The following is an excerpt from our February issue:

By Michael Roy Hollihan

Some numbers are stark. One in eight Memphians live at or below the poverty level. An estimated thirty percent of all Memphis children live in poverty. But some numbers are slippery. So it is with the working poor. As many as one in four Memphians belong to the vague category of the working poor. These are individuals who have jobs but have been unable to rise above the poverty line. They live paycheck to paycheck and are one automobile problem or medical emergency away from complete disaster. On the ladder of economic success, they are one rung above ground.

Most Memphians know the working poor are out there – they’ve seen pictures in the papers or stories on the news. But for the middle-class and wealthy in Memphis, it’s a problem of others. Not me, someone else. Not here, somewhere else.

Large swathes of the city are filled with the working poor: North Memphis, Downtown, Midtown, and southwest Memphis. Drive the major traffic arteries and you see hints of them. Get onto streets like McLemore, South Third, Chelsea, Summer Avenue, Danny Thomas, Raines, and Neely, become immersed in the neighborhoods, and the impression is inescapable – we are failing ourselves. Whole neighborhoods, whole subdivisions of substandard or worn-out housing, ruined streets and alienated, lost people. We may be a top twenty metropolis, but we are a top three economic disaster for our residents.

One of the most pressing areas of concern is the issue of health care. Rarely do the working poor have the luxury of indulging an illness. Being home sick means lost wages or even a lost job. Either way, it is an economic catastrophe. Persistent illness or disease, or lifestyle-associated diseases like obesity and hypertension can reduce productivity or even limit job opportunities. Meager gains melt away. Chronic problems prevent forward progress.

While some jobs, especially corporate or government routinely offer health benefits, employment at small businesses or service/distribution sectors often means no health coverage. Although insurance companies offer rock-bottom basic packages for as low as $60 per month, even this can be too much. And that assumes that potential customers are even aware of these offerings. Most working poor simply do not get exposure to health care insurance options unless it intersects their lives.

TennCare is not the solution many may think. It was designed for the most desperately poor and the uninsurable. If you have some options in terms of insurance, no matter how expensive or inadequate, then TennCare can’t help. Add to that state-mandated cuts which took 170,000 off the rolls and the road looks bleak. The competition for available government funds is fiercer than ever. The private sector assumes that government is taking care of things and just doesn’t worry any more.

Nor is the Regional Medical Center an answer. In 2003, one-third of its patients were the uninsured. Charity care and so-called “bad debt” care (people who received treatment but never paid the bill) amounted to $50 million in 2001. These costs are transferred to the other patients, resulting in higher treatment costs that begin to cut off the poorest of the middle class as well.

The Med, as it is popularly known, may have a twenty-four hour emergency room, but emergency treatment is not a sustainable way to maintain community health. People will often allow an illness or injury to fester waiting for severity to justify a trip to the Med. A problem that could have been solved quick and cheap in the early stages (a routine visit to the doctor) will instead be treated with high-dollar emergency-level care. Others will unthinkingly use the emergency room as a doctor’s office, unmindful of the waste of high-level medical services. A doctor treating a festering sore or a cold-turning-into-pneumonia is a doctor not able to treat a heart attack.

It is the idea of early and preventive care, catching the problems small, when intervention is modest but effective. It is preventative changes to lifestyle that can obviate disease or chronic conditions that plague the working poor. The affordable and economical ninety-nine cent value meals fit into time-stressed schedules, but the cost of obesity-related disease. Telling someone to give up a greasy, meat-heavy diet when their entire family has been eating it for decades is to fight cultural inertia.

Into this storm-tossed sea stepped a man and his calling, Dr. Scott Morris. As a young man, he didn’t so much juggle twin careers of doctor and minister as seamlessly blend them into a practical and groundbreaking whole. Beginning in his native Atlanta, the young Morris began to experiment with various ways of using his medical skills to amplify his calling to minister to the poor, borrowing and discarding a great many ideas. His guiding principle, then as now, has always been clear. “The church has always been intimately involved in health care, especially the poor. One-third of the Bible is on healing the sick.”

Ready to get to work, in 1986 he moved to Memphis, “the poorest major city in America.” He arrived not knowing anyone, relying on “God’s providence.” He found a position with St. John’s United Methodist Church as an assistant pastor but his eye turned to the Randolph House across the street, at the corner of Peabody and Bellevue. Once an upper-class home, it had slid down into disrepute and settled as a boarding house when Morris considered it. So was the Church Health Center born.

That first day, he saw only a dozen patients, but today the Center sees 36,000 patients regularly and has nearly 50,000 patients of record. It’s just a fraction of the estimated 150,000 uninsured in the Memphis area.

That doesn’t matter to Dr. Morris. He is softly energized and determined. “The great countries are measured by how they treat the most deserving. We don’t measure up.”

“Poverty is fundamentally a spiritual disease. It will beat you down so fast. It tears at your spiritual fabric.” He calls living in poverty “a struggle day in and day out.” It is this focus on spirit and the individual that make the Church Health Center unique. Everything is driven by the volunteers ministering to those in need.

Doctors, physicians, nurses, optometrists, dentists and other specialists – well over 500 professionals and countless more just-plain volunteers – all donating their time and sometimes their supplies. Many will see Church patients in their own offices, though many also come to the Walk-In Clinic.