Samuel Langhorne Clemons, a.k.a. MarkTwain, is famous for his ability to express a profound truth in a few pithy words. I frequently am reminded of his wisdom when I try to write. He is famous for saying “I apologize for such a long letter – I didn’t have time to write a short one.” But, there is some doubt that he was the first to express that idea. There is also some debate about whether or not he really said that the coldest winter of his life was the summer that he spent in San Francisco. Even his famous discourse on fabrications may not have been original. It probably is not true that he came up with the core concept that forms the thesis of his statement about prevarications. Never-the-less, he usually gets credit for the statement : “There are three kinds of lies: lies, damned lies, and statistics.” Do I care if he originated any of these ideas or just gets credit for passing them along?
I have thought of lies, damned lies, and statistics several times over the last two weeks as I have served as the “KREM steward.” Let me backup and provide some explanatory information. KREM stands for Kearsage Regional Ecumenical Ministries. If you click on the link you will learn that our mission is: “… meeting the emergency needs of people in the Kearsarge/Sunapee region when other services are unavailable.” Reading a little further you will discover the population we seek to serve.
Residents of the following New Hampshire towns, who have an emergency needs which cannot be met by other means may be eligible for KREM assistance: Andover, Bradford, Danbury, Elkins, Georges Mills, New London, Newbury, Salisbury, Springfield, Sunapee, Sutton, Warner, Wilmot.
A broad description of the problems we stand prepared to help can also be found on the site.
KREM can be of assistance when individuals or households have experienced …
- Unexpected loss of income
- Accidental Injury or serious illness
- Major crises which threaten children or families
- Other critical situations for which no other help is available
That last statement can be best interpreted as, “If you are suddenly presented with a bill or expense that you can’t afford and can’t neglect, call us.” These days the phone is ringing off the wall. There is verbiage on the website that is an attempt to educate visitors to the site of just how the social safety net in New Hampshire works. My sense is that it is a net that frequently fails to catch the fall of many of our more unfortunate or challenged neighbors. New Hampshire has employed a tactic that is seen with increasing frequency across the country: Make seeking help such an onerous task that no one who is stressed has the energy or expertise to ask. When the barrier to gaining help is so high that no one can climb the wall then the call for help and benefits goes unheard and the budgetary expense goes down. What I would argue is that the need does not go away, and like unattended medical issues, there comes a day when a much more expensive bill to society is presented in a way that can’t be ignored.
In New Hampshire, persons with little or no income may be entitled to financial help from their town or city. New Hampshire law (RSA 165) requires each town and city to have a local welfare program to help people who are poor and in need of assistance.
Individuals and families with low incomes may also be eligible for state assistance programs such as Temporary Aid to Needy Families (TANF), aid to the elderly, blind or disabled, food stamps, fuel assistance and/or WIC (Women, Infants & Children), as well as the federal Supplemental Security Income (SSI) program. Contact your Local Town Welfare Officer for assistance.
I could write volumes about what a porous social safety net exists in New Hampshire. I guess the slogan on our license tags says it all; LIVE FREE OR DIE. If you follow the link to RSA 165 you will discover, that the “floor” of help for the disadvantaged or poor is the town welfare officer. The largest towns, and the towns with the most robust tax base in the KREM service area are New London and Sunapee at about 4,500 and 3,500 residents each. Most of the towns are in the 1500 to 2500 population range. You can imagine the social stigma associated with “going to the town welfare officer” for help. If you do have the courage, and if you do not run into a neighbor who is at the town hall to get a permit or pay some taxes, the paperwork that must be completed to obtain help is much more complicated and intrusive of personal information than the old long form IRS 1040. If you do complete the forms for the town welfare officer, you are likely to be reminded that the town is entitled to recover the money it has “loaned you” by putting a lien on your property. Fortunately, despite this threat, I have not identified anyone who has lost a home through that process, but the threat works, as does the concept, be it real or rural legend, that if you have a relative who has property in town, the town may seek to recover funds from them.
