STARVATION in THE AFFLUENT SOCIETY

...The way in which the food stamp program operated, particularly the cash payments required of poor families, was seen by the Subcommittee as a major obstacle to alleviating hunger...

...Here is part of their findings on hunger among the Delta's children: "We saw children whose nutritional and medical condition we can only describe as shocking—even to a group of physicians whose work involves daily confrontation with disease and suffering...

...This time the Subcommittee, which I serve as chairman, was walking along the dusty, sun-seared country roads of the Mississippi Delta...

...I am convinced from what I saw that among the great number of Negroes who have moved from the Deep South to Northern ghettos are some who knew starvation in the South as children, and that this bitter experience makes some of them potential recruits for the riots in cities...

...The main cause of lack of resistance is malnutrition...

...In addition, the Subcommittee persuaded Sargent Shriver's Office of Economic Opportunity to institute an emergency $1,000,000 four-month Food Stamp Loan Program in twenty counties in seven Southern states...

...As the long hot summer of 1967, with its unprecedented civil disorders, bloodshed, and looting, recedes into history, the nation and its leaders find themselves reassessing their goals and priorities...

...We do not want to quibble over words, but emalnutrition' is not quite what we found...

...We saw children who don't get to drink milk, don't get to eat fruit, green vegetables, or meat...

...No matter how familiar you may be with the facts and figures of malnutrition, nothing can avert the feeling of stunned, disbelieving horror at the sight of little children with swollen bellies, shriveled limbs, and open sores that disfigure the small, bewildered faces and weakened bodies...

...With other members of the Subcommittee, I hope that even the fifty cents charge can be eliminated and stamps be made available to the needy free of cost...

...Twelve years ago a Federal study estimated that twenty-three per cent of America's poor—those with incomes under $3,000 —had "poor diets...

...the prevalence of bacterial and parasitic diseases as well as severe anemia with resulting loss of energy and ability to lead a normally active life...

...Manifestly what is needed before the Government can deal decisively with hunger and malnutrition is a comprehensive and incisive study of the problem...

...She didn't know what she would do...

...serious untreated skin infections and ulcerations...

...They are suffering from hunger and disease and directly or indirectly they are dying from them—which is exactly what 'starvation3 means" The charge of starvation was supported by all six of these eminent doctors...

...Another index of deficient diets in the nation's capital is found in Public Assistance payments which provide a maximum of $417-a-month for a family of thirteen, including $228 for food, which comes to nineteen cents-a-meal for each member of the family...

...and Dr...

...The fact is we simply do not know the extent or severity of malnutrition in this country today...

...From all that one can learn, the aches and sores of the body become, for a child of four or five, more than a concrete physical factor of life...

...We didn't have any lunch," said Gloria quietly, and added, "But we have black-eyed peas for supper a lot...

...The Subcommittee's disclosures—preliminary as they are—of hundreds of thousands, perhaps millions, of hungry Americans have had two early results...

...Senate moved with dispatch...

...One-fifth of Mississippi's entire population is now being fed through the Federal food distribution programs...

...Appalling as this situation was it became worse when a shift from surplus commodities to food stamps in just eight Mississippi counties in one year's time deprived 36,000 poor residents of their commodity allotments...

...Ollie May Chapman and her nine children live in a tar-paper shack in Belzoni...

...In their individual testimony before the Senate Subcommittee, the doctors presented other observations and conclusions, some of them almost heartbreaking...

...Milton J. E. Senn, Sterling Professor of Pediatrics, Yale University...

...Over and over again I was told that the staple diet for Belzoni's poor was beans, rice, margarine, lard, meal, peanut butter, raisins, powdered milk, and one can of meat for each person in the family per month...

...Soup," George said...

...It now makes possible the purchase of food stamps by thousands of families that previously could not afford them...

...Many families, we were told, went "months on end without seeing twelve dollars all together...

...But the too-seldom recognized fact is that surplus foods were never intended to comprise full meals or adequate diets...

...the boys and girls we saw were hungry—weak, in pain, sick, their lives are being shortened...

...Curiosity and childish bafflement were written across their faces...

...Nationally, a total of eleven per cent of all school children receive free school lunches, but in Washington they are provided to fifty-one per cent of all school youngsters...

...Their report emerged as a unique document, unique in its fusion of professional and humanitarian shock and profound concern...

