Cincinnati’s Child Poverty Crisis: One of the Worst in the Nation
For much of the past decade, Cincinnati’s child poverty rate has ranked as the second highest in large cities of the United States. As of 2019’s American Community Survey, over 40.4% (or 2 in 5) children in the city of Cincinnati live below the federal poverty line — an appallingly high value in comparison to the national average of 19.5% (UpSpring, 2021). Although the nationwide rate of child poverty is still rather grim, it has generally been on the decline over the past decade. Cincinnati, however, cannot claim to mirror the behaviour of most large American cities; according to the Cincinnati Enquirer, the Queen City’s child poverty rate has continued to fluctuate since the Great Recession of 2007–2009, increasing by 32.4% between 2008–2013 to reach a staggering 53.1% (Horn & DeMio, 2019). Cincinnati’s slow tackling of child poverty lies in the deeply rooted and systemic impoverishment of African American communities, ignored plights of impoverished women and mothers, and a reluctance for Cincinnati society to address a maternal and infant mortality rate that primarily affects African American women.
It is no secret that the effect of child poverty in Cincinnati is disproportionally skewed by race. Upon examining BestNeighborhood’s interactive maps of the Greater Cincinnati area, it is easily noticeable that areas in which the per capita income and household income is lowest, match up with the areas in which minority populations — particularly the African American community’s population — are highest (BestNeighborhood, 2021).
The story of African American populations being disproportionally impoverished in comparison to white residents of cities is unfortunately a familiar story in America. Richard Rothstein reminds us in his short film, Segregated by Design, that when planning the cities of America, it was “the intention of the federal government to segregate neighbourhoods throughout the nation…” (Rothstein, 2019). President Roosevelt’s New Deal First Civilian Public Housing Program demolished a series of integrated neighbourhoods to create segregated public housing; Lyndon B. Johnson’s Austin Housing Authority forced African Americans into a specifically designated ‘ghetto’; and the Federal Housing Administration subsidized suburban communities on the condition that houses only be sold to white families while prohibiting resale to African Americans (Herriges & Rothstein, 2019). As such, the quality of education in inner-cities in comparison to suburban public school systems mirrors the quality of life in each area. As African Americans historically were forced into low-quality inner city public housing, while white populations were ferried into higher-value suburbs, white populations funded higher quality public schools through taxation that the inner-city African American populations intentionally could not imitate (Herriges & Rothstein, 2019).
But if, sadly, the case of urban vs. suburban segregation of America is synonymous with most of America’s cities, why is Cincinnati’s child poverty rate recovering so poorly compared to the rest of the nation? Researchers of the phenomenon rightfully tackle hunger and education rates, but for Cincinnati’s crisis I would argue that racial biases in medicine — particularly in obstetrics and gynecology — and high frequencies of unwanted teen pregnancies cause Cincinnati’s abysmally high infant and maternal mortality rates’ that contribute immensely to the crisis. Tackling such issues alongside hunger and education quality may remove Cincinnati from its unenviable status.
Ohio’s Hamilton County — which includes the city of Cincinnati and many of its surrounding suburbs — cowers behind its terrible infant and maternal mortality rate which ranks at the second highest in the nation (Stankorb, 2018). While hunger continues to be addressed, I wager that tackling this sub-crisis may be the key to removing Cincinnati from its infinitely increasing child poverty rate. Kathleen Brinkman of The Cincinnati Enquirer references research by the CDC that proves teen pregnancies significantly contribute to female high school dropout rates, and that tackling unwanted pregnancies would naturally reduce the rates of girls ceasing their education and rendering themselves unemployable for higher-paying jobs (Brinkman, 2016). Teens in already impoverished areas of Cincinnati who don’t have access to abortion clinics, or who choose to follow through with pregnancies, would likely struggle to financially support a child, unfortunately perpetuating a status of poverty. Even teens who do not come from poverty may end up impoverished because of unwanted pregnancies if they are not already financially self-sufficient. Unfortunately, for teen girls who grow up in poverty and become pregnant, health is incredibly difficult to maintain, and mortality can easily result.
