MD Mama

The Death of the American Dream: A Pediatrician's View

5444565574_a05ea6febc.jpgAs a pediatrician who works with many low-income families in Boston, I feel like I watch the divide between rich and poor grow bigger every day. For the children of those families, the American dream isn't the kind of dream you strive toward. It's the kind of dream you have when you are asleep, the kind that isn't, and never will be, real.

That's why I wasn't even vaguely surprised when I read the study that compared a bunch of low-income teens who won a lottery to get into a high-performing public charter school in Los Angeles with a bunch of teens who wanted to go but didn't win. The ones who went to a charter school not only had better test scores and were less likely to quit school, they were also less likely to have trouble with substance abuse, risky sex and gangs.

It's all about the expectations people have of you--and the people you hang out with. Somebody has got to tell you that things are possible in order for them to be possible. And no kid can climb out of poverty entirely on his own. Everyone needs some help.

What's so depressing to me is that I watch it in slow motion, from the time a child is born. So many families can't afford quality daycare, so leave their babies and toddlers with busy, distracted neighbors or elderly grandparents who sit kids in front of the TV all day because they aren't physically able to chase them around, let alone take them outside to play. Hours of crucial brain development time gets squandered.

It's not just childcare that does the squandering. If nobody ever read you bedtime stories, or took you to a museum, or did finger painting with you or helped you make castles out of blocks, it might not occur to you to do it with your child. Even if it does occur to you, it might feel too strange to do it in any sustained way. And so your kid misses out on all those early learning experiences that encourage creativity and learning and help teach children about opportunity and possibility.

And once kids get to school (which may not be until kindergarten or even first grade, if parents can't afford preschool or can't work out the logistics of low-cost options like Head Start around their work schedules), there is a whole new set of of ways kids can fall behind. Parents who don't really speak English can't help with homework. So many parents don't realize that they can and should talk to the teacher if they have questions or concerns, or don't feel empowered to do so--and don't routinely look at school assignments or ask about tests and projects. School problems that could have been helped with some tutoring or simply a parent-teacher collaboration grow big and harder to fix.

And then there's the whole extracurricular aspect. Upper income kids play sports, take music lessons, and otherwise strengthen their bodies and their minds and increase their chances of getting into a good college. While some of my low-income patients do these things, most don't. Their families can't afford those extras--and they don't think of them as important. Passing school and staying out of trouble is enough.

The thing is, it's not enough. Not that you have to do activities to the extent some overscheduled kids do. But when you don't do them at all, especially if you have fair grades at a low-achieving school, chances are you aren't going to get a whole lot past minimum wage--and you are far more likely to be overweight and otherwise unhealthy.

The parents of these kids love them and want the best for them just as much as any higher-income parent. But getting the best for your kid can be complicated, hard--and expensive.

Now, I do have low-income patients who succeed. The ones who do best are the ones who end up in successful schools like the kids in the study, whether it's a private school (with financial aid) or one of the exam schools in Boston, where teachers and peers set the bar high (the combination is key--even the best teachers can be thwarted by school culture). The kids who do best also have the motivation and support to do what's expected of them. It's all about that bar, that motivation and that support--which are, for all sorts of reasons, harder to come by for low-income kids.

It's not fair. These kids are just as bright and talented and full of possibility as any other child, and that should mean something. Future success, income and health shouldn't be decided by the education level of your parents or by your zip code, but too often it is.

The American dream is dying--it may even be dead. We should care. Do we?

Photo credit: © 2011 Laurel L. Ruswwurm, Flickr | CC-BY | via Wylio

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