Behind all the numbers for poverty and inequality presented in the preceding pages are the lives of nearly 1 billion desperately poor people across the world who live in some of the worst conditions possible. AIDS, malaria, malnutrition, and other deadly diseases are common. Many children die before reaching adolescence, and many adults die before reaching what in the richest nations would be considered middle-age. Many people in the poorest nations are illiterate, and a college education remains unattainable. Millions of people on our planet die every year because they do not have enough to eat, because they lack access to clean water or adequate sanitation, or because they lack access to medicine and/or medical care.

As noted earlier, the United Nations Development Programme, the World Bank, and other international agencies issue annual reports on human development indicators that show the impact of living in a low-income nation. This section begins with a look at some of the most important of these indicators.

Human Development

The status of a nation’s health is commonly considered perhaps the most important indicator of human development. When we look around the world, we see that global poverty is literally a matter of life and death. The clearest evidence of this fact comes from data on life expectancy, the average number of years that a nation’s citizens can be expected to live. Life expectancy certainly differs within each nation, but poverty and related conditions affect a nation’s overall life expectancy to a startling degree.

Figure 8.4 Average Life Expectancy Across the Globe (Years)

Source: Adapted from Global Education Project. (2004). Human conditions: World life expectancy map. Attribution: WikiRigby at English Wikipedia. Retrieved from https://commons.wikimedia.org/wiki/File:World_Life_Expectancy_2011_Estimates_Map.png

A map of global life expectancy appears above in Figure 8.4 “Average Life Expectancy Across the Globe (Years)”. Life expectancy is highest in Western Europe, North America and certain other regions of the world and lowest in Africa and a few countries of South Asia. The gap in life expectancy when comparing high-income and low-income nations can be some 30 years shorter.

Child Mortality

A key contributor to life expectancy and also a significant indicator of human development in its own right is child mortality, the number of children who die before age 5 per 1,000 children born. As Table 8.2 “Human Development Index and Child Mortality, 2013” shows, the average rate of child mortality in the five nations with the lowest human development is 120, meaning that 12% of all children who are born in these nations will die before age 5. In contrast, the average child mortality rate in six nations with the highest HDI values is only 4. Children in these low-income nations are 30 times more likely to die before age 5 than children in the high-income nations.

Table 8.2 Human Development Index and Child Mortality, 2013

Source: data from “Human Development Reports.” | Human Development Reports, hdr.undp.org/en/composite/HDI. Retrieved from http://hdr.undp.org/en/composite/HDI

Two other important indicators of a nation’s health are access to adequate sanitation (disposal of human waste) and access to clean water. When people lack adequate sanitation and clean water, they are at much greater risk from life-threatening diarrhea, from serious infectious diseases such as cholera and typhoid, and from parasitic diseases such as schistosomiasis (World Health Organization, 2010). About 2.4 billion people around the world, almost all of them in low- and middle-income nations, do not have adequate sanitation, and more than 2 million, most of them children, die annually from diarrhea. More than 40 million people worldwide, almost all of them again in low- and middle-income nations, suffer from a parasitic infection caused by flatworms.

Access to adequate sanitation and clean water is strongly related to national wealth. Adequate sanitation is virtually universal in wealthy nations but is available to only 38% of people in low-income nations. Similarly, clean water is also nearly universal in wealthy nations but is available to only 67% of people in poor nations (World Health Organization, 2010).

Malnutrition

Another health indicator is malnutrition. This problem is caused by a lack of good food combined with infections and diseases such as diarrhea that sap the body of essential nutrients. About one-fifth of the population of low-income nations, or about 800 million individuals, are malnourished; looking at children in low-income nations, more than one-fourth of children under age 5 or about 150 million altogether, are underweight. Half of these children live in only three nations: Bangladesh, India and Pakistan; almost half the children in these and other South Asian nations are underweight.

About one-fifth of the population of poor nations are malnourished. Image by Fifaliana Joy by Pixabay.

