BALTIMORE - Whenever I write about people who are struggling, I hear from readers who say something like: Folks need to stop whining and get a job. It’s all about personal responsibility.
In a 2014 poll, Republicans were twice as likely to say that people are poor because of individual failings as to say the reason is lack of opportunity (Democrats thought the opposite). I decided to ask some of the poor what they think. Here in Baltimore, I consulted Andrew Jackson Phillips Jr., 28, who’s been homeless for the last eight years or so, and he thinks that there is something to the personal responsibility narrative.
“I had multiple chances,” he acknowledged. “I made some bad choices” - although he added that he thought “the system” had failed him as well.
I asked about his childhood. Phillips said that his mother had been a drug addict and that he may have been born with drugs in his system. His siblings had had acute lead poisoning, and he may have had toxic lead levels as well, with lifelong cognitive and behavioral consequences. At age 3, Phillips said he saw his brother shot dead. At age 5, he himself was shot in the head by a drug dealer (he showed me the scar). In the eighth grade, he dropped out of school.
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Sure, he made bad choices. Who among us, after going through his traumatic childhood, could be sure of making optimal choices?
Too often, I believe, liberals deny that poverty is linked to bad choices. As Phillips and many other poor people acknowledge, of course, it is.
Self-destructive behaviors - dropping out of school, joining a gang, taking drugs, bearing children when one isn’t ready - compound poverty. Researchers have often found that very poor families worldwide spend more of their income on alcohol than on educating their children. And, in central Kenya, a government study published a few years ago found that men there, on average, spent more of their salaries on alcohol than on food.
Yet scholars are also learning to understand the roots of these behaviors, and they’re far more complicated than the conservative narrative of human weakness.
For starters, there is growing evidence that poverty and mental health problems are linked in complex, reinforcing ways. In the United States, a Gallup poll a few years ago found that people living in poverty were twice as likely to have been diagnosed with depression as other Americans. One study in 2010 found that 55 percent of American babies living in poverty in 2001 were raised by mothers showing signs of depression.
The journal JAMA Psychiatry last year estimated that millions of low-income Americans suffer from parasitic infections such as toxocariasis and toxoplasmosis that, in turn, are associated with cognitive impairment or mental health disorders.
“I estimate 12 million Americans living in poverty suffer from at least one neglected parasitic or tropical disease,” says Dr. Peter Hotez, the author of that study. “The media places so much emphasis on imaginary infectious disease threats, when millions of people in poverty, mostly people of color, have neglected infections that are almost completely ignored.”
If you’re battling mental health problems, or grow up with traumas like domestic violence (or seeing your brother shot dead), you’re more likely to have trouble in school, to self-medicate with drugs or alcohol, to have trouble in relationships.
“There’s a strong association between poverty and low mental health,” notes Johannes Haushofer, a psychologist at Princeton University.
A second line of research has shown that economic stress robs us of cognitive bandwidth. Worrying about bills, food or other problems, leaves less capacity to think ahead or to exert self-discipline. So, poverty imposes a mental tax.
Sendhil Mullainathan of Harvard and Eldar Shafir of Princeton explored this research in their important book “Scarcity.” They note that Indian farmers test about 10 points lower on IQ tests before the harvest (when they’re stretched economically) than afterward (when they’re flush). Indeed, even asking poor people in psychology experiments to imagine a $1,500 car bill leads them to perform significantly lower on IQ tests.
It turns out that when people have elevated levels of cortisol, a stress hormone, they are less willing to delay gratification. Researchers have raised cortisol levels in research subjects - who then became more impatient for immediate rewards, and thus more prone to “bad choices.”
“This is a really difficult conversation,” notes Haushofer, “because you very quickly can end up in the corner of blaming the poor for poverty, and that’s not the message I’ve been telling. Rather, it’s circumstances that can land you in a situation where it’s really hard to make a good decision because you’re so stressed out. And the ones you get wrong matter much more, because there’s less slack to play with.”
Esther Duflo, a poverty expert at the Massachusetts Institute of Technology, wonders whether America’s ideology of mobility, the Horatio Alger notion that people can pull themselves up by their bootstraps, may empower some poor people but leave others feeling like failures, brimming with self-doubt that makes bad choices all the more likely.
Certainly that self-doubt is ubiquitous among the poor.
“Everything that happened in my life was bad choices,” Bernard Jackson, 53, who has battled poverty, crime and drugs for decades, told me here in Baltimore. “I take full responsibility for everything that happened.”
I suggested that Jackson had the deck stacked against him, considering that he was raised by a single mom in poverty, began smoking at 10 and was arrested for the first time at 13. But he was accepting no excuses.
“If I don’t get into the real core of what caused the problem, I won’t have success,” said Jackson, who is on a drug-treatment program and has been clean for 10 months. “The real problem is me. If I don’t change me, I won’t get anywhere.”
That emphasis on personal responsibility is part of the 12-step program to confront alcoholism or drug addiction, and it may be useful for people like Jackson. But for society to place the blame entirely on the individual seems to me a cop-out.
Bill O'Reilly of Fox News is among the many commentators who has emphasized this theme of personal responsibility. “Our culture is cluttered with excuses for bad behavior,” O'Reilly has said. “It’s always somebody else’s fault.” In some sense, he has a point, along with Jackson and Phillips: Bad choices are real and have consequences.
Let’s also remember, though, that today we have randomized trials - the gold standard of evidence - showing that certain social programs make self-destructive behaviors less common. Infant home visitation can reduce lead exposures and help moms with breast-feeding and reading to their children. Mental health outreach reduces homelessness. Career Academies, which give at-risk teenagers work experience, boost earnings. Family-planning programs for the needy pay for themselves: An IUD or implant costs $800, a Medicaid birth is around $13,000.
So as long as we’re talking about personal irresponsibility, let’s also examine our own. Don’t we have a collective responsibility to provide more of a fair start in life to all, so that children aren’t propelled toward bad choices?
When the evidence is overwhelming that we fail kids before they fail us, when certain programs would actually save public money while elevating personal responsibility, isn’t it also time to stop making excuses for our own self-destructive behaviors as a society?
Contact Kristof at Facebook.com/Kristof, Twitter.com/NickKristof or by mail at The New York Times, 620 Eighth Ave., New York, NY 10018.