These are all really great points Ashley. One of the may examples of poverty focuses' around the family's ability to access medical help, simply the inability for Esch to access birth control or condoms is one of the main focus. Esch talks about aborting her child, shes hurt, alone, and doesnt know where to turn. Her inability to access a safe abortion could be detrimental to her health and well being but sadly shes left to figure things out her own way, which might even end up in death for her. Esch's position is one that anyone will understand to be terrifying, but the idea that she had already lost her mother due to childbirth calls Esch's future and wellbeing into question. We here are fairly lucky to have some free access but in the US where the book takes place we frequently hear about poverty due to medical debit, its a real issue many struggle with and its one of the many reasons poverty can be deadly to many.