...Later on, doctors suggested to us a more shocking reason: "bloated stomachs, chronic sores of the upper lip, and extreme lethargy—all tragic evidence of serious malnutrition...

...A spot-check study in seven Delta counties was made by the Mississippi Council on Human Relations and reported to us by its Executive Director, Kenneth L. Dean...

...I asked Gloria—one of eleven children of Wilhelmina Palmer—what she had eaten for lunch...

...Between forty and fifty per cent of these youngsters were found to have low hemoglobin counts, a condition (when not caused by infection) reflecting a food deficiency which produces nutritional anemia...

...In child after child we saw evidence of vitamin and mineral deficiencies...

...There is, certainly, widespread hunger and malnutrition in all the Negro ghettos, north and south...

...Coles agreed on the use of the word "starvation" rather than "malnutrition...

...The first was an unexpected public response...

...Time and again, in Mississippi and in Washington, the Subcommittee was told that many families could not afford the two dollars per person a month that would buy them desperately needed food stamps worth much more when exchanged for commodities...

...they bring in the child's mind a reflection of his worth and a judgment upon him and his family by the outside world...

...These children are vulnerable because their bodily resistance is so low they don't have ability to cope with infections the way healthy children have...

...The fact that we receive more Office of Economic Opportunity poverty program funds per capita than any other state, and that during the month of March, 1967, 405,000 people received food assistance, indicate that there is a widespread problem of poverty that could, at any given moment, turn into acute hunger or a slow starvation if Federal programs are not upgraded in keeping with population trends...

...They did not know what Senators were or why they should be asking questions, nor did they recognize Senator Robert Kennedy or me...

...There must be between 50,000 and 100,000 children -suffering from malnutrition in the Delta...

...Under the District of Columbia's Headstart program, for example, 4,200 children recently received physical examinations...

...On the basis of other figures compiled by the Department of Agriculture, it seemed more realistic to assume an annual minimum food cost per individual of $225, about twenty-one cents a meal...

...They had had no breakfast and did not know where they would find food for lunch...

...STARVATION in THE AFFLUENT SOCIETY by SENATOR JOSEPH S. CLARK Gloria Palmer, a round-eyed, solemn-faced little girl of ten, stood shyly outside her slum home in Washington, D. C. and shifted her six-months-old baby brother from one arm to another, while two other tots leaned against her and stared up at the two United States Senators...

...Only recently was the one can of meat per person per month added to the diet...

...In Belzoni, heart of the Delta, a mother of four told me that she and her brood had bologna sandwiches for breakfast and this would be the big meal of their day...

...For supper they would have beans—and a rare treat, a can of peaches...

...mostly the writers inquired (as did the callers) where money and collections of food and clothing could be sent...

...and finally, in boys and girls in every county we visited, obvious evidence of severe malnutrition, with injury to the body's tissues —its muscles, bones, and skin as well as an associated psychological state of fatigue, listlessness, and exhaustion...

...In other years they could have fished, but the stream had dried up...

...For lunch the adults will eat nothing, and the children who are at home will be given a piece of bread and a drink of Kool-aid or water...

...This meant that the family of six that previously paid twelve dollars for $72 worth of food would now pay three dollars...

...By the end of the year it is expected that 30,000 families (with an average of four to a family) will have obtained OEO loans for food stamps in these Deep South counties...

...The value of all the meals consumed by the average individual in the study was a miserable four dollars a week, or fifty-seven cents a day, including the foods distributed free by the Federal Government...

...He is the author of two books, "The Senate Establishment" and "Congress: The Sapless Branch...

...Deficient diets among Washington children are also indicated in the School Free Lunch Program which provides free lunches in elementary and secondary schools only on application by the family, certifying need...

...Joseph Brenner, Medical Department, Massachusetts Institute of Technology...

...Other times they have rice or grits, she told me in an infinitely tired voice, "but we never have any milk or fruit or fresh meat...

...As we talked in front of the dilapidated and condemned tenements on Defrees Street, five blocks away could be seen the gleaming white dome of the Capitol...

...the second was the Subcommittee's success in effecting a quick change in the Department of Agriculture's food stamp policies and in moving emergency legislation through the Senate...

...also unattended bone diseases...

...When Senator Kennedy remarked that Gloria should have been in school during this neighborhood visit of our Senate Subcommittee on Employment, Manpower and Poverty, my thoughts suddenly whirled back two weeks to another group of youngsters who were also hungry and also not in school...

