The link in the US between economic advantage and outcomes in health and education is tightening:

• An American child residing in a household in the upper 20% of income is six times more likely to complete a college education than a child in the bottom 20%.
• With the loss of good manufacturing jobs, the difference in lifetime earnings between a person with a high school diploma and a college degree is now estimated at more than $1 million.
• The difference in net worth between the least and most wealthy 10% of US households headed by a person under 30 was almost $700,000 in 2007, with the bottom six deciles—60%—in flat to negative territory. 

Researchers Thomas Piketty of Princeton and Emmanuel Saez of the Paris School of Economics found that between 1972 and 2006, the portion of income earned by the wealthiest 10% of Americans increased by 50% but doubled for the top 1%, quadrupled for the top tenth of 1% and expanded seven times for the top one-hundredth of one percent. Over the same period, median wages, adjusted for inflation, were largely static despite significant productivity gains, in part because rising health care costs absorbed potential wage increases. 

The sum of these trends is that the US today is the most unequal among wealthy developed nations, while Boston and Massachusetts are in the top 10 among their counterparts as measured by the broadly accepted Gini Index. According to Harvard Business School professor Michael Porter, recent economic trends have “hollowed out middle-income jobs and erased rungs on the ladder of opportunity.” 

In Boston in 2008, the top 20% of earners received 55% of all annual income compared to 2% for the bottom 20% of earners. Moreover, more than 40% of white families had incomes greater than $100,000 and 12% had incomes less than $25,000. In mirrored contrast, among African American, Asian and Latino families, about 40% had annual incomes below $25,000 while just 10% to 18% had incomes above $100,000. Tragically, the foreclosure crisis and recession are disproportionately harming those neighborhoods and groups that can least bear further economic dislocation. 

A silver lining in the current crisis is that layers of distraction are being peeled away. Awareness is now building of the high degree of inequality with which we now live, and its threat not only to American ideals of fairness and opportunity but, potentially, to economic and social stability. The challenge now is to respond with a sense of urgency and to take proven solutions to scale—even in this period of scarce resources.