The town welfare office is an example of either a lie or a damn lie. Town welfare is advertised as a source of help, but that help seems to rarely occur in a timely fashion. You can’t preapply for “just in case” insurance. New Hampshire residents do get their fair share of federal programs like social security, social security disability, food stamps (SNAP), and may be eligible for fuel assistance assistance from a federally funded program, but the place most people in the region who need immediate help turn to is KREM. KREM has been an asset to the community for over twenty years. We have a simple intake process that is respectful of privacy, and we will give you the help you need in a timely, often same day, fashion. We give vouchers for food or gas. We will call the electric company for you and negotiate getting your electricity turned back on. I have even seen us “rescue” a client from darkness while the man from the electric company was on the pole outside their window. We will buy tires for your car or get it repaired. Helping a client get the family clunker past inspection is a frequent activity. The run up to winter, beginning about now, and winter in its entirety, are the times when we hear the most calls for help. We will definitely find a way to get oil, propane, or wood delivered to you so that you and your children won’t freeze. What we don’t do is give you a lecture about your past mistakes, or make any suggestion that your current plight is a function of some character flaw with in you.
Recently, we have seen the need for a companion organization that can take referrals from KREM or from other sources, that we are calling Kearsage Neighborhood Partnership, or KNP (in the vernacular of acronyms, spoken as “Kah nip.”) KNP will offer long term neighborly advice and assistance in maximizing resources, helping in interactions with the bureaucracy, and provide friendly emotional support for those who feel overwhelmed by the multiple issues they face.
KREM has no employees. It’s work is done by a “board” of ordinary citizens that are drawn from the local churches that provide much of the funds that are distributed . I joined the board about two years ago. About twice a year each of the members of the KREM board carries the phone for two weeks. The phone is the source through which calls come from clients who need help. As much as possible, we set a boundary of partial anonymity when we return a call. I will usual say, “Hello, I am Gene, a KREM steward. How can I help you today?” The process reminds me of my “on call” experiences as an intern or resident almost fifty years ago, or it might be like the experience of a general practitioner in a small community. The phone calls come at unpredictable and often inconvenient times. You never know beforehand what the extent of the challenge will be, or just how much time, or how many phone calls it will take to marshall the resources necessary to meet the need.
We even have records that remind me of the voluminous charts that I once would trudge to medical records to recover in the middle of the night. Now, as then, if I am lucky, there will be a name and a phone number of a contact who might be a resource, or some other piece of information that will provide some critical insight that will lead to a quick resolution of the problem. Then, as now, I am frequently left with the impression that there “must be a better way,” or all of this could have been avoided “if only…” Like all clinical systems, communications and collaboration are important. When I am on call I reach out to other board members for help with situations that I have not encountered before. We have a resource manual that is continuously updated and improved. Our meetings are brief reviews of our financial status followed by in depth discussions of cases and ways in which we can continue to improve the service we offer.
I have commented before on the unbelievable statistic that 40% of Americans would need a loan if they had an unexpected bill of $400. Serving as a KREM steward has introduced me to many of my neighbors who are members of that 40%. What the statistic doesn’t reveal is that like it is true with episodes of disease, surviving one “attack” often weakens you and makes you more vulnerable to the next challenge.
What was a surprise to me when I first started was that these poor people are not unemployed. At 2.5 % in June 2019, New Hampshire has one of the lowest rates of unemployment of all the states in the nation. That is a statistic that feels worse than a “damn lie” because many of those “jobs” pay $7.25/hour, the minimum wage, and don’t yield a “living wage.”
According to the living wage calculator for Merrimack County, New Hampshire, the living wage for a family of two adults (one working) and two children in our area is $25.34/hour, or roughly $50,000/year. The living wage for a single adult is $12.19 or about $25,000 annually. I rarely encounter an individual or a family in need of help who earns at these levels. There are at least two reasons that the cost of living is so high here, housing and transportation. The cost of food and services are similar to Boston. I recommend that you click here and explore the Living Wage calculator from MIT. The typical expense of rent from $800 to $1200 a month, plus utilities, is consistent with the information that I get from clients, and largely explains some of the statistical lies which I will describe below.
I have met clients that work more than one job, their spouse or partner works, and they still do not earn a living wage although they may earn enough to be above the federal poverty level which is $12,140 for an individual and $25,100 for a family of four. In 2016 New Hampshire had a poverty rate of 7.3%, the lowest in the whole country. That statistic is in essence a lie, and it comes from federal standards that are lies that have such a hurtful impact on individuals and families that they should be called “damned lies.” In May the largest paper in the state, The Manchester Union Leader published an article entitled “New Hampshire ranks second overall in ‘Best State’ survey.” Really? My take is that if you cluster multiple misleading statistics you can create a real “whopper” of a damned lie.
