In this dissertation I analyze the work of a Michigan based NGO (non-governmental organization) that provides health and social service advocacy and assistance to low income individuals. The NGO, which I call the Smith Street Center, or SSC, is a non-profit organization funded by several agencies to promote public health and social services, administer programs and provide assistance to low income neighborhood residents. This study explores the SSC's role in the neighborhood it serves and its relationships with its public funders and other NGOs. I document the SSC's work of providing health advocacy and assistance for the neighborhood it serves in the wake of changes in public support for health and social services. I situate the SSC's work within a broader context of public health and social service distribution and investigate the experiences of low income, sick and vulnerable people participating in its services. Specifically, the project addresses how changes in funding policies have influenced the role of non-profit organizations like the SSC and the availability and distribution of public health and social services in Michigan in the last twenty years. Using ethnography, I demonstrate that the current political-economic climate that promotes privatization and decreased public services leaves many already marginalized people without necessary healthcare, food and housing. The ethnographic examples provided challenge neoliberal rhetoric about the merits of smaller government, increased choices and liberation through work. Specifically, I expose fallacies of neoliberal rhetoric and policies that promote self-sufficiency and personal responsibility for poor, sick and marginalized people. I use case examples to argue that an increased reliance on NGOs does not replace a competent, easily navigated public health and social service sector. Based on this analysis, I argue that many people "fall through the cracks" in the current system of public health and social service distribution.
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