First Person

I Broke My Tooth. It Almost Broke the Bank.

I was enjoying chips and salsa while out with friends when I felt a jolt in one of my back teeth. I ran my tongue over the area and realized I’d lost part of a tooth from a particularly hard tortilla chip.

“What’s wrong?” my friend asked.

“I think I just chipped my tooth.”

My other friend waved her hand at me. “Just go to the dentist.”

It wasn’t an unreasonable suggestion, but I didn’t have medical insurance, let alone dental: a whopping 33.6 percent of US adults don’t have dental coverage.

Not only did I not have dental insurance, but I hadn’t been to the dentist in more than a decade. My parents, who both had all their teeth pulled in their forties, had stopped taking me to the dentist when I was around ten. I assumed it was because of the cost. Even with dental insurance, most plans only cover one to two grand of dental work per year, with a deductible. This seems reasonable until you need something more than a cleaning, like a crown, which costs between $750 and $1200.

When I got back home, to the house that I lived in with six other people, I looked in the bathroom mirror and discovered a whole side of the tooth had come off, right down to the gum line. I didn’t want to get an infection, so I did a Google search for cheap dental care.

There was a college nearby with a teaching school, meaning that students worked on you while supervised. The only problem was that it required an initial interview and then a separate exam on a different day before they even started treatment. A car was a luxury that I couldn’t afford, and the trip to the dental school would take hours and multiple buses, not to mention unpaid time off of work.

The next best option was Superteeth, a dental clinic that advertised most basic dental services at $99. Fortunately, Superteeth was on a busy road easily accessible by one bus. A few days later, I headed to the clinic. It was hard to miss, as the outside of the building was covered with signs advertising cheap dentistry.

I walked in without an appointment and filled out some forms, crossing out the insurance section. After an hour, the dentist saw me and told me, without even doing an x-ray, that I needed a root canal.

“How much is that going to cost?”

“The procedure is between six and eight hundred dollars.”

Six hundred dollars was what I made in two weeks. I did not have that kind of money. Then she explained that it was just the cost of the root canal. I’d also need a crown, which would push the total past a thousand dollars and require multiple visits. I must have looked shocked, because she added that they could just pull the tooth for $99.

“Can I think about it and come back?” I asked.

“Sure, but don’t wait too long.”

I'd rather have a missing tooth that wasn't too noticeable than a rotting tooth.

For the next week, I smiled in front of mirrors and windows, trying to figure out if a missing tooth would be noticeable. The tooth was on my left side, third from the back. My biggest concern was how a missing tooth would affect my job prospects. In a list of common nonverbal mistakes made during job interviews, not smiling came in third, with 38 percent of hiring managers citing it as an issue. Smiling is hard when you’re self-conscious about your teeth. Sure, I could do a closed-mouth smile, but it doesn’t have the same effect on people.

In the end, I decided that I’d rather have a missing tooth that wasn’t too noticeable than a rotting tooth that could get infected and cause further, more expensive issues. Even if I could get my hands on a thousand dollars, I would have used it to pay down my credit card that was maxed out from college expenses instead.

When I got the courage to go back, the dentist asked for the $99 upfront. I wasn’t sure what to expect, since I’d never had a tooth pulled before. My friends all had their wisdom teeth pulled and they were all knocked out for the procedure. This was not the case for pulling other teeth.

The dentist shot up my gums to numb them. She then grabbed what seemed to me like regular pliers that you would find in a hardware store. I was awake as she clamped down on the tooth and used all her strength to yank it out.

I was expecting something more surgical and less brutal. I heard the tooth shatter and then the sounds of the dentist scraping the area.

“I think I got all the bone fragments out, but it’s hard to tell. You might have some bone fragments come through the gums in the next few weeks. You can just pull them out yourself or you can come back and we can do it.”

She didn’t mention if it would cost me or not to come back. I didn’t ask, because I knew I’d just go the DIY route. She told me not to drink from straws, as this could cause the blood clot to dislodge, and then sent me on my way without so much as a Tylenol.

