For the majority of people in the United States, disease, poverty and premature death are so remote they are not even a concern. America has the largest and most technologically powerful economy in the world, with a per capita GDP of $37,600. Health and longevity are based on factors such as genetics and lifestyle. These are also largely taken for granted by most Americans. However, despite the "American Dream," the country is stratified with an increasing distance occurring between the upper and lower classes. In fact, by one measurement of inequality, the Gini coefficient (that is not accepted by all in the field), the U.S. has the highest inequality of any wealthy country. As Stephen Bezruchka notes, social class has a profound effect in the U.S., even for those in the middle class. What cannot be refuted is the difference between the standards in America and many other countries in the world. However, says Jeffrey Sachs, this distinction between those who have and those who have not could be eliminated with the right steps. .

             According to Bezruchka, the facts show that the U.S. today has more poverty than all other rich countries. In fact, he states, we are becoming increasingly "unhealthy" because of this disparity. The richest and most powerful country in world history has the greatest number of homeless children, over a million. No one knows for sure the total number of homeless. In addition to this, are the scores of people who are just a fraction away from homelessness. In the state of Washington, a worker earning the minimum wage of $7.01 per hour must work 86 hours a week to afford a two-bedroom unit. .

             Bezruchka notes that despite the fact that many people own goods, TVs, VCRs, automobiles, these are only "things." The mindset remains with such individuals that they are poor. They do not have the resources as others in society. They see the differences between themselves and those who have and will always have more.