When it was first developed in 1963, the poverty threshold was set at the cost of a minimal diet defined by the U.S. Department of Agriculture. Then, a family of two adults and two children under age 18 were considered in poverty with an annual income of $3,104 or less. In 2024, that threshold was $31,812.

That’s an average annual increase of 3.9%, which happens to be exactly equal to the rise in the Consumer Price Index (CPI) during that period. This is nowhere near the increase in the median family income of 4.7% annually which would put the poverty threshold at $51,128 in 2024.

In the past decade alone, Indiana has seen a reduction of the number of persons in poverty from 972,000 persons to 822,000, a decline of 150,000 persons. Our poverty rate has fallen from 15% to 12%. While we’ve seen a 5.4% growth in total population, our poverty population has fallen by 15%.

Sounds good, but half (52%) of this fall was due to a decline in the number of children under age 18. In 2014, one in five children (21.5%) was in poverty. That rate fell to 16.4% in 2024. Could that have been a decline particularly among teen births?

Offsetting the decline in our youth population was the 30% rise in those 65 and older and an 81% increase of those in poverty among those in this population. The elderly have gone from 6.5% of our poverty population to 13.9% over the past 10 years.

Poverty in Indiana is primarily a white problem. Of those in poverty, 64% identify as white, while equaling 76% of all Hoosiers. The general image of poverty, however, is driven not by this reality, but by the incidence of poverty in minority populations. Both the Black (or African American) and the Hispanic populations (of any racial color) are each 9% of Indiana’s people, yet they make up 16% and 13% respectively of the people in poverty.

Education is also related to poverty status. Of Hoosiers 25 years and older, 59% have schooling beyond high school. Despite their low poverty rate of 6%, they constitute 37% of those in poverty. For some the problem is a disability which limits their labor market participation. While only 15% of Indiana’s population have a disability, 24% are in poverty.

Of particular concern are 61,000 Hoosiers, 16 to 64 years old, who worked full-time, year-round in 2024 and are nonetheless in poverty. We would expect holding a full-time, year-round job in Indiana would be sufficient to keep workers out of poverty.

Also, in this 16-64 age group, those who worked less than full-time and year-round had a 17% poverty rate (182,000 persons) and others who did not work at all saw a 29% poverty rate (234,000 persons).

There is still much progress to be made. The answers probably lie with programs that attack the causes of poverty rather than those that directly ameliorate the problem.

Dear Eric: During our morning walks, my husband and I became acquainted with “Ron”, a homeless man who always sits on the same bench and always has a cheery hello. During the holiday season, we decided to gift him a box of homemade cookies and a Christmas card with $200 in cash slipped inside. I’ve imagined him treating himself to a decent dinner or buying something nice. We knew nothing about Ron, except that he seemed sweet and sober and appreciated our little gifts.

Recently, from several reliable sources, we’ve discovered that Ron has been sending money, including his VA checks, to a woman in China in the hope of getting her to come to America and marry him. People have repeatedly tried to tell him that this is an internet scam, but he refuses to listen.

I find it upsetting that our money is being handed directly over to a scammer somewhere. My inclination next holiday is to continue to hand him the cookies and the card but not the cash. I figure it’s just $200 less for some heartless con artist to steal.

My husband, however, objects. He says it’s none of our business how Ron spends his money. If this gives Ron purpose or pleasure, then who are we to interfere? Our reward should be in the giving and nothing else. My compromise is to give Ron a gift certificate, perhaps to a grocery store, but my husband feels that even this safeguard is too judgmental. What is your opinion?

– The Christmas Judge

Dear Judge: We don’t get to choose how other people make use of our gifts, especially strangers. Since you don’t have a relationship with Ron beyond these very generous gifts, you’re not in a position to safeguard him. I’m not wagging my finger, but it’s notable that you know nothing about him and you heard about the supposed scam from others, not from Ron. He’s not shared this part of his life with you.

What you might do is ask him, “what do you need?” or “is there someplace from which you’d like a gift card?” This way, you can be more confident that you’re meeting him where he is without trying to police his spending.

Dear Eric: I have a friend who is driving me and other friends to the brink with her persistent negativity. This has been going on for years but is much worse lately.

