Another view is the mobile American. Those with more intelligence, money, education, leave the deep south, for New York, California, Washington.
Those left behind are left in even worse shape.
In general, in pockets of poverty, people get what they can, which is mostly eating and drinking a lot.
Obese TV watchers, low IQ, no goals, for parents, and kids raised on sugar, white flour, who go to schools who pass everyone.
There is little money, and most of that flows out. There is nothing to build on, few things like the Football Cult, that can lead to playing for State, joining the service, and getting a local government job. Most who leave never return.
Those with mechanical skills left for Detroit long ago, the Brain Drain in action. There is nothing left to build on, and other places could do it much better.
It is a lack of intelligence, talent, drive, good genetics, sinking in a gravity well for generation after generation.
Medical care, education, will not cure this problem.
Those chosen to be sold as slaves in Africa, those maybe useful that cleaned out debtors Prisons, swept the streets of Europe for people who should be gone, sent to America, were not great stock to start with. Isolated for generations in a rural Mississippi County, the best left and the worst bred.
The Liberal view that everyone is equal, and just needs a chance, met reality in the movie, Deliverance. The only way to control them is kill them. It was a Hate Crime by Homophobes, and it felt good.
So yes, thankfully, some sectors of the population do die young. It has been the same through history, without the Empire to hold them in check, they return to Paleolithic behavior. Evolution works both ways.
So we live in an experiment, seeing who is fitest to survive. There are stories from Europe, of those who lived under bridges, in caves, and ate travelers. Children were eaten by Dragons. The poor, deprived of their food stamps, will eat.
Towns and cities are both forts and prisons, where the serfs can be confined and controlled. They can be made productive. Records are kept, the missing are looked for.
Murder we find the bodies, autos leave bodies, but a larger number just vanish from the face of the earth never to be found. Aliens? Perhaps, Satanic Cults? but 1500 per State per year, just gone.
That was from the good times, decline speeds it up, and real income is down, mostly on the bottom end, cuts in food stamps, less jobs, and there are those fittest to survive those times.
This is the forth wave of city building, and the first three fell, were abandoned, when people took their chances in the wilderness, when savage forces hunted the cities at night.
Ibn Khaldun in 1300 said cities fall when protecting the people from each other costs so much taxes have to go up, It is a Police State, and both Romans, feed the lions, and Chinese chop off a hundred heads, found regular slaughter was needed.
"We have met the enemy and they is us." Pogo