Uninsured. Food insecure. Unhoused. These are the names given to the untenable conditions that arise from poverty—some of them, at least. There is still no common language to describe the condition of being unable to afford diapers, toothpaste, laundry detergent, tampons, and the like, however, which is a shame. People don’t turn out in mass protests to demand the right to soap—but they should. Hygiene poverty is rampant in the United States and affects health as well as the capacity of millions of Americans to succeed at school, work, or virtually anyplace. And this crisis must be talked about.

While there are many public programs—albeit underfunded ones—to help families obtain health care, food, and housing, there are none to help with hygiene products. (To add insult to injury, rather than being subsidized, these essential items are often taxed, when food, medicine, and other widely recognized necessities are not.) The programs most commonly used by low-wage earners to help pay at the grocery store—SNAP and WIC—do not cover hygiene supplies. We are not suggesting that they should. Those programs need much more robust funding simply to meet their original mandate of helping residents, particularly children and pregnant and nursing women, to get the food they need. We are pointing out that people who cannot afford everything from shampoo to baby wipes have no source of public help. We are also pointing out that this is a disaster.

One in three U.S. families with young children report that they are unable to afford an adequate supply of diapers for their children. People often respond to this disturbing fact with, “Why don’t they just use cloth?” Cloth is a good option for some, but for a variety of reasons, including that most daycares require disposables, there are still families left without options.

A study of low-income families who received free diapers from the nonprofit Diaper Bank of Connecticut saw an $11 economic gain for every $1 spent on diaper aid.1 People who received such assistance stopped losing paid shifts on the job because they didn’t have the diapers to bring their children to day care. Some got raises because they were able to complete education or training programs that qualified them for better-paying jobs. Some needed to take their children to the pediatrician for fewer sick visits, because babies stayed healthier.

It is hard to imagine any public- or private-sector program showing a better return on investment. Yet various congressional champions have been pushing for federal assistance to provide diapers for families in need since 2011 and gotten nothing to show for it—unless you count Representative Rosa DeLauro grabbing the honor of being thoroughly mocked by Rush Limbaugh for introducing the DIAPER Act.

Limbaugh’s scatological send up of legislation that would have kept children clean, dry, and healthy was instructive, though of course not in the way that he intended. Many Americans seem to be embarrassed when talking about all things to do with excrement, body odor, and the like, and break the tension by making jokes instead of talking seriously. But it is time to get past the giggles and, even worse, the silence. It is time to be adults, because the stakes are high.

Chronic absenteeism is a problem among students from low-income households. Various remedies have been tried to address this, including locking kids up for truancy, but have failed because they lack an appreciation of the obstacles that experiencing poverty presents. In one successful approach, the washing machine maker Whirlpool responded to the many school teachers who talked about taking bags of students’ dirty clothes home to launder, buying moms detergent, and more. The company started giving washing machines to high-poverty schools. In the 2019–20 school year, schools in the program reported that 73 percent of elementary students who had been chronically absent had good attendance once they could get laundry done in school.

The success of Whirlpool’s initiative should come as no surprise. Of course children are significantly more likely to go to school when they know they won’t be teased about how their clothes look or smell. When it comes to hygiene and poverty, the connection should be overwhelmingly obvious, but this is not a widely held perception. People may count their blessings because they have a roof over their heads, but not so much because they have toothpaste. It’s such a little thing. Money is the oil that lubricates people’s lives, so smoothly that they are often unaware of the enormous good fortune found in small things. Didn’t fill out those important papers soon enough? Overnight them. Got stuck at work and came home to a kid in desperate need of science project help? Order dinner out. Pantyhose ran on the way to an important interview? Stop into a convenience store and buy another pair. These incidental expenses might not add up to much in aggregate, but for people lacking resources, these conveniences are simply out of reach, and any of those minor hassles could turn into a major problem. Life becomes a series of major problems, causing chronic stress with devastating consequences for physical and mental health.

Progressives agree that food, housing, and health care are rights. It is not that policymakers are opposed to putting hygiene in the same category—it is just that they don’t think to, because cleanliness is such an ordinary, baseline thing. There certainly are systemic measures that can be taken to build an economy that does not consign close to half the country to hardship. But until systemic change lifts more people out of poverty, there must be much more policy attention paid to the humdrum, the granular.

In order to understand what a real living wage would be, or what programs such as Temporary Assistance for Needy Families and Supplemental Security Income really need to pay, policymakers must first understand what it actually costs to live. There’s been great work in this area, notably the Self Sufficiency Standard project at the University of Washington. Everyone who cares about economic justice has a part to play as well: when talking about basic needs, people need to be clear that the list is long, and must include even hygiene. They need to be outraged that two in five people in this country have struggled to purchase something as simple and necessary as period products. And they need to be further outraged that so much is unknown about how hygiene poverty affects their neighbors, because almost no one is researching it. People need to get past the giggles and the silence, and instead start talking, asking questions, and searching for solutions.


  1. One of the authors of this commentary, Joanne Samuel Goldblum, is the founder of the Diaper Bank and participated in all of their referenced studies on diaper need.