While it is normal to expect high levels of hunger and poverty in a developing country, it may come as a surprise to observe a similar epidemic in one of the richest countries in the world. The Food Bank for New York City recently reported that nearly 20 percent of children in the city rely on free food to survive. According to statistics from Bread for the World, 13 million children went to bed hungry in the United States in 2004, the most recent year for which statistics are available.
There's a debate about the real extent of U.S. hunger. The direst statistics, like those above, come (it is claimed) from advocacy groups. Others claim that "the poor here aren't really poor." Another claim is that the numbers are inflated or somehow "aren't that big," given the hugeness of the whole country. We are about to crest the 300 million mark in total population, and 13 million doesn't "sound so big" up against that. Divide 13 million by 50 states and you get about 65,000 hungry kids per state. That isn't so much - is it? Still others say that "the numbers are skewed by how bad the big cities are," as if somehow we shouldn't count the situation in, say, New York, when we look at the entire country's children. If you manhandle the numbers, you can make the problem sound smaller.
While I wish to acknowledge the controversy, I'm really not at all persuaded by these cavils. In my travels around the world, I see a lot of poor children. And I would say that, ironically, hungry children in places like the Philippines or India may be less miserable than hungry children in the United States - simply because the horizons of expectation are so much lower for the Filipino or Indian children. If we have even 10 million truly hungry children in the United States, even five million, we have a crisis, and if they are the world's most miserable children - hungry while the computer age whirls about them, denied entry into that age of plenty - we have a treble crisis.
Let's look closely at New York - that city we shouldn't include in our averages. The latest statistics from the U.S. Census Bureau show that more than one in four New York City children and adolescents younger than 18 live below the federal poverty level. And indeed, this figure is 50 percent higher than the national average. What makes this particularly worrisome is that between 2000 and 2005, the number of children living in poverty in New York City has increased by 5 percent, a trend that will probably continue.
According to recent information from the Food Bank for New York City and City Harvest, published in "Growing Up Hungry in New York City: An Analysis of Hunger Among Children," hunger among children has reached critical levels. Almost a third (29 percent) of New Yorkers who receive emergency food aid are children.
Hunger is one of the clearest expressions of poverty. A child is born into poverty every 17 minutes in New York City. Children who are chronically hungry suffer from malnutrition, which can have devastating effects on their physical and mental development. Malnutrition can result when children are undernourished, or overnourished with the wrong kind of foods, particularly those that are fried and high in fats.
I'll admit that the District of Columbia is in some ways a worst case - and yet, the badness of the actual case can be surprising. The infant mortality rate in the District of Columbia, the nation's capital, is more than twice as high as in Beijing. In 2002 in the district, the number of babies who died before their first birthday was 11.5 per thousand live births versus 4.6 in Beijing. The United Nations Development Program reports that an African American baby in Washington has less chance of surviving its first year than a baby born in urban areas of the state of Kerala in India. The United States ranks 43d in the world in infant mortality levels.
In the United States, it's often said that "it isn't race - it's class." Fine. But the fact is, hunger and race are strongly related: 41.9 percent of African American children and 40 percent of Latino children are chronically hungry, compared to 16.2 percent of white children - and that percentage of white children is terribly high!
UNICEF has indicated that although the United States is still the wealthiest country in the world, with incomes higher than any other country's, it has also one of the highest incidences of child poverty among the rich, industrialized nations. Denmark and Finland have levels of less than 3 percent, closely followed by Norway and Sweden. All of those countries have high levels of social spending.
Several factors contribute to poverty and hunger among children and their families in the United States. Among those factors are poor education; discriminatory practices against minorities and women; limited job opportunities; unstable family life; mental illness; and substance abuse. Perhaps the most important factors are unemployment and gender earning disparities.
Nobel laureate Amartya Sen has stated: "A person may have little means of commanding food if he or she has no job, no other sources of income, no social security. The hunger that will result can coexist with a plentiful supply of food in the economy and the markets." These are conditions that apply to the United States, where there are increasing gaps between the rich and the poor, who remain permanently marginalized and forgotten.
We can't totally eliminate poverty or its consequences. We can, however, lower the number of poor by acting on all of the factors that contribute to their poverty. No matter how rich a country is, if it doesn't fill the needs of its children it is, in fact, a poor country.
César Chelala is an international public health consultant and author of Children's Health in the Americas, a publication of the Pan American Health Organization. Contact César Chelala at email@example.com