Alabama is a poor state that consistently ranks among the lowest in categories pertaining to child poverty. A town hall meeting hosted by the UAB School of Medicine sought to address these issues last week.
“Frederick Douglass once said, ‘It is easier to build strong children than to repair broken men,’” said Dr. Jaime McKinney, a general pediatrician at UAB who moderated the event. “I think that really encapsulates what we are trying to do.”
A 2014 study conducted by the National Center of Family Homelessness found Alabama to be the worst state in terms of child homelessness. The study found that about 5 percent of Alabama’s children under 18 are homeless.
In 2012 there were an estimated 35,239 homeless children in Alabama. In 2013, that number jumped to 59,349 — that’s one in 20 children without a home — well above the national average. Persistent homelessness, experts say, can lead to any number of health complications.
Research indicates that those in poverty will stay in poverty, McKinney explained. “Poverty leads to little to no education, which leads to low income, which leads to food insecurity and the cycle repeats,” McKinney said. “And with poverty you have a 31 percent greater likelihood that you will be hospitalized.”
In a related vein, the Alabama Department of Education recently concluded that 18 Birmingham City Schools were failing, which is a troubling number, said Randall Woodfin of the Birmingham Board of Education.
In 2015 Birmingham voted to increase the ad valorem tax in order to fund an expansion of pre-K classes offered. “Over 60 percent of that money, in addition to local revenue, would go toward putting a pre-K class in every school in the city limits of Birmingham,” Woodfin said. “We thought that was important because looking at our students’ K-12 performance and the gaps there, what we found was that the foundation had not been laid for these children.”
As of 2016, there is a pre-K class at every school in Birmingham, Woodfin explained, which will go a long way toward establishing a foundation for city students, but will not, by itself, solve all the problems that plague local children living in poverty.
“Overall we perform very poorly in reading comprehension. Overall, our children are at 21 percent of grade level reading. That is deplorable and unacceptable and doesn’t bode well for our community,” Woodfin said. “We are trying to have our community partners be on the same page so that our children will be able to read at a minimum grade level.”
Woodfin said he remains optimistic about the direction the school system is headed, citing several grants and initiatives that have recently been put in place to increase the reading level and test scores in the Birmingham City Schools.
At the other end of the educational spectrum, Kristina Scott, executive director of Alabama Possible, a statewide nonprofit focused on reducing poverty, said that only 33 percent of working age adults in Alabama have a two- or four-year degree. As a result Alabama’s median household income is $10,000 less than the national average.
“In the past you didn’t need a college degree to be successful in the state of Alabama,” Scott said. “You could go straight from high school to a mill or a quarry or steel plant. You weren’t going to get rich but you could support your family. By the end of the decade, 62 percent of the jobs in Alabama are going to require a [post]secondary education.”
Scott sees this as a major problem looming over the state. While 35.9 percent of white adults have a post-secondary degree, only 23.8 percent of African-American adults have completed college. “That’s a problem for all of us,” Scott said, adding that only 16 percent of Latinos in Alabama have a degree.
“If you have college-educated parents, you are far more likely to go to college. If you come from a place where you have a cycle of people being excluded from education, like we have in Alabama, you are at a serious disadvantage,” Scott said. More than half of Alabama children living below the poverty line do not attend preschool.
From a healthcare standpoint, children from poverty are at a much higher risk to be hospitalized or suffer from illnesses, compared to those on the other end of the economic spectrum, McKinney said.
“If you’re a single parent you not only have to worry about healthcare, but also the stressors of transportation, food insecurities and having the energy to tackle these issues,” McKinney said. According to a 2014 Jefferson County census, 19 percent of people live in poverty. “It really makes you wonder about the quality of life for the average Jefferson County citizen,” McKinney said.
Dr. Frank Franklin, professor emeritus at the UAB School of Public Health, said that UAB should take the lead in combating issues of childhood poverty. “I’m going to propose a community solution to reduce poverty and improve community health by harnessing the power of anchor institutions,” Franklin said. “I’m talking about ‘Eds’ and ‘Meds,’ such as major medical institutions like Children’s Hospital and UAB and the schools in town like UAB, Samford, Miles and so on.”
The majority of factors that lead to poor community health is not due to health care access or quality of care, Franklin said. “Actually 50 percent is due to the physical environment and socio-economic factors including education, employment and income,” Franklin said.
“One of the not-frequently discussed parts of the Affordable Care Act is the requirement of nonprofits, hospitals — to maintain their federal tax exempt status they must perform a community needs assessment and implement a strategy to address community health needs,” Franklin said. “Even a modest reinvestment of these current federal health exemption funds — which amounts to about $25 billion a year — investing only 20 percent of that in community health improvement would have a major impact here in Birmingham.”