I was planning to take the bus home but called my sister for a ride instead. I didn’t want to scare strangers with my bloody gauze and slack mouth. A day later, I was back at work, as I didn’t have vacation days and was now out $99.

I remembered the dentist telling me to “get back in for an exam soon.” She looked concerned. I was having pain in other teeth and was using copious amounts of Orajel to deal with it.

I landed a job with better pay and benefits a few months later. As soon as my dental insurance kicked in, I made an appointment. I had 16 cavities and had to get them filled four at a time over four sessions. As I’d just started work three months earlier, I still didn’t have the money to pay all the out-of-pocket costs and ended up putting some of the expenses on a high-interest credit card.

My dentist kept pushing me to get a dental implant. He warned me of gum loss that could disfigure my face. He also told me my teeth would shift to fill in the gap, causing my bite to change. He did a thorough job of scaring me, but I didn’t have the $2400 to cover the out-of-pocket costs.

A few years and a few raises later, I was able to get the dental implant. I had been experiencing TMJ jaw pain due to the shifting teeth that got so bad that I went to the dentist to make sure I didn’t have an infection.

Like getting the tooth pulled, I was awake for the whole implant procedure. The dentist drilled into my gums, placed a metal screw in the hole, and stitched my gums back up around it. It would be a couple of months before the gums were healed enough to place the fake tooth on top of the screw. Again, I was thankful that the tooth was in the back. A missing tooth was one thing, but a screw sticking out of the gums was quite another.

Years have gone by and the fake tooth still gives me issues. Because I waited too long, I lost a lot of gum tissue and the fake tooth doesn’t fill the space well. Food gets stuck underneath the tooth and when I run the floss all the way under, I sometimes cut the gums. This leads to bleeding, puffiness, and a few days of pain. Once, it led to an infection.

The implant troubles are a constant reminder of how lucky I was to find a job in time, before I — like my parents — lost all my natural teeth. Not everyone is as fortunate.



New York’s Salon Workers Are Fighting For Better Conditions—And Winning

Glenda Sefla got a job in a nail salon in New York City when she first arrived from her home country of Ecuador because it was the first option she could find to make some money. But from the very beginning she knew something was wrong. “The conditions were really bad,” she told me, speaking in Spanish through an interpreter. One of those conditions was wage theft. She was working 10-hour days but making just $30 a day. That amounted to a mere $3 an hour, even though her wages and tips were supposed to come to at least $8 an hour.

That small amount of money didn’t cover her bills and expenses. “So then I just ended up working more,” she explained. She would work six or even seven days a week just to try to make ends meet. “I would just go to sleep and then go to work and then go to sleep and go to work,” she said. She spent three years putting in those kinds of hours. “I felt totally exhausted, physically and mentally.”

She eventually started working in a different salon in Manhattan where she made slightly more: $50-60 a day for the same hours. It still wasn’t enough to cover her bills. She had to eat “the most basic things,” always at home because she couldn’t afford to eat a meal out. She couldn’t buy herself anything, not even new clothes. “I couldn’t take care of my physical and mental health,” she said.

“You’re working so hard, but at the end of the week you still don’t have enough,” she added. “It makes it impossible to imagine a dignified life.”

Meanwhile, the salon owners never gave her and her coworkers information about how to protect their health and safety when working with chemicals everyday. Salon workers are routinely exposed to the “toxic trio” of formaldehyde, toluene, and dibutyl phthalate, common nail polish ingredients, as well as disinfectants such as alcohol. Exposure can lead to skin irritation and chronic conditions, allergies, and even reproductive problems.

Sefla didn’t realize that she had the right to more pay and better protection until she found the New York Nail Salon Workers Association, which organizes nail salon workers in the state around wages and working conditions. She’s now an organizer there.

“This wasn’t just something that was just happening to me,” she noted. For all of her compañeras in the industry, “This is the reality that we’re living.”

Low prices translate into illegal poverty wages.

