Urban Injustice: How Ghettos Happen

Urban Injustice: How Ghettos Happen by M.D. David Hilfiker - Book Review

The book "Urban Injustice" has been written by M.D. David Hilfiker, who as a young do-gooder moved to inner-city in Washington DC. The objective for his shifting was to provide poor souls a "hand-up," but unfortunately what he discovered soon that most inner city poor were as meager, diligent and sincere as his friends from med school (Krista's Journal).

The book written in an energetic style, putting together personal experience with social science studies of poverty; discusses the old myth that the poor typically had themselves to blame, deconstructing it with a story, similarities, and hard, cold numbers. Being a sympathetic white doctor, who has spent his more than two decades living with the poor and practicing "poverty medicine," he began doctoring with the idea he could turn his patients' lives around with his sufficient "strengthening."

Thus, "Urban Injustice" represents Hilfiker's exploration of that unsuccessful idea with his answer to the question as to why African-American poverty is stubborn and structural. The book also includes a very well explained chapter on welfare history, which included the 1960s "skirmish" on poverty (Krista's Journal). However, in his last chapter, he has suggested very practical public policies and budgets that could win a real war on poverty only if the United States would overcome the political issues inbuilt in it (Krista's Journal).

About the Author

M.D David Hilfiker is a physician and a writer who has committed his life to social justice in the practice of his two professions. It was, in 1983, after seven years as a rural physician in north-eastern Minnesota, that he shifted himself to Washington, D.C., in order to practice medicine in the center of the city at Christ House. The Christ House is a 34- bed, medical recovery shelter for destitute men, where his family also lived with him (Krista's Journal).

In 1990, he confounded Joseph's House, which was a community and hospital for previously homeless men, who now were dying with AIDS. Thus, he then spent his three years over there. He was Medical Director and Finance Director at Joseph's House until September 2002. Now he is no longer in active medical practice, and works toward the creation of a just society through his writing and speaking (Krista's Journal).

He has also spent three weeks in Iraq in December 2002, and since then he has written and lectured against the assaults of that country. His previous two books are "Healing the Wounds" and "Not All of Us Are Saints" (Krista's Journal).

Analysis of the Book

Hilfiker, who has worked for almost 20 years with homeless and HIV-positive men in Washington, D.C., began by noting:

W]hen most Americans think about poverty, or see the poor on television, or read about them in the newspapers, the images are of poor black men hanging around the street corner, poor black teenagers selling drugs, poor black single mothers living on welfare, poor black inner-city schools failing their children."

The author is well aware of the medical and psychosocial issues. He, however, appeared to be puzzled by many things, such as how there has been such strong geographical clustering of poverty, how this cycle continued from one generation to the next one, how did 'govt. assistance' worked and planned? (Seven Stories Press)

Thus, in order to find answers to all such queries, he did a survey on the sociological, economic, and public policy literature, which he described in his book as the type of resource he wished he had approached during in medical school (Seven Stories Press). Hilfiker is particularly sensitive to the source of poverty in African-American inner-city ghettoes.

His recommendation for ending poverty, was one new program: universal health coverage, to which he argued convincingly, would save all of us as a nation on current health costs and yet could include the 43 million presently uninsured (Seven Stories Press).

He also suggested three other existing programs:

1) the earned income tax credit, shown by the economists as the most profitable program for bringing up families out of poverty;

2) Unemployment insurance, that could be expanded in order to distribute enough income to keep the unemployed at least at poverty level;

3) Supplemental Security Insurance for the disabled. As he noted,

As a physician, I sometimes struggled for years to get examiners at S.S.I. To understand that one or another of my patients was, indeed, disabled."

Furthermore, for Hilfiker, the fundamental grounds of American poverty were mostly structural:

Inadequate educational resources in inner cities;

Scarcity of jobs on which one can take care of a family;

Structure & workings of the criminal justice system; and,

Insufficient access to health care and child care;

distressing history of slavery, segregation and discrimination for African-Americans.

In addition, he tried to explain how morally impartial developments often had unintentional social consequences (Seven Stories Press). He further explained this point by illustrating with a trickier problem: the civil rights acts of the fifties and sixties, which eliminated legal segregation in education and housing that actually helped, make the ghettos worse, by easing a brain drain from the poor neighborhoods (Seven Stories Press).

However, Hilfiker agreed and gave his observation on a few longitudinal studies of deprived families who were given permitted to move out of the ghetto. Even though the shift to suburban life was a culture shock, but the social infrastructures helped hugely. Children who runaway from ghetto were far more likely to graduate and went to college than the last peers they left behind (Seven Stories Press).