Parts Of America
Are As Poor
As Third World
By Paul Vallely
09 September, 2005
lndependent/UK
Parts of the United States are as poor
as the Third World, according to a shocking United Nations report on
global inequality.
The US is the only
wealthy country with no universal health insurance system.
Claims that the New Orleans floods have laid bare a growing racial and
economic divide in the US have, until now, been rejected by the American
political establishment as emotional rhetoric. But yesterday's UN report
provides statistical proof that for many - well beyond those affected
by the aftermath of Hurricane Katrina - the great American Dream is
an ongoing nightmare.
The document constitutes
a stinging attack on US policies at home and abroad in a fightback against
moves by Washington to undermine next week's UN 60th anniversary conference
which will be the biggest gathering of world leaders in history.
The annual Human
Development Report normally concerns itself with the Third World, but
the 2005 edition scrutinizes inequalities in health provision inside
the US as part of a survey of how inequality worldwide is retarding
the eradication of poverty.
It reveals that
the infant mortality rate has been rising in the US for the past five
years - and is now the same as Malaysia. America's black children are
twice as likely as whites to die before their first birthday.
The report is bound
to incense the Bush administration as it provides ammunition for critics
who have claimed that the fiasco following Hurricane Katrina shows that
Washington does not care about poor black Americans. But the 370-page
document is critical of American policies towards poverty abroad as
well as at home. And, in unusually outspoken language, it accuses the
US of having "an overdeveloped military strategy and an under-developed
strategy for human security".
"There is an
urgent need to develop a collective security framework that goes beyond
military responses to terrorism," it continues. " Poverty
and social breakdown are core components of the global security threat."
The document, which
was written by Kevin Watkins, the former head of research at Oxfam,
will be seen as round two in the battle between the UN and the US, which
regards the world body as an unnecessary constraint on its strategic
interests and actions.
Last month John
Bolton, the new US ambassador to the UN, submitted 750 amendments to
the draft declaration for next week's summit to strengthen the UN and
review progress towards its Millennium Development Goals to halve world
poverty by 2015.
The report launched
yesterday is a clear challenge to Washington. The Bush administration
wants to replace multilateral solutions to international problems with
a world order in which the US does as it likes on a bilateral basis.
"This is the
UN coming out all guns firing," said one UN insider. "It means
that, even if we have a lame duck secretary general after the Volcker
report (on the oil-for-food scandal), the rest of the organization is
not going to accept the US bilateralist agenda."
The clash on world
poverty centers on the US policy of promoting growth and trade liberalization
on the assumption that this will trickle down to the poor. But this
will not stop children dying, the UN says. Growth alone will not reduce
poverty so long as the poor are denied full access to health, education
and other social provision. Among the world's poor, infant mortality
is falling at less than half of the world average. To tackle that means
tackling inequality - a message towards which John Bolton and his fellow
US neocons are deeply hostile.
India and China,
the UN says, have been very successful in wealth creation but have not
enabled the poor to share in the process. A rapid decline in child mortality
has therefore not materialized. Indeed, when it comes to reducing infant
deaths, India has now been overtaken by Bangladesh, which is only growing
a third as fast.
Poverty could be
halved in just 17 years in Kenya if the poorest people were enabled
to double the amount of economic growth they can achieve at present.
Inequality within
countries is as stark as the gaps between countries, the UN says. Poverty
is not the only issue here. The death rate for girls in India is now
50 per cent higher than for boys. Gender bias means girls are not given
the same food as boys and are not taken to clinics as often when they
are ill. Fetal scanning has also reduced the number of girls born.
The only way to
eradicate poverty, it says, is to target inequalities. Unless that is
done the Millennium Development Goals will never be met. And 41 million
children will die unnecessarily over the next 10 years.
Decline in health
care
Child mortality
is on the rise in the United States
For half a century
the US has seen a sustained decline in the number of children who die
before their fifth birthday. But since 2000 this trend has been reversed.
Although the US
leads the world in healthcare spending - per head of population it spends
twice what other rich OECD nations spend on average, 13 per cent of
its national income - this high level goes disproportionately on the
care of white Americans. It has not been targeted to eradicate large
disparities in infant death rates based on race, wealth and state of
residence.
The infant mortality
rate in the US is now the same as in Malaysia
High levels of spending
on personal health care reflect America's cutting-edge medical technology
and treatment. But the paradox at the heart of the US health system
is that, because of inequalities in health financing, countries that
spend substantially less than the US have, on average, a healthier population.
A baby boy from one of the top 5 per cent richest families in America
will live 25 per cent longer than a boy born in the bottom 5 per cent
and the infant mortality rate in the US is the same as Malaysia, which
has a quarter of America's income.
Blacks in Washington
DC have a higher infant death rate than people in the Indian state of
Kerala
The health of US
citizens is influenced by differences in insurance, income, language
and education. Black mothers are twice as likely as white mothers to
give birth to a low birthweight baby. And their children are more likely
to become ill.
Throughout the US
black children are twice as likely to die before their first birthday.
Hispanic Americans
are more than twice as likely as white Americans to have no health cover
The US is the only
wealthy country with no universal health insurance system. Its mix of
employer-based private insurance and public coverage does not reach
all Americans. More than one in six people of working age lack insurance.
One in three families living below the poverty line are uninsured. Just
13 per cent of white Americans are uninsured, compared with 21 per cent
of blacks and 34 per cent of Hispanic Americans. Being born into an
uninsured household increases the probability of death before the age
of one by about 50 per cent.
More than a third
of the uninsured say that they went without medical care last year because
of cost
Uninsured Americans
are less likely to have regular outpatient care, so they are more likely
to be admitted to hospital for avoidable health problems.
More than 40 per
cent of the uninsured do not have a regular place to receive medical
treatment. More than a third say that they or someone in their family
went without needed medical care, including prescription drugs, in the
past year because they lacked the money to pay.
If the gap in health
care between black and white Americans was eliminated it would save
nearly 85,000 lives a year. Technological improvements in medicine save
about 20,000 lives a year.
Child poverty rates
in the United States are now more than 20 per cent
Child poverty is
a particularly sensitive indicator for income poverty in rich countries.
It is defined as living in a family with an income below 50 per cent
of the national average.
The US - with Mexico
- has the dubious distinction of seeing its child poverty rates increase
to more than 20 per cent. In the UK - which at the end of the 1990s
had one of the highest child poverty rates in Europe - the rise in child
poverty, by contrast, has been reversed through increases in tax credits
and benefits.
© Copyright
2005 Independent News & Media (UK) Ltd.