health Care Cost Put at $125 Billion,” Common Dreams News Center, (Reuters, May 11, 2004).

[13] S. Levitan et al., Programs in aid of the Poor, p. 274 (Johns Hopkins Press, 8^th ed., 2003).

[14] Kevin Carey, “Education Funding and Low-Income Children: A Review of Current Research,” Center on Budget and Policy Priorities (Nov. 5, 2002).

[15] Joan E. Ohl, “Head Start: Building on the Pillars of our Success” presented at the National Head Start Association Conference, May 28, 2003.

[16] Oden, et al., “Into Adulthood: A Study of the Effects of Head Start” (High/Scope Educational Research Foundation, 2005).

[17] J. Oppenheim and T. MacGregor, “The Economics of Education: Public Benefits of High-Quality Preschool Education for Low-Income Children” (Entergy Corp., n.d. [2002]).

[18] Minimum wage is $5.15 per hour. Average hours worked for a service worker is 32.4 hours a week or 1684.8 hours per year. Bureau of Labor Statistics. The total income would be $26,030.

[19] $26,640 in 2004. US Census.

[20] David Mericle, “Profiting from Poverty: The U.S. Prison-Industrial Complex,” Http://www.impactpress.com/aticles/febmar01/prisonind020301/html.

[21] http://www.ncpa.org/pi/crime/pd041100e.html, citing David A. Anderson, "The Aggregate Burden of Crime," Journal of Law and Economics (October 1999).

[22] http://www.ncvc.org/ncvc/main.aspx?dbName=DocumentViewer&DocumentID=38710, citing Miller et al. (1996). Victim Costs and Consequences: A New Look. Washington, DC: National Institute of Justice, U.S. Department of Justice. Online: http://www.ncjrs.org/pdffiles/victcost.pdf.

[23] http://www.ncvc.org/ncvc/main.aspx?dbName=DocumentViewer&DocumentID=38710.

[24] www.ojp.usdoj.gov/bjs/glance/tables/exptyptab.htm.

[25] “Overview of Homelessness In America” National Student Campaign Against Hunger and Homelessness, http://www.studentsagainsthunger.org/hunger.

[26] Jay Shaft, “US Homelessness and Poverty Rates Skyrocket,” (Information Clearing House, July 7, 2003), http://www.informationclearinghouse.info/article4305.htm.

[27] “The State of the Nation’s Housing” (Harvard University Joint Center for Housing, June 13, 2005) http://www.jchs.harvard.edu/media/son2005_fact_sheet.pdf.

[28] “A Plan, Not a Dream: How to End Homelessness in Ten Years,” citing research by Dr. Yvonne Rafferty of Pace University (National Alliance to End Homelessness, 2000), http://www.endhomelessness.org/pub/tenyear/cost.htm.

[29] “Hunger, Poverty and Nutrition Policy: Childhood Hunger, Childhood Obesity” (Tufts University 1995-2005), http://nutrition.tufts.edu/consumer/hunger/hunger_and_obesity.html.

[30] “Overview of Hunger In America” National Student Campaign Against Hunger and Homelessness, http://www.studentsagainsthunger.org/hunger.

[31] Id.

[32] Industry Solutions, The CBE Group, http://www.cbegroup.com/industry/utilities.aspx.

[33] “Utility Collections Best Practice: Theory Into Practice” (Peace Software White Paper, May 2005). http://www.peace.com/industry-watch/whitepapers/Peace-Collections-Best-Practice.pdf This paper also states that total utility bad debt written off in the U.S. each year is as high as $1.7 billion.  This study used the more conservative $1 billion.

[34] LIHEAP Clearinghouse, National Energy Assistance Directors’ Association (NEADA), National Center for Appropriate Technology (NCAT), National Community Action Foundation (NCAF).

[35] Legal Services Corp. fy2005 appropriation; "Documenting the Justice Gap in America" Legal Services. Corp, Sept. 2005; Tax Policy Center -- Urban Institute and Brookings Inst. Joint venture from OMB; http://www.whitehouse.gov/omb/budget/fy2006/treasury.html; U.S. Dept. of Health and Human Services – Office of Family Assistance; Center on Budget and Policy Priorities; http://www.ssa.gov/policy/docs/statcomps/ssi_monthly/2005-11/table01.html; National Center for Appropriate Technology (NCAT).

