I mean it really depends on your definition here. I too have been to third world countries. And while it might be comforting to know people in Alabama aren';t going to starve or die from dysentery. But consider those people die fairly quickly and inexpensively and thier populations are often low. Then consider the 35% of the almost 5 million people in Alabama who are obese and their impact on the society they live in. Because isn't turning people away to die in the streets, yet, that 35% of Alabama is going to be very very fucking expensive to treat and they will live much much longer than their third world counterparts. A child dying of hunger in Africa has very little impact overall, it's a tragedy and an unnecessary one, but the impact overall is very small compared to the 300 lb 10 year who went to the ER 5 times last month for ketoacidosis and will live another 40 or so unhealthy years continuing to cost an amazing amount of money. And it's only going to get worse. You think the baby boomers are expensive?!?! Pshhhh, wait until the 20 or so % of currently obese children mature to adulthood. No Atlanta isn't a 3rd world country, but 3rd world countries aren't the only ones with large impacts on global health.