The value of seeing and treating poverty as a health issue


December 28, 2017

In July of this year, Barry Ostrowsky, the CEO of RWJ Barnabas – the largest hospital-based health care provider in New Jersey — sat down with PBS talk-show host Steve Adubato to talk about RWJB’s recently developed “social impact initiative.” In Ostrowsky’s words: “It is an attempt to make communities throughout the state healthier by partnering with organizations to help individuals break down major personal and social barriers to achieving wellness.”
The Barnabas CEO began the discussion by explaining: “We’ve studied it for more than 20 years and found that social determinants, frankly the elements of poverty for the most part: unemployment, lower education, food insecurity, bad housing, these are the things that actually contribute to, and for the most part create, bad health in our communities. And so while we’ve concentrated on clinical care historically, we really haven’t concentrated on these social determinants of bad health.”

I could hardly wait for the next day’s business hours to commence so I could call Ostrowsky’s office, thank him for saying that, and volunteer to help Barnabas create new ways of providing preventive care and wellness services to the people who need them the most: the poor.

You see: I am an independent grassroots activist supporting the poor and homeless in my community as well as a national advocate for poor peoples’ rights. To date, I’ve written more than a dozen articles on poverty and homelessness in America that have been published by the Coalition for Human Needs, Talk Poverty, The Nation, Spotlight on Poverty and Opportunity, Real Clear Politics, Rebelle Society, and others. The topics have ranged from A Campaign to Broaden Prosperity to What to Know if you ever Face Homelessness.

Four months after my initial phone call to Barnabas – I was told by someone in Barnabas’s community relations office that Barnabas was like a gigantic cruise ship, “it does not make turns in course easily or quickly” – I met with three executives from Barnabas: their marketing director, vice-president of community affairs, and their community relations manager.

We agreed that there is a “trust deficit” and “communications problem” between the poor and homeless and large institutions like Barnabas.

Let me provide you with a snapshot of how this works.

We – the Barnabas execs and me – agreed to start out by holding one-day health care clinics on-site where the poor and homeless congregate.  The most obvious place to do this is at our Outreach Center, which assists the poor and homeless and is located near where many homeless people live.

Earlier this week we held our monthly free haircut day at the Outreach Center. A professional hair-stylist devotes one morning every month to providing haircuts to those who could not otherwise afford them.

One of the people who volunteers at the Outreach Center lost his construction job three months earlier and is in serious jeopardy of becoming homeless – behind on rent; credit cards maxed out. And another younger man there for a haircut was sick with a cold or flu.  The younger man lives in a tent in the woods; the weather the last few days had been at or near freezing.

I called one of my contacts at the hospital and asked if I could bring in someone for a job interview and also talk with them about what “community relations” between the poor and the hospital means in real terms.

They said yes.

I then asked the young man if he’d like us to drop him off at the emergency room of the hospital on the way to our meeting. He declined, citing his Medicaid status: “Medicaid only pays 61 percent of the hospital bill so you only get 61 percent service. Plus, once they find out you are homeless ‘their gives-a-shit meter shuts down’.”

So while my 60 plus year old, job-seeking friend was learning how to apply for a hospital job online I told the community relations person about what the younger man had said about their emergency room treatment of the homeless.

“That’s not true,” she said. “But true or not, I’m shocked to hear that that’s how people perceive us.”

It’s a start.

James Abro is the author of “Facing Homelessness.” He is also a grass roots anti-poverty activist in his community, as well as a national advocate for Homeless Citizens Rights. James helps others write about homelessness and poverty, providing editing and writing assistance. His articles have appeared in The Nation, and for blogs published by the Center for American ProgressThe Coalition on Human Needs and others. He is an active member of The Kairos Center for Religion, Rights and Social Justice.


health care
Housing and Homelessness
Poverty and Income