This paper was presented at the conference "Unequal incomes, unequal outcomes? Economic inequality and measures of well-being" as part of session 1, "Health status of children and households in poverty." The conference was held at the Federal Reserve Bank of New York on May 7, 1999. This paper discusses health as a direct measure of economic well-being and draws attention to those suffering the worst outcomes. The author identifies a set of young people at particular risk of high mortality rates. She observes that in some U.S. communities - especially urban areas in the North - young people cannot expect to survive through middle-adulthood. Whites generally fare substantially better than African-Americans, yet whites in poor neighborhoods in northern cities experience mortality rates roughly comparable to those of African-Americans nationwide. Furthermore, among the urban African-American poor, mortality rates worsened relative to those of whites from 1980 to 1990. The author also indicates that circulatory disease - not homicide - has been the most important contributor to the higher mortality rates across all poor populations.