What would happen if we trusted each other?: MS Pulse

A report released Wednesday outlined the ways in which Mississippi leaders have for decades undermined federal public assistance programs, requiring recipients to jump through hoops based on false narratives of poverty.

The hoops — drug testing, work requirements, etc. — paint folks seeking assistance as suspicious characters who must prove their value.

On the same day the report was published, Mississippi officials met to discuss adding a work or job training requirement for Medicaid.

There's some important historical context to consider surrounding public benefits in this country, starting with the fact the 1935 Social Security Act excluded those in domestic and agricultural work, the jobs employing more than 63 percent of African-Americans across the country.

Accessibility of public assistance conformed to profit industries, with increased restrictions on receiving benefits during harvesting seasons, according to the report by the D.C.-based policy research group New America.

Work requirements for benefits intensified, the report states, when black families began migrating north and accessing the programs, even though the original Aid to Dependent Children program, the predecessor of Temporary Assistance for Needy Families, was meant to "enable widowed mothers to meet their basic needs without wage work."

The attitudes surrounding these programs became highly racialized, (i.e. President Ronald Reagan's "welfare queen").

While the Social Security Act bill was pending, the Jackson Daily News reported: "The average Mississippian can't imagine himself chipping in to pay pensions for able-bodied Negroes to sit around in idleness on front galleries, supporting all their kinfolks on pensions, while cotton and corn crops are crying for workers to get them out of the grass."

Ask most Republican lawmakers in Mississippi today what they think about work requirements, and they'll say they support them, that they just want to make sure folks aren't "gaming the system."

The "othering" that folks do when they tell this story about people in poverty, says activist Mia Birdsong, results in paternalism, which stems from an attitude of superiority and does not respect the dignity and agency of others.

There's something that makes doing this really hard, though: hanging out with folks.

In the last few months, I have spent time with families living in poverty in the Mississippi Delta, one of the poorest areas of the country, and in our own capital city. What I experienced, the people I met, couldn't be further from the narratives that drive conversations about public assistance in this state.

Take Patricia Aaron, a 54-year-old Hinds Community College student. She's studying architecture, hopefully so she can own a construction company one day, employing folks in her neighborhood. She doesn't have a "job," viewing her school schedule, and her age, as a barrier to employment.

But she works. Aaron collects cans and scrap metal around her neighborhood, which earns her a few extra dollars and benefits her community by ridding the streets of litter. She also acts as a mentor to some young men in the neighborhood, who seek her out for advice and friendship.

Shoot, just navigating JATRAN, something Aaron must do every day to get to school and other appointments, is like a full-time job.

Bridges Out of Poverty, a research-based framework for helping communities address poverty, acknowledges that traditional employment is a middle-class construct. It's grounded in the hidden rules of middle class that exalt "achievement." Hidden rules are rarely articulated — folks in the generational middle class may neither see nor question them.

The hidden rules of poverty, the research goes, have more to do with getting through the "tyranny of the moment," placing much more emphasis on problem solving through relationships.

From my experience, people in poverty work harder than just about anybody, though the work might look different to someone in the middle class. All that is is an argument for finding connections with folks whose circumstances are different than yours.

Dr. James Comer, professor of child psychiatry at Yale University, said, "No significant learning occurs without a significant relationship."

Really changing our society, making our communities more sustainable, requires engaging with folks of different backgrounds, races and socioeconomic classes.

Will we?

More health news

MEDICAL PROFESSIONALS MET WEDNESDAY to discuss the opioid prescription rule changes proposed by the state Board of Medical Licensure. Many attendants at the board meeting expressed concerns that the rules, which aim to limit opioid use, are too restrictive.

FOOD INSECURITY IN THE CAPITAL CITY especially impacts the population in poverty, which makes up 30 percent of the city. Not knowing where your next meal is coming from, and eating what's in reach, can lead to poor health outcomes, like diabetes and heart disease.

In Clarion Ledger's latest story on the issue, readers follow Aaron, a Hinds Community College student, as she manages paying for food and traveling to where she can get it. An investigation into food and how people eat ended up touching on the economy, education and entrenched poverty in the poorest state in the country.

PATIENTS, SURVIVORS AND CONCERNED CITIZENS are urging lawmakers to increase the price of cigarettes by $1.50 a pack, hopefully to deter more folks from smoking.

In Mississippi, the cigarette tax is more than a dollar less than the national average. The American Cancer Society's Cancer Action Network organized a press conference on the issue Thursday.

THE COST OF LONG-TERM, AT-HOME CARE INCREASED in Mississippi and nationally in the last year, even as overall long-term care services in the state decreased 2.6 percent from 2016 to 2017, according to Genworth's 14th annual Cost of Care Survey.

"Given today's increasing labor costs, strict Medicaid eligibility requirements, and more stringent Medicare regulations, we are seeing a corresponding increase in the cost of long-term care services across most states," David O'Leary, president and CEO of Genworth's U.S. Life Division, said in a release. "Although home health care is far less expensive than care in a facility, in Mississippi, home health care costs can add up to as much as $41,184 per year. Government programs may not cover all of these costs, if any, which is why it's so important for people to plan ahead for how they will pay for these costs."

MORE ON THE MEDICAID WORK REQUIREMENT: Medicaid is an insurance program that provides health care to more than 700,000 Mississippians, mostly children.

Mississippi and other states have wanted to add work requirements for Medicaid, but they have never been authorized to do so by the federal government. Earlier this month, we officially learned the Trump administration expects to grant these requests.

Reports say up to 20,000 low-income parents or caretakers in Mississippi, the only able-bodied folks on Medicaid, could be affected by the requirement.

The new rule would require these recipients to participate in volunteering programs, job training or work 20 hours a week.

If they chose to work, it's likely they would lose eligibility for Medicaid: a part-time, minimum-wage job pulls $580 a month while the Medicaid cutoff is anything over $306 a month. It's likely they would fall into the coverage gap and become uninsured.

MS Pulse is a weekly column by health reporter Anna Wolfe. Contact her at 601-961-7326 or awolfe@gannett.com. Follow her on Twitter.