About 35,000 Fairfax County residents, almost 5 percent of the population, live in poverty and do not have enough money to pay for decent housing, health care, food or other necessities, according to a new report. About 45 percent of those in need are children.

Almost 14,000 people do not have medical insurance, and many families run out of food by the end of each month. In one case, according to the report, an 87-year-old woman and her 59-year-old daughter "stretch their food budget by eating flour and water pancakes."

Programs to help families and individuals break the cycle of poverty, which can lead to generations of families relying on government subsidies, also are inadequate, according to the annual report by the county's Department of Community Action, which oversees county services for the very poor. Transportation to job interviews and training programs, language courses for poor people who don't speak English, and day care for low-income families are in short supply.

"In this county, where middle-class living standards and the ideal of equality are predominant, it is paradoxical that so many people lead lives of such deprivation," said Sandra S. Lowe, the department's executive director.

"The thing that's encouraging is that the numbers are manageable," she said. "We're talking about 12,000 families with 35,000 people in an area where resources are plentiful and there's a will to improve . . . as opposed to Chicago or New York, where the problems seem insurmountable."

The report, released last week, was based on a 1989 survey of 52 homeless families and 458 county households with incomes below the federal poverty level, which is $15,125 a year for a family of four or $7,475 for a single person.

The county is required to produce the report, which helps locate poverty-stricken families and identify programs to assist them, to receive funding from certain state-run anti-poverty programs.

The 55-page report, "Poverty in Fairfax County," offers a general profile of the county's very poor residents -- where they live, their race or ethnicity, income level, age and other characteristics.

With the state and county facing lean budget times and probable cuts in services, said Verdia Haywood, deputy county executive for human services, such information will help the county determine which programs need to be increased and where they should be targeted.

The report documents a shift in where the very poor live. Previously, most impoverished people were concentrated in the Lee and Mount Vernon districts in the southeastern part of the county; now about 50 percent of the county's very poor reside in the Mason, Providence and Annandale districts in the central and eastern parts of the county.

That seems to track with an increase in the number of Asian and Hispanic poor, who tend to favor living together in neighborhoods inside the Capital Beltway near Arlington, such as Baileys Crossroads.

According to the report, more than 9,000 children, or 59 percent of the very poor who are 18 or younger, live in families where English is not the main language. The majority of those live in the central and eastern parts of the county.

In contrast, another growing impoverished group, the elderly, are concentrated in the Dranesville and Centreville districts in the northern part of the county. According to the report, this area has 28 percent of the county's very poor families but 53 percent of the families headed by a person older than 75.

The report also identifies areas where programs are falling short of need. For example, although 25 percent of the very poor -- roughly 9,000 people -- receive some sort of local government assistance for dental care, 27 percent do not and are not otherwise covered. Similarly, 41 percent are aided by county programs for health care, but 11 percent are not.

"During the {18 months} before the survey, more than 8,000 very poor persons in Fairfax County had needed medical or dental care, but had been unable to obtain it," the report says.

Other areas where large portions of the very poor population are not being helped by the county include food programs, where 18 percent of the impoverished are not aided, and housing assistance, where 13 percent of the poor receive no local subsidies.

The high cost of housing in the county is the toughest burden for the poor to bear. According to the report, the typical poor family earns $711 a month but pays 64 percent of that, or $458, for housing. That leaves about $63 a week for food, clothing, transportation and all other living expenses.