Poverty strikes health, education across region

The freezers at the Wesley House are running out of meat.

One freezer contains just five packages of hot dogs, while another freezer holds three small packages of edamame beans and one package of deer hamburger. All told, freezers that should be full are empty and becoming more empty.

These freezers are supposed to be full of proteins for those who need it — a surprisingly large number in this region. These pantries tend to get low from time to time during the year, but the cupboards are bare a little earlier this year.

Bare cupboards and freezers at the Wesley House are just one symptom of an ongoing problem in the Four States region. Declining health statistics and poor economic conditions are two more symptoms. The pervasive problem in this region is poverty, and it’s not going to go away.

Simple numbers

Pick any figure that details the impoverished, and those in Southeast Kansas and Southwest Missouri will be among the worst of the bunch.

Let’s start with the most basic: the percentage of those in local counties that are considered below the poverty level. In Crawford County, 15.6 percent of the population was below the poverty level in 2007. Neighboring counties Bourbon and Cherokee were at 16.3 and 13 percent.

But that was in 2007. Since then, the numbers have only gotten worse. Now, close to one in every five people in the county live below the poverty line.

In Crawford County, the number has risen to 19.2 percent. In Cherokee County, it’s 20.1 percent. Bourbon County improved slightly, to 15.9 percent, according to the U.S. Census Small Area Income and Poverty Estimates.

The sad statistics are not limited to the west side of the state line. Dade County in Missouri now has a 21.7 percent poverty rate. Lawrence, Jasper, Barton and Vernon counties — none of them have a poverty level below 16.5 percent. The lowest of area counties is Newton County, at only 15.5 percent.

There are a high number of poor people in the region. But how poor is poor? According to the Department of Health and Human Services, a family of four people living on less than $22,350 a year is considered in poverty. A family of two living off less than $14,710 a year or a single person making less than $10,890 are considered poor by federal standards.

And between one in six and one in five people in the region are below those annual salaries.

Even the median incomes in the region still don’t stack up. The Kansas median income comes in at $47,888 for 2011. Crawford, Bourbon and Cherokee counties don’t come within $10,000 of that number. Bourbon County comes the closest, at $37,192, Cherokee County is next at $36,204, and the median income for Crawford County is a paltry $35,407.

In fact, the top five worst median incomes in the state are all in greater Southeast Kansas (Elk, Woodson, Chautauqua, Greenwood and Crawford counties). In 2009, the City of Pittsburg’s median income alone was almost half of the state median income ($47,817 for Kansas, $27,976 for Pittsburg).

The numbers in Missouri are a mix of better and worse. The state median income is lower, at just $44,306, but still no county in Southwest Missouri comes close. Newton County is the only one with a median income over $40,000, at $40,955. Lawrence and Jasper counties are both slightly above Bourbon County in Kansas, with Barton County coming in at $36,851.

But below even the low numbers of Crawford County are Vernon and Dade counties in Missouri, at $34,985 and $33,452, respectively.

Detailed figures

Still not convinced? Perhaps the more frightening numbers are those that show not how many adults are affected by poverty, but rather those that show the number of children affected.

No county in Southeast Kansas or Southwest Missouri had fewer than 23.4 percent of their children below the poverty level in 2010. All were above state averages of 18.1 percent for Kansas and 21.0 percent for Missouri.

Jasper and Newton counties in Missouri were the lowest rates of poverty in children, at 23.4 and 23.7 percent, respectively. More than one in four children in Lawrence County in Missouri (25.8 percent) and Bourbon County in Kansas (25.7 percent) were in poverty. The numbers only rise from there.

Barton County in Missouri (26.7 percent), Crawford County in Kansas (26.8 percent), Missouri’s Vernon County (27.3 percent), and Kansas’ Cherokee County (28.2 percent) are among the next highest in the region, with Dade County in Missouri topping the list at 33.8 percent of their children below the poverty line.

Southeast Kansas in general is in the same boat. In 2010, there were 14 counties in Kansas with children in poverty rates above 25 percent. Ten of those counties were in Southeast Kansas. The numbers don’t change much. In 2009, of the 11 counties above 25 percent, 10 were from Southeast Kansas.

