UN report on the ‘Third World’ in the U.S.
By Fred Goldstein
Published Sep 18, 2005 9:09 PM


At the very moment that the profound racism and class oppression in the U.S. has been highlighted by the disastrous toll on the poor, largely African-American population of the Gulf Coast, the United Nations has issued a report about racism and poverty affecting the U.S. health-care system.

The highly prestigious UN report has singled out the U.S. health-care system as being fraught with such inequality that sections of the population are at health-care levels comparable to that of countries suffering from the long-term effects of colonialism.

The U.S. leads the world in health-care spending on a per capita basis. But “U.S. public health indicators are marred by deep inequalities linked to income, health insurance coverage, race, ethnicity, geography and—critically—access to care,” said the 2005 annual UN Human Development Report (HDR).

The Indian state of Kerala “has an urban infant death rate lower than that for African Americans in Washington, D.C.” And Malaysia, like India a country long ruled and kept in a state of underdevelopment by British colonialism, with an average income one quarter that here, “has achieved the same infant death rate as the United States,” according to the HDR.

Although the U.S. is the richest nation on earth, “infant mortality trends are especially troublesome,” continues the report. “Since 2000, a half century of sustained decline of infant death rates slowed and then reversed. The infant mor tality rate in the U.S. is now higher than for many other industrial countries.”

Racism is a major feature of the inequality in health care. “African American mothers are twice as likely to give birth to a low birth weight baby. Their children are twice as likely to die before their first birthday.”

The lack of health-care coverage is cited as a major cause of the declining health of the population. Over 45 million were uninsured in 2000, one in six of the non-elderly population. And racism deeply affects health-care coverage. “Hispanic Americans are more than twice as likely to be uninsured as white Americans and 21 percent of African Americans have no health insurance,” according to the report.

“One study finds that eliminating the gap in health care between African Americans and white Americans would save nearly 85,000 lives a year.”

Poverty and lack of health care for all races and nationalities kills. “The Institute of Medicine estimates that 18,000 Americans die prematurely each year solely because they lack health insurance.” Many of the uninsured have no place to go for vitally needed health care. And when they are admitted to hospitals, they are far more likely to die.

The high-tech revolution in healthcare is out of reach for millions of poor workers and oppressed people.

The study of deterioration of health care in the U.S. is only the tip of the iceberg. Declining health care as a social indicator linked to poverty, race and nationality is not isolated from other basic conditions of life among the people. Those with no health care or poor coverage generally have low incomes and live from paycheck to paycheck; have poor housing; lack social services; are pushed into the poorest neighborhoods; suffer the most police brutality; are most likely to be in prison; and are disproportionately African American and Latino, including many, many immigrant workers, documented and undocumented.

The findings of the UNHDR are consistent with the racist oppression of Black people during the destruction of Hurricane Katrina and the overwhelming toll it took on the African American population of New Orleans and the entire Gulf Coast. It is estimated that 130,000 families had no cars in New Orleans. The likelihood is that families that cannot afford a car cannot afford health insurance. They lived in the poorest neighborhoods, with the highest poverty rates. Many of those 130,000 families who were on the roofs in the Lower Ninth Ward and other poor Black neighborhoods probably were reflected in the UN statistics about lack of health care in the U.S.

They are not isolated, either. Look in any urban center, from St. Louis to Pittsburgh, New York to Los Angeles, and the same so-called “Third World” conditions, that is, neocolonial conditions, exist for African Americans, Latinos and other nationalities.

The vast majority of the people in these neighborhoods are workers, employed or unemployed. The suffering revealed by Katrina and documented by the UN report points in the direction of renewed struggle against racism, national oppression and class exploitation.

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