Poverty in rich countries

By Amartya Sen

EVEN the causes of the persistence of hunger in rich societies cannot be fully understood if we confine our attention only to the size of incomes. Hunger in the USA is associated with many parameters of which low income is only one. The health aspects relate to the social environment, to the provision of medical care to the pattern of family life, and a variety of other factors, and a purely income-based analysis of poverty cannot but leave that story half told.

The extent of capability deprivation can be quite remarkably high in the world’s most affluent countries. For example, a study by McCord and Freeman (1990), presented in The New England Journal of Medicine, indicates that men in the Harlem region of prosperous city of New York have less chance of reaching the age of 40 or more than Bangladeshi men have. This is not because the residents of Harlem have lower incomes than the average Bangladeshi does. The phenomenon is more connected with problems of health care, inadequacy of medical attention, the prevalence of urban crime, and other such factors that affect the basic capabilities of the Harlem resident.

The problem is not confined only to ‘pockets’ of deprivation in a small number of places. There are systematic patterns of intense inequality in non-income features between different groups. For example, in an article in The Journal of the American Medical Association, Otten et al. (1990) show that in the age group between 35 and 55, African-Americans have 2.3 times the mortality rate as do whites in the USA and that only about half their excess mortality can be explained by income differences. The need to go beyond the information on incomes to the pervasive diversities of social circumstances and characteristics is well illustrated by the nature of these terrible problems. The social environment is deeply influenced by the inadequacy of health facilities, the violent modes of inner-city living, the absence of social care, and such other factors. The lowness of income is only one factor among many that influence poverty in the USA.

The issue of food deprivation in rich America also raises a question of profound importance in understanding the nature of American poverty. Surprise is sometimes expressed at the fact there could be any actual hunger in a country as rich as the USA, where even the poorest groups tend to have much higher incomes than the middle-classes in many poorer countries which may not be particularly bothered by hunger as such. To some extent the difference may be due to the fact that money buys less of some types of commodities in the richer countries. But even after corrections are made for these price differences, the paradoxical feature is still retained. Also, as it happens, food is not one of the items that are typically very much cheaper in the poorer countries than in the USA.

In explaining the apparent paradox, the capability perspective can help in two different ways. First, hunger and undernutrition are related both to food intake and to the ability to make nutritive use of that intake. The latter is deeply affected by general health conditions, and that in turn depends much on communal health care and public health provisions (a subject that will be further examined in the next section). This is precisely where the civic problems of health delivery and inequalities in health care can precipitate capability failures in health and nutrition even when personal incomes are not that low in international standards.

Second, being poor in a rich society itself is a capability handicap for reasons that I have tried to discuss elsewhere. Relative deprivation in the space of incomes can yield absolute deprivation in the space of capabilities. In a country that is generally rich, more income may be needed to buy enough commodities to achieve the same social functioning, such as ‘appearing in public without shame’. The same applies to the capability of ‘taking part in the life of the community’ These general social functionings impose commodity requirements that vary with what others in the community standardly have.

While the rural Indian may have little problem in appearing in public without shame with relatively modest clothing and can take part in the life of the community without a telephone or a television, the commodity requirements of these general functionings are much more demanding in a country where people standardly use a bigger basket of diverse commodities. Not only does this make it more expensive to achieve these social functionings themselves, but the deflection of resources involved in pursuing these social functionings also drains the financial means that are potentially usable for health and nutrition. The apparent paradox of hunger in the rich countries is not hard to explain once our attention is shifted from exclusive concentration on the space of incomes, so that we can take note of the conversion of income and other resources into capabilities of various types.

The distinction between ‘low income’ and ‘capability failure’ does matter. A poverty analysis that concentrates only on incomes can be quite remote from the main motivation behind our concern with poverty (viz. the limitation of the lives that some people are forced to live). It may also fail to provide empirical guidance regarding the genesis and prevalence of deprivation. Concentrating on the right space is no less important for poverty study than it is for the general investigation of social inequality.

Excerpted from Inequalities Reexamined published by Oxford

Aami Nobel peyeechhi, maa

Amartya — meaning out of the world ( a-martya) — was a name given to the recipient of the Noble Prize for Economics, 1998, by the Nobel laureate of 1913 vintage Rabindranath Tagore. Son of Ashutosh and Amita Sen, Amartya was born on November 3, 1933. His maternal grandfather, Kshitimohan Sen, a renowned Sanskrit scholar, was considered to be the "right hand man" of Rabindranath. His paternal grandfather, Saradaprasad Sen, was a Judge in Dhaka. After naming the child, Rabindranath had told the mother, "Amita, I have given a rare name to your son, a name you cannot find in this world".

The incident is recalled by the 87-year- old mother, a widow, who lives in Santiniketan. She received a phone call at 2.45 p.m. in the afternoon of October 14 from her son. "How are you, mother? Were you having a siesta?",he said. "Oh, how can I sleep? We are having load shedding here", replied Amita Sen. Amartya Sen did not come to the point right away. He enquired from his mother whether she had eaten her lunch properly and then said he had to convey a "chhotto khabar" (small news): "Aami Nobel peyeechhi maa" (I have got the Nobel, mother)

x x x x

According to Calcutta’s The Telegraph once a California telephone operator asked him to spell out his surname. He spelt out "SEN" as "S" for "somebody", "E" for "everybody" and "N" for "nobody".