...Senator from Pennsylvania and one of the Senate's foremost spokesmen for progressive legislation...

...Remembering the devastated neighborhoods, the burned-out homes and shops, in nearly thirty cities across the country, I found the words of the philosopher Seneca, 2,000 years ago, echoing meaningfully down to our day: "A hungry people listens not to reason, nor cares for justice, nor is bent by any prayers...

...Cyril Wal-wyn, Medical Adviser to Friends of the Children of Mississippi and a private practitioner in Mississippi...

...Finally, after an impatient exchange of letters between the Subcommittee and Secretary of Agriculture Orville Freeman, and appeals to the White House, the Department of Agriculture was induced to cut the cost of food stamps from two dollars to fifty cents...

...The bill sailed through the Senate the next day without a single dissenting vote...

...Mrs...

...Another doctor who worked for the World Health Organization in Asia told me, "I've been in India and I've seen famine and starvation...

...Perhaps we should have anticipated the public's warm, sympathetic response to the revelations of hunger, but actually members of the Subcommittee were surprised by the letters and telephone calls they received from concerned citizens...

...I am hopeful that the new war on poverty legislation—which includes additional funds of $2.8 billion approved by the Senate Committee on Labor and Public Welfare for a series of improving amendments to the existing Economic Opportunity Act—will make a major contribution toward the abolition of poverty and hunger...

...And what did you have for breakfast...

...These people, while not starving in the extreme sense of the word, are suffering from acute hunger...

...It was the first meat the family had eaten in three months...

...There was no food in the house, she said, and no money...

...I am describing in detail what it means for a child and his or her parents to be sick, more or less all the time, and hungry, more or less regularly...

...He said such studies have not been made in this country and, if they were to be made, he was not sure which agency should make them...

...JOSEPH S. CLARK is the senior U.S...

...Washington, D. C., for example, is no better nor any worse than any other American city, although undoubtedly, as the center of Federal Government, it should be better...

...Later I asked Dr...

...Most of the children will be of school age but many will not be attending school...

...eye and ear diseases...

...Increasing evidence has come from different countries to suggest that infants both before birth and after birth, deprived of the kinds of foods which are necessary for normal bodily growth, suffer not only visible damage to their bodies but also to the central nervous system, to the brain...

...What we have seen in Mississippi and places in the north is slow starvation...

...A study this year by the Department of Agriculture covered 509 poor families in two wealthy Delta counties...

...It's been that way ever since I've been here, years and years...

...We saw severe malnutrition, hunger, and starvation in the sense that the body is irretrievably going downhill...

...Senator Kennedy remarked that what he saw on our visit to the Mississippi Delta was as bad as anything he encountered in Latin America...

...One mother summed up the question of diet in a single, poignant sentence: 'These children go to bed hungry and get up hungry and don't ever know nothing else in between.' Thin arms, sunken eyes, lethargic behavior, and swollen bellies were everywhere to be seen...

...A family of six, for example, would have to pay twelve dollars a month for coupons exchangeable for $72 worth of food...

...By late afternoon, seven other Senators and I, all members of the Labor and Public Welfare Committee, had joined as co-sponsors of the bill and had pledged the speediest possible action on the proposal...

...The children we saw were visibly underweight, their bodies spotted with sores and untreated lesions...

...In 1955 that meant 7,500,000 Americans had insufficiently nutritious diets...

...Newspapermen were shocked when the U.S...

...I asked her little brother, George, aged seven, "What did you have for lunch yesterday...

...They consist chiefly of flour, cornmeal, dry milk, and shortening...

...By strengthening the Job Corps, the Neighborhood Youth Corps, adult work-training, aid to small business, community action programs, assistance to migrant workers, rural loans, Headstart, and VISTA—by making these programs more effective, I believe we can do much to raise American living standards and begin the long-overdue eradication of poverty, hunger, and malnutrition...

...Dr...

...Near Greenville, Mississippi, I came across a tumbledown collection of shacks ironically called Freedom City, housing the families of displaced plantation workers...

...The result simply had to be more hunger and more malnutrition since these people could not afford to buy food stamps to exchange for groceries...

...Dr...

...The evening meaf usually consists of boiled beans and corn bread...

...Nor do we know with any degree of accuracy the minimum cost of an adequate diet...

...I wish to reemphasize, as would the doctors, that hunger, malnutrition, and slow starvation are not confined to the Deep South nor to any other part of the country...