A new report backs her up. In a survey of about 100 nail salon workers in New York City and surrounding counties, the New York Nail Salon Workers Association found that 82 percent experienced wage theft. Employers are failing to pay the state’s tipped minimum wage, aren’t making up the difference when employees’ base wages and tips don’t add up to the full minimum wage, and don’t pay extra for overtime work. The hours are long: nearly two-thirds of nail salon employees say they work shifts that are at least 10 hours. But many aren’t paid time and a half for the extra hours they put in.

That wage theft is costing them, on average, more than $180 a week, or over $9,000 a year—steep sums for the majority immigrant female workers who survive off of little pay to begin with. More than 10 percent of respondents were losing more than $400 a week.

One source of the problem, the report finds, can be traced back to how little it costs to get a manicure in New York. Workers at salons that charge the lowest prices—$9 or less for a manicure—reported experiencing higher rates of wage theft and losing more money, while those at salons that charged at least $16 for a manicure kept more of the money they were due. “Low prices translate into illegal poverty wages,” the report states. But “as service prices increase, wage theft decreases.”

On top of the inadequate pay, the report also found that 86 percent of nail salon workers in New York City aren’t being given paid sick days, as is the law.

In 2015, a New York Times expose shone a light on the rampant mistreatment of nail salon employees in the city, who are often forced to work extremely long hours in harsh conditions for little pay. In its wake, the state implemented health and safety standards dealing with ventilation and protective equipment. It also now requires owners to take financial steps to ensure that workers can recover wages if it’s found they’re being underpaid and created a voluntary recognition process for those deploying best practices. But workers argue that even with some protections in place, they need stronger enforcement to get what they’re due. “While the legislation provided new protections for workers and regulations for employers, workers continue to organize to make those protections a reality,” the report notes.

“We still aren’t really seeing changes,” Sefla said. “We have established better laws, but we’re seeing that a lot of the owners are not complying with the new laws. So we haven’t seen the change that we’re looking for.”

In December, Governor Andrew Cuomo announced he would get phase out the tipped minimum wage for a group of workers that includes nail salon employees (although excluded restaurant and hospitality workers), meaning salon owners will be required to pay the full minimum wage regardless of how much customers tip. But as the report notes, many workers weren’t even being paid the lower tipped wage to begin with. So they’re demanding more legislative action.

“We need mechanisms for enforcing those established laws,” Sefla said. “There won’t be any change without consequences and accountability.”

The heart of their demand is that the state legislature pass the Nail Salon Accountability Act, which will be introduced later this month. The law would change the licensing process so that workers’ feedback would be incorporated into the renewal process and owners would have to get certification proving that they are complying with labor, health, and safety laws. It would also mandate training for owners and workers on those laws. “Compliance with the law must become part of the cost of doing business,” the report states.

There are other potential legislative fixes in the works as well. Members of the assembly are considering a bill that would criminalize wage theft. The New York City council is working on a bill that would give salon owners subsidies so they could add proper ventilation.

“Esos son básicos,” Sefla said: These are basic things. “Son derechos que tenemos aquí en este país.” These are rights we have here in this country.



How Dollar Stores Sell Low-Income People a Sense of Belonging

Loretta Brown’s local dollar store is about a seven- or eight-minute walk from her apartment complex in Upper Darby, Pennsylvania, a small suburb right outside of Philadelphia. “According to my husband, I’m there every day, but that’s not true,” she said with a laugh, explaining that the bulk of her purchases are household necessities.

“I love the dollar store,” she said.

As do most dollar store shoppers, according to at least one Morning Consult Brand Intelligence poll that recorded favorability ratings around 60 percent. Even as retail sales decline, the major dollar store brands — Dollar General, Dollar Tree, and Family Dollar (which was bought out by Dollar Tree in 2015 for $8.5 billion) — are experiencing rapid growth, with Dollar General and Dollar Tree adding upwards of 10,000 locations over the past decade and continued plans for expansion. The key to their success is a strategic focus on poverty: Deep discount retailers are uber-accessible to low-income consumers even when there’s a net negative economic benefit to shoppers and the community.

