This new Consequences of Insufficient Household Income report provides a deeper level of understanding of the choices that ALICE and poverty-level families across the country make when they do not have enough income or assistance to afford basic necessities, and the consequences of those choices.
Strategy 3: Forgo Other Essentials ALICE and poverty-level households often neglect other needs in order to afford food, most frequently forgoing much-needed medical care. They are more likely than other households to have no regular source of medical care and to postpone purchasing or taking medications. Children in food insecure households are also more likely to skip recommended well-child visits (Ma, Gee, & Kushel, 2008). Dental care is even more likely to be ignored, with many food insecure households reporting that they had not visited a dentist in the last five years (Harrison, 2003; Chi, Masterson, Carle, Mancl, & Coldwell, 2014). The other key area that competes with paying for food is paying for housing. In a survey commissioned by Feeding America, 57 percent of respondents reported choosing between food and rent or mortgage payments. Up to 69 percent could not cover the costs of both food and utility bills in the previous year, and 34 percent faced that dilemma every month (Feeding America, 2014). Consequences Less money for other necessities: As an ALICE family’s food costs rise, other current needs are compromised, including doctors’ appointments and medicines, child care, heat and other utilities, or housing itself. These deprivations, as well as the stress they cause, can increase the need for health care, which becomes yet another expense. Less money for savings: Choosing food over other essentials also means that less money is available to save for future expenses such as higher education or retirement, and less is available should an emergency arise in the present. That lack of savings creates a vicious cycle of financial instability, and increases the risk of higher costs for health care and social services over the longer term (Belsky, Goodman, & Drew, 2005; National Low Income Housing Coalition, 2016). THE BROADER COSTS OF FOOD INSECURITY Not having sufficient income to afford enough food or healthy food has consequences not only for ALICE’s health, but also for the strength of the local economy and the future health care costs of the wider community: • Many of the strategies people use to avoid hunger are not sustainable, particularly eating cheaper, less healthy food and selling or pawning personal property to have money for food. In fact, these strategies are likely to lead to more families becoming ALICE or slipping into poverty, either through poor health and additional health care costs or reduced assets to weather an unexpected emergency (Feeding America, 2014). • In 2014, the U.S. spent an estimated $160 billion on health care costs related to hunger and food insecurity, as estimated by the Bread for the World Institute. These costs are borne substantially by Medicare and Medicaid, but also by employers and communities. Adults and children suffering from food insecurity are more likely to have no source of usual health care or to ignore health problems until they become severe. As a result, they are more likely to need hospitalization and to visit emergency rooms (Ma, Gee, & Kushel, 2008; Weiser, et al., 2012; Kushel, Gupta, Gee, & Haas, 2006; Cook & Poblacion, 2016; Seligman H., 2016). 46 UNITED WAY ALICE REPORT – THE CONSEQUENCES OF INSUFFICIENT HOUSEHOLD INCOME
FUTURE TRENDS: FEEDING ALICE More young adults are using food pantries. Food pantries are used by households of all ages, but they have been growing significantly as a resource for people under the age of 25, the group most likely to be ALICE or to be in poverty in all states included in the United Way ALICE Project. Reports consistently find higher rates of food insecurity among college students – 59 percent among students at Western Oregon University, for example – and private charitable contributions through food pantries have responded accordingly. Across the country, the number of university-affiliated food pantries rose from four in 2008 to 121 in 2014, and colleges continue to build them (Bahrampour, 2015). The number of people receiving longterm food assistance is increasing. There has been a shift in the use of food pantries since the Great Recession. Food pantries continue to be used as emergency Robert, a 50-year-old living in Lansing, Michigan, is so worried about putting food on the table for his wife and son that he has donated plasma for a fee. Despite working for an auto parts supplier, Robert brings in just enough money to pay the bills, but not always enough for the food bill. “Towards the middle of the week, there are times I go without lunch so I can make sure there is enough food in the house for my wife and son,” he says. He works a union job, but has to pay 20 percent of his health insurance (about $200 a month) and pays child support to his ex-wife for his two other children, who live with her. “Now that my son is getting older, we find it more difficult to get him what he needs for school and for other activities he wants to do as an 8-year-old,” Robert says. They live in a modest home and Robert drives an old pickup truck. Despite their struggle, Robert donates to the local United Way and to his church, where he also volunteers every Friday night. “We don’t have much but we try to give back to our community where we live,” he says. “Life is such a struggle that at times I wonder what it’s all about. Then a small voice tells me it’s about the future and the next generation. That’s what keeps me going.” Photo courtesy of United Way UNITED WAY ALICE REPORT – THE CONSEQUENCES OF INSUFFICIENT HOUSEHOLD INCOME 47
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