Children who are malnourished are at a much greater risk for fat and muscle loss, brain damage, blindness and death. Not surprisingly, child malnutrition contributes heavily to the high rates of child mortality that we just examined and is estimated to be responsible for more than 5 million deaths of children annually (UNICEF, 2006; World Health Organization, 2010).

Adult Literacy

Moving from the area of health, a final indicator of human development is adult literacy, the percentage of people 15 and older who can read and write a simple sentence. The global rate of adult literacy is 86%, with higher rates of literacy for young people compared to the elderly, as indicated in Table 8.3 “Global Rates of Literacy.” This difference reflects increased access to schooling among the youth population in comparison to the access had by their parents and grandparents. The United Nations Educational, Scientific and Cultural Organization (UNESCO) reported in 2016 that 750 million adults worldwide are illiterate, 2/3 of whom are women (2016).

Table 8.3 Global Rates of Literacy

Source: data from Literacy Rates Continue to Rise from One Generation to the Next. UNESCO Institute for Statistics, Sept. 2017. Retrieved from http://uis.unesco.org/sites/default/files/documents/fs45-literacy-rates-continue-rise-generation-to-next-en-2017_0.pdf

Global Illiteracy is concentrated in low- and middle-income nations, specifically in the regions of South Asia, where 49% of the global illiterate population live, and sub-Saharan Africa, which houses 27% of the world’s illiterate population (UNESCO, 2016). There are 20 countries where rates of literacy fall below 50%. Two of these are countries in South Asia (Afghanistan and Iraq), while the remainder are all low-income nations found in sub-Saharan Africa (UNESCO, 2016). The high rate of illiteracy in poor nations not only reflects their poverty but also contributes to it, as people who cannot read and write are obviously at a huge disadvantage in the labor market.

Gender Disparities

In discussing illiteracy above, it was noted that women are disproportionately likely to be illiterate. This reflects the status of females in general, where it is estimated that females make up 70% of the world’s poor. Because females tend to be poorer than males worldwide, they are more likely than males to experience all the problems that poverty causes, including malnutrition and disease. But they also suffer additional problems. Some of these problems derive from women’s physiological role of childbearing, and some arise from how they are treated simply because they are female.

Let’s first look at childbearing. One of the most depressing examples of how global poverty affects women is maternal mortality, or the number of women who die during childbirth for every 100,000 live births. More than 500,000 women die worldwide each year from complications during pregnancy or childbirth. Maternal mortality usually results from one or more of the following: inadequate prenatal nutrition, disease and illness, and inferior obstetrical care, all of which are much more common in low-income nations than in high-income nations. In high-income nations, the rate of maternal mortality is a minuscule 10 per 100,000 births, but in low-income nations the rate is a distressingly high 790 per 100,000 births, equivalent to almost 1 death for every 100 births. Women in low-income nations are thus 79 times more likely than those in high-income nations to die from complications during pregnancy or childbirth. Figure 8.5 “Global Stratification and Medically Assisted Births, 2000–2007” suggests a reason for this difference, as it shows that births in poor nations are less than half as likely as those in wealthy nations to be attended by skilled medical staff.

Figure 8.5 Global Stratification and Medically Assisted Births, 2000-2007

Source: Data from World Bank. (2010). Health, nutrition and population statistics. Retrieved from http://databank.worldbank.org/ddp/home.do?Step=s&id=4.

In addition to these issues, women in poor nations fare worse than men in other ways because of how they are treated as women. One manifestation of this fact is the violence they experience. About one-third of women worldwide have been raped or beaten, and Amnesty International (2004) calls violence against women “the greatest human rights scandal of our times.” Although violence against women certainly occurs in wealthy nations, it is more common and extreme in low- and middle-income nations.

