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Leon Friedman

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Where Our Nation Has Failed

Posted: 01/17/12 04:47 PM ET

According to the CIA World Factbook, our infant mortality rate (the death rate for infants one year or less) is 6.06 per 1,000 births. That puts the United States 48th in the world in that category. Forty-eighth in the world! We are behind Cuba, Taiwan, Hungary, South Korea as well as all the major European countries in insuring that our infants survive their first year.

As for life expectancy of the entire population, we have the 33th best record. Our population's life expectancy is 78.5 at birth. Countries such as Slovenia, Taiwan, the United Arab Emirates, Cypus, Andorra, Chile and Cuba (again) have better rates than we do.

Measuring educational accomplishment, our students rank 15th in terms of reading literacy, among the 30 industrial countries who are members of the Organization for Economic Cooperation and Development. Our students are also 21st in scientific literacy and 25th out of 30 in mathematical literacy. We are also 21st out of 30 in terms of the percentage of our students who graduate from high school. The OECD report stated that: "Half of American students fell below the threshold of problem-solving skills considered necessary to meet emerging workforce demands."

One area where we do much better is with respect to our economic output. According to statistics prepared by the World Bank, our Gross Domestic Product (GDP) in 2010 was $14.582 trillion, first in the world. China was second with $5.878 trillion. Germany had GDP of $3.309.

In the face of our enormous economic success, why are we so deficient in dealing with the health of our infants and the population as a whole or in educating our children, in comparison with other countries in the world?

At the heart of the problem is the fact that there are two, three, four or even five levels of economic success among our population which bear directly on the deficiencies noted above. The top 1% of our households own 35% of the nation's total wealth, amounting to over $20 trillion. The next 4% own an additional 27% of the nation's wealth, meaning that the top 5% own 62% of our total wealth. The next 5% own an additional 11% and the next 10% own 12% of the wealth. That leaves the bottom 80% owning only 15% of the nation's wealth. At the very bottom we have about 40% of the population, 120 million Americans, who own virtually nothing (0.3% of total wealth), not even their own homes.

One measure of economic inequality is the Gini coefficient which measures the extent of inequality between persons on the top and those at the bottom of the income ladder. Recent studies have shown that we are 90th in the world in terms of income equality between the richest and the poorest.

So we have the top 5% who own most of our wealth, another 15% in the upper middle class who live quite comfortably. The next 40% (the true middle class) may own their own homes, manage to save something for their children's college education and for retirement and endure from year to year when times are good. Below them are the lower middle class, about 25%, who have insignificant personal wealth and must stretch each year to provide the basics for their families. And, as noted blow, the final 15% are below the poverty line.

Those at the bottom of the economic ladder are indeed a separate nation, as deficient in terms of health protection and educational advantage as an African country. The poverty rate in the United States now stands at 15.1%, meaning that 46.2 million people fall within that category. That is the highest rate in the nation since 1993. Inevitably, persons at the bottom are primarily minorities, blacks and Latinos In terms of race, 27.4% of all black persons live in poverty and 26.6% of all Hispanic persons, while only 9.9% of white persons fall within that category.

There has always been a correlation between poverty on the one hand and bad health and high infant mortality on the other. Since a much higher percentage of blacks are in the poverty grouping, they necessarily have more health problems and access to fewer medical facilities. As of 2009, the life expectancy rate for blacks in this country was about four years less than for whites, at 74.3years.

As far as infant mortality is concerned, the rates are also much higher for the poor, primarily minority groups. A recent article in the Milwaukee Journal Sentinel examined sections of the city which had the highest infant mortality rates. There were some areas in the city (high minority sections) where the rate was 19.5 deaths per 1,000, worse than the rates in Colombia, Bulgaria and the Gaza strip. The rates of crime were also high while educational attainment was low. The Journal Sentinel reported that "the group of ZIP codes with the most poverty and lowest college graduation rates had the highest infant mortality rate. It also has the highest premature death rate, Chlamydia rate, HIV rate and teen birthrate."

Poor pregnant women, often unmarried teenagers, do not have access to, or seek out, proper health facilities, such as prenatal clinics, who could advise them and guide them through their pregnancies and help them in caring for their infants after they are born.

The answer must be more attention to this forgotten or ignored group. Milwaukee is attempting to establish a partnership program with the University of Wisconsin School of Medicine to improve birth outcomes in the most troubled areas. Improvements in social programs that take account of poverty and inadequate health and educational facilities would also help. That takes money which is hard to come by in this time of budgetary strain, with schools, public employees and public transportation already facing cuts.

Politically, the Republican Party, in control of the House of Representatives and many state governments, is not in the least concerned about this problem or other problems facing the bottom 40%. First, many members of that group are generally so disillusioned with politics that they rarely vote in any election. That is one reason why only 60% of the eligible voters actually cast votes even in a presidential contest. When these persons do vote, they generally vote Democratic. So Republican legislatures in various states have passed laws requiring voters to have government-issued photo identification which many poor do not have. They do not own a car and never get a driver's license. The Republican plan is to limit all social programs for the very poor (so the rich will have to pay fewer taxes). The latest Republican proposal (advanced by Michelle Bachman) is to require even the poorest among us to pay some federal taxes. That will not help to lower the infant mortality rate.

Can we do something to save the lives of our most vulnerable children?

Leon Friedman is a Professor of Constitutional Law at Hofstra Law School.

This post was originally published on 12/14/2011 and is being re-featured for HuffPost Global Motherhood.