NACCHO Book Review – Broke in America: Seeing, Understanding, and Ending Poverty in America


Each month, NACCHO brings you a new public health book, read and reviewed by NACCHO staff. Book reviews in this series originally appeared on NACCHO Voice: The Word on Local health Departments and are republished here with permission.

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Broke in America: Seeing, Understanding and Ending Poverty in the United States, critically examines public policies and how they have contributed to the inequitable access and distribution of resources that meet basic human needs. In three sections, 15 chapters and nearly 300 pages, Joanne Samuel Goldblum and Collen Shaddox tell just how multidimensional poverty in the United States really is. In Parts I and II, they examine and share experiences of implicit and explicit stigma, stories of oppression in its many forms, as well as the impact of seemingly harmless policies and how these tend to intersect (e.g. example, structural racism and housing policies) – create or strengthen barriers that hinder access to resources and opportunities for much needed progress.

For those of us who work or are interested in public health and public health policy, this book reinforces the impact of social determinants of health, as we see the direct impact of living conditions, in particular how lack of access to resources such as electricity, transport, and housing actively contribute to the poor health outcomes of people living in poverty. Thus, throughout the text and supported by research, the authors systematically stress the importance of questioning current discourses on poverty and this because of a “lack of ambition or character” (Samuel Goldblum et al. Shaddox, 2021).

Understanding that poverty must be attributed to a lack of resources and access to them is the key argument of the text. You are forced to reassess past beliefs about poverty when you are invited to read the experiences of those who live it. It becomes difficult to ignore the pervasive structural barriers that prevent people from effectively accessing clean water, reliable transportation, hygiene supplies, food and other resources that many can hold. for granted. In fact, one need only reflect on the current public health emergency of the COVID-19 pandemic to remember how the inequitable access and distribution of resources has not only exacerbated the effects for people living in poverty, but have also brought many of these veiled issues to the fore.

It was important that while describing in detail how policies and actions significantly contributed to the impoverishment experienced by millions of Americans, the authors sought to encourage readers to have hope for a future without poverty. In Part III, they take the time to describe macroeconomic policies and realistic approaches that have been successfully implemented elsewhere and that can potentially help effectively address poverty and the associated negative effects in the United States. In the end, a comprehensive and adaptable framework that can be used by individuals and communities to tackle unjust and inequitable policies and actions is provided.

In summary, while Broken in America pulls no punches at the reality and extent of poverty in the United States, and the litany of why it exists, it is essential to remember that there are tangible solutions available for people to consider . Solutions that support transformational thinking by ensuring the availability of resources, making them accessible to break the cycle of disruption in America.


  • Goldblum, JS and Shaddox, C. (2021). Broke in America: Seeing, Understanding, and Ending Poverty in the United States. Dallas, Texas: BenBella Books, Inc.

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Author profile

Julia mandeville

Julia Mandeville is a program analyst and works in the Injury and Violence Prevention portfolio at the National Association of County and City Health Officials (NACCHO) in Washington, DC. In this role, she supports local health services in the implementation of overdose prevention and intervention strategies in their jurisdictions. Julia obtained her MPH in Global Health from the University of Manchester-Manchester UK. She also holds a BSc. in Biology with Microbiology from the University of the West Indies, Campus Cave Hill, Barbados.


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