Desmond begins with the central question of why there is so much poverty in America. It has been the focus of his academic career, and the subject has deep personal resonance for him as well. He grew up in a modest home near Winslow, Arizona, that his family lost to the bank. He attended Arizona State University and met people his age with great privilege while the city of Tempe, where the campus is located, had severe poverty.

As an undergraduate at Arizona State University and then as a graduate student at the University of Wisconsin, Desmond began talking to the poor and documenting their struggles. He has long sought to understand how a country as rich as the United States could also have higher levels of poverty than other developed nations. Despite its massive gross domestic product (GDP), there are US citizens lacking running water and suffering from treatable diseases.

The existing literature has tended to focus on the facts of poverty that, while important, are not sufficient in themselves to explain why the US still has so much poverty. Reexamining this issue from a structural perspective can help shed light on the policies needed to ameliorate and even solve the problem.