Hospitals brace for uptick in typhoid and bacterial infections; and mosquito- and fly-borne diseases like dengue
The list goes on and on, and perhaps later this year it will be capped by the election of a black president. What a difference from as recently as the 1960s when only sport, the arts and preaching were open to ambitious blacks. Even in the 1970s, as I long ago documented in Encounter magazine, (few believed me), middle class professional blacks in sizable numbers were beginning to roar ahead, closing the gap with their white peers. Thank you Martin Luther King.
But like America's infrastructure, neglect has meant that the cracks and strains beneath are once again coming to the surface, if not, as in the past, in civil rights agitation or riots, but in the shearing of family, in educational failure and in its appalling state of health and morbidity. The “benign neglect”of Patrick Moynihan, then social affairs adviser to president Richard Nixon, has moved to malign neglect.
Not that recent presidents ignored the issue, but what they initiated paled before the ambitions of America's one and only big presidential plan, Lyndon Johnson's "War on Poverty", a farsighted plan of action, which was sabotaged by the Vietnam war. Another such war on poverty is now needed.
The basic statistics have been thrown into relief by a new report, "The Measure of America", published by the American Human Development Report, modelled on the UN annual report of the same name. The UN report was the brainchild of the late Pakistani economist Mahbub ul Haq and based on the work of the Nobel laureate in economics, the Indian, Amartya Sen.
Haq and Sen were convinced that the contemporary obsession with increased GNP blinded both observers and participants to the tremendous advances that could be made in social wellbeing, even in quite poor countries, with only a modest rise in incomes. Haq produced sophisticated tables in which countries were not ranked by income per head but by yardsticks more telling — longevity, knowledge and a decent standard of living. He called this the “Human Development Index”. Sweden and Norway come out top, with Denmark and Canada not far behind. The US is twelfth. Among the Third World countries, some of those low in GNP outrank much more “developed” countries.
Now America is being measured, not just in the round, as in the UN report, but in great detail. Northeastern states are way ahead, the South way behind. Broken down by race and ethnicity, Asians are at the top of the index. They live an average eight years longer than whites and more than thirteen years longer than African Americans. African Americans have a lifespan shorter than the average American did forty years ago, and worse than American Indians, the second most disadvantaged group.
Huge disparities in human development can be found in groups that live only a few miles from each other. In health, those living in New York's 16th Congressional District (the South Bronx) are at a level that those living in New York's 16th Congressional District (Manhattan's East Side ) were at 50 years ago.
Latino results are a rather contradictory lot. They have the lowest ranking of all in education. But they score well on health, coming third behind Asians and whites. But in a disturbing pattern, known as the Latino paradox, the longer Latinos immigrants live in the US the less healthy they become.
Another paradox is that in the better off groups men earn more than women, but in the poorer groups women earn more than men. And one more: Asian females have the highest health index. But note, African American men live lives 20 years shorter than Asian women.
Because the poorer groups drag the average down so significantly American health care, although spending more per head than any other nation, ends up with producing an average life expectancy lower than Western Europe, Singapore, South Korea and Costa Rica. The US infant mortality rate is on a par with Croatia, Estonia, Cuba and Poland.
The US has five per cent of the people on the planet, but 24 per cent of the prisoners, mostly blacks and Indians. Almost all three and four years old children were enrolled in pre-school education in France and Italy; in the US it is 53 per cent.
The report continues like this. I have run out of space. Has America run out of compassion and its sense of equal opportunity? Will the next election make a difference, even if a black man is elected?
Jonathan Power is a veteran foreign affairs commentator based in London
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