During the Bicentennial of the Constitution, Justice Thurgood Marshall irritated some patriots by reminding one and all that the Framers left some people out of that document. With the Bicentennial of the Bill of Rights nearly here, there are those who would question how meaningful those amendments are to some of the people who are still on the far margins of the nation.

In January the nation's most prestigious medical publication, the New England Journal of Medicine, reported that a black man in Harlem has less chance to reach the age of 65 then a man in Bangladesh. Indeed, said the researchers, "death rates for those between the ages of 5 and 65 are worse in Harlem than in Bangladesh."

Many newspapers ignored the story, and in the others it was on the inside pages for a day. I saw no television coverage, but to be sure, the Amsterdam News, a Harlem weekly, put it on the front page.

This month the National Center for Health Statistics noted that whites on the average can now expect to live more than 75 years. In 1900 life expectancy for whites had been only48 years. As for blacks, their life expectancy had been rising to nearly 70 -- until now. That figure, however, is going down. Poverty is a factor, as is terminal violence in what used to be called neighborhoods.

The grievous lack of health care for the poor is underlined by a current study in the International Journal of Epidemiology. From 1980 to 1986, 121,560 Americans died prematurely. That is, they died from disorders that are usually not lethal if treated early.

They include pneumonia, gall bladder infection, appendicitis, asthma, tuberculosis (which is rising in the ghettos), acute respiratory disease, hernia and influenza.

Of all those dying prematurely, almost 80 percent were blacks. They did not have health insurance, or they got bad care or no hospitals were anywhere near them to which theycould go for regular treatment. If they were finally taken to a hospital, it would be to the emergency room -- where it often was too late.

I covered the march on Washington in 1963, and on television, every once in a while, I hear again Martin Luther King's resounding dream of what could and should be -- an integrated nation where what matters is not your color but you.

We are now more segregated than we were when King made that speech. In the nation's 10 largest cities, according to a University of Chicago study, segregation is so deeply entrenched that, as reported in The New York Times, "blacks and whites in the cities rarely interact outside the workplace, and blacks isolated in central cities have even less contact with whites."

In fact, you can walk for miles in black neighborhoods and see no whites. We keep breeding our own Sowetos.

And in the ghettos, a study by the National Research Council in 1989 found that "status of blacks relative to whites has stagnated or regressed since the early 1970s." Even blacks who are not poor still often find it difficult to get housing in largely white neighborhoods.

Prof. Douglas Massey, director of the Population Research Center at the University of Chicago, points out: "Where you live determines the chances you get in this world. It determines the school your children go to, the crime you're exposed to, the peer influences on your children. If you're isolated from the mainstream, it's not a fair contest."

In city after city, the schools are more segregated than they were in 1954, when the U.S. Supreme Court -- in Brown v. Board of Education -- declared segregated education inherently unequal and therefore unconstitutional. Yet because residential patterns have become even more segregated in the big cities and other places, the only way to integrate many public schools is by fusing city schools with those in the suburbs. This Supreme Court is not about to do that. And more and more blacks are giving up on integrating the schools.

Five years ago, at a meeting of the National Conference of Catholic Bishops, Archbishop Rembert Weakland of Milwaukee quoted a Brazilian economist who described what is happening in America as "economic apartheid."

Actually we have apartheid in many of its forms. Four years ago, Justice William Brennan -- speaking to the American Bar Association about the lack of "justice, equal and practical" for members of minority groups -- said: "ugly inequities continue to mar the face of our nation. We are surely nearer the beginning than the end of the struggle."