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Policy provokes me to think, write and verbally spew. I currently work in ivory towers inspiring young people to engage in their world. I am a student of the human condition and my classroom is the world. I don't need credentials to have an opinion but I've got paper to prove I know a few things about public health, social welfare and economics. I'm coming out of the tower and taking the words to the people and hope you will send some words back at me.

Saturday, October 27, 2012

Good intentions, exploitation and studying 'the poor'

I am an academic and thus I am required to do research and to write. As someone who studied sociology, social welfare, public health, international health, and economics I am plenty equipped to study poverty and the lives of poor people. And in my areas of study, these are the people of whom we ask questions, whether here or abroad.Were I to do a search of any library database using poverty as a keyword, I will get hundreds of hits for journal articles published in the past month alone. But I have decided that I will no longer study 'poverty' or 'the poor' because I find it exploitative in its convenience, somewhat useless in its findings and creates a conundrum in its recommendations: how to change poverty by changing the poor.

We study how the poor shop, what they eat, what they drink, how fat they are, how (un)educated they are, how much health care they (don't) get, how they parent, and how a wide range of social, political and economic factors interact to influence their patterns of behavior.

Given that the poor have been studied for more than a hundred years and are not responsible for their poverty, and that poverty is a result of social and economic policies and systems, the objective of studying the poor or poverty seems unproductive. For example, Charles Booth's study of the poor in East London in the late 19th Century has findings similar to recent studies of the poor of East London. Finding that poverty did not change should not be surprising if the system that creates vast swaths of poverty: capitalism and social/political neglect, have not changed. That we are fascinated by the increases in inequality after creating systems that create such inequality makes us seem out of touch with the 'real world' outside of the towers of ivory.

Through our 'engagement' with the poor and with poverty, academics have implicitly and explicitly made poverty, and especially the poor, the object of our inquiry and therefore the focus of our interventions. There is something inherently 'perverse' or 'interesting' or 'puzzling' about the behaviors of the poor that inspires intellectuals of all stripes to spend lots of time writing grants, seeking out 'controlled and randomized' samples (or more likely samples of convenience), and doing complicated qualitative and quantitative analyses using sophisticated software to find out wherein lies the problem of poverty and how we can change the behaviors of the poor to make them less poor or more 'functional' within their poverty.

 In the global arena, economists are leaving the theoretical equations of the classroom to test their ideas in the real world (see the books More Than Good Intentions, Poor Economics etc). Using localized research projects, these economists from Yale and The Poverty Action Lab at MIT seek to find 'the answers to poverty' by comparing how samples of poor people respond to different 'aid' scenarios. I will not deny the fascinating results of these studies, but the power dynamics of the 'lab rat' experiences that poor people must endure at our expense in the production of knowledge, leaves me queasy; despite all the very careful ethical standards that are in place.

Our extensive studies of the poor goes against the justice principle of the 1978 Belmont report that defined ethical standards for protection of 'subjects' in research. Academics put undue burden of research on the poor because the benefit to the poor is hard to justify the more we study them and the longer they remain 'poor' as mobility upwards slows down and the top 1% get increasingly wealthy. Perhaps we should study the rich in order to benefit the poor. We know a lot about the poor but it is hard to say how much 'new' information we gain about poverty/the poor with each new study, or how much poverty alleviation has happened as a result of the waves upon waves of various methodologies and strategies we have employed in the study of individuals who are poor.

The problem is not poor people. The problem is poverty. And there is no way to 'find answers to poverty' by studying poor people as they are not the creators of their demise. However, as people with power, we have chosen them as the 'object' of our research (though 'partners' is a more trendy notion - and lofty goal - I hesitate to tarnish the meaning of the word by using it in this context). We do this because it is challenging to find a sample of the top 1% to study in the same way that we study the bottom 1%. How fascinating it would be to find out about how the wealthy give to charity, pay their workers more, consume less, vote in a particular way, their savings patterns, their inheritance patterns, their parenting, consumption of pharmaceuticals and recreational drugs, their romantic relationships, their residential patterns etc. etc. However, the wealth and power of the rich insulates them from being subjected to the querying minds of academe. The Center for Wealth and Inequality at Columbia University was created several years ago in a groundbreaking move to study wealth and inequality and yet it still identifies poverty as the first item in its list of research interests.

