Too Poor to Die
Amy Shea
Rutgers University Press (2025)
ISBN: 978-1978843981
Reviewed by Ava DePasquale for Reader Views (10/2025)
Death is our one certainty in life. It’s something we will all experience, yet many of us have never had to think about what happens to the unhoused and poor when they die in the United States. In Too Poor to Die: The Hidden Realities of Dying in the Margins, we learn that the playing field of death is not always level. As the author, Amy Shea, says, “Not all deaths are created equal. Not everyone has a good or dignified death or is treated with respect.” Shea draws on in-depth research, personal anecdotes, and fieldwork experience with marginalized communities to tell the story of what happens to those who can’t afford dignity in death.
Through several connected essays, Shea shares her own journey of discovering the fate of the indigent and unclaimed dead, from visiting potter’s fields with her father to meeting unhoused hospice patients in a medical respite center. She takes great care to write about this topic responsibly by blending facts with moving stories that follow unhoused and disadvantaged individuals leading up to and after their deaths. Through these essays, a story unfolds that sheds light on a system that is ill-equipped to provide a dignified death to those who can not afford one.
Shea points out the privilege behind the growing death positivity movement and how good death education, while useful to many and often driven by good intentions, fails to meet the needs of marginalized communities. She examines the influence of capitalism on death care, stating, “Where there is death, there is profit to be had.” Shea backs up this claim by uncovering what is done with the bodies of the unclaimed and indigent and who is left to foot the bill. The stories she shares are handled with care and compassion and are accompanied by context that highlights how close the average American is to experiencing this fate themselves.
Too Poor to Die highlights differences in the indigent death care industry in several different locations across the United States. Having lived in the Boston area, Shea shares her experiences working with the homeless population in the city. She shares their stories and common struggles of finding shelter, holding on to personal property, and staying healthy on the streets. Being from Massachusetts myself, this book has changed the way I view the local unhoused community when I walk through the Boston Commons on my way to work each day. While I’ve always had sympathy for this community, I now have a deeper understanding of the complex struggles they face and how we need to do more as a society to care for these marginalized communities, both in life and death.
If you are privileged enough to have the finances or a family to facilitate your passing and burial when the time comes, you may never know the fate of those who have neither. Too Poor to Die draws attention to this important issue that often goes undetected by the general public. It introduces a need for more funding, more advocacy, and more compassion when it comes to dealing with the deaths of those who can not afford a good death. Amy Shea is a compelling storyteller who creates urgency around this issue and asks us all to reflect on what it means to die (and live) well and why this should be available to everyone.