...On the following Tuesday the bill was unanimously approved by the full Committee but not before the $10,000,000 appropriation was increased to $25,000,000 for the first year and $50,000,000 for the second, and an amendment added to initiate the first comprehensive study in the nation's history "of the incidence and location of serious hunger and malnutrition and health problems incident thereto...

...They live on starches—grits, bread, Kool-aid...

...Hunger, we discovered, is no respecter of area or region...

...epileptic and other neurological disorders...

...On Friday, July 21, Senator John Stennis, Mississippi Democrat, introduced a bill proposing a $10,000,000 appropriation to provide, on an emergency basis, "food and medical services to any individual in any state whenever such action is required to prevent the loss of such individual's life or to avoid suffering caused by lack of food or medical attention...

...They are living under such primitive conditions that we found it hard to believe we were examining American children in the Twentieth Century...

...They have more food, more welfare money, and, in the public hospitals of the Northern city, certain medical services...

...Surviving, somehow, in this appalling squalor were forty-eight children who subsisted entirely on grits, rice, soybeans, and "whatever is donated," plus the customary one can of meat per month...

...There is no way, at present, of knowing for certain," he replied...

...In my experience with families in the Delta, their kind of life can produce a form of withdrawn, sullen behavior...

...I fear that we have among us now in this country hundreds of thousands of people who have literally grown up to be and learned to be tired, fearful, anxious, and suspicious...

...In some we saw children who are hungry and who are sick—children for whom hunger is a daily fact of life and sickness, in many forms, an inevitability...

...One-third of the population of the nation's capital exists at little more than subsistence level...

...Moreover, these family diets were seriously deficient in milk, vegetables, and fresh fruits...

...No state is free of hunger any more than any state is free of poverty and deprivation...

...Surgeon General told the Subcommittee that we know more about malnutrition in Pakistan and other poor countries than in the United States...

...A community action worker who accompanied Senator Kennedy and me on this personal inspection of slums in the shadow of the Capitol, commented : "There are hundreds of others in this neighborhood who are hungry, kids and adults who get up in the morning hungry and who go to bed at night hungry...

...In the San Joaquin Valley of California," our report continued, "fifty yards off a seldom-traveled road, a migrant family of seven, the youngest child not yet two, were living in a pick-up truck abandoned by a small stream...

...The diet of such a family usually consists of a breakfast of grits, molasses, and biscuit...

...Raymond Wheeler, a private practitioner of Charlotte, North Carolina...

...Frequently the letters combined expressions of heartfelt solicitude with indignant comments on the affluent society that allowed penury and hunger to persist...

...Emergency legislation was the next step, and for once the normally laggard machinery of the U.S...

...On the day she was interviewed the family had gone without breakfast...

...Nevertheless, they have become almost the only source of food for hundreds of thousands of Americans...

...This provides the needy with cash loans ranging from two dollars to twelve dollars a month, depending on the size of the family...

...Dr...

...But one sees how persistently sickness and hunger in children live on into adults who doubt any offer, mistrust any goodness or favorable turn of events...

...The meaning of this for nutrition and health can be perceived in the fact that the total value of the commodities distributed amounts to about five dollars per person per month...

...I have seen some of the families I knew in the South go North and carry with them that state of mind and I am now working with them in Boston...

...The children need food, the kind of food that will enable their bones to grow, their blood to function as it should, their vital organs to remain healthy, and their minds to stay alert...

...Coles, a vital young psychiatrist who has not become insen-sitized by repeated trips into the most poverty-stricken areas of the Deep South and Appalachia, how many children suffering from malnutrition live in the Delta region today...

...As such specific cases as these came increasingly to the attention of the Subcommittee, we were struck by the discovery that these instances could not be projected against an overall picture of malnutrition and hunger in the United States...

...Here in ramshackle homes of one or two rooms holding families of eight and ten, we encountered children who were not sent to school by their mothers because they had no shoes...

...Brenner: "What is it that makes these Negro children so vulnerable to diseases that ordinarily are no longer considered killers in the United States...

...One reaches desperately for comparisons to give some semblance of reality to an experience that is essentially unreal and irrational...

...The most acute problem of hunger, and the most common situation, is the middle-aged mother, without a husband, in a small two-room shack, caring for somewhere between four and fifteen children...

...for lunch they had soup made from a meat bone and cornmeal bread...

...There is no way in which you can prepare yourself for the overpowering effect of hunger and starvation seen close up...

