Residents of some Baltimore neighborhoods are no better off than people living in impoverished North Korea and the violent West Bank, Bernie Sanders said during a campaign rally in Maryland ahead of that state’s primary.

"Poverty in Baltimore, and around this country — poverty is a death sentence," Sanders said April 24. He then laid out some rather unflattering and harsh comparisons:

"Fifteen neighborhoods in Baltimore have lower life expectancies than North Korea. Two of them have a higher infant mortality rate than the West Bank in Palestine. Baltimore teenagers between the ages of 15 and 19 face poorer health conditions and a worse economic outlook than those in distressed cities in Nigeria, India, China and South Africa. We are talking about the United States of America in the year 2016 — a country in which the top 1/10th of 1 percent now owns almost as much wealth as the bottom 90 percent."

While it would be wrong to take Sanders’ claim to mean that conditions overall are worse than Baltimore, we found that his specific comparisons are largely accurate.

"The comparisons fairly make the point that there are some parts of this rich country where conditions resemble those in much poorer countries," said Alan Berube, an expert on urban poverty at the Brookings Institution. "This isn't isolated to Baltimore; there are neighborhoods in nearly every big U.S. city and metropolitan area, and many rural communities, that perform just as poorly on these outcomes."

Let’s take Sanders’ claims one by one.

Life expectancy in North Korea

The Sanders campaign referred us to a Washington Post article noting that 14 Baltimore neighborhoods had shorter life expectancies than North Korea in 2013. (The article originally said 15 but was corrected.)

His number is slightly outdated.

In 2014, the latest year where there’s data on both places, the average life expectancy in North Korea was 69.81 years, according to the CIA World Factbook. That placed the impoverished dictatorship at No. 155 in longest lifespans out of 224 countries. The United States overall ranked at No. 42 with 79.56 years.

Residents in 12 of Baltimore's 56 neighborhoods lived shorter lives, according to data from the Baltimore City Health Department provided to the Baltimore Neighborhood Indicators Alliance. That’s not 15, but it’s close.

(For context, just five Baltimore neighborhoods have life expectancies higher than the U.S. national average, and four of them are relatively affluent and white.)

Here’s a map from the University of Maryland’s Capital News Service that compares the life expectancies of Baltimore neighborhoods in 2013 to other places in the world:

An important caveat: The city of Baltimore has a total population around 600,000 people while North Korea has a population 40 times that. That means fewer events in Baltimore neighborhood could swing the overall life expectancy of a neighborhood up or down.

Infant mortality in the West Bank

For this claim, the Sanders campaign referred us to a Vox article that said two neighborhoods in Baltimore — Little Italy and Greenmount East — had a higher rate of infant mortality than the West Bank, Honduras and Venezuela in 2013.

But in his speech, Sanders only mentioned the West Bank. In 2014, 13.49 out of 1,000 babies died before their first birthday in the notorious conflict zone, according to the CIA’s World Factbook.

The West Bank places in the middle of the pack in infant mortality at No. 117 out of 224 countries. The United States, meanwhile, ranked at No. 169 with a rate of 6.17 deaths per 1,000.

In 2014, 11 Baltimore neighborhoods had a higher rate than the West Bank. In Hilltop and Little Italy, at least 20 out of 1,000 infants died before their first birthday. That’s not only higher than the West Bank, Honduras and Venezuela but also war-torn Syria and oppressive Uzbekistan.

Teen health in distressed cities in developing countries

Sanders claimed that "Baltimore teenagers between the ages of 15 and 19 face poorer health conditions and a worse economic outlook than those in distressed cities in Nigeria, India, China and South Africa."

The Sanders campaign cited a Washington Post article by Johns Hopkins University researchers. "Teenagers in Baltimore face poorer health and more negative outlooks than those in urban centers of Nigeria, India and China," they write.

Contrary to what Sanders said, the work by the Johns Hopkins researchers don’t consider economic outlooks nor do they show Baltimore conditions being worse than South Africa’s. Nonetheless, his broader point is accurate.

The researchers published a comprehensive set of studies published in the Journal of Adolescent Health in 2014 that compared the well-being of teens in impoverished areas in Baltimore; Ibadan, Nigeria; Johannesburg, South Africa; New Delhi, India; and Shanghai, China.

Baltimore teens reported the highest rates pregnancy and, after Johannesburg, the second highest rates of substance use, sexual and physical violence, and feeling unsafe in their community:

Our ruling

Sanders presented a series of comparisons showing that conditions in some parts of Baltimore rivaled that of "the West Bank in Palestine," "North Korea," and "distressed cities in Nigeria, India, China and South Africa.

Some of Sanders’ figures need to be updated, but the gist of his specific comparisons are accurate: 12 Baltimore neighborhoods have a lower life expectancy than North Korea; 11 have a higher infant mortality rate than the West Bank; and research shows health conditions are worse for poor teens than in Baltimore than in Ibadan, New Delhi and Shanghai.

We rate his claim Mostly True.