Brinkman therefore emphasizes the importance of services supplied by Planned Parenthood, which continues to supply low-income areas with birth control units, long-acting reversible contraceptives, access to on-site abortion clinics, and education about gynecological health and pregnancy (Brinkman, 2016). Brinkman’s hypothesis proves worthy: according to Paola Suro of WCPO Cincinnati, “in 2017, the teen pregnancy rate [was] down in Cincinnati [for the first time in decades], and officials say the availability of quality birth control is behind the drop” (Suro, 2017). By democratising contraceptives — particularly long-term ones, such as IUDs — not only can Cincinnati prevent unwanted pregnancies, but with Planned Parenthood’s support, young girls can also have quality gynecological education (Planned Parenthood, 2021). Imparting on vulnerable young women knowledge about the immense life changes that arrive with pregnancy while providing contraceptive material and services would surely reduce occurrences of unwanted teen pregnancies. Making sure that teenage girls are not at risk of becoming pregnant when their life is not ready to handle such financial responsibility may decrease the number of impoverished young mothers and children, and thereby lower the mortality rate of mothers and infants.
Secondarily, to tackle the infant and maternal mortality rate, I feel that it is imperative to focus on Cincinnati’s racial bias in the OBGYN medical industry. The United States has the highest rate of maternal and infant mortality of any developed nation in the world, and to be the county with the second highest rate in the US is appalling. According to Lucy May of WCPO Cincinnati, “African American women [in Cincinnati] are nearly three times more likely to die of a pregnancy-related condition than white women…and 57% of those deaths could be prevented.” (May, 2020). Given that Cincinnati’s areas of poverty coincide with highly concentrated populations of particular races, it is important to understand child poverty’s relation to the high risk of African American maternal mortality in the city. The Ohio Department of Health revealed that 29.5 black mothers vs. 11.5 white mothers per 100,000 live births die, excluding births whose complications led to stillborn babies. Causes of these racially skewed deaths take the form of insurance differences, financial and marital status, and education, but racial biases remain a prominent reason still. Dr. Roosevelt Walker, president of the Cincinnati Medical Association, cements that, “even when exhibited subtly, implicit racial bias is at the root of the racial disparity in maternal deaths” (May, 2020). He continues to assert that, “the danger is that the implicit racial bias affects the way a healthcare provider interacts with the patient, the diagnosis that the healthcare provider assigns, and even treatment options for the patient can be influenced by racial bias.” The medical industry is notorious for discounting the needs of black women, especially in comparison to white women, and pregnancies prove to be no exception. The reality is often women’s issues, racial issues, and especially women’s issues based on race take the back burner in tackling any societal problems.
Fortunately, movements like Cradle Cincinnati, whose mission is to lower the rate of infant mortality in the city, particularly focusing on the plight of African American mothers, have been making significant strides to ameliorate Cincinnati’s crisis. The executive director of Cradle Cincinnati, Ryan Adcock launched initiatives to support black mothers in the city: he kickstarted the introduction of healthcare workers to vulnerable communities, group prenatal care that encouraged black women to attend, strong implicit bias training for healthcare workers, and policy-based legal solutions with Ohio’s legislators advocating for better Medicaid reimbursements (May, 2019). Cradle Cincinnati offers emotional support and the forging of a supportive community for black mothers in need to foster a city in which the upholding of their medical rights, especially in pregnancy, are achieved. In tandem with medical institutions, Cradle Cincinnati could unpack the biases that inhibit black women from receiving appropriate pregnancy care that they need and request. According to Elizabeth Chuck of NBC News, to combat implicit biases in medicine, hospitals have begun to introduce participation in the Harvard Implicit Association Test to determine and combat any and all biases that would negate from uniform quality healthcare based on a person’s belonging to one sect of humanity (Chuck, 2018). Medical institutions must accept the initiatives proposed by NBC and Cradle Cincinnati to understand and eliminate a primary cause of maternal mortality for black women; once they do, we can expect the mortality rate to decline, and with it, the child poverty rate.
