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ItsNotJustAboutBadChoicesNYTimes.com

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SundayReview

OPEDCOLUMNI ST

ItsNotJustAboutBadChoices
JUNE13,2015

NicholasKristof

BALTIMORE
WHENEVERIwriteaboutpeoplewhoarestruggling,Ihearfromreaders
whosaysomethinglike:Folksneedtostopwhiningandgetajob.Itsall
aboutpersonalresponsibility.
Ina2014poll,Republicansweretwiceaslikelytosaythatpeoplearepoor
becauseofindividualfailingsastosaythereasonislackofopportunity
(Democratsthoughttheopposite).Idecidedtoasksomeofthepoorwhatthey
think.HereinBaltimore,IconsultedAndrewJacksonPhillipsJr.,28,whos
beenhomelessforthelasteightyearsorso,andhethinksthatthereis
somethingtothepersonalresponsibilitynarrative.
Ihadmultiplechances,heacknowledged.Imadesomebadchoices
althoughheaddedthathethoughtthesystemhadfailedhimaswell.
Iaskedabouthischildhood.Phillipssaidthathismotherhadbeenadrug
addictandthathemayhavebeenbornwithdrugsinhissystem.Hissiblings
hadhadacuteleadpoisoning,andhemayhavehadtoxicleadlevelsaswell,
withlifelongcognitiveandbehavioralconsequences.Atage3,Phillipssaidhe
sawhisbrothershotdead.Atage5,hehimselfwasshotintheheadbyadrug
dealer(heshowedmethescar).Intheeighthgrade,hedroppedoutofschool.
Sure,hemadebadchoices.Whoamongus,aftergoingthroughhis

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traumaticchildhood,couldbesureofmakingoptimalchoices?
Toooften,Ibelieve,liberalsdenythatpovertyislinkedtobadchoices.As
Phillipsandmanyotherpoorpeopleacknowledge,ofcourse,itis.
Selfdestructivebehaviorsdroppingoutofschool,joiningagang,taking
drugs,bearingchildrenwhenoneisntreadycompoundpoverty.
Researchershaveoftenfoundthatverypoorfamiliesworldwidespendmoreof
theirincomeonalcoholthanoneducatingtheirchildren.And,incentral
Kenya,agovernmentstudypublishedafewyearsagofoundthatmenthere,on
average,spentmoreoftheirsalariesonalcoholthanonfood.
Yetscholarsarealsolearningtounderstandtherootsofthesebehaviors,
andtheyrefarmorecomplicatedthantheconservativenarrativeofhuman
weakness.
Forstarters,thereisgrowingevidencethatpovertyandmentalhealth
problemsarelinkedincomplex,reinforcingways.IntheUnitedStates,a
Galluppollafewyearsagofoundthatpeoplelivinginpovertyweretwiceas
likelytohavebeendiagnosedwithdepressionasotherAmericans.Onestudy
in2010foundthat55percentofAmericanbabieslivinginpovertyin2001
wereraisedbymothersshowingsignsofdepression.
ThejournalJAMAPsychiatrylastyearestimatedthatmillionsoflow
incomeAmericanssufferfromparasiticinfectionssuchastoxocariasisand
toxoplasmosisthat,inturn,areassociatedwithcognitiveimpairmentor
mentalhealthdisorders.
Iestimate12millionAmericanslivinginpovertysufferfromatleastone
neglectedparasiticortropicaldisease,saysDr.PeterHotez,theauthorofthat
study.Themediaplacessomuchemphasisonimaginaryinfectiousdisease
threats,whenmillionsofpeopleinpoverty,mostlypeopleofcolor,have
neglectedinfectionsthatarealmostcompletelyignored.
Ifyourebattlingmentalhealthproblems,orgrowupwithtraumaslike
domesticviolence(orseeingyourbrothershotdead),youremorelikelyto
havetroubleinschool,toselfmedicatewithdrugsoralcohol,tohavetrouble
inrelationships.
Theresastrongassociationbetweenpovertyandlowmentalhealth,

