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Yes, It’s Better To Be Poor In The Mississippi Delta Than In Bangladesh


Last week, The Atlantic ran an interview with Angus Deaton, the Nobel laureate and emeritus Princeton economist, under the provocative headline: “Is It Better to Be Poor in Bangladesh or the Mississippi Delta?”

Deaton can’t say for sure. He notes (somewhat dubiously) that there are three million people in America living below the World Bank’s extreme poverty line, that “life expectancy in much of Appalachia is below life expectancy in Bangladesh,” and that “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.”

Maybe Deaton is speaking in hyperbole to make a point about the difficulty of economic comparisons between countries. Or maybe, and most likely, he has a rather provincial worldview that’s typical of his milieu. By Deaton’s own admission, he’s never really spent much time in Kentucky or West Virginia. If he had, he’d know those places are not at all like Bangladesh, where seasonal floods regularly wipe out entire villages, and factory buildings sometimes collapse, as one did in 2013 killing more than 1,100 people.

That such things don’t happen in America is a testament to what should be obvious, especially to someone like Deaton: it’s much better to be poor in America than to be poor anywhere else in the world. In fact, it’s better to be poor in America than it is to be middle class in Bangladesh, where the average income for the 7 percent of the population that constitutes the middle class is $5,000 a year.

Liberal Elites Condescend to The Poor

What Deaton is getting at, though, is the distressing state of America’s rural poor. As an economist, Deaton is known for, among other things, his focus on poverty. He won the 2015 Nobel Memorial Prize in economics for his work on consumption (what people eat, where they live, what goods and services they buy), and last year during the presidential election, Deaton and his wife Anne Case (also an economist) drew national media attention for a startling paper they published showing the life expectancy of middle-aged white people is falling—largely because of drugs, alcohol, and suicide.

The ensuing media coverage of Donald Trump’s campaign found connections between support for Trump and rural and suburban areas of the country most afflicted by poverty. Such connections helped fuel a convenient narrative that poor whites, in their desperation, were turning to a political outsider who recognized their plight and promised to do something about it. Baked into this narrative was the assumption that much of Trump’s support was due to racism and xenophobia.

It’s all well and good that liberal elites, thanks in part to scholars like Deaton, have begun paying attention to the poverty and despair in rural white America. But too often it comes with an odd mix of condescension and contempt. On the one hand, liberals wonder what they can do to help these opioid-addled white men in hollowed-out Rust Belt towns. On the other hand, they parrot Thomas Frank’s line from his 2004 book, “What’s The Matter With Kansas”: these rubes did this to themselves by voting Republican.

In the interview, Deaton pushes back against the notion that government welfare makes poor people’s lives better. But he also suggests that poor people dying of OxyContin in the Mississippi Delta are victims of rent-seeking by pharmaceutical companies pushing their drugs onto Medicaid enrollees. Not that there isn’t merit to the rent-seeking charge—Medicaid after all is more or less a giant rent-seeking scheme—but it glosses over the fact that most people in America are poor because of bad choices they made voluntarily.

Poor People Aren’t Helpless

The default assumption among liberal elites, by contrast, is that poor people are helpless. You’re born in some Appalachian backwater, end up on drugs and welfare, and die young. One can see this assumption even in the changing way we talk about drug addiction. In a sobering essay on America’s opioid crisis for the April edition of First Things, Christopher Caldwell touched on the surge of politically correct language among those who treat addicts and the mentally ill:

The director of a Midwestern state’s mental health programs emailed a chart called “‘Watch What You Call Me’: The Changing Language of Addiction and Mental Illness,” compiled by the Boston University doctor Richard Saltz. It is a document so Orwellian that one’s first reaction is to suspect it is a parody, or some kind of “fake news” dreamed up on a cynical website. We are not supposed to say “drug abuse”; use “substance use disorder” instead. To say that an addict’s urine sample is “clean” is to use “words that wound”; better to say he had a “negative drug test.” “Binge drinking” is out—“heavy alcohol use” is what you should say. Bizarrely, “attempted suicide” is deemed unacceptable; we need to call it an “unsuccessful suicide.” These terms are periphrastic and antiscientific. Imprecision is their goal. Some of them (like the concept of a “successful suicide”) are downright insane. This habit of euphemism and propaganda is not merely widespread. It is official. In January 2017, less than two weeks before the end of the last presidential administration, drug office head Michael Botticelli issued a memo called “Changing the Language of Addiction,” a similarly fussy list of officially approved euphemisms.

These euphemisms serve a purpose: to rob the addict of agency, and put the onus for recovery on the medical and welfare establishment. To circle back to Bangladesh, this way of speaking and thinking about the plight of the poor in America misses the glaring difference between a young person in Warren, Ohio, and someone born in Rangpur City, Bangladesh. In Warren, it’s possible—albeit difficult—to move somewhere with better job prospects. In Rangpur, the best you can hope for is life just above the poverty line in a city mired in destitution. Unless, of course, you emigrate.

The irony is that Deaton is skeptical of foreign aid to impoverished countries like Bangladesh. He argues it distorts and undermines the development of local economies, and it’s a powerful argument. But Deaton and his liberal peers are reluctant to think about the plight of America’s poor in the same way.

That’s too bad, because although it’s not as bad as being poor in Bangladesh, being poor in Appalachia or the Rust Belt or the Mississippi Delta means not just missing out on the promise of America. For a growing number of people it also means missing out on life itself. Condescending to them and indulging their destructive pathologies might assuage the guilt of liberal elites, but it’s not going to pull anyone out of poverty—or save anyone’s life.