To fully combat Cincinnati’s maternal and infant mortality rate, I suggest an organized coalition of Cradle Cincinnati, Cincinnati’s medical institutions, and Planned Parenthood. Cradle Cincinnati and Planned Parenthood have proven their success by advocating for at-risk communities in reintroducing trust in medical institutions for black women, that understandably has faltered in the past. Furthermore, giving democratic access to teen girls to the services of Planned Parenthood — contraceptives, safe abortion clinics, pregnancy education — can only decrease the risks of financial and health complications due to unwanted teen pregnancies. Currently, only three Planned Parenthood locations exist in the Greater Cincinnati area, and only one is in the vicinity of the highly vulnerable downtown Cincinnati area.
I strongly believe that introducing more Planned Parenthoods to downtown Cincinnati, introducing their service to high schools, funding and broadcasting Cradle Cincinnati’s efforts, and having both services collaborate with Cincinnati’s Health Commission and medical institutions would lead to a drop in maternal and infant mortality rates for the city. With all three services in collaboration, Cincinnati could experience effective change with the emotional support for a community that has been so wronged by its institutions. Hopefully, as a result, Cincinnati’s child poverty rate will start to also decrease.
Although opposition to the nationwide amelioration of child poverty would largely seem unethical, Americans who are economically removed from the situation often fail to see the urgency of fixing the crisis. Most of the United States’ legislative efforts to combat child poverty assume the form of tax credits, and the Child Tax Credit and Child and Dependent Care Tax Credit in President Biden’s American Rescue Plan is the latest example. According to Indivar Dutta-Gupta of the Georgetown Centre on Poverty and Inequality, the initiative “will lead to the most substantial one-year reduction to child poverty in US history” (Dutta-Gupta, 2021). Particularly, the bottom 20% of Americans by income would receive an increase in income of 33%; those who have been for generations unable to lift themselves out of poverty, and subsequently lift their children from growing up in a perpetually impoverished state, would have the means by which to begin their escape. To most, or perhaps just to me, the notion of monetarily reducing the plight of child poverty seems a saving grace, but much of America’s legislative bodies, high earning individuals, and those who subscribe unshakingly to the notion of the American Dream may disagree. In any tax credit initiative, funds reallocated from the Federal Government to the American people; as such, the government must reduce budgets for other initiatives, or even eliminate them entirely. The prioritization of child poverty amelioration for many legislators simply does not outweigh the reduction of federal funds, and therefore bills like Biden’s American Rescue Plan always remain opposed to a certain degree. Furthermore, if taxation of the top 1% of America was reallocated to fund America’s bottom 20%, legislators who propose such initiatives may lose the support of their wealthier audience; as such, even if they feel morally connected to the cause, they may not politically advocate for it. Lastly, Dutta-Gupta reminds us of the American Dream notion of picking oneself up by the bootstraps; to strict adherers of the philosophy, tax credits may seem like meritless handouts — a picking-up of others’ bootstraps, perhaps, and a stain on ‘American values’ (Dutta-Gupta, 2021).
To opposers of initiatives that mirror child tax credits, I simply ask, “do America’s values not propose to all the guaranteed rights of life, liberty, and the pursuit of happiness?” Ensuring that everyone be equally able to live without the tarnishes on the quality of life that child poverty perpetuates for generations, to me, seems as American as anything can be. As such, I choose to advocate for the amelioration of Cincinnati’s child poverty crisis, particularly with regards to infant and maternal mortality and unwanted teen pregnancy. Addressing the limitations that Cincinnati individually fails year after year to overcome may only lift the city out of child poverty enough to place it level with the rest of the nation, but that would still be a celebrated 62% decrease. As a community, Cincinnati must begin to prioritise the morally correct and equal treatment of black women and their societal oppression. The nation’s quest against child poverty is another story altogether, albeit one that merits legislative pursuit. If proper federal and local governmental effort pursues the cause effectively and accurately, hopefully child poverty in America will continue on its decline, and child poverty in Cincinnati will too assume a decline.
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