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notesJohannesHaushofer,apsychologistatPrincetonUniversity.
Asecondlineofresearchhasshownthateconomicstressrobsusof
cognitivebandwidth.Worryingaboutbills,foodorotherproblems,leavesless
capacitytothinkaheadortoexertselfdiscipline.So,povertyimposesa
mentaltax.
SendhilMullainathanofHarvardandEldarShafirofPrincetonexplored
thisresearchintheirimportantbookScarcity.TheynotethatIndianfarmers
testabout10pointsloweronI.Q.testsbeforetheharvest(whentheyre
stretchedeconomically)thanafterward(whentheyreflush).Indeed,even
askingpoorpeopleinpsychologyexperimentstoimaginea$1,500carbill
leadsthemtoperformsignificantlyloweronI.Q.tests.
Itturnsoutthatwhenpeoplehaveelevatedlevelsofcortisol,astress
hormone,theyarelesswillingtodelaygratification.Researchershaveraised
cortisollevelsinresearchsubjectswhothenbecamemoreimpatientfor
immediaterewards,andthusmorepronetobadchoices.
Thisisareallydifficultconversation,notesHaushofer,becauseyou
veryquicklycanendupinthecornerofblamingthepoorforpoverty,and
thatsnotthemessageIvebeentelling.Rather,itscircumstancesthatcan
landyouinasituationwhereitsreallyhardtomakeagooddecisionbecause
youresostressedout.Andtheonesyougetwrongmattermuchmore,because
thereslessslacktoplaywith.
EstherDuflo,apovertyexpertattheMassachusettsInstituteof
Technology,wonderswhetherAmericasideologyofmobility,theHoratio
Algernotionthatpeoplecanpullthemselvesupbytheirbootstraps,may
empowersomepoorpeoplebutleaveothersfeelinglikefailures,brimming
withselfdoubtthatmakesbadchoicesallthemorelikely.
Certainlythatselfdoubtisubiquitousamongthepoor.
Everythingthathappenedinmylifewasbadchoices,BernardJackson,
53,whohasbattledpoverty,crimeanddrugsfordecades,toldmeherein
Baltimore.Itakefullresponsibilityforeverythingthathappened.
IsuggestedthatJacksonhadthedeckstackedagainsthim,considering
thathewasraisedbyasinglemominpoverty,begansmokingat10,andwas

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arrestedforthefirsttimeat13.Buthewasacceptingnoexcuses.
IfIdontgetintotherealcoreofwhatcausedtheproblem,Iwonthave
success,saidJackson,whoisonadrugtreatmentprogramandhasbeen
cleanfor10months.Therealproblemisme.IfIdontchangeme,Iwontget
anywhere.
Thatemphasisonpersonalresponsibilityispartofthe12stepprogramto
confrontalcoholismordrugaddiction,anditmaybeusefulforpeoplelike
Jackson.Butforsocietytoplacetheblameentirelyontheindividualseemsto
meacopout.
BillOReillyofFoxNewsisamongthemanycommentatorswhohas
emphasizedthisthemeofpersonalresponsibility.Ourcultureiscluttered
withexcusesforbadbehavior,OReillyhassaid.Itsalwayssomebodyelses
fault.Insomesense,hehasapoint,alongwithJacksonandPhillips:Bad
choicesarerealandhaveconsequences.
Letsalsoremember,though,thattodaywehaverandomizedtrialsthe
goldstandardofevidenceshowingthatcertainsocialprogramsmakeself
destructivebehaviorslesscommon.Infanthomevisitationcanreducelead
exposuresandhelpmomswithbreastfeedingandreadingtotheirchildren.
Mentalhealthoutreachreduceshomelessness.CareerAcademies,whichgive
atriskteenagersworkexperience,boostearnings.Familyplanningprograms
fortheneedypayforthemselves:AnIUDorimplantcosts$800,aMedicaid
birthisaround$13,000.
Soaslongasweretalkingaboutpersonalirresponsibility,letsalso
examineourown.Dontwehaveacollectiveresponsibilitytoprovidemoreof
afairstartinlifetoall,sothatchildrenarentpropelledtowardbadchoices?
Whentheevidenceisoverwhelmingthatwefailkidsbeforetheyfailus,
whencertainprogramswouldactuallysavepublicmoneywhileelevating
personalresponsibility,isntitalsotimetostopmakingexcusesforourown
selfdestructivebehaviorsasasociety?
Iinviteyoutosignupformyfree,twiceweeklynewsletter.Whenyoudo,youll
receiveanemailaboutmycolumnsastheyrepublishedandotheroccasional
commentary.Signuphere.

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AversionofthisopedappearsinprintonJune14,2015,onpageSR1oftheNewYorkedition
withtheheadline:ItsNotJustAboutBadChoices.

2015TheNewYorkTimesCompany

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