“The core of what dollar stores have done and really capitalized on is recognizing that there are people who really don’t have other options,” said Dr. Sriya Shrestha, who teaches at California State University Monterey Bay. Her work on the dollar store phenomenon, “Dollars to dimes: Disparity, uncertainty, and marketing to the poor at US dollar stores,” chronicles the dueling tensions of a capitalist entity that both aids and exploits the poor. “We know what dollar stores ultimately are: an attempt for a way for very wealthy people to capitalize on poverty.”

Women with families who earn under $40,000 per year dominate the dollar store model. They purchase only what they can afford to buy now, in smaller packages that often cost more per unit than they would at big box retailers. “Our customer doesn’t buy until she absolutely has to — she’s that stretched,” noted one Dollar General executive, according to Dr. Shrestha’s research.

Clearly, the dollar store fills a need. Stagnant wages have kept purchasing power flat over the past 40 years, wage inequality has grown to levels not seen since the Great Depression, and the richest five percent of Americans own two-thirds of the country’s wealth. As the New York Times reported a few years ago, retail is now split into factions: luxury items and deep discounts, with nothing in between. Where dollar stores succeed — Dollar General, Dollar Tree, Family Dollar, the 99 Cent Store, and local mom and pop shops that follow the same model — is in giving low-income consumers the American Dream for a dollar a day.

Dollar stores attempt to create a sense of abundance, filling their stores with thousands of products placed on shelves that are below eye level. According to Dr. Shrestha’s research, companies will also engage in “downward brand extensions,” developing less expensive brand-name products specifically for dollar stores. When a consumer can walk out of a store having purchased a multitude of brand-name products, it presents them with a positive shopping experience and adds to their self-worth.

“I used to be embarrassed about the dollar store,” said Loretta Brown, “especially when I first became disabled and lost my job and was unemployed for a minute.”

Brown is a 53-year-old  with an ongoing affinity for her childhood home in South Philadelphia, which she calls “that diverse part of the city that we love.” She’s married with three grown step-children, and while her husband works, she no longer does, and has relied on Social Security Disability for the past 10 years.

Dollar stores attempt to create a sense of abundance

“My attitude has changed over the years,” she continued. “I’m not embarrassed. I don’t care… I’m making a smarter financial decision when I shop at the dollar store for whatever I get there.”

Feeding America, one of the nation’s largest hunger-relief organizations, co-authored a report with Proctor & Gamble showing more than one-third of families struggled to afford essential household goods. According to the findings, many families will skip out on personal care rituals or substitute products when possible, such as using hand soap as dish detergent. School supplies have become more costly, too, with the Huntington Backpack Index noting that parents can now expect to spend anywhere from $1,000 to $1,600 per child per year depending on their grade level.

“I used to shop sales and just use store discount cards, but as time has gone on, I’ve learned how to clip coupons,” said Kristine, a former social worker who owns her home with her husband. “I will buy hygiene products since they have full-size name-brand items… toothpaste, body wash, shampoo, some medicine,” she continued, “also, cleaning supplies and some food items.”

Though individual consumers can find shopping at dollar stores rewarding, the impact on communities can be more complex. The Institute for Local Self-Reliance, a nonprofit that works for sustainable community development, found that dollar stores contribute to the economic distress found in urban and rural communities. In 2018, the group put out a report finding dollar stores target low-income neighborhoods, especially Black neighborhoods, and drive out grocers and other healthy eating options. As a byproduct of these moves, local jobs have been eliminated as well.

Criticisms of the dollar store model have pushed local communities to fight back. Tulsa, Oklahoma, placed restrictions on the distance between dollar stores following a brief moratorium on new retail locations in 2017. Small towns in Kansas and Texas passed ordinances limiting the number of stores allowed within their limits.

But efforts to ban dollar stores and replace them with community-centric retailers have, at times, failed to gain traction. In Cleveland, for example, a local grocer received a $1 million subsidy to open up shop but, according to The Progressive, it struggled to find a customer base. Much of the nuance on this issue is lost in translation between reformers and the monied interests who stand to gain from tilting the conversation.

