Death in America

Dorothy Guellec


people do not take hunger in America seriously, but add this to cutbacks in food

stamps, the daily need for insulin, and low wages, and then we really have a

life-threatening situation here. If diabetics don’t eat, they can develop

ketoacidosis, a potentially deadly complication of diabetes, if severe enough,

can end up in coma.  A number of factors not directly related to the

delivery of medical care have been shown to affect health status, including

education, race, literacy, socioeconomic status, cross cultural stumbling blocks

and the injustices of our Welfare system, constantly changing, and giving mixed

messages about food stamp allocations to immigrants, both legal and illegal.


survey of food insecurity among adult patients seeking medical care at the

Hennepin County Medical Center in Minneapolis found that 24% of those

interviewed has decreased the size of meals or skipped meals because they could

not afford food: “12% said they did not have enough food; 13% reported not

eating for an entire day because they could not afford food; and 14% said they

were hungry but didn’t eat because they could not afford food. The study was

published in JAMA April 15, 1998 – Vol 279, No.15 (Journal of the American

Medical Association) so this is hardly conjectured. It was researched and

written by Dr. Karin Nelson, Margaret E. Brown, MS; and Dr. Nicole Laurie who

also holds a MSPH.


authors described “during the past year, we have observed increasing numbers

of patients in our practice setting who lack money to buy food. This is

particularly troubling given the current implementation of welfare reform, in

which nearly half of the cost savings come from reduction in food and nutrition

programs.” They “undertook the study to determine the prevalence of hunger

and to assess the level of food adequacy in adult patients who seek care at a

public teaching hospital”.


the 567 patients interviewed in early 1997, 13% reported that during the

previous year they had, on several occasions, not eaten for an entire day

because they could not afford food. A separate survey of 170 diabetics revealed

that almost 19% had suffered complications that resulted from not having enough

money to eat. Hennepin County Medical Center, which is a public hospital in an

urban setting, treats many low-income patients. About half of the patient sample

had annual incomes less than $10,000, 11% reported being homeless for some

period of time, and 20% reported having to live with friends or relatives

because they could not afford housing on their own. “We hope this sends a

message to policy makers,” said Dr. Nicole Laurie Professor of medicine and

public health. “Cuts in food stamps may not be benign. It’s another example

of squeezing the balloon.  There are clear health consequences and often

expensive ones, at least for people with diabetes.” Dr. Laurie’s study

estimates that 30 million people cannot obtain enough food to meet their daily

needs. Her study charges that hunger is now as prevalent as such common medical

conditions as hypertension, diabetes and heart disease.


researchers wrote, “During the past year, we have observed increasing numbers

of patients in our practice setting who lack money to buy food. This is

particularly troubling given the current implementation of welfare reform, in

which nearly half of the cost saving come from reduction in food and nutrition

programs.” They were referring to The Personal Responsibility and Work

Opportunity Act of 1996 (welfare reform), which disqualified most legal

immigrants from receiving food stamps, and SSI (disability). Although the

Balanced Reconciliation Act of the 1997 Congress restored SSI to many legal

immigrants, food stamps were not restored. On March 27,2000 the Supreme Court

refused to listen to the appeal which would have forced the government to

restore food stamps and other benefits for legal immigrants cut off in the

massive 1996 welfare overhaul.


are allowed into the country but are denied benefits. In the one-line order the

court let stand a lower court ruling that said the federal government was

entitled to cut off benefits to noncitizen residents. The city of Chicago had

sued to block these provisions. As part of the welfare system overall, these

changes received very little attention, certainly not from the mainstream media.

Chicago sued in 1997, arguing, “This type of discrimination is repulsive. The

federal government, after all is solely responsible for the presence of lawful,

noncitizens in the country. It should not be allowed to shirk all responsibility

for their welfare.”


diabetics in Dr. Laurie’s study had stopped taking insulin because they could

not afford food. In this study, of the 103 diabetic individuals who reported

hypoglycemic reactions (i.e., low blood sugar), 32 said it was because they

could not afford food. The diabetics interviewed had rates of food insecurity

and hunger that were quite similar to the rest of the individuals in the study.

The authors suspected that “actual rates may be higher than those reported

herein as some people may not admit to food inadequacy even if the problem

exists.” Asian Americans are 2 to 3 times as likely as Caucasians to have

diabetes. In Minnesota, Asians are the second largest racial group among

children of color, and diabetes is one of the leading causes of death for this



did the U.S. government consider how drastic these food restrictions would be

for the Hmong elderly in the country. Today there are over 150,000 Hmong

refugees in America who came here unprepared and psychologically damaged from

war-torn Laos. Because dependency rates are so high within Hmong communities,

the Welfare Reform bill has stirred up much controversy. This is especially true

amongst the elderly who are illiterate hence unable to take the citizenship

test. Many have committed suicide as their only solution. They do not want to be

a burden. In some counties the welfare dependency rate is 70%, higher than that

of any immigrant group.


where are we now? It seems that Congress has made a down payment on food stamp

restoration for legal immigrants, but not for all of them. The Agricultural

Research Bill sets aside a little over $800 million of the $1.8 billion in food

stamp administration savings. The remainder of the savings will go to agents who

write crop insurance, and increased spending for agricultural research. The

measure falls short in many ways. Beginning 11/1/98 the changes

  1. extended

    the refugee exemption from 5 to 7 years

  2. restored

    benefits to Hmong veterans

  3. restored

    benefits for Jay Treaty Indians

  4. restored

    benefits for persons who are or who become disabled and entered the U.S.

    before 8/22/96

  5. restored

    benefits to those who were 65 and in the country on 8/22/96.and

  6. restored

    benefits to children who were in the country on 8/22/96


package does not restore benefits to families with children-only to the children

themselves; does not restore benefits to elderly persons who were already 65 or

older on 8/22/96, and does not restore benefits to non-elderly, non-disabled



disturbing study by Physicians for Human Rights, found that 79% of legal

immigrant households surveyed in March 1998 were “food insecure”—meaning

they often went hungry and worried about when their next meal would be. The

study coordinator. Jennifer Kasper of the Boston University School of Medicine

notes that because hunger has been linked to asthma, diarrhea and anemia in

children, “policymakers should consider the true cost of cutting food



the fall of 1997 Chia Yang hung herself in her garage. “She didn’t want to

become a burden on her children if her SSI were cut. She didn’t want them to

have to support her.” The 54-year old mother of seven was receiving SSI for

her many disabilities; high blood pressure, panic attacks, diabetes, kidney

stones, bladder infections, arthritis, night sweats, and even stroke. Her

husband Sua Chai Vue was one of the many thousands of Hmong men who served in

the CIA’s secret army.


have tried to demonstrate a callousness and lack of compassion on the part of

officials in high places, and their immediate and far reaching consequences down

into the lives of people. The mainstream media editors can also share in this

because they choose not to print these events. Stories left out are as

important, if not more, than the ones that make it to print. Georges Seldes used

to say, “tell the truth and run”. If we are so fond of saying that we live

“in the greatest country in the world” over and over we must feel as

insecure as the ones who are truly suffering from food insecurity – that’s

an issue to be reckoned with!

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