I mean there's more integration in the states so I'm curious.

lol I'm kidding.

Climate.

And I am sure if there was an ATRL during the American colonial times, Native Americans would say the same thing about White Europe. So keep it cute.

Also over population, lack of hygiene, lack of access to medication, poor use of contraception, unsanitary utilities etc.

Overpopulated and underdeveloped.

Less developed?

Overpopulation, mass underdevelopment, poorer hygiene standards, less access to readily-available clean drinking water, more areas with little or no sewerage systems, etc etc.

Though a quick Google search/a little common sense/a little basic knowledge of how the world works could've answered this question for you.