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America’s neglected poor: The deeper message behind New York’s mayoral election

By Bharat Dogra 
In his mayoral campaign, Zohran Mamdani brought to the centre stage the distress and deprivation suffered by New York’s working class and poor—focusing on issues such as housing, transport, and childcare. Unlike many others, he did not abandon these concerns midway through his campaign. He spoke firmly against the billionaires who opposed him most aggressively, and who poured massive funds into his opponents’ coffers.
That a candidate who consistently stood for the poor and challenged billionaire dominance has won is encouraging news for U.S. democracy—where the pervasive influence of big money, and the massive donations of the super-rich in particular, have long obstructed sincere reform of the economy and society.
Senator Bernie Sanders, writing in The Guardian on August 5, 2024, had lamented this absence of serious debate on economic distress:
“In the midst of all the political gossip on TV and in newspapers… 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 and lower middle classes has led to alarming levels of hardship and stress—now reflected in official data and human development indicators. Health experts have expressed concern that U.S. life expectancy has been falling steadily compared with other wealthy nations. Researchers have begun quantifying the “missing Americans”—those who die earlier than expected when compared to mortality rates in peer countries.
A major study by Jacob Bor, Andrew C. Stokes, and others, published in PNAS Nexus on May 29, 2023, estimated that 622,534 such excess deaths occurred in the United States in 2019 alone. In other words, over six lakh lives could have been saved if U.S. life expectancy had matched that of comparable nations.
An earlier study by David Brady, published in JAMA Internal Medicine (April 2023), focused solely on poverty-related mortality among those aged 15 and above, estimating 183,000 such deaths annually.
UN data adds another alarming dimension: while maternal mortality rates declined in most countries between 2000 and 2020, they increased in the United States—from 12 to 21 deaths per 100,000 live births.
Such figures point to a shocking reality: more than half a million avoidable deaths occur in the U.S. each year. Addressing the root causes of this crisis could make one of the greatest possible contributions to human welfare.
The path forward is well-known, especially in a country with such a wealth of scholarship and research. Health services must be made universal and equitable. Inequalities must be drastically reduced to ensure fair access to nutrition and healthcare. Environmental safety and social housing must improve, while addictions and mental health crises demand systematic prevention and support.
The deeper question is: if these solutions are so clear, why has the situation continued to worsen in key respects? Why are billions of dollars readily available for weapons, but not even millions for essential social spending? Why are tax breaks for the wealthy easier to justify than welfare for the poor?
A 2018 Urban Institute study found that nearly 40% of American adults struggled to afford at least one basic need—healthcare, housing, utilities, or food—even during a period of high employment. In the 18–64 age group, 23% reported food insecurity, 18% struggled with medical bills, and a similar proportion skipped needed treatment due to costs.
In a nation of about 330 million people and 128 million households, nearly 45% suffer from chronic diseases, many from multiple conditions linked to environmental hazards. The price of medicines is among the highest in the world. Nearly 40% of Americans are expected to face cancer in their lifetime. Each year, there are 40 million medically treated injuries and poisonings, and 12 million vehicle crashes.
Child poverty rates are 1.5 times higher than those of adults. Among senior citizens, the Elder Economic Security Standard Index (2016) found that a majority lacked the financial resources to meet basic needs. Housing remains a major crisis, with Princeton University’s Eviction Lab estimating 3.7 million eviction cases annually.
Social isolation compounds these problems. Nearly 28% of U.S. households consist of single individuals. Even before the COVID-19 pandemic, nearly half of adults reported feeling lonely sometimes or often—a factor linked to higher rates of dementia, coronary disease, and stroke.
The U.S. National Survey on Drug Use and Health (2023) reported that 48.5 million Americans aged 12 or older battled a substance use disorder in the past year: 10.2% struggled with alcohol abuse, 9.7% with drug addiction, and 2.7% with both.
In such grim conditions, continuous public mobilization is crucial. Elections, in particular, should serve as opportunities to demand accountability and commitment to social justice and equality. Unfortunately, these themes have been increasingly absent from U.S. political debates. It remains to be seen whether Zohran Mamdani’s victory in New York—a city of global importance—can spark a wider shift toward more humane and inclusive priorities in American politics.
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The writer is Honorary Convener, Campaign to Save Earth Now. His recent books include Protecting Earth for Children, Planet in Peril, Earth Without Borders, and A Day in 2071

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