Moreover, as Dr. Shrestha said, in some ways, banning dollar stores misses the point.

“We need to make it so that people have the income so that they don’t have to rely on the dollar store for meeting their basic needs,” said Dr. Shrestha, explaining that wealth distribution, not market-based solutions, could help to eliminate poverty itself. “Eradicating the dollar store isn’t going to really solve that problem.”

Neither will a Whole Foods, Walmart, or local grocer that doesn’t meet the needs of low-income consumers in the here and now. Women-headed households are the primary consumers of deep discount retailers, according to Dr. Shrestha, and those households are disproportionately in poverty.

The real question she said is, “Are we okay with that?”



North Carolina Wants To Penalize Prenatal Substance Exposure

Activists in North Carolina are scrambling to stop the state from passing a law that would allow the state to charge parents with abuse if their infants are born “substance-exposed.” House Bill 918 has been making its way through the North Carolina legislature and may be up for a final senate vote as early as April. If signed into law, it stands to dramatically change the way many child welfare cases are handled, and to codify discrimination against pregnant people who use drugs.

The bill seeks to make three major changes: It would define illicit drug use during pregnancy as child abuse regardless of actual harm to the infant; remove the state’s obligation to engage in family reunification efforts when a child was exposed to drugs; and significantly shorten the amount of time it takes to begin terminating parental rights.

Although the bill’s stated purpose is the protection of infants, opponents say it does the exact opposite: Separating infants from their parents causes potentially irreversible trauma to a child’s brain. In addition, this type of bill deters pregnant drug users from seeking much-needed medical care for fear of punishment, and denies families the resources to heal from addiction and parent their children to their best capacities.

The North Carolina Urban Survivor’s Union, a harm reduction organization dedicated to protecting the rights of drug users in North Carolina, is doing everything they can to stop this bill from becoming law. They are reaching out to senators, gathering signatories on a letter of opposition (which I joined), and preparing to implore the governor to veto it, failing efforts to stop it from passing. To them and many other harm reduction and reproductive rights advocates, this bill represents a growing national trend to use fear-mongering as a basis for stripping pregnant people of crucial rights, even well beyond pregnancy.

Aly Peeler, advocacy coordinator for the North Carolina Urban Survivor’s Union, notes that although the bill is written to target drug users, it has the potential to affect a much larger population: “It opens the door for prosecuting people who can get pregnant for anything that can harm a fetus. What if you’re not exercising enough, what if you don’t have healthcare when we know that prenatal care is the biggest determinant of fetal health? We are really invested in stopping the bill.”

Allowing the state to define in utero substance exposure as child neglect would permit child services to remove newborn infants from their parents’ custody at birth. Should this pass, North Carolina would join 23 other states in defining prenatal substance exposure as civil child maltreatment. This has a ripple effect: A recent study from the RAND corporation discovered that areas with punitive policies toward drug use during pregnancy, such as conflating it with civil or criminal child maltreatment, saw higher rates of infant withdrawal. Patients who fear being punished for using drugs avoid medical care, whether that means continuing to use drugs instead of engaging in treatment, or avoiding prenatal care altogether.

It is a measure that invites a host of problems, including the traumatic interruption of the dyad between a birthing parent and newborn. Contact between newborns and the parent who birthed them is crucial during the first days of life; this is especially true for infants who experience withdrawal from substances they were exposed to during pregnancy, whether or not those substances were prescribed and taken as recommended. Nursing and skin-to-skin contact have been shown to reduce symptoms of neonatal abstinence syndrome (NAS), or infant withdrawal.

Many hospitals around the country have begun to change their NAS protocols to be more inclusive of families, implementing “mother as medicine” approaches to treating withdrawal symptoms that have led to dramatic decreases in the amount of time infants diagnosed with NAS require medical intervention. The University of North Carolina Children’s Hospital-Chapel Hill recently implemented a new approach to treating NAS called “Eat, Sleep, Console,” which heavily integrates familial support as part of the treatment for infant opioid withdrawal. House Bill 918, however, would undermine that medicine by denying parents access to their newborns, potentially even while the baby is still in the hospital, despite the new protocol’s positive outcomes.