Among my colleagues around the globe, I would be hard pressed to find anyone who finds new research on poverty groundbreaking in any way. This particular blog post was inspired by an online discussion on the Spirit of 1848 listserv of the American Public Health Association - a left wing community of public health professionals from around the world interested in the issues of inequality and its impact on health. Recently, the conversation was exploring the issues raised in an article titled, 'Low income linked to poorer health in both US and England, despite different health systems', which was published in the American Journal of Public Health in late September. An article that created a resounding 'duh!' online.

I think it is time to leave poor people alone; to use our power to protect them from our insatiable curiousity about their lives through actively fighting with them for social policies that raise their standard of living and education and gives them more access to resources and power. Replicability may be a founding principle of science but after a point we move to redundancy. If we still feel the need to ask questions of the poor, perhaps we can let them guide the way. This means we give up our 'intellectual superiority' and become servants to the poor, asking the questions to which they want answers. This may mean less articles for me to review for lofty (and not so lofty) journals but it may mean that more of what we write gets read by more people, and more of what we read educates us in a meaningful way that makes social change possible.

Picture from Grandmother's March 2012, sponsored by St Francis Health Services of Njeru, Uganda, 



17 comments:

  1. Great post! Thanks for sharing your thoughts. I think that more research that reveals how wealth is established and maintained is definitely needed. I look forward to your work if you do decide to pursue this innovative approach!
    Danielle Rolfe, Post-doctoral fellow (health sociology)
    University of Ottawa, Canada

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    1. You're at my alma mater. I tend to write more than I research. I raise questions more than answer them. I think I'm better at that. I also like it more. Now it's for you a post-doctoral fellow to go poke at the rich

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  2. From western Honduras I want to thank you for this article. Poverty is the problem and here the poverty (and the violence) are rooted in the injustice and inequality of a broken system.

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  3. This is a beautiful post and, hopefully, the first of many from you on this topic - the time may not be ripe (is it ever?) but it has come. The NCI did a conference of "disparities science" a couple of years back and after a discussion of bench marks and such, a woman stood up in the audience and suggested that NIH might be held to a few bench marks itself! There were more than a few "amens" from the assembled. The next step: a study, funded by NIMH, of course, "The Psychology of the Institutional Predispostion to Turn a Blind Eye."

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    1. Thank you. I do have a book in mind. And given the response to this post, I think it would have an audience. These are thoughts I have been thinking for a long time without being able to put them in some sort of 'order'. I think I am ready to put it in an 'academic' space to 'legitimize' it in some way that being my own editor and having popular readership does not.

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  4. Not to say that there isn't bad research out there, for it is rampant, but you seems to misunderstand what research, on groups at least, is about.

    Any kind of systematic endeavor of discovery is valuable research. Using a group of people who share commonalities is to discovery the implication of this commonalities/patterns. That's why studies on gender, age, ethnicities, income groups can be revealing. The soundness and validity of the study, however, depend on the research design. One cannot simply suggest that the study of a certain group is, in your word, "exploitative"; it depends, again, on the hypothesis and parameters--the design. On the other hand, if you can prove, with well designed parameters, that there is no common behaviors patterns or characteristics among social groupings as understood in the ordinary sense, say the elderly, then congratulation, they owe you a well deserved Nobel Price in economics.

    You also seem to miss the fact that there are studies on rich people's behaviors. Economists know that higher income groups tend to buy imports and lower income groups tend to buy local, and that's how we know trickle-down does not work. We know that higher margin of effective tax won't alter rich people's behaviors, and that's the reason why some economists recommend a 70% tax on the rich. Understand how lower-income group rely more on public programs allows us the say that austerity will hit the poor disproportionately hard.

    Behaviors reinforce, or are reinforced by, psychology and identities, and they are connected to institutional issues. Sometimes people simply do something because it is expected of them;rich people in some countries give more to charity than the others because there is cultural reinforcement. Poor people in both poor and rich countries tend make risky decisions because they are influenced by their social-psychology. The knowledge in behaviors allow us to suggest institutional changes to promote and deter some kinds of behaviors. Understanding behaviors allow us to design proactive development policies, such as industrial policy and conditional transfer and not rely on the usual prescriptions of trickle-down and laissez-faire.

