Living in poverty is a very complicated enterprise that requires vast amounts of emotional energy, time and money. You pay a "food tax" if there are no supermarkets in your neighborhood, because corner stores are more expensive. You pay additional fees to have electricity or the phone turned back on because you couldn't pay the bill on time, and you're at higher risk of losing your job because you have so little control of your environment and anything could happen at any time to keep you from getting to work.
This Washington Post article is one of the few I've seen that does a really good job of separating the strands:
Anajyha, a serious girl with two younger brothers and a mother who has lost two of her three part-time jobs, is growing up with an ebb and flow of food typical of a growing number of families. In her home, in a scuffed neighborhood called Strawberry Mansion a few miles north of the Liberty Bell, food stamps arrive but never last the month. There can be cereal but no milk. Pancake mix and butter but no eggs.
The intricacy of the problem -- and of the Obama administration's task -- plays out here, where Anajyha could have enough to eat but shortchanges herself.
Philadelphia offers a particularly vivid ground-level view of what researchers call a "silent epidemic" of hungry and undernourished youngsters. For years, local civic activists, health experts and politicians have tried some of the nation's most innovative experiments -- and learned how intractable hunger can be. Researchers here have also been at the leading edge in trying to fathom the effects of a scarcity of food.
Even when children are not hungry, studies have found that slight shortages of food in their homes are associated with serious problems. Babies and toddlers in those homes are far more likely to be hospitalized than children in families with similar incomes but adequate food. School-age children tend to learn and grow more slowly, and to get into trouble more often. Teenage girls are more prone to be depressed or even flirt with thoughts of suicide.
Solving the problem is further complicated by its subtle nature. "Most people who are hungry are not clinically manifesting what we consider hunger. It doesn't even affect body weight," said Mariana Chilton, a Drexel University medical anthropologist who is part of Children's HealthWatch, a network of pediatricians and public health researchers in Philadelphia and four other cities. Hunger cannot be solved by food alone, their work shows, because it is one strand in a web of pressures that trap families, including housing and energy costs.
This more nuanced picture is emerging as the problem has become more widespread. With the economy faltering, the number of youngsters living in homes without enough food soared in 2008 from 13 million to nearly 17 million, the Agriculture Department reported last month.
In Philadelphia, researchers found that, during the first half of this year, one in five homes with a baby or toddler did not have enough food. And one of every dozen young children was outright hungry, a rate twice that of the same period the year before.