Another figure that details how many students need financial help is the percentage of students on free and reduced lunches.

Only one county — Jasper County — is below 50 percent, and only barely (49.2 percent),. The state average for Kansas and Missouri are 47.4 and 42.0 percent, respectively. The counties in Missouri are generally in the 50-60 percent range, from Jasper County on the low end to Dade County (57.1 percent) on the high end.

Kansas comes out the worse for wear on free and reduced price lunches. Crawford County has 59.1 percent — close to three of every five children — on free or reduced lunches. And they’re the lowest when compared to neighboring counties.  Cherokee County and Bourbon counties both have free and reduced lunches above 60 percent, at 60.9 and 62.0 percent, respectively.

Effects on Education

Those numbers are nothing new to Destry Brown, superintendent of USD 250 Pittsburg. The numbers for Pittsburg are even worse than Crawford County in general.

“Numbers wise, we’re at about 60 percent just for free lunch,” Brown said. “You can add another 10 percent for the reduced lunch. Almost 70 percent of our kids get free or reduced lunch when it’s all counted together.”

Education is often seen as the great equalizer. But according to Brown, poverty puts many students at a disadvantage at all stages of education.

It starts early, with the early grades in elementary schools.

“It takes them longer to learn how to read. We have to add interventions and resources to meet their needs,” Brown said. “We need to have smaller class sizes to help them out. We try to keep the numbers under 20 for kindergarten through 2nd grade.”

Generally, these poor students at the beginning of their education also have lower speaking vocabularies, and therefore lower reading vocabularies. The process of teaching new words is greater, too, with teachers having to build connections so the students can understand the words. In effect, Brown said this means teachers have to spend a lot more time trying to build vocabularies in young students.

By the middle grades, impoverished students need more small group work, more individual tutoring and more summer school opportunities.

In high school, the effects of poverty change.

“We typically see a higher dropout rate. We have put in several programs to keep some of those engaged and in school,” Brown said. “A lot of people living in poverty also didn’t graduate from high school, so it’s not a priority for their kids.”

More on Education

At the school district level, there are other considerations. USD 250 transports a lot more students than typical because of the demographics, busing students down to a half mile from schools, since many families in poverty may not have reliable enough transportation to get students to and from school.

Pittsburg also receives extra funding from Kansas and the federal government based on the number of students on free and reduced lunches and the number of kids in poverty.

“For us, that’s around 1,500 or 1,600 kids,” Brown said.

But even on a personal level in education, teachers and administrators have to think differently with students in poverty.

“The dynamics of relationship building are very different,” Brown said. “Take Westside Elementary as an aexample. We work at trying to connect with families outside of the school by going to them rather than waiting for them to come to us. Some of those families have a hard time coming to school because they had a bad experience themselves when they were in school.”

Westside, for example, has more than 90 percent of their students on free and reduced lunches.

Effectively, those numbers and issues put the onus on teachers and administrators to reach out to parents before small issues become full-out problems. It even extends to having patience with some families when problems do exist.

“We have noticed that people in poverty, the way they deal with problems with their children is that they usually get angry and start yelling,” Brown said. “It’s just how many know how to defend and stick up for their kids. It takes us more time sometimes because of that. Sometimes we get the feeling they think we’re out to get them. We try to get across that we want to work with them to solve whatever issue.”

Brown said he often feels like the deck is stacked against the district before even starting, but interventions and structures have been put into place. Studies have shown that kids in poverty typically perform worse on standardized tests, and although Brown said there is a gap between those in poverty and those who aren’t, he said the gap is smaller than expected because of preschool programs, early identification and other programs at USD 250.

He also noted that at least in this area, the numbers of kids in poverty are not just one ethnic group or one demographic. Poverty knows no boundaries.

“We have poverty in every racial category,” he said. “In fact, the largest group in poverty is white families. That’s just the demographics we have in this area. That may not be the largest percentage, but that’s the largest group. Our area is a lot more like the West Virginia area, which is economically depressed and there aren’t many available jobs. We’d be more comparable to that than Arkansas, because Arkansas is more racially diverse.”