The absolutist attitude toward drug addiction appears to favor stigma over science. It states that in order for a substance exposure-based neglect charge to be substantiated, child services must be able to demonstrate that the parent is “unable to discharge parental responsibilities due to a history of chronic drug abuse.” This would allow a parent’s history of addiction to be weaponized against them, something which is generally not done with other medical conditions unless there is a similar element of stigma involved, such as that which is seen in some cases of intellectual or physical disabilities.

It also opens the door to using addiction treatment history as evidence of an inability to parent. Addiction is defined as a chronic relapsing disorder. It is not uncommon for patients to attend more than one treatment program before achieving long-term remission, or to require long-term medication management with methadone or buprenorphine in the case of opioid addiction. When these histories become confused with the definition of parental fitness, it labels people with substance use disorders as undeserving to parent simply because of their condition.

In an interview for a story published by The Appeal, obstetrician and addiction medicine physician Mishka Terplan described recovery as “finding community connection, purpose, and meaning…Motherhood fits right into that, and yet we have this system that has labeled certain people and populations as being less deserving of that than others, so we are going to even take that away from them, or make it yet another battle in a grossly unfair universe.”

Stating that child services is not required to engage in reunification efforts further codifies this dismissive attitude toward people with substance use disorders. Normally, when a child welfare department opens a case on a parent that involves the removal of a child from the home, the department is required to pursue reunification efforts before moving to forcibly adopt the child to another family.

This means that the department has an obligation to provide referrals and financial assistance for any services the parent is required to complete in order to regain custody. In cases that involve parental drug use, this typically means that the child welfare department must provide timely and appropriate referrals for addiction treatment, and often must also cover the costs of such treatment. But North Carolina’s new bill would remove this burden from the state in cases that involve “exposure to nonmedical substances in utero.”

“[A pregnant person with an untreated substance use disorder] can’t stop using [solely due to pregnancy] because that’s one of the defining features of having a use disorder, and people with a use disorder — they need treatment,” said Terplan, describing with eloquent simplicity the inherent injustice of removing a child due to parental drug addiction, then refusing to provide treatment.

Amber Khan, a senior staff attorney at National Advocates for Pregnant Women (NAPW), has helped oppose bills like this in the past, like a 2017 bill that made substance use during pregnancy civil child neglect in Kentucky and forced mothers to enroll in drug treatment within 90 days of giving birth or face termination of parental rights. Khan said these bills “are counter-intuitive and dangerous and based on misinformation. They certainly do not address a substance use disorder. If the concern is a parent’s substance use disorder, these bills create a punitive system but don’t increase funding for care.”

The absolutist attitude toward drug addiction appears to favor stigma over science.

Finally, North Carolina’s bill also decreases the amount of time it takes to permanently separate parent and child by terminating parental rights, an act that has been dubbed the “civil death penalty.” Currently, federal legislation known as the Adoption and Safe Families Act (ASFA) requires states to file for termination of parental rights when a child has been in foster care for 15 of the past 22 months (it does not necessarily apply in situations of kinship care, when children are living with relatives). Some states have opted to shorten that time, and if HB 918 passes, North Carolina will join them. The bill will shorten the requirement to one year. It also gives foster parents the same rights as relatives, allowing them to petition for custody after only nine months.

“People don’t understand substance use,” said Louise Vincent, the executive director of the North Carolina Urban Survivor’s Union. “I find bills like this really manipulative…You start talking about pregnant women using drugs and people lose their mind. People don’t understand that love doesn’t cure addiction.”

Compounding all of this is the fact that these issues will not be faced by all populations equally. In North Carolina, for example, Black children comprise 33 percent of the foster care population, but only 23 percent of the state’s total population. This law would give the system further leeway to discriminate by race and class, issues already embedded into the child welfare system.

