On December 31, 2009, the work of the Robert Wood Johnson Foundation Commission to Build a Healthier America came to a close. To stay up-to-date on the latest news and efforts related to health disparities and the social determinants of health, visit rwjf.org

Beverly Davis

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Number 72 today.

Number 10 tomorrow.

She's always a number.

Fifty-two.

Thirty-three.

Twenty-four.

Those little paper slips that scroll out of the red "take-a-number" machines-the kind deli counters use-define Beverly Davis' days, complicate her life, suck away hours.


Because she is poor and sick, she hears "take a number" almost every day.

She takes a number at the housing authority. She takes a number at the local clinic when 7-year-old Semaj needs a checkup-even though he has an appointment. And she takes a number when bureaucrats at the welfare office want proof her kids are attending school regularly.

The life of Beverly Davis, African American, single mother of two, amateur poet and welfare recipient, resembles a roller coaster in slow motion, inching slowly up, only to roll back down. At times in her 27 years, Davis has risen above her circumstances. But the high points never last long, a new setback always looms.

"Most days I'm thinking to myself, 'How am I just going to stay above water,'" she observes.

Born to a high-school dropout who struggled with addiction, Beverly spent most of her childhood "bouncing around a lot," helping her grandfather raise her four younger brothers. While other girls were skipping rope, she was "making bottles, changing diapers and cleaning dishes."

Even when her mother, Andrea Jones, won back custody of the children, it was often short-lived and problematic, says Davis.

In and out of hospitals over the course of four years, she was eventually diagnosed with a chronic, painful inflammation of the digestive tract. The illness robbed her of a job, her savings and the modest existence she was maintaining for her and her two children.

Without a car, Davis spends at least five dollars a day on public transportation – she cannot afford the up-front expense of a monthly pass, even though she knows it would be cheaper in the long run. She travels a total of six hours each day to get the children to school and back.

But Davis, a bright, determined young woman with a mischievous smile, managed to finish high school and pass the Army's entrance exam. By age 20, she was married to a fellow soldier, living in Germany and collecting a steady paycheck with benefits. Good health and a bit of pluck were her ticket out of a dysfunctional family and poverty-stricken neighborhood.

 "I thought I was the epitome of good health," she says.

Until four years ago.

That is when the roller coaster came crashing down. Back in Long Beach, California, separated from her husband, Davis was hit with an intestinal illness that caused vomiting, diarrhea, chills and crippling stomach pain.

In and out of hospitals over the course of four years, she was eventually diagnosed with a chronic, painful inflammation of the digestive tract. The illness robbed her of a job, her savings and the modest existence she was maintaining for her and her two children. Her car died, she signed up for welfare and canceled her telephone service.

"Some days I can't get out of bed or I have to go to the bathroom constantly," she says, sprawled out on her bed after a long day. "My mouth gets all dry, my teeth hurt, my knees swell, my hair falls out," and she's gained 40 pounds because of steroids doctors prescribed. At one point, the pain was so bad, she considered suicide and was placed under watch in a mental ward.

Yet the toll of her condition goes beyond physical pain and financial expense. What the medical records miss is the stress, humiliation, frustration and isolation that compound life's challenges.

"I know a lot of people," Davis remarks one hot day as she and her 4-year-old daughter Alyla board a local commuter train. "But a lot of them don't know me."

After two bus rides, the family nears Semaj’s school. Though the simple task of taking her kids to school takes hours by bus and walking, Beverly feels this is important because the schools are excellent and the sense of continuity is critical for her children.

Without a car, Davis spends at least five dollars a day on public transportation-she cannot afford the up-front expense of a monthly pass, even though she knows it would be cheaper in the long run. She travels a total of six hours each day to get the children to school and back. The schools are not the closest, but Davis has kept her children in them because they provide free meals, quality after-school care and a measure of stability for two youngsters who fret about their mother's well-being.

"When I was a child we were bouncing around and I never made any solid friends," she explains. "I don't want that for my kids."

 Davis and Alyla travel from the cheery Long Beach that tourists see – with clean-swept sidewalks and bustling cafes – to the dusty outskirts of town where welfare recipients cross under a highway and over shattered beer bottles to the county office building.