    You can say the institutional changes did not come forth despite of the research, but that is not a research problem; it's a sociopolitical problem that's outside the power of any researcher.

    Last but not least, you seems to misrepresent the paper "Low income linked to poorer health in both US and England, despite different health systems", which you described as "duh!" rather unfairly. First, you failed to name name so the question cannot be addressed to the author and that prevents her to come here to defend herself. Secondly, the author produces two institutional recommendations:1) universal health care system, and 2) greater income equality. You seem not to be aware of the fact that many countries do no have universal health care and the supporters of which need well-thought out argument based on empirical research. In addition, the author expected universal health care to a better explanation to health outcome that income disparity, and she admitted that the outcome proves otherwise. That there is already knowledge gained. You may say "duh!" and that's common knowledge. Well, as a researcher you have the duty to show it, common knowledge is not fact. That's what research is all about. Using your line of reasoning, the discovery of the theory of gravity is "duh!" as well; I don't see me flying off space so your equations and theories are meaningless. Please remember, you are supposed to test common knowledge to see if it is correct in you research.

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  5. (cont')

    Furthermore, I'm not sure what more can you ask for, regarding "groundbreaking research". Do you expect "an advance theory of relativity in health economics"?? Researches are based on facts and already established knowledge. A phenomenal research paper asks fascinatingly interest questions, but it always has to use exiting models and methods that we know to give come up with new models of understandings. Keynes did not produce groundbreaking research in your sense, rather, he used what was already known and putting it into a more coherently and holistic a new model. And you simply can't expect every paper to be like that. A good paper polishes the existing models and use the models to ask questions that would give new insights. Another type of good papers is to test what is considered common knowledge by collecting and rearranging data. The author of "Low income linked to poorer health" did her job just fine, albeit not phenomenal.

    You can, of course, criticize the current research approach. But in your criticism, you need to setup a baseline for your critiques. Is there any failure in prediction with the current models? How group-based research hinders better understanding? Can group-based research provides insights on institutional issues? After answering the above questions, then you need to come up with remedies that address the above challenges. And you have not done that so far.

    You say, "the problem is not poor people. The problem is poverty", and that has nothing to do with your points and it's rather meaningless. The question we ask in research is "how do you know?". We understand that there is the glass ceiling problem faced by women and minorities because we have compared groups of women and minorities to the white-male population who has the same qualifications. Using your line of reasoning, I wouldn't be able to do this comparison, because "the problem is not women and minorities but social perception". How do you know there is a social perception in the first place? It's a tautology running in circular reasoning.

    Since you produced no alternative, I'm not sure what'd be your direction of research. But given what you have said, I suspect you kind of like anything that is "led by the group", like poor people groups coming up to provide a narrative ? I really don't know how you can organize that as research and how you isolate the biases. Do you test the narrative? Do you suspect that this narrative can be wrong and what they are asking may not make sense from a policy design point of view? What do you do when there are conflicting narratives? Not that narratives are not useful, but they are only useful as starting point and to provide interpretations. The question remains, how do you know it is a good narrative? How do you know if you assume away the common patterns? And without common patterns, meaning that the issue just randomly comes into existence by sheer luck or misluck, is it meaningful to conduct any research at all?

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    1. i understand the research process quite well. i've designed surveys, implemented them, analyzed data, reported on findings and helped implement recommendations. my point is simply that as a group of people, we study poor people to the nth degree more than we study others and the reasons are about their accessibility (urban universities in particular are surrounded by seas of poverty where they can indulge their need for production of knowledge), and their lack of power to say no. Also given that they, as 'victims' of poverty are not the 'cause' of poverty then studying them doesn't much change their circumstance. Lastly, we know plenty enough to go do what we have to do to change their lives; poking at them anymore doesn't really serve them but it serves us and our publish or perish needs.

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    2. You may understand, but you haven't displayed it in you article. If you take away poor people in the studies, you cannot study poverty because you take away the phenomenon that is expressed in the people.

      You can argue for better designs, better focus on institutional connections etc., but you cannot say study on a certain does not reveal information. How do you study the impact of a policy if you don't study the recipient of it???

