IN his election campaign Zohran Mamdani brought to centre stage the distress and deprivations suffered by New York’s City’s bottom half of the population, including problems relating to housing, transport and child-care. He did not depart from this agenda midway, and also spoke strongly against the billionaires who were opposing him the most. The billionaires, in fact, gave massive amounts to Mamdani opponents. The fact that the candidate who spoke steadfastly for the poor and against the billionaires has been able to win the election is very good news for US democracy where the big role of money in elections generally and the donations of big billionaires in particular have become a huge obstruction for sincere reform of economy and the country.
Senator Bernie Sanders had written this in the run-up to the presidential election last year (The Guardian, August 5, 2024), “In the midst of all the political gossip on TV and in newspapers (leading up to the elections of 2024), what Americans will not encounter is a serious discussion of the multiple economic crises facing the 60% of our fellow-citizens who live pay-check to pay-check—the working class of this country. What you will not hear about is why, in the richest country in the history of the world, so few have so little. What you will not hear about is the pain, the stress, the anxiety that tens of millions of Americans experience on a daily basis and how governmental decisions can improve their lives.”
The neglect of the poorest sections as well as the lower middle class has led to surprising levels of aggravation of distress and stress experienced by them, which is also getting reflected in official data and human development indicators. Concern has been expressed by health experts that life-expectancy in the United States has been getting down steadily in comparison to levels attained in several other rich countries. This has led some researchers to explore the number of excess deaths in the US (or number of ‘missing Americans’) which they define as the deaths which are in excess of the number that would have taken place if the life-expectancy rates in the US had remained at par with those of comparable rich countries.
One such important recent study by Jacob Bor, Andrew C. Stokes et al was published in the journal PNAS Nexus on May 29, 2023. This study has estimated the number of such excess deaths in the US in 2019 at 622,534. What this study is saying is that on the basis of comparisons with other rich countries, the US should have been able to achieve the sort of life expectancy that results in avoiding over 600,000 deaths in a year.
Earlier, another study by David Brady on only poverty-related mortality published in the US in JAMA Internal Medicine in April 2023 (for over 15 years age group) had estimated that there are 183,000 poverty-related deaths in a year in the USA.
UN data tells us that at a time when maternal death rate was declining in most countries, in the US maternal death rate increased to a shocking from 12 to 21 during 2000-2020.
More such data can be provided to show that the number of excessive and easily avoidable deaths in the US is shockingly high at well over half a million every year. A very big contribution to human welfare can be made by taking steps to ensure that these avoidable deaths are actually avoided.
The steps that are needed for improvements are well-known in a country so blessed with eminent scholars. In a nutshell, health services have to be improved in a big way for all weaker sections without any discrimination, and inequalities are reduced so that the poorer people have much better access to nutrition and environment. Besides, safety must be much better protected, shelter and health and overall social conditions need to be improved to make way for better physical and mental health while avoiding all harmful addictions.
The bigger question is—when these solutions are well-known, why have not these been adopted and why the situation in some importance respects continues to deteriorate? We need to ask why billions are easily available in the US for weapons but even millions are not available for some important aspects of social justice: why billions worth of tax gifts can be given to the rich but millions worth of essential expenditure for the poorest is more difficult to find.
In the context of the US, a study by the Urban Institute in 2018 found that nearly 40 per cent of adults and their families in USA struggled to afford at least one basic need for health care, housing, utilities or food in 2017, even in normal conditions of high employment levels. The study, based on a well-being and basic needs survey in the age-group of 18-64, found out that 23% people felt food insecurity in the last 12 months; 18% struggled to pay medical bills while almost the same percentage decided to go without some required medical treatment due to the costs involved.
In a population of about 330 million people and 128 million households in the US, around 45% persons suffer from chronic diseases, many from multiple chronic diseases, related to a significant extent to increasing exposure to various hazardous substances. Regularity of medicines is very important for treatment, but price of medicines in the US is often much higher than in comparable countries. Nearly 40% of people of US are likely to suffer from cancer in their lifetime, based on data of prevailing trends. Nearly 40 million medically consulted injuries and poisoning cases are reported in a year. About 12 million vehicles are involved in crashes in one year.
In 2020, it was reported that child poverty levels have been found to be 1.5 times higher than adult poverty levels. As for senior citizens, the Elderly Economic Security Standard Index found that in 2016 a majority of them lacked the “financial resources required to meet basic needs.”
A very large number of people are unable to afford expensive housing and the rising rents. The Eviction Lab, Princeton University, has estimated that there are 3.7 million eviction cases in the US in a typical year.
Economic problems are also aggravated by social factors. Nearly 28 per cent of US households are single person. A survey before the onset of COVID revealed that almost half of the adults feel lonely sometimes or all the time. Increasing loneliness has been associated with significant increase of dementia, coronary disease and stroke.
According to the US National Survey, year 2023, on Drug Use and Health, 48.5 million Americans (16.7%), aged 12 or older, battled a substance use disorder in the past year. While 10.2 per cent had an alcohol abuse disorder, 9.7% had a drug abuse disorder, while 2.7% suffered from both disorders.
In such conditions surely it is important to campaign for significant improvements all the time with continuity, but elections are a particularly good time to mobilise people and obtain the commitment of politicians and political parties for important aims and programmes of justice and equality. This had been increasingly neglected in the US, and it remains to be seen to what extent a bigger change for the better can come following the electoral success of Zohran Mamdani in as important a city as New York.
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Bharat Dogra writes extensively on environment, development and welfare issues. The views expressed here are the writer’s own, and Clarion India does not necessarily subscribe to them. He can be reached at: bharatdogra1956@gmail.com