We are all retired, and this friend is substantially better off financially than the rest of us. Despite this, everything is a litany of “poor me” and nonstop negativity. No one else has suffered grievous losses as she has (we have). No one else is as burdened with problems as she is (we have our own issues, and deal with them). No one experiences as much pain, suffering, loss, misfortune or tragedy as she does.

Literally every conversation ends up being her listing a multitude of problems, all featuring her as the victim. When we try to gently point out that they are financially secure, or have many blessings to be grateful for, it’s just a doorway to yet more complaining, whining and “poor me.”

It’s clear she’s depressed, and it’s also clear that the medications and counseling she’s receiving are not helping. We’ve tried patience, listening, kind boundary-holding on topics, and redirection.

It’s to the point where some friends have stepped way back from the relationship, and where several of us are questioning why we continue on. This woman can be kind, generous and caring but rarely, and there’s little joy in any of our relations with her. Help, please.

– Overwhelmed by Negativity

Dear Overwhelmed: It sounds like you’ve been very empathetic toward your friend, while also communicating – in many different ways – what you need from her. One of the tactics that strikes me is boundary-holding. Presumably you’ve said to her, “complaining about this subject is not something I’m able to listen to right now,” or something like that. And, presumably, she’s ignored that. When people aren’t willing or able to honor the boundaries we’ve set, it often becomes necessary for us to take a step back.

You can tell her this. Indeed, while it may be uncomfortable, it’s better to be upfront than to drift away. You can tell her that you care about her and you value your friendship, but specific parts of it aren’t working for you right now and you need to take a break.

In all likelihood, this will be added to her list of complaints. But there is a chance that she’ll hear what you’re saying and try to change her behavior. Her outlook may not change, but right now the substance of your friendship – at least from your perspective – is all negative. She can choose other things to share.

Send questions to R. Eric Thomas at eric@askingeric.com or P.O. Box 22474, Philadelphia, PA 19110. Follow him on Instagram and sign up for his weekly newsletter at rericthomas.com.

As a physician, former U.S. Surgeon General, and former Indiana State Health Commissioner, my career has been guided by a simple belief: health care should work for everyone, not just those with the best insurance, the closest specialists, or the ability to pay for concierge care.

In an ideal world, every American would have affordable medications, easy access to on-call doctors, and seamless, high-quality care close to home. But we do not live in that world. And until we do, we should be careful about shutting down responsible alternatives that help fill real gaps in care, especially for rural and underserved communities.

That is why I am paying close attention to legislation moving through the Indiana Statehouse. Senate Bill 282 is motivated by a legitimate and important goal: protecting patient safety. Lawmakers are right to want guardrails that ensure medications are prepared, prescribed, and dispensed appropriately. Patient safety must always come first.

At the same time, as originally written, the bill risks going too far. It could restrict access to individualized treatments that many Hoosiers rely on today, including compounded therapies that are legally prescribed by licensed physicians and dispensed by regulated pharmacies operating under existing state and federal oversight.

For many patients, this issue is not theoretical. It impacts their ability to access many medications- including GLP-1-based therapies for weight management and metabolic disease. These medications have been life changing for many people and are now being studied for broader benefits across a range of chronic conditions. Yet access remains uneven. Cost, insurance coverage gaps, supply issues, and geography all matter. For some patients, responsibly compounded alternatives are not a preference. They are the only realistic current option to get therapies they need and deserve.

This conversation should not be framed as patients versus pharmaceutical manufacturers, or innovation versus safety. We need all of it. Breakthrough drugs developed by pharmaceutical companies save lives and advance medicine, and we must be cognizant of the need to reasonably protect intellectual property rights and incentives for future innovation. At the same time, personalized care exists — and is rapidly expanding — for a reason. Patients are different. Their medical histories, tolerability, comorbidities, geography, and financial realities vary. A system that works only for those who can afford the most expensive or most convenient option is not a system that serves the public’s health.

