A year and a half ago, renowned travel writer Paul Theroux wrote an opinion piece for the New York Times — based on his then-new book “Deep South: Four Seasons on Back Roads” — that raised a lot of hackles. Some objected to Theroux’s views on manufacturing jobs and globalization, which we would now call Trumpian. Then there was this assertion:
I found towns in South Carolina, Alabama, Mississippi and Arkansas that looked like towns in Zimbabwe, just as overlooked and beleaguered. It’s globalization, people say. … To me, globalization is the search for a new plantation, and cheaper labor; globalization means that, by outsourcing, it is possible to impoverish an American community to the point where it is indistinguishable from a hard-up town in the dusty heartland of a third world country.
To a wonky economic journalist, this begged for refutation. Annie Lowrey, writing for New York magazine, offered this:
No, economically depressed towns in the United States are not “indistinguishable” from economically depressed towns in countries like Zimbabwe. Even the poorest regions of the United States are vastly wealthier and better developed than comparable regions in Sub-Saharan Africa. Pick your data point. The state of Mississippi, the poorest in the country, generates about $30,000 of goods and services per person every year. In Zimbabwe, that number is $1,700. In one, infants frequently die of diarrhea. In the other, adults frequently die of heart disease. I think I’d rather be in the latter camp.
I was reminded of this exchange last week when, in a conversation with none other than Annie Lowrey, who is now at the Atlantic, economist Angus Deaton said:
If you had to choose between living in a poor village in India and living in the Mississippi Delta or in a suburb of Milwaukee in a trailer park, I’m not sure who would have the better life.
This has been a theme lately for Deaton, a Princeton professor who a few weeks after winning the Nobel Memorial Prize in Economic Sciences in 2015 published, together with his wife and fellow economist, Anne Case, the blockbuster finding that mortality rates have been rising among middle-class white Americans.
During a panel discussion at the American Economic Association’s annual meeting in January, Deaton said that the World Bank has started measuring incomes in rich countries as well as poor ones, and its latest data shows more than 3 million people in the U.S. getting by on incomes of less than $1.90 day — the international poverty line. This has generally “been discounted as impossible” by economists, Deaton said, but recent studies such as Kathryn Eden and H. Luke Shaefer’s “$2 a Day” and Matthew Desmond’s “Evicted” have shown that maybe it isn’t:
What you have to remember is that when the World Bank counts the poor in rural India or in rural Africa — those living on $1.90 a day — they’re essentially assuming that housing is free. Rural people in poor countries also spend very little on transport or on child care, whereas those three items — shelter, transport and child care — are making life a misery for the people that Desmond and Kathy Eden write about. So perhaps there are people living in the U.S. who are worse off than people in Africa or Asia.
Deaton said that when he makes such observations, he usually gets the response that poor people in the U.S. are much healthier than their counterparts in India or Africa. Which is mostly true — there’s a vastly better public health infrastructure here, along with sewage systems and (mostly) easy access to clean water. Nevertheless, he concluded, “life expectancy in much of Appalachia and the Mississippi Delta is lower than in Bangladesh or in Nepal.”
Part of the story here is that some countries — Bangladesh and Nepal among them — have made enormous strides. As the late Hans Rosling tried and tried to get across with his TED talks and Gapminder animations, there is no longer a clear divide between a third world and a first world, just a continuum of nations that have had varying degrees of success in fostering economic growth and improving their citizens’ health.
Zimbabwe, to which Theroux compared the rural South, is decidedly not one of those countries. Decades of misrule by Robert Mugabe and devastation wrought by AIDS have left real per capita income at about half what it was in 1985, life expectancy barely higher, and infant mortality down only modestly. (Neighboring Botswana, while it has had similar health struggles, saw real incomes more than double over that period.)
Still, there are lots of other poor or once-poor nations, especially in Asia, where incomes and health indicators have been rising and rising. In the U.S. there’s lots of debate over whether poverty has been getting worse or not, but things certainly haven’t been getting much better over the past 15-plus years. So nowadays, when you compare the worst-performing U.S. states with countries around the world on a measure such as infant mortality, you find some interesting peers.
Infant Mortality in States and Countries
Deaths per 1,000 live births, 2015
Sources: World Bank, Centers for Disease Control and Prevention
Infant mortality in Bangladesh is, at 30.7 deaths per thousand in 2015, still much higher than in any U.S. state. Still, the trajectory is pretty encouraging (the rate was was 117.9 in 1985, and 176.3 in 1960). That has to make a difference. As writer Anand Giridharadas put it in his book “The True American,” paraphrasing the thoughts of a Bangladeshi immigrant working in a Dallas minimart: “The poverty of a place that is breaking can differ from the poverty of a place still being made.”
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Justin Fox at [email protected]
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