“We know that poor women and women of color are more likely to be suspected of drug use, so they’re more likely to be screened and more likely to be reported,” said Peeler. “The bill is really worrying partially because everyone really values trusting and confidentiality with their doctors and it wouldn’t afford that to people who can get pregnant.”

When legislation perpetuates the idea that addiction can be a chronic relapsing medical condition up until the point of pregnancy — when it becomes a moral failing and representative of a lack of appropriate maternal love — it fails to protect the community, which should be the basic function of the law. HB 918 and other similar laws defy science in favor of stigma and move the government one step closer to repealing reproductive agency in the United States. And, of course, it creates a new avenue for punishing drug users even while the criminal justice system finally, albeit slowly, begins to recognize that punitive measures are ineffective against addiction.

“This is certainly another part of the business as usual for the drug war,” emphasized Vincent.



A Secret Spreadsheet Shows There Are No Raises In Coffee

In early October of 2019, a Google spreadsheet circulated through the Philadelphia coffee community. Baristas could anonymously report their wages and compare what they were making with their colleagues. Since then, the spreadsheet has become a powerful tool, making information that is often difficult to track accessible, and it has allowed baristas to advocate for higher wages. The spreadsheet, however, unexpectedly uncovered another problem: there’s not a lot of upward mobility in coffee.

On the spreadsheet, managers and shift leads made the same amount as new baristas. Some entries showed that many baristas worked for companies for years and still made the same amount as those just starting in their careers; the average wage of hourly employees hovered just above $10 an hour, regardless of their role. Over 200 baristas entered their wages into the spreadsheet, which was first reported on by the Philadelphia Inquirer and has inspired similar lists across the nation. Although the spreadsheet isn’t wholly scientific — information, like average tips, benefits, and if they receive federal aid, is self-reported — it does call into question if there’s a correlation between how much experience and knowledge a person has and their ability to move up in their careers and make more money. And in the coffee world, despite the fact that jokes about getting a “real job” run prevalent, a considerable amount of skill, technique, and practice are required just to make a beverage properly, let alone do it well.

Service work has the potential to equalize. There aren’t a lot of jobs where almost everyone starts at the bottom, and the low barrier to entry means anyone can work their way up. Upward mobility can seem really clear in these types of roles — barista to shift lead to… — but where do these roles lead? If you’re making the same amount of money you were ten years ago, or if accepting a leadership position means you make less money because you lose tips, does the idea of upward mobility actually exist?

“I had been working in various capacities on the cafe side of things for nearly ten years when an opportunity to become a roaster came my way,” said Trevor Szewczyk, a roaster based in Philadelphia. He was working in Oakland when he started exploring positions outside of the cafe. “At the time, I was pretty ready to do something else, as it felt like I had been bumping my head on the ceiling of cafe management in the Bay Area.” He balanced two realities: a barista job that pays a lower hourly wage but collects tips at the end of the day, or a slightly higher wage without tips in a management position, which is a pretty common reality for most baristas.

After oscillating between both options, he decided to pursue a different coffee journey.

Szewczyk interviewed for an open position with a coffee company just outside of Oakland. He said the initial interview went well, and he expected to get an offer that was at least comparable to what he was making in his last position. “As I had been the shift lead for the cafe I was leaving at the time, I was making about $25 an hour — a base wage of $14 averaging $10 an hour in tips. So when the offer letter came I was a little taken aback that I was being offered $17 an hour.”

The position — an associate roaster for a local but large coffee company with multiple locations and wholesale accounts — seemed like a step up. However, Szewczyk never made close to the amount he was making as a shift lead, even though he was learning new skills. After a year and a half with the company, Szewczyk’s wage was bumped up to $18.50, but never matched what he was making at the cafe.

The promise of a career is what drives many to accept positions that, given a closer look, don’t actually deliver on what they promise: a stable life in their chosen field. And often, that means taking jobs that are underwhelming and financially not viable to escape the perceived bottom of the field.

