NYTimes | There are 5.3 million Americans who are absolutely poor by global
standards. This is a small number compared with the one for India, for
example, but it is more than in Sierra Leone (3.2 million) or Nepal (2.5
million), about the same as in Senegal (5.3 million) and only one-third
less than in Angola (7.4 million). Pakistan (12.7 million) has twice as
many poor people as the United States, and Ethiopia about four times as
many.
This evidence supports on-the-ground observation in the United States. Kathryn Edin and Luke Shaefer have documented
the daily horrors of life for the several million people in the United
States who actually do live on $2 a day, in both urban and rural
America. Matthew Desmond’s ethnography of Milwaukee explores the nightmare of finding urban shelter among the American poor.
It
is hard to imagine poverty that is worse than this, anywhere in the
world. Indeed, it is precisely the cost and difficulty of housing that
makes for so much misery for so many Americans, and it is precisely
these costs that are missed in the World Bank’s global counts.
Of
course, people live longer and have healthier lives in rich countries.
With only a few (and usually scandalous) exceptions, water is safe to
drink, food is safe to eat, sanitation is universal, and some sort of
medical care is available to everyone. Yet all these essentials of
health are more likely to be lacking for poorer Americans. Even for the
whole population, life expectancy in the United States is lower than we
would expect given its national income, and there are places — the
Mississippi Delta and much of Appalachia — where life expectancy is
lower than in Bangladesh and Vietnam.
Beyond that, many Americans, especially whites with no more than a high school education, have seen worsening health: As my research with my wife, the Princeton economist Anne Case,
has demonstrated, for this group life expectancy is falling; mortality
rates from drugs, alcohol and suicide are rising; and the long
historical decline in mortality from heart disease has come to a halt.
