Economic circumstances shape all aspects of people’s lives. In Southeast Asia, as elsewhere, people need sufficient income for the basics of a healthy life, such as clean water, nutritious food and safe housing. If the income is insufficient, people live with risks of all kinds, including poor health and diminished life expectancy. For example, income inequality greatly affects life expectancy at birth. Not only is the infant mortality rate much higher, but babies born into poverty will rarely live to old age as long as babies are born into wealthier circumstances. Certainly, inequitable distribution of wealth in any nation of Southeast Asia does not benefit the population as a whole. Rather, the massive accumulation of wealth by transnational companies and state elites, combined with tax avoidance, restricts the distribution of state benefits to lower-income levels of society, impacting negatively on job creation, housing provision, schooling, pro-poor interventions, social welfare assistance, health and medical services. Social scientists in the region have documented the struggles of poorer people in the region to improve their livelihoods and their lives. Recent research implies that Western ideas about pro-poor development may not achieve the widespread benefits anticipated by aid donors.