“There have been a few instances where I have really been underwhelmed by promotion promises — the most recent was leaving my management role to go over to a different cafe where I was hired to do beverage development,” says Oodie Taliaferro, a barista working in Austin, Texas. “In that move I was also promised that I’d start at a higher rate than their starting rate…and after it was all said and done I started at the company’s minimum and my non-tipped hours in research and development were just that — full shifts with no tips and making only $10 an hour.”

Taliaferro left that job and did what a lot of baristas do after being let down by seemingly better job: they go back to being a barista. For many baristas attempting to “move up,” barista work often ends up being the best balance between responsibility and wages. Most management and behind-the-scenes jobs pay nominally more than a barista wage, and without tips, jobs with more responsibility are often not worth it. However, that means that there’s nowhere to go when you want to move further in your career.

Essentially, you’re stuck.

Mika Turberville is right in the middle of navigating that messy place — moving from a job that sounded like a step up in their career to working back on the floor.

“I initially took this job because I was working as an intermediate manager at a cafe and had been for several years with no prospects of upward mobility,” they said, even moving from Austin to New York to pursue a new opportunity within the same company. Turberville had ten years of experience, and when they landed the job, was surprised to learn that although their wages were technically higher, they didn’t cover the added cost of living in a city with higher expenses, let alone the fact that their position was technically a promotion.

“My pay as an intermediary manger in Austin was $13.50 an hour with tips, which is almost twice the minimum wage for that area…In New York, I used my savings to move for this job, they paid me $19 an hour, $4 more than the minimum for New York, and I don’t know if you’ve ever been here, but that’s not a living wage at all.”

Service work is both mentally and physically exhausting.

Eventually, Turberville left, and has since returned to making drinks. “While I feel I have taken a step backwards a bit, I feel hopeful that I can continue to pursue a Q Grader certification [a coffee certification similar to a test a sommelier would have to take for wine] while working there and that they will support whatever next steps in coffee look like for me.” The Q grader certification is a three-day class followed by 17 coffee evaluation tests — the classes cost about $2,000 and people study for months, expecting to fail at least a few of the tests on their first try. Although it’s a helpful certification for roasters and green buyers to have, it’s rare that a coffee company would pay for this course for a barista.

Folks like Szewczyk and Turberville are still fighting to establish a career in coffee, but it’s common for people to walk away from the industry. “I left my last coffee job for a lot of reasons, one of which was not being paid appropriately for my work,” says Meghan-Annette Reida, a former barista working in Milwaukee. After years of being underpaid, Reida decided to leave coffee altogether. “I got a job in insurance; I’m the lowest paid staff member and I’m still paid twice what I was paid to run a coffee shop.”

On Twitter, Taliaiferro asked folks to detail their coffee journeys, charting the ups and downs of their own employment in coffee as an example. Their reason for asking echoes the experiences of a number of baristas: “Feeling like half a dozen lateral moves isn’t what I pictured for my career, but wondering if it’s more common than I think.” When your career is a series of seemingly similar jobs dressed up in titles like “manager” or “shift lead,” which are often codes for “no tips,” it can be difficult to see a clear pathway for baristas to pursue.

An opportunity to move away from barista work is tempting. Along with wage ceilings, service work is both mentally and physically exhausting, and baristas are often not making the same in tips as their other service colleagues are, so the drive to move off the floor and into roles with more responsibilities is enticing, and many baristas are led down a false pathway that often leaves them both stagnant and burnt out. Because of the way tips are ingrained into specific service settings and because coffee is often priced lower than similar food and beverage experiences, it’s much more lucrative to be a career waiter or bartender than it is a career barista.

Documents like the barista wage spreadsheet will hopefully give power to baristas to demand more from their employers. Baristas at Starbucks have already banded together to call for better wages and more predictable schedules after the company added a meditation app to its benefits package while slashing employee hours. If anything, it’s a cautionary tale to the pitfalls of trying to build a career in coffee — what should be an arrow pointing upward often ends up being a web of ups, downs, crashes, peaks, all together writing an uncertain future for many of our most vulnerable service industry members.