[36] S. Levitan et al., Programs in aid of the Poor at pp. 43, 262 et seq. (Johns Hopkins Press, 8^th ed., 2003).

[37] See generally http://www.sixstrategies.org/includes/productlistinclude.cfm?strProductType=resource&searchType=type&strType=self-sufficiency%20standard.

[38] E.g., D.Pearce and J. Brooks, “The Self-Sufficiency Standard for Georgia” (Women’s Policy Group, 2002).

[39] Self-sufficiency income required for a single parent with two children in Boston is $51,284. D.Pearce and J. Brooks, “The Self-Sufficiency Standard for Massachusetts” (Women’s Educational and Industrial Union, 2003). Massachusetts state median income in 1999 was $50,502. http://quickfacts.census.gov/qfd/states/25000.html.

[40] Self-sufficiency income required for a single parent with two children in Atlanta is $37,982. D.Pearce and J. Brooks, “The Self-Sufficiency Standard for Massachusetts” (Women’s Educational and Industrial Union, 2003). Georgia median income in 1999 was $42,433. http://quickfacts.census.gov/qfd/states/13000.html.

[41] At a multiplier of 2, the impact of an increase in income is doubled through the economy. This is accounted for in the report only with regard to unemployment.

[42] J. Oppenheim and T. MacGregor, “The Economics Of Low-Income Electricity Efficiency Investment” (Entergy, 2001, rev. 2002).

[43] J. Oppenheim and T. MacGregor, “The Economics of Education: Public benefits of High-Quality Preschool Education for Low-Income Children” (Entergy, n.d. [2002]).

[44] E.g., J. Abramson, M.D., Overdosed America at pp. 49, 166 (Harper Perrennial 2005).

[45] E.g., “Millions of eligible children do not receive free or reduced price lunches.” S. Levitan et al., Programs in aid of the Poor at p. 122 (Johns Hopkins Press, 8^th ed., 2003). “Whereas [the job training program phased out in 2000] ended with sufficient funds to enroll approximately 1 percent of those who  were eligible for its services, [its replacement program] adult ratio approaches the infinitesimal.” Id.  at p. 234. Housing programs are inadequately funded and do not pay enough in many markets to keep housing costs below 40 percent of income. “They simply need more resources to meet the needs of those eligible by cutting interminable waiting lists.” Id. at p. 272.

[46] E.g., J. Fraser Mustard, “Health and social capital” in D. Blane et al., Health and Social Organization, at p. 306 (Routledge, 1996).

[47] E.g., M. Wadsworth, “Family and education as determinants of health,” in D. Blane et al., Health and Social Organization, at pp. 154-156 (Routledge, 1996); J. Fraser Mustard, “Health and social capital” in id. at pp. 304-306; V. Lazariu-Bauer et al., “A Comparative Analysis of Effects of Early Versus Late Prenatal WIC Participation on Birth Weight: NYS, 1995,” 8 Maternal and Child Health Journal 77 (2004), www.springerlink.com/(baf1qf55lma12mnqiwgv13qi)/app/home/contribution.asp?referrer=parent&backto=issue,5,8;journal,9,38;linkingpublicationresults,1:105600,1; USDA, Economic Research Service, Effects of Food Assistance and Nutrition Programs on Nutrition and Health, Volumes 1-4,  and Nutrition and Health Characteristics of Low-Income Populations, volumes 1-4, www.ers.usda.gov/Publications/fanrr19-1/. 

[48] www.fns.usda.gov/wic/

[49] E.g., The “School Breakfast Program [p]rovides nutritious breakfasts to promote learning readiness and healthy eating behaviors.” www.fns.usda.gov/cnd/Default.htm.

[50] “Some form of postsecondary career preparation has become essential to earning a family-sustaining income. …***…skill training can be accomplished through apprenticeship or employment with an employer committed to substantial incumbent training … few will escape poverty or near-poverty in the future without setting foot on a substantial career ladder and following it upward.” S. Levitan et al., Programs in aid of the Poor at pp. 208-209 (Johns Hopkins Press, 8^th ed., 2003). See generally chapters 5-6. “Poverty prevention is more dependent on education than on any other factor, as is escape from poverty.” Id. at p. 274.

[51] “Marriage is unlikely to occur or last without [affordable housing].” S. Levitan et al., Programs in aid of the Poor at p. 271 (Johns Hopkins Press, 8^th ed., 2003).