I'm reasonably certain that a lot of people cash out whatever they receive, be it SBD or STEEM. If they are writing you about their lives being dire then clearly they are using rewards as a form of income to support their living expenses (which implies "cashing out").
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Indeed, Steemit has become a source of income for people in Africa, Venezuela and other economically stricken countries. No wonder we see a lot of undesirable methods (spam, scams) probably driven by exasperation to earn a buck 😥