      Changing lives is a political action not research; don't confuse the two. A politically charged research is a biased research

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    3. We collect plenty of data on poor people (especially those who receive services) without having to further bother them. But the issue is that studying the same thing over and over and over will not change the phenomenon being studied.

      I did not say that the poor should never have been studied but I am very clearly stating that we can back off for a while and still have plenty of information on the nature of poverty. Poverty is an economic state that has social implications and thus it can be studied without the engagement of the people who it impacts; especially if we really want to change it. Looking at differential outcomes in health, education and social welfare is enough to change policy. Poor people across the world have similar experiences and studying them in each and every microlocale in which they exist hardly adds to the knowledge base.

      I agree that changes in social policy require research on effectiveness. However, depending on the policy, this data can be gleaned from indirect sources. And though I did not touch on this in the post, the surveys used in research on the poor are onerous (I collect them as fodder for my research classes) and almost noone except poor people who are given a small cash incentive would agree to answer all those questions. (One of the reasons that the Census keeps reducing the number of people that must answer the long survey). THAT is the oppressive piece. They are an 'easy target' for our efforts. And believe me, I'm no innocent in this process. However, it is my discomfort with it over time that led to me writing this post.

      And as for changing lives, unbiased research is a key weapon for the political action that is essential for social change. Again, it should be research that is useful for the researched and not just interesting to the researcher.

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    4. What do you mean by "backing off"?? The job of a research is to do research on questions they find interesting. There is no "back off" in science; there are, however, better designs, data collection process and interpretations.

      Supposed I agree with your points, yet I still don't know what are we supposed to do alternatively, because you neglect to mention it.

      What you mentioned about the census is bad design. It is nothing to do with the study of poor, if that's what you want to call it, at all. You can still study poor people with much better design. It is a design problem!

      "it should be research that is useful for the researched and not just interesting to the researcher."

      This statement shows your misunderstanding about research. First, knowledge is knowledge, a knowledge that prompts some actions, for example, changing lives, is not superior than the knowledge that doesn't. The invention of LASER is a good example. When it was first invented, nobody knew how to use it and today we use it in medical operations.

      Secondly, knowledge is gained by asking questions. These questions are just issues that interest the knowledge seekers. You will have a vastly reduced amount of knowledge if you only allow research that is deemed useful. Useful to you? To whom? Who decides what is useful or not? Sarah Palin considered the research on fruit flies not useful and uninteresting and suggested to cut funding for that reason. Many fundings would be cut if the scientific community starts to think like that. That's just not how research is conducted.

      If you say we need more culturally-aware researchers with holistic thinking and I will agree with you. I will agree with any statement that suggests we need better design and moral guidance. But saying that we don't need to conduct study regarding the poor people is just simply ignorance.

      "the issue is that studying the same thing over and over and over will not change the phenomenon being studied."

      This is just simply not true. Poverty happens because of a myriad of reasons. Poverty in one place is differed from another. Poor people living in a desert are poor partly because they don't have enough water source, while poor people living in an industrial state are poor partly because of stagnating social mobility.

      People in communist states are poor because productivity is so very low; people in mainly agricultural countries are poor because population growth begins to eat away their wealth. People all over the world will become poorer because of climate change but the impact will not be felt equally. Middle class people could become poor when they lose their jobs or fall sick if there is no social insurance scheme, and in poor countries, the state cannot afford universal social insurance. I don't think I need to go on. No, it's not the same thing over and over.

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    5. i'm not confused about the purpose of research but my ethical standards are rather high. my moral guidance demands that i distribute my prodding and poking across all classes. the disproportionate negative social and economic impacts of poverty should not also include being the disproportionate object of our inquiry. THAT is almost the entire premise of my post. The reasons you list for the causes of poverty are not located in poor people so thanks for articulating my point so well. Regardless of cause or source, all poor people no matter where they are have relative or absolute lack of access to key resources: (nutritious) food, shelter, education, employment, healthcare etc. That was the universality of which i spoke

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  6. You might enjoy the work of some friends, Sarah Augustine and Dan Peplow Augustine, who are doing epidemiological studies with indigenous people in Suriname, and have written about how to engage the indigenous as participants rather than objects of study. See http://www.sihfund.org/publications.htm and the articles noted.

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