This is deep poverty: living on less than $6,000 a year, or raising a child alone on roughly $7,600. More than 20 million adults and children in the United States get by on that or less. But focusing solely on income obscures the real and complex picture of the poorest of the poor.

Deep poverty is defined as having income below half the federal poverty level, but “it’s not just a matter of dollars,” said Laudan Aron, coauthor of Addressing Deep and Persistent Poverty: A Framework for Philanthropic Planning and Investment. Drawing an income boundary can help us understand who is in deep poverty at a given moment in time, but, as Aron and her coauthors found, the deeply poor move above or below that arbitrary line with some frequency.

Many don’t get very far, hovering around the deep poverty threshold without ever earning enough to escape poverty altogether. It’s not just the result of a bad year or a job loss from which they can recover; the deeply poor are more likely to stay poor—a troubling distinction that sets them apart from other poor people.

This is deep and persistent poverty: a chronic state characterized by multiple, serious challenges—including addiction, homelessness, disabilities, and chronic illness—that can stand in the way of work. It’s a place where families can get stuck, generation after generation, without enough help from the safety net to move up and out.

But the deeply and persistently poor aren’t the focus of major antipoverty efforts, Aron and her coauthors conclude, drawing from interviews with other experts in the field. Those in deep and persistent poverty are a difficult group to reach, one that defies easy solutions. Fifty years ago, President Johnson declared an unconditional war on poverty. While we’ve seen some major successes—Head Start, food stamps, the earned income tax credit, and other programs that have kept poverty at bay for many vulnerable families—these programs aren’t enough to lift the deeply poor out of poverty for good.

“I don’t think there’s much acknowledgment that there are desperately poor people in the United States,” said Greg Acs, director of Urban Institute’s Income and Benefits Policy Center. And while we’ve gotten somewhere in terms of supporting the working poor, as far as helping the deeply poor, “we haven’t made much progress on that front.”

Work-based defenses against poverty
Three-quarters of deeply poor adults haven’t worked in the past year. Their obstacles to work are complex and feed into one another: unstable housing, unreliable child care, lack of education, criminal records, mental and physical health problems that aren’t severe enough to qualify for disability benefits but that can limit steady work.

“There’s the old saw about how the best antipoverty program is a job. And that’s true,” Acs said. “The problem for the deeply and persistently poor is they can’t hold down steady work.”

What work they can find is often low-wage, high-turnover, and hard to sustain.

“You take someone who has asthma and their job is cleaning grimy work sites with lots of particulate matter in the air,” Acs said. Or “you work at a big box retailer who views employees interchangeably” and fires you when your car breaks down and you can’t make it in. The very nature of the jobs they can get can make it hard to work steadily.

The next line of defense against poverty—the safety net—is largely conditioned on work, so those who can’t work aren’t fully supported. For example, the earned income tax credit, one of the biggest antipoverty programs, is based on work. Temporary Assistance for Needy Families (TANF), the cash assistance program created by welfare reform, has mandatory work requirements.

Housing assistance helps, even for those who receive scarce subsidies, but is no guarantee against poverty or food insecurity. And the barriers that keep the deeply poor from work can also be obstacles to getting and keeping benefits.

Further, piecemeal supports for food, health care, and child care aren’t designed to lift people from poverty, much less deep and persistent poverty; neither is cash assistance, which reaches fewer than one in three poor families through a fixed block grant that has eroded in value since 1996. What’s more, TANF does not count “poverty reduction” as one of its goals.

That’s not to say that these supports aren’t helping; without these programs, many poor households would be in worse situations. The Supplemental Nutrition Assistance Program (formerly food stamps), for one, plays a crucial antipoverty role. But safety net programs aren’t designed to provide the sort of consistent, comprehensive support that those in deep and persistent poverty need.

“We just skim the surface,” said Mary Cunningham, a senior Urban Institute researcher. “We only provide just enough and expect people to move up.”

But what does addressing the problem mean for a population struggling with multiple, complex barriers to work?

“It means acknowledging that the work-based safety net needs to better accommodate people who can’t work steadily, but can work some,” Acs said. “They should work when they can and be supported when they can’t.” For example, letting families keep child care assistance when parents lose their jobs makes it easier for them to find new jobs.

Deeply poor adults may never be financially self-sufficient or get very far out of poverty, but helping them reach a more stable place supports their efforts to work and can help protect their children.

Intervening early in children’s lives is a long-term investment
More than one-third of those in deep poverty are single mothers and their children. Roughly half are under age 25.

Many “live in neighborhoods that are unsafe, deeply troubled, with really low-quality schools…and a lot of exposure to crime and interpersonal violence,” Cunningham said. Mass incarceration for drug offenses has had a hand in destabilizing these families. Circumstances are particularly tough for those living in severely distressed neighborhoods.

About 3 percent of all children—and an astonishing 15 percent of black children—spend at least half their childhoods in deep poverty.

“We are an outlier on poverty compared with other high-income countries, especially when it comes to child poverty,” Aron said. “There is no question that child poverty is real and is a big problem. And certainly with respect to deep and persistent poverty, it can be very damaging.”

Poverty in childhood can have lasting consequences that handicap kids later in their lives. Research has shown that the toxic stress of being poor as a baby or toddler can harm brain development and early functioning and can put children at risk for poor health and chronic illnesses. Those early years are so important that an infant who is poor from birth to age 2 is worse off than a child who becomes poor at age 5 or 6.

“I think we’re getting more and more evidence about what living in chronic poverty…does to kids,” said Sue Popkin, an Urban Institute senior fellow who has studied public housing for 25 years. “For girls, it seems to lead more to depression and anxiety. For boys, it seems to lead more to anger. And it leads to chronic physical health problems… and chronic malnutrition, which, in the United States, manifests itself as obesity. The families eat what’s cheap and available…and you end up with kids who are obese and malnourished and hungry, because they’re not getting what they need.”

Caroline Ratcliffe and her Urban Institute colleagues have studied the effects of persistent childhood poverty. Being poor for at least half of childhood is associated with a greater likelihood of not graduating high school and of having a child as a teenager. Adults who were persistently poor as children are more likely to be poor as adults and less likely to have steady work than those who were not poor at birth.

Considering the bleak trajectory deep and persistent poverty sets for children, addressing this problem should mean getting it right for kids at the start. Research shows how crucial it is to intervene early. Ratcliffe suggests reaching out to mothers in the hospital to connect babies to resources at birth. Home visiting programs have shown promise in helping connect depressed mothers to needed mental health services.

Intensive and sustained supports will be needed to make inroads, Aron said, and that takes patience, a willingness to work across multiple barriers, and money. Intervention programs for children are costly, but so is incarceration, emergency room care, diabetes, and obesity, Popkin added.

“Intervention programs for kids are a good investment for the long-term,” Ratcliffe said. “We’re going to pay one way or the other: we can pay up front and help children achieve a healthy, stable, productive life, or we can wait until later when they have a lot of problems.”

Small-scale interventions like Promise Neighborhoods and the Housing Opportunity and Services Together (HOST) demonstration are testing intensive, wraparound services for families in poor communities. HOST’s case management, “whole family” approach of helping parents and children is designed to blunt the effects of living in chronic poverty.

“I think success is small changes to get to the next generation,” Popkin said. “I don’t know if we can fix it, but we can sure make things better for the kids.”