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The Cause of Causes

October 23, 2016

“St. Martin and the Beggar” by El Greco (c. 1598), National Gallery of Art (Accession No. 1942.9.25), Source Web Gallery of Art (PD)

“Socioeconomic status is the most powerful predictor of disease, disorder, injury and mortality we have.”

– Tom Boyce, MD, Chief of Division of Developmental Medicine, Dept. of Pediatrics, UCSF

Epidemiologists term poverty the “cause of causes” because it underlies so many illnesses.

The life expectancy of an adult living at or below the federal poverty level ($11,770 per one-person household) in the Rust Belt or rural South is 7-8 years less than that of an individual making the average American income of $55,775 [1].

Race, Poverty, and Chronic Illness

Race further widens the gap.  Chronic illnesses (responsible for 70% of the deaths in this country) show earlier onset and greater frequency in minority populations living in poverty [2].

According to the Gallup-Healthways Well-Being Index, Americans living in poverty suffer from depression at twice the rate of those not in poverty.  Asthma, diabetes, hypertension, and heart attack rates are, also, higher among the poor [3].

And the United States is second to last among 29 developed countries ranked by child poverty rates – scoring worse than Poland, Latvia, Hungary, and Lithuania [4][5].

A Complex Relationship

The available data barely scratches the surface of the relationship between poverty and illness.

The relationship between poverty and depression is, we know, complex.  Depression can both cause and be caused by poverty [6].

Other health problems may be influenced by the limited healthcare available to the poor, and the environmental conditions under which they  live.  Lead pipes, for example, are common in America’s inner cities [7].

The Most Toxic Aspect

But the sheer stress of poverty may be its most toxic aspect.

The countless traumas of poverty – the absence of a reliable source of income (and, therefore, a reliable source of nourishing food); the chronic instability, including frequent relocation and school transfers made necessary by eviction; the unsafe neighborhoods; the dilapidated housing; the inadequate schools; the constant disappointments; the lack of resources, role models for success, or means of escape – take a terrible toll.

Those traumas deprive a child of all hope.  Later in life, the patterns of behavior they generate chain the children raised in poverty to the same destitution which held their parents captive [8].

If a brother or sister is naked and destitute of daily food, and one of you says to them, ‘Depart in peace, be warmed and filled,’ but you do not give them the things which are needed for the body, what does it profit?” (James 2: 15-16).

Thomas Aquinas famously argued that God is the First Cause – a cause unto Himself, and the origin of all other causes.

When we look into the face of poverty, we cannot help but wonder what role God plays.  Can He not feel the same pity we do?  Will He not intervene?

Yes, He can and will.  That is why He put us here.  We are not meant to recite homilies at the poor then pass them by, smug and self-satisfied.  We are meant to share their burdens, meant to share their pain.

After all, Christ does.  In fact, it is His face we see.

[1][2]  University of California, San Francisco (UCSF), “Poor Health:  When Poverty Becomes Disease” by Claire Conway, 1/6/16,

[3][6]  US News, “Americans in Poverty at Greater Risk for Chronic Health Problems” by Danielle Kurtzleben, 10/30/12,

[4]  UNICEF, Innocenti Report Card 11, “Children’s material well-being”,

[5]  Malaria, tuberculosis, and AIDs are responsible for about 18% of illness by the poor, worldwide.  Treatable childhood diseases like polio, measles, and whooping cough make up another 5%.  Respiratory infections take some 3.9 million lives annually.  Diarrheal diseases, the result of inadequate sanitation, take an additional 1.8 million.  See, World Health Organization (WHO), “Diseases of Poverty and the 10/90 Gap” by Philip Stevens, 11/04,

[7]  Huffington Post, “Poor Americans Face More Toxic Exposure”, 1/27/11, Updated 5/25/11,

[8]   National Child Traumatic Stress Network (NCTS), Family-Informed Trauma Treatment Center (FITT), “Understanding the impact of trauma and urban poverty on family systems:  Risks, resilience and interventions” by Collins, K., Connors, K., Davis, S., Donohue, A., Gardner, S., Goldblatt, E., Hayward, A., Kiser, L., Strieder, and Thompson, E., 2010,







  1. I often wonder how much of the damage that poverty does is related to the way we fail to love the poor? So many of the challenges poor people face have to do with broken relationships, being left behind, not having social networks, mentors and support systems. That’s what “wealth” is really all about, having the people resources and contacts you need to make things happen.

  2. Monochrome nightmares permalink

    Anna, you’re writing about the most
    powerful nation on earth.
    And yet, so many of your people are starving!
    And Donald Trump is running for president!
    The most frightening clown I have ever come across.
    Where will it all end?

  3. Not sure what Donald Trump has to do with the post Anna,but in the interest of fairness both candidates scare me. The fact that people still believe one particular candidate actually has the plight of the helpless near their heart scares me even more. Nothing could be further from the truth,TV commercials notwithstanding.

    In my opinion, this isn’t a societal issue,nor is it a political issue. At its core it is a heart issue. Jesus said that the poor would always be with us because he knew the heart of man is selfish at best. Simply stated,the God of self is in full control of the majority of us. And the poor and hungry among us suffer because of it.

    I’ve said this many times,that if the churches in America would have a heart transplant the issue of hungry children would disappear very quickly. The church has the resources and the means to make this happen. What it lacks is love in action.

    As long as Christians look to government to solve the problems mentioned in this post they (unsuccessfully) attempt to absolve themselves of one of its primary missions. What baffles me is that we refuse to accept the charge,or responsibilities given us by our Leader.

    • Evidently, I did not make myself clear, Ron. This was not meant as a “political” post. I intended to convey precisely the point that poverty is, above all else, a heart issue. No government program can substitute for that. We as Christians and we as a society have forgotten that we are our brother’s keeper. As for the candidates, both are in my opinion deeply flawed. Whichever is elected, I fear for the nation. God will, however, remain in control. I cling to that truth.

      • Absolutely agree with everything you say Anna. My apologies if I failed to understand.

      • I have yet to come across anything you need to apologize for, my friend. 🙂

  4. This so important to hear and so powerful. Thank you Anna.

  5. Nice Article.

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