...severe kidney ailments that in other children would warrant immediate hospitalization...

...We found a mother of fifteen children nursing a three-day-old child which she had delivered herself...

...Sometimes boiled rice, dry peanut butter, or a canned meat substitute from the commodity program will supplement the evening meal...

...At least sixty per cent of these families had diets providing less than two-thirds of the minimum dietary requirements recommended by the National Research Council...

...There is hunger, for example, in prosperous Illinois, which admits that 1,281,100 people, or twelve per cent of the state's population, have incomes below the poverty line...

...We must know the number of Americans who suffer from malnutrition and, next, what can be done to correct their inadequate diets...

...The can lasts, at the most, a week and a half...

...Eggs, milk, and fruit juice, the mothers told me, were unknown...

...Any consideration of hunger, in Mississippi or elsewhere, must take cognizance, as does the Council's report, of the distribution of surplus foods...

...How vague our information is can be judged by the fact that the Subcommittee was forced to report, after soliciting the best opinion available, that "estimates of the number of American citizens in serious need of food vary from as few as 400,000 to more than 4,000,000...

...Sponsored by the Field Foundation, the doctors comprised a distinguished panel of medical experts: Dr...

...I would estimate that among the many families that I saw and I visited, with 150 or 160 children, at least three-quarters of them get less than the vital amount of animal protein per day—at least three-quarters, and I think I am being very conservative...

...The food available to them lacks the vital components that are necessary to build healthy bodies that can develop resistance against disease...

...Let us return to Mississippi because here surveys and studies have been made, and possibly they may provide clues to the nationwide dimensions of the hunger problem...

...A former British Army doctor with extensive experience in Africa told us that what he saw in Mississippi was comparable only to what he had observed in primitive parts of Kenya...

...An Office of Economic Opportunity official told me a tentative conclusion had been reached that an average of $16 a month or $192 a year would provide one person with a "minimum low standard diet— enough to hold body and soul together...

...Here are brief excerpts from the report: "Using an economic standard, Mississippi is the poorest state in the republic...

...They ask themselves and others what they have done to be kept from the food they want or what they have done to deserve the pain they feel...

...Medical doctors who work among these people say they never know the depth of their hunger for, from the time of birth on, they never have enough to eat...

...There are thousands and thousands of children in the Delta we didn't see, out of sight, out of reach, out of mind, out of access to white doctors and Negro doctors...

...This hunger could be called starvation in that people's bodies actually are being denied proper sustenance, which causes the mortality rate of the [Negro] children to be much higher than that of whites, and which also shortens the life span of adults considerably...

...We saw homes with children who are lucky to eat one meal a day—and that one inadequate so far as vitamins, minerals, or protein are concerned...

...The mind rejects the evidence that innocent children can and do starve in this most abundant and fruitful of all nations, or go hungry in the Delta which contains 6,000,000 acres of the richest land on the continent...

...The Subcommittee recently reported that in a small Appalachian town, near the border between Virginia and Tennessee, five small children tore apart and devoured a chicken before it could be cooked...

...they are, in fact, visibly and predictably losing their health, their energy, and their spirits...

...It is inconceivable to us that children at this stage of American history, and in the context of American wealth, continue to live like this in Mississippi, in Alabama, in Kentucky, in West Virginia, in the Southwest, and, indeed, carry this condition of life to all of our Northern cities...

...The visitor reaches for analogies...

...Some of the letters contained checks...

...Robert Coles, Harvard University Health Service...

...George replied, "Soup...

...Coles: "I would like to speak briefly about the psychiatric aspect of my work...

...By far the most impressive testimony on hunger was given to the Senate Subcommittee by a group of six doctors who made a first-hand investigation of malnutrition and starvation in the Delta...

...Yes, the North, too, allows its citizens, including its children, to waste away with hunger and to starve...

...Wheeler: "Only one of the [Delta] families I visited ever had milk at all and this was reserved for 'the sickliest' ones...

...The kind of starvation we observed," he said, "is the kind of starvation in which the body is slowly consuming itself...

...The body is victimized by diseases which definitely can shorten life...

...diseases of the heart and lung— requiring surgery—which have gone undiagnosed and untreated...

...Now, as never before, reason and justice dictate that we devote our purpose and our nation's resources to the goal that there shall no longer be hungry people in an America of overflowing abundance...

...Alan Mermann, Department of Pediatrics, Yale University...