Beyond violence, women in low-income nations are less likely than their male counterparts to get a higher education, and girls are less likely than boys to attend primary school. Women are also less likely than men to work in jobs that pay a decent wage and to hold political office. In many low-income nations, girls are less likely than boys to receive adequate medical care when they become ill and are more likely than boys to die before age 5. In all these ways, women and girls in low-income nations especially suffer.

Two sets of international statistics cited by writers Nicholas D. Kristof and Sheryl WuDunn (2009) are especially troubling. Because women outlive men, ordinarily there should be more females than males in a country. Yet China has 115 males for every 100 females, and India has 112 males for every 100 females. In these nations, girls and women have died at far greater numbers than men because of infanticide, abuse and lack of health care, and the number of females born is lower due to sex-selected abortion.

A second set of statistics concerns sexual slavery. Kristof and WuDunn (2009, p. MM28) summarize this problem,

In the developing world, …millions of women and girls are actually enslaved. While a precise number is hard to pin down, the International Labor Organization, a U.N. agency, estimates that at any one time there are 12.3 million people engaged in forced labor of all kinds, including sexual servitude. In Asia alone about one million children working in the sex trade are held in conditions indistinguishable from slavery, according to a U.N. report. Girls and women are locked in brothels and beaten if they resist, fed just enough to be kept alive and often sedated with drugs—to pacify them and often to cultivate addiction.

This situation is so horrid that Kristof and WuDunn (2009, p. MM28) call for a moral crusade to save women’s lives. “In the 19th century,” they write, “the paramount moral challenge was slavery. In the 20th century, it was totalitarianism. In this century, it is the brutality inflicted on so many women and girls around the globe: sex trafficking, acid attacks, bride burnings and mass rape.” They add that an important reason for global poverty is that women in poor nations are uneducated, victimized by violence, and generally oppressed. For this reason, they say, international organizations are increasingly recognizing that “focusing on women and girls is the most effective way to fight global poverty.”

Status of Children

Because of their size, immaturity, and lack of resources, children are considered the most vulnerable members of any society. We have already seen evidence of this vulnerability in this chapter’s earlier discussion of childhood disease, malnutrition, and mortality. International agencies estimate that 5.6 million children under age 5 died in 2016 across the world. This equates to more than 15,000 children dying each day. The two world regions with the highest rates of child mortality are sub-Saharan Africa, with a rate of 78 children dying per 1000 live births, and South Asia, whose rate is child mortality rate is 48 (Suzuki, 2017). More than 80% of deaths of children under the age of 5 occur in these two regions. Typically, conflict-ridden nations see the most extreme rates of child mortality, Somalia being a good example, with a rate of 133 children dying by the age of 5 per every 1000 children born. This equates to 1 in every 8 children dying before their 5^th birthday.

As disturbing as these statistics might be, there is also good news, as much progress has been made during the past few decades in helping the world’s children, thanks to the focus placed on women and children by agencies of the United Nations. For example, child mortality worldwide declined from 142 to 41 deaths per 1,000 live births from 1970 to 2016. International efforts have saved millions of children’s lives during the past four decades. Similarly, literacy rates have improved within this timeframe.

Before we leave the issue of children’s welfare, it is worth noting one additional problem they face in certain parts of the world. In some low- and middle-income countries, children are taken by force to join the armed forces or armed groups, or they join out of economic necessity or to escape abuse. These “child soldiers” may bear arms and engage in combat, serve as cooks and messengers, or be sexual slaves. Approximately 300,000 children (under age 18) worldwide are thought to be child soldiers. Beyond the dangers of being involved in armed conflict, these children are not in school and are often sexually abused.

 

Key Terms

Adult literacy rate – the percentage of people aged 15 and above who can read and write a simple sentence.

Child Mortality Rate – the number of children who die before age 5 per 1,000 live births.

Life Expectancy – the average number of years that a nation’s citizens can be expected to live.

Malnutrition – a dietary deficiency where an individual lacks adequate nutrition.

Maternal mortality – the number of women who die during childbirth for every 100,000 live births.