Statistics are more than a numerator and a denominator multiplied by a hundred and compared to a list of other percentages. Income and percent of employment may be high in New Hampshire, but because housing costs are very high and in most parts of the state you need a car to be employed what might be true in Idaho or Alabama is not the reality in New Hampshire. But, even if the statistics are correct and still look good after everything is “normalized” to a local cost of living, and the extra efforts made by people to hold down multiple jobs and get their income up by working sixty or eighty hours a week are disregarded, it is outrageous that even 7% of the population is suffering the physical pain, anxiety, and the humiliation of “living on the edge” as defined by a standard that is a “damned lie” based on even more outrageous statistics that do not conform to reality.
It takes a lot of strategic thinking to survive when you are poor. Do you pay the electric bill, and pass on the overdue balance with the fuel company? Can you make a tweak that will allow your car to pass inspection? Do you know which food pantry has paper products for free since you can’t buy those with food stamps? Which church runs a “store” where you can fill a brown paper bag full of clothes for you and your daughter for $5.00? Is you child signed up for the “backpack program” at school so that they can bring home enough food to get through the weekend? It may be fun to spend the weekend in a rusty old camper down a dirt road in the woods near a lake like the one in this week’s header, but what if you and your children live in a camper all the time in the state where you are told that everybody has a job and only residents of the state of Washington have it better than you? There are many roads in the woods near me where people are living in very marginal circumstances not far from multimillion dollar homes. It is a very strange juxtaposition of opulence and poverty that is a visual presentation of some form of an unhealthy economic reality.
Many of us consider opioids and gun violence to be public health problems. New Hampshire is up there statistically in the opioid crisis. We are in the top five in opioid deaths, or should I say the bottom five? We also own a lot of guns, and allow “open carry.” I don’t have any lies or statistics to support my impression, but it feels like our level of poverty, as low as the statistics suggest it is, is a bigger public health issue than are guns or opioids. I have a bias that there are connections between all three.
In last Friday’s post I quoted from an editorial in my regional newspaper, “The Valley News.” One of their core ideas that keeps coming back to me was:
…even if there were a “normal” to revert to, it must be remembered that that normal gave rise to a large number of embittered Americans who felt left behind as the rest of the country moved ahead, and who were primed to respond to the politics of grievance…
Perhaps one significant consideration is that even if it is true, and not a damn lie, that New Hampshire is number one or two in optimal economic status in America, and by extension of that reality, there are at least 48 states where things are worse, we have a national problem that has implications for the health of the nation that we are ignoring. The damned lie of statistics says that only 7% of our residents live in poverty, but there must be many more who live “near poverty” and their attitudes and fears need to be addressed in a way that does not undermine our attempts to improve the social determinants of health.
The most vulnerable people that KREM sees are children, single women who are victims of domestic abuse and are are trying to support a family alone, and the elderly. Fortunately, because of the ACA and the state’s reluctant and conditional acceptance of the ACA, they all theoretically have access to some form of healthcare. Many cases I hear begin with the realities of domestic abuse. Our local hospital is attempting to address the social determinants of health, but what I see when I am on call for KREM, and when we review our twenty years of statistics, is that the pain of poverty has never been greater in our area than it is now, and I shudder to think about what the downstream impact on the health of the children and others who are struggling will be. I am reminded of another old “saw” that describes the experience of poverty that I doubt has been attributed to Mark Twain, “The harder I/we try, the behinder I/we get.” Does it really have to be this way? KREM is a wonderful organization doing Mother Teresa like work, it is necessary in this moment, but the sad reality is that it can never really solve the problems that it tries to ameliorate. Solutions can only occur through changes in public policy.
I grew up listening to my father’s stories of being the son of a poor mill hand in the depression. If, like me you have been enjoying, Ken Burns’ latest production, a historical appreciation of Country Music, that is currently showing on PBS, then you have seen some of the devastation that poverty can bring in the lives of people who are trying hard. Historians may quibble, but there is little doubt in my mind that without Roosevelt’s New Deal, there would have been more suffering. Leadership, public policy, and a national war time effort that brought the country together led to a unity of purpose, which though never completely encompassing, and continuously flawed by racism, did bring us a better day. We need policies and a leader that might ultimately make organizations like KREM unnecessary. Our country has the capacity to lift everyone out of poverty. Do we have the will? And if not, what might be the price we all eventually pay?