 It is a familiar route, one she traveled often as a young girl with her mother.

"It's like a note in my head," Davis says, describing the sense of deja vu.

"If we don't got food, I know where the food shelter is. If we're homeless, I know where to go."

The relationship with her mother is complex.

"The one thing my mom prepared me for is she gave me the knowledge to survive," she acknowledges. But her childhood memories are largely of an absent or irresponsible mother, who had three children by age 19. Yet Jones has been an invaluable help caring for her grandchildren during Davis' worst bouts.

"I made some bad choices, but a lot of things I didn't get to choose," acknowledges Jones, who today is employed and has been clean and sober for four years.

Davis and Jones are a "miracle," says Loretta Jones, a family friend and executive director of the Los Angeles-based Healthy African American Families II. "They are beating the system, just a little bit."

Four years after applying for government-subsidized Section 8 housing, Davis and the children recently moved into a two-bedroom, two-bath apartment and filled it with "trash-truck treasures," as Davis puts it. The difference between the dreary basement studio that had no stove and the new place is like "heaven and hell," says her mother.

"The old place was a 'wall-banger,'" says Jones, using the term of art to describe a space so small that you smack the walls by simply spreading your arms and spinning. She jokingly compares her family to the Jeffersons-"movin' on up."

 In the old place, which cost her full $700-a-month welfare allotment, Davis felt "like a rat in a shoebox." Now, she can rest in the privacy of her own room, while Alyla and Semaj can play in theirs.

Davis feels trapped in a nasty cycle: her illness triggers anxiety, depression and isolation, pressures that in turn exacerbate her condition. "I have no way to express my own humanity," she observes.

In reality, she is better than most at finding low-cost outlets for her stress. In a worn, salmon-colored notebook, she is penning a collection of poems titled "Letting My Pen Bleed." The evocative writings capture feelings of fear, pain, anticipation and love.

Davis and Alyla travel from the cheery Long Beach that tourists see-with clean-swept sidewalks and bustling cafes-to the dusty outskirts of town where welfare recipients cross under a highway and over shattered beer bottles to the county office building.

Four years after applying for government subsidized Section 8 housing, Davis and the children recently moved into a two-bedroom, two-bath apartment and filled it with “trash-truck treasures,” as Davis puts it. The difference between the dreary basement studio that had no stove and the new place is like “heaven and hell.” –Andrea Jones

Three years ago, she and her friends formed F.O.C.U.S., which stands for Forgiving Ourselves and Others, Creating a United Sisterhood. Over a home-cooked meal, the group commiserates, compares notes or organizes self-help seminars. Yet even FOCUS has become a stressor. With little money or energy, Davis finds it difficult to fully participate. She became so disappointed in herself, she quit the group she helped found.

"They do what they're supposed to do and I don't," she says. "That's not right."

In October, after twice being rejected for permanent disability, Davis appears before a Social Security judge to make one last appeal. With her mother at her side, she sits in a windowless hearing room recounting the four-year saga.

"I don't plan on being on it the rest of my life. I want to do something on my own," she tells the judge. "But right now I need it."

As Davis proffers hospital records and doctors' notes, the judge tells her she is entitled to a lawyer. But that would take more time and money, so Davis goes it alone.

 The life Beverly Davis has assembled for herself and her children teeters on the edge, like a roller coaster at the moment before it plummets, says Loretta Jones, the veteran community activist.

 "If Beverly's health gets worse, all these things are lost," says Jones. "She won't have the energy to spend three hours taking the kids to school, so she'll stay home in bed, losing her hair, losing her intestines, losing her mind. Then the kids won't have any hope for the future."

For a rare treat, Beverly takes her children to a buffet breakfast in downtown Long Beach.

 "What she's holding onto right now is so fragile," Jones says. "If she gets (the disability award), she has a chance of at least having enough money to keep the kids in the same place, possibly get a car, buy the kinds of foods they should be eating."

Davis has even grander dreams, of publishing her poetry, starting a clothing design company, sending her children to college.

 "I think I've got enough to decide your case," the judge says. The testimony "supports a finding of disability." Still, he wants to review the documents once more.

 Davis won't celebrate until she gets a decision in writing. But things are looking up again.