I have felt the frustrations of our health care system personally. In 2024, I received a nearly $5,000 bill for an emergency room visit, despite having insurance. That experience reinforced what millions of Americans already know. Care is often too expensive, too difficult to access, and too disconnected from patients’ daily realities. When people feel boxed out of the system, they look for alternatives. Our goal should be to make more options safer and transparent, not to eliminate them altogether, while pretending the status quo is fine.

To be clear, there are bad actors in every corner of health care, including in the telehealth and compounding space. They should be identified, regulated, and removed. Strong enforcement of existing laws matters. Patient safety matters. But safety and access are not mutually exclusive. We can do both.

Indiana has an opportunity to lead with balance. Strengthening oversight, improving transparency, and reinforcing the physician-patient-pharmacist relationship can raise standards without reducing access. Model approaches, such as the ALEC Safe Compounding Act, show that it is possible to protect patients while preserving individualized care and state-based regulatory authority.

At its core, this debate is about trust and choice. Hoosiers value the freedom to make medical decisions in consultation with licensed professionals they know and trust. They also understand the realities of living far from major medical centers or facing financial barriers that limit options.

We should aim for legislation that reflects those realities. Laws should protect patients, encourage innovation, and expand access, not narrow it. They must recognize our health care system is imperfect, and that responsible alternatives sometimes matter most for those with the fewest choices.

Indiana lawmakers do not have to choose between safety and access. With thoughtful policymaking, we can and should do both.

Dr. Jerome Adams, MD, MPH, is a former U.S. Surgeon General and former Indiana State Health Commissioner. He currently serves as a Presidential Fellow and the Executive Director of the Center for Community Health Enhancement and Learning at Purdue University. Send comments to editorial@therepublic.com.

It’s one thing to embarrass yourself before a national audience, but when you embarrass the entire United States with your nonsensical responses to questions from members of Congress, it’s time for a major change.

That’s what U.S. Attorney General Pam Bondi did when she recently testified before the House Judiciary Committee concerning the Department of Justice’s handling of the Jeffrey Epstein case.

Some headlines called her responses fiery, others called them explosive. Many are calling them what they truly were — disgraceful.

Because of her “performance” in the Washington hearing and her refusal to allow the FBI to share evidence with Minnesota law enforcement to investigate the killings of Renee Good and Alex Pretti, Bondi should resign.

The likelihood of that happening is slim. Therefore, if there are enough members of Congress who feel that same sense of disgrace, impeachment is one solution.

For that to happen, Democrats would need three Republican House members to vote against corruption and for justice. Republican Rep. Thomas Massie of Kentucky, who sparred with Bondi during the hearing, is one who would likely vote for justice. Others who realize her role and style would be a drag on the GOP ticket this fall could possibly join in removing Bondi.

A conviction in the Senate with its larger margins, however, would be the challenge. Still, an impeachment of Bondi would be a sign that recalcitrant Republicans are starting to share the consternation of American voters over how Bondi has so compromised the crucial role that the DOJ historically has played.

Among her transgressions is the release of documents that included the unredacted names of some of Epstein’s sex-trafficked survivors, but redacted names of rich and powerful men associated with Epstein.

In the hearing, she accused a Jewish member of Congress, Rep. Becca Balint, D- Vermont, of antisemitism. And after Balint, whose grandfather was killed during the Holocaust, responded with great emotion and stormed out of the room, Bondi laughed.

In response to New York Rep. Jerrold Nadler’s chastisement for not indicting anyone in the Epstein investigation despite photos and other evidence pointing toward possible culpability, her response was “Americans’ 401(k)s and retirement savings are booming. That’s what we should be talking about.”

An astonishing development is that Bondi’s DOJ also apparently monitored House members’ computer activity as they accessed some of the 3 million documents related to the Epstein files in preparation for the hearing. That included the search history of Washington’s Rep. Pramila Jayapal, D-Seattle.

Worse, Bondi did not deign even to glance at the survivors of Epstein’s and Ghislaine Maxwell’s sick behavior, even though those women sat just a few feet behind her.

Bondi’s failures are numerous, which reflects on the Trump administration, and thus the nation as a whole. A nation governed by laws can’t afford to have lawlessness in a department that was created to assure justice for all.

She is protecting Trump; she is protecting Epstein’s rich friends. She is not protecting the victims.