“To Elsie” deals with the spectrum of American social class—the ends of which, the speaker presents, are not so different from one another in the end. The poem focuses on the marginalized, impoverished, and lower class people: “deaf-mutes, thieves / old names / and promiscuity” (Lines 7-9), as well as the “devil-may-care men” and “young slatterns” (Lines 10, 13) who populate this contemporary world. However, there are also mentions of the wealthy and elite: “some doctor's family” (Line 40) and “rich young men with fine eyes” (Line 48), both of which are seen as outside forces that the lower class is in service to, or aspires towards. The poem presents social class as a predetermined prison, where young people are encased in a way of living right from the start of lives “hemmed round / with disease or murder” (Lines 32-33).

The disparity between these extremes is an overlying influence throughout the poem as one side—the doctor’s family—is held at a distance from the struggles of the lower class. The higher class families live in comfort while people like Elsie are shuffled from place to place facing deprivation and hardship. However, the eponymous character becomes a bridge between their world and her own as she reveals the truth of what she sees around her.