The word “poverty” conjures up images of rundown houses and blighted neighborhoods, ragged clothes and empty cupboards. But try instead to see poverty as having a face. Whose face would that be?

It might be the face of a child. The face of someone from a developing country that’s stricken by drought or famine. The face of a young man or woman crushed by opioid addiction.

What you probably don’t picture is the face of an older adult.

A staggering 37 million people who are 50 or older don’t have adequate financial resources to meet their most basic needs. Americans are living longer lives — but for many, longer lives also mean having to deal with impossible choices: Do I put food on the table, or do I get my prescription filled? Do I pay the rent or the electricity bill? Do I find a less expensive place to live, or do I try, somehow, to hold on to my home?

The burden of these decisions would bring a look of anguish to anyone’s face. It’s no wonder, then, that the face of senior poverty is often the face of despair.

Not a Penny Saved

That sense of despair underscores the challenges confronting older adults. A 2016 survey by GOBankingRates, for example, showed that about 3 in 10 adults over the age of 55 had not one penny saved for retirement. For low-income older adults struggling to meet their basic needs, Social Security is often the only source of retirement income, if they’re able to retire at all — and many discover that the average monthly benefit of just $1,369 is simply not enough.

There’s a perception in some circles that when someone struggles financially, it’s because they’ve done something wrong. But most have done everything right; in fact, countless older adults worked hard and planned carefully for the future. And there are the millions — literally millions — who planned for their retirement, only to fall victim to unforeseen circumstances that changed the whole equation.

Many can’t save, for retirement or for anything else, because they aren’t working at all. Adults age 50 and older face the longest spells of unemployment and the least likelihood of finding jobs.

Even those who are employed may fall short of financial stability. By 2020, workers 55 and older are expected to approach 25 percent of America’s workforce, a doubling in the space of just 30 years. Over half of these older workers either don’t know when they will retire or have no plans to retire, a fact reflecting the economic pressures they face.

The stark reality is that 13.2 million older adults get up every day and go to their full-time jobs — and they still can’t make ends meet. And yet, poverty is often left out of the conversation about aging.

Why?

Into the Shadows

One reason is America doesn’t like to talk about poverty. Even when we acknowledge that extreme poverty exists in this country, we see it as somehow outside the mainstream American narrative. We push it away from us, imagining it to be only in regions of the country or neighborhoods that are safely removed from our own.

But it’s not just poverty that we push away. America is uncomfortable talking about aging, too — perhaps even more than poverty.

Consider the widespread belief that Social Security and Medicare and pensions enable seniors to meet all of their basic needs. The country by and large thinks older adults are doing just fine. But that’s hardly the full picture.

“The sad truth is that the social safety net is no longer sufficient, and the guarantees of security as we age no longer hold true,” says Lisa Marsh Ryerson, president of AARP Foundation, which works to end senior poverty by helping vulnerable older adults build economic opportunity and social connectedness. “Consequently, senior poverty is a widespread and deeply disturbing problem in the U.S. — but it’s often hidden from sight.”

Why don’t we see this face of poverty as clearly as we should? Senior poverty can be harder to recognize than other types of poverty because, frankly, it dresses differently. It dresses in pride. It disguises its anguish. Many older adults suffer in silence; they don’t want to be a burden or to complain. They may feel embarrassed by their circumstances, or ashamed that they need help.

All of which makes senior poverty easy to push into the shadows.

One way to bring it out is to shift perspective: to view senior poverty as a health issue.

Senior poverty manifests itself in many ways: as food insecurity, as unaffordable or inadequate housing, as social isolation and loneliness. It leads to more cases of diabetes, depression, heart disease and other ills. These in turn lead to rising health care costs, which reduce financial resources, perpetuating a vicious cycle and a downward spiral.

Recognizing senior poverty as a health issue, as a fundamental threat to well-being not just for individuals but for society as a whole, may be the first step toward breaking that cycle.

Treating the Illness

Where do we start?

We can begin by having the courage to put the words “senior” and “poverty” together, as often and in as many places as possible: at the highest levels of government, in town councils, in places of worship.

Next, we can start to treat senior poverty not as an individual failing but as a disease. Not of the body, or of the mind, but as a societal disease — one ultimately rooted in discrimination, and spread by indifference.

Then, we can move towards prevention and treatment. We approach senior poverty with the same sense of urgency that drives the CDC in attacking an epidemic.

In treating this disease of senior poverty, financial security is essential. It’s critical to help older workers get the resources and skills they need to compete with confidence for jobs that are in demand.

Health security is equally important. That includes affordable food and livable housing, and making sure that seniors stay connected to their communities. When social ties come apart, the negative effects on health can be worse than those caused by obesity or smoking.

But prevention and treatment require acknowledging that the problem exists. Real progress will only come when we accept that poverty, in all its forms, is not the problem of any particular group or class. Fundamentally, poverty is America’s problem.

Poverty has a face. It has tens of millions of faces. And many of those faces aren’t the ones you’d expect. They bear the imprint of decades of achievements and challenges, of joys and sorrows. And now they bear a worried countenance. You can see it; you only have to look.