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Despite the fact that the United States is the world's richest economy, it lags behind many other nations in fulfilling the needs of all of its citizens: 20 percent of children under the age of five live in poverty - the highest child poverty rate of any fully-industrialized nation; millions of people still lack health insurance; between 40 and 44 million are functionally illiterate; and 28 million people face food insecurity.

A 2010 CESR factsheet reveals that despite the country's wealth, the United States has one the poorest records of economic and social rights achievement of all high-income countries. Child poverty and infant mortality are far higher than in other comparable countries. Health and education disparities, particularly between ethnic groups, are extremely wide: African American women are almost four times more likely to die in childbirth than white women. 

The United States stands virtually alone in the world as an opponent of economic and social rights. The Second Bill of Rights proposed by President Franklin Roosevelt in 1944 which focused on guarantees of work, adequate housing and income, medical care and education, protection from economic fears of old age, sickness, injuries, and unemployment, and a market free from unfair competition and domination of monopolies was to serve as basis of economic security. While FDR's vision was never integrated into American domestic policy it did serve to inspire the drafting and adoption of the Universal Declaration under the leadership of Mrs. Eleanor Roosevelt.

American administrations - regardless of the broad global consensus to the contrary - regularly take the position that economic and social rights are merely "aspirational," unenforceable and best approached as a policy matter leaving broad latitude to governments to provide or deny such rights depending on the political context of the moment. On the domestic level, the United States provides no federal constitutional guarantees for economic and social rights, and has yet to ratify the International Covenant on Economic, Social and Cultural Rights. Instead, American governments over the last two decades have steadily eroded domestic legislative protections and international legal standards for economic and social rights, which are particularly vulnerable to regression in the current political and economic environment.

The election of President Obama in 2008 created new hope that the position of past governments would be rectified. There have been increased efforts among the US human rights community to encourage the new administration to change its stance on economic, social and cultural rights and to ratify the Covenant. For example, a 2009 paper by former CESR board member and UN Special Rapporteur on Extreme Poverty and Human Rights Philip Alston suggests how these rights can be put back on the US agenda and advocates for more constructive engagement with them by the new administration.

Recognition of economic and social rights in the American public and policy arena will strengthen government accountability regardless of political shifts. For example, American legal, political and popular cultural recognition of political and civil rights protected the core of the 1964 Civil Rights Act against sustained concerted political and judicial attacks during the 1980s and 1990s.

CESR's strategy to promote economic and social rights in the United States focused on actual project work, supporting grassroots social justice movements, developing education and training materials, and linking international legal mechanisms with domestic violations of economic, social and cultural rights.

CESR began its advocacy work in the United States in 1998, beginning with a collaboration on cross-border health issues surrounding the maquiladoras at the Texas-Mexico border, and went on to work on the rights of workers in New York City with the National Mobilization Against Sweatshops. CESR also initiated a project on the right to education which linked the visit of the United Nations Special Rapporteur on the Right to Education with domestic groups. The report Civil Society and School Accountability was produced by the Center for Economic and Social Rights and the New York University Institute for Education and Social Policy. The report argues that parents and communities have a human right to participate in the management and oversight of the school system, and that the effective protection of the right to participation is essential for creating greater accountability at all levels. It identified and critiqued the obstacles to participation in New York City schools and made recommendations based on human rights standards for how to better ensure effective civil society participation.

CESR also served on the secretariat of the US Human Rights Network, which emerged from the US Human Rights Leadership Summit - "Ending Exceptionalism: Strengthening Human Rights in the United States" - held on July 12-14, 2002 at Howard University Law School.

CESR has also advocated for the right to universal health care in the United States. In 2004, CESR published "The Right to Health in the United States of America: What Does it Mean?" The report analyzed how the US health care system falls short of international standards on the right to health.

CESR's work also focused on the US appearance before the Universal Periodic Review (UPR) at the UN Human Rights Council, in order to highlight the urgent need for increased efforts to fulfil many fundamental economic and social rights. As part of this work CESR co-organized a side event called "Building Foundations for Freedom from Want in the Land of Plenty" with other US-based NGOs during the 9th session of UPR Working Group. Some of the concerns highlighted during this event were included in the interactive dialogue of the UPR and also in the list of recommendations prepared by the UPR Working Group. The first US UPR process finished at the 16th session of the Human Rights Council when the United States made its final comments about the recommendations it received.

In 2017, CESR raised concerns about US tax reforms before UN Special Rapporteur on Extreme Poverty and Human Rights Philip Alston as he launched his official visit to the US to investigate the links between the growing phenomenon of poverty and human rights deprivations there. Fiscal Impoverishment in the United States warned that the Republican-backed tax plans would only deepen poverty and inequality within the U.S., while also enabling transnational tax abuse and therefore undermining the ability of countries around the world to invest in human rights.