Death in America

Dorothy Guellec

Most people do not take hunger in America seriously, but add this to cutbacks in food stamps, the daily need for insulin, and low wages, and then we really have a life-threatening situation here. If diabetics don’t eat, they can develop ketoacidosis, a potentially deadly complication of diabetes, if severe enough, can end up in coma.  A number of factors not directly related to the delivery of medical care have been shown to affect health status, including education, race, literacy, socioeconomic status, cross cultural stumbling blocks and the injustices of our Welfare system, constantly changing, and giving mixed messages about food stamp allocations to immigrants, both legal and illegal.

A survey of food insecurity among adult patients seeking medical care at the Hennepin County Medical Center in Minneapolis found that 24% of those interviewed has decreased the size of meals or skipped meals because they could not afford food: “12% said they did not have enough food; 13% reported not eating for an entire day because they could not afford food; and 14% said they were hungry but didn’t eat because they could not afford food. The study was published in JAMA April 15, 1998 – Vol 279, No.15 (Journal of the American Medical Association) so this is hardly conjectured. It was researched and written by Dr. Karin Nelson, Margaret E. Brown, MS; and Dr. Nicole Laurie who also holds a MSPH.

The authors described “during the past year, we have observed increasing numbers of patients in our practice setting who lack money to buy food. This is particularly troubling given the current implementation of welfare reform, in which nearly half of the cost savings come from reduction in food and nutrition programs.” They “undertook the study to determine the prevalence of hunger and to assess the level of food adequacy in adult patients who seek care at a public teaching hospital”.

Of the 567 patients interviewed in early 1997, 13% reported that during the previous year they had, on several occasions, not eaten for an entire day because they could not afford food. A separate survey of 170 diabetics revealed that almost 19% had suffered complications that resulted from not having enough money to eat. Hennepin County Medical Center, which is a public hospital in an urban setting, treats many low-income patients. About half of the patient sample had annual incomes less than $10,000, 11% reported being homeless for some period of time, and 20% reported having to live with friends or relatives because they could not afford housing on their own. “We hope this sends a message to policy makers,” said Dr. Nicole Laurie Professor of medicine and public health. “Cuts in food stamps may not be benign. It’s another example of squeezing the balloon.  There are clear health consequences and often expensive ones, at least for people with diabetes.” Dr. Laurie’s study estimates that 30 million people cannot obtain enough food to meet their daily needs. Her study charges that hunger is now as prevalent as such common medical conditions as hypertension, diabetes and heart disease.

The researchers wrote, “During the past year, we have observed increasing numbers of patients in our practice setting who lack money to buy food. This is particularly troubling given the current implementation of welfare reform, in which nearly half of the cost saving come from reduction in food and nutrition programs.” They were referring to The Personal Responsibility and Work Opportunity Act of 1996 (welfare reform), which disqualified most legal immigrants from receiving food stamps, and SSI (disability). Although the Balanced Reconciliation Act of the 1997 Congress restored SSI to many legal immigrants, food stamps were not restored. On March 27,2000 the Supreme Court refused to listen to the appeal which would have forced the government to restore food stamps and other benefits for legal immigrants cut off in the massive 1996 welfare overhaul.

People are allowed into the country but are denied benefits. In the one-line order the court let stand a lower court ruling that said the federal government was entitled to cut off benefits to noncitizen residents. The city of Chicago had sued to block these provisions. As part of the welfare system overall, these changes received very little attention, certainly not from the mainstream media. Chicago sued in 1997, arguing, “This type of discrimination is repulsive. The federal government, after all is solely responsible for the presence of lawful, noncitizens in the country. It should not be allowed to shirk all responsibility for their welfare.”

The diabetics in Dr. Laurie’s study had stopped taking insulin because they could not afford food. In this study, of the 103 diabetic individuals who reported hypoglycemic reactions (i.e., low blood sugar), 32 said it was because they could not afford food. The diabetics interviewed had rates of food insecurity and hunger that were quite similar to the rest of the individuals in the study. The authors suspected that “actual rates may be higher than those reported herein as some people may not admit to food inadequacy even if the problem exists.” Asian Americans are 2 to 3 times as likely as Caucasians to have diabetes. In Minnesota, Asians are the second largest racial group among children of color, and diabetes is one of the leading causes of death for this population.

Little did the U.S. government consider how drastic these food restrictions would be for the Hmong elderly in the country. Today there are over 150,000 Hmong refugees in America who came here unprepared and psychologically damaged from war-torn Laos. Because dependency rates are so high within Hmong communities, the Welfare Reform bill has stirred up much controversy. This is especially true amongst the elderly who are illiterate hence unable to take the citizenship test. Many have committed suicide as their only solution. They do not want to be a burden. In some counties the welfare dependency rate is 70%, higher than that of any immigrant group.

So where are we now? It seems that Congress has made a down payment on food stamp restoration for legal immigrants, but not for all of them. The Agricultural Research Bill sets aside a little over $800 million of the $1.8 billion in food stamp administration savings. The remainder of the savings will go to agents who write crop insurance, and increased spending for agricultural research. The measure falls short in many ways. Beginning 11/1/98 the changes

1. extended the refugee exemption from 5 to 7 years

2. restored benefits to Hmong veterans

3. restored benefits for Jay Treaty Indians

4. restored benefits for persons who are or who become disabled and entered the U.S. before 8/22/96

5. restored benefits to those who were 65 and in the country on 8/22/96.and

6. restored benefits to children who were in the country on 8/22/96

The package does not restore benefits to families with children-only to the children themselves; does not restore benefits to elderly persons who were already 65 or older on 8/22/96, and does not restore benefits to non-elderly, non-disabled adults.

One disturbing study by Physicians for Human Rights, found that 79% of legal immigrant households surveyed in March 1998 were “food insecure”—meaning they often went hungry and worried about when their next meal would be. The study coordinator. Jennifer Kasper of the Boston University School of Medicine notes that because hunger has been linked to asthma, diarrhea and anemia in children, “policymakers should consider the true cost of cutting food stamps.”

In the fall of 1997 Chia Yang hung herself in her garage. “She didn’t want to become a burden on her children if her SSI were cut. She didn’t want them to have to support her.” The 54-year old mother of seven was receiving SSI for her many disabilities; high blood pressure, panic attacks, diabetes, kidney stones, bladder infections, arthritis, night sweats, and even stroke. Her husband Sua Chai Vue was one of the many thousands of Hmong men who served in the CIA’s secret army.

I have tried to demonstrate a callousness and lack of compassion on the part of officials in high places, and their immediate and far reaching consequences down into the lives of people. The mainstream media editors can also share in this because they choose not to print these events. Stories left out are as important, if not more, than the ones that make it to print. Georges Seldes used to say, “tell the truth and run”. If we are so fond of saying that we live “in the greatest country in the world” over and over we must feel as insecure as the ones who are truly suffering from food insecurity – that’s an issue to be reckoned with!