New Delhi, April 27 (IANS) With per capita income hovering around USD 80,000, the USA is among the richest societies in human history. Its technological sophistication, institutional depth, and global influence are unmatched. Yet, beneath this extraordinary wealth lies a social landscape that is, for millions, marked by dysfunction, insecurity, and despair. This is not poverty born of scarcity; it is a distress amidst abundance.

The epidemic of “deaths of despair” in the US, documented by Anne Case and Angus Deaton, records over 100,000 drug overdose deaths annually, alongside rising suicides and alcohol-related mortality. Among certain demographic groups – particularly less-educated middle-aged Americans – mortality rates have actually worsened over time, an anomaly in the developed world.

Visible disorder compounds the picture. In cities such as Los Angeles, San Francisco, and New York City, homelessness has become entrenched and conspicuous. Hundreds of thousands live without stable shelter on any given night, often struggling with severe mental illness or addiction. These are not slums born of mass rural migration or subsistence poverty; they are the result of systemic failures in housing, public health, and social protection.

The opioid epidemic offers an even starker indictment. What began as a medically sanctioned wave of prescription painkillers has evolved into widespread addiction, then into heroin and fentanyl dependence. Entire regions have been hollowed out. This was not an unavoidable tragedy – it was, in significant part, the outcome of regulatory failure and corporate malpractice.

Violence, too, occupies a peculiar place in American life. With roughly 45,000 to 50,000 gun deaths annually and a civilian arsenal unmatched anywhere in the world, the US stands as a stark outlier among advanced democracies. The persistence of such levels of lethality reflects not inevitability, but political choice.

Then there is incarceration. With close to two million people behind bars, the US maintains the highest prisoner population in the world. The system falls disproportionately on minorities and the poor, entrenching cycles of marginalization. It is not merely a criminal justice regime; it is a social order that has normalized and commercialised mass confinement.

Healthcare presents perhaps the most revealing paradox. The US spends nearly a fifth of its GDP on healthcare – far more than its peers – yet leaves millions uninsured or underinsured, with medical bills bankrupting more than half a million Americans each year. Outcomes such as life expectancy and infant mortality compare poorly with other wealthy nations. This reflects inefficiency on a grand scale, but also structural inequity.

Education, long celebrated as the engine of American mobility, now reflects a deepening divide. While elite institutions remain world-leading, large segments of the population face declining standards and crushing student debt, now exceeding USD 1.7 trillion. Even as trends in upward mobility through education weaken, costs have soared.

For decades, economic growth and productivity gains have failed to translate into rising real wages for most workers. As wealth is concentrated at the top, economic insecurity spreads downward. A significant proportion of Americans live paycheque to paycheque, with limited resilience to shocks. The old promise – that each generation would do better than the last – no longer holds.

Perhaps the most damning indicator is aggregate: life expectancy in the US has stagnated, even declined in recent years. For a country of such immense wealth, this is extraordinary. It signals not just isolated failures, but systemic malaise.

Across most of these parameters, the situation has worsened significantly under Donald Trump’s leadership. Trump is presiding over a declining empire, and is enormously accelerating the approach to collapse. America’s future is almost certainly going to be much worse than its present, as Washington embraces international chaos, and the world turns away, engineering alternatives to the fragmenting US hegemony.

India’s failures are, to a considerable extent, the failures of a country still struggling to generate sufficient wealth and distribute it effectively. The United States’ failures are of a different order. They persist at levels of prosperity where such outcomes are neither necessary nor typical among peer societies.

There are, in the world today, hellholes of necessity and hellholes of choice.

India, for all its inequities and injustices, belongs largely to the former. The US, despite its immense resources, is certainly among the latter – a society where deprivation is not imposed by scarcity, but sustained by ideology, politics and institutional design.

(The author is Executive Director, Institute for Conflict Management)

–IANS

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