While there are many programs, organizations and non-profit groups out there dealing with other effects of poverty, Brown noted one such program at two local elementary schools.

“Poverty adds a lot of stress in people’s lives. We have a program called Kids of Hope that we started because we have so many kids in poverty that their parents lose hope,” Brown said. “So we talk to them about their futures. We try to instill in their kids that they can graduate high school, they can graduate college, and we take them places and see things and give them desires to want to go to college and pursue a career. I think that’s the greatest effect we can have is to break that mindset.”

Effects on Health

Several organizations in Southeast Kansas exist to fight the effects of poverty on health.

The Community Health Center of Southeast Kansas (CHC-SEK) is looking to expand in the coming months to fight overcrowding and packed waiting rooms at its Pittsburg location. The Crawford County Health Department recently completed an expansion of its own.

“Unfortunately, my business is really good,” said Krista Postai, director of CHC-SEK. “Obviously, we’re the poorest region in Kansas. It has been for 100 years. We’re on fourth and fifth generation poverty. It has a huge impact on every aspect of life. Health is no exception.”

Just one aspect of health that is impacted by poverty is nutrition. Postai noted that for many people in poverty, macaroni and cheese is less expensive than an apple. And more and more boxes of macaroni and cheese tend to contribute to obesity.

Poverty is the problem, and the health of the region is the symptom, she said.

“We die younger in our area,” Postai said. “We are sicker than the rest of the state. The rates of every disease are higher. We have higher rates of suicide. Thirty percent of our working adults are disabled. At the end of the day, 90 percent of that goes back to the economic status of people in the region.”

Unfortunately, Postai said the numbers aren’t getting any better. And that just makes people sicker.

When in poverty, health care becomes delayed. When health care is delayed, minor issues become irreversible or end-stage, even.

The direct problems can include hypertension, asthma, diabetes and depression. Often, it’s not just any one or two of those problems. Sometimes it’s all four.

“Those in poverty have an increased risk of chronic diseases and an increased risk of mental health diseases, too,” said Janis Goedeke, Crawford County Health Officer. “They often don’t go to preventative visits, so it’s usually much worse when we see them.”

But it’s not just those in poverty that have this issue. It’s those just above the poverty threshold, too.

“A lot of people make too much to qualify for federal benefits, but they may have such a high deductible that they can’t afford anything,” Postai said. “They’re between a rock and a hard place.”

In addition to the direct health effects, Postai said she notices a higher frequency of depression and anxiety issues created by poverty.

And the problem is just made worse when forced to make a choice between prescription drugs or healthy meals.

“Poverty impacts everything. You can’t afford to follow up on even the simple things. It’s hard to be compliant to what the doctor recommends,” Postai said. “Not having money touches everything. Sometimes people are too proud to acknowledge a problem. With the older population, on several occasions I’ve heard stories of having to choose between eating and getting prescriptions filled. It’s not a new problem, but we’re seeing it more and more.”

Or, because of poverty, those affected by asthma go back to homes filled with mold or dust that aren’t clean enough to breathe properly. The underlying issue has not been addressed.

“It all comes down to poverty. People who lived in less than desirable situations couldn’t change those situations because of poverty,” Postai said.

When a family is in poverty, the slightest shock to the family’s assets can send them off kilter. That’s where groups like CHC-SEK and the Crawford County Health Department step in.

“Family dynamics are just a constant battle,” Goedeke said. “People can’t afford car insurance, but they have to drive. And if they do, eventually they’ll get pulled over and get a ticket they can’t afford. When they can’t pay the ticket, they can’t drive, and if they can’t drive, they can’t work. If they can’t work, they can’t buy groceries, they can’t find a suitable place to live and they can’t have electricity. It’s one vicious cycle. Our goal is to wrap around individuals and break one barrier at a time.”

Andrew Nash can be reached at andrew.nash@morningsun.net or by calling 231-2600 ext. 140.