Photo by kind permission of Matt Stuart Why more equal societies do better Richard Wilkinson Emeritus Professor of Social Epidemiology
Photo by kind permission of Matt Stuart
Why more equal societies do better
Richard Wilkinson Emeritus Professor of Social Epidemiology
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Income per head and life-expectancy: rich & poor countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
‘‘Cross-country data show almost no relation between changes in life expectancy and economic growth over 10, 20, or 40-year time periods between 1960 and 2000. Many countries have shown remarkable improvements in health with little or no economic growth...’’
Cutler D, Deaton A, Lleras-Muney A. The Determinants of Mortality. J Economic Perspectives 2006; 20: 97–120.
www.equalitytrust.org.uk
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www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Life expectancy in rich countries is no longer related to National Income per head
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Local Neighbourhoods(in England & Wales)
Life
exp
ecta
ncy
(yea
rs)
Richest Poorest
Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk
Life expectancy is strongly related to income within rich countries
3.7 3.94.3 4.6 4.8
5.2 5.3 5.6 5.6 5.6 5.76.1 6.2
6.7 6.8 6.87.2
8.5
9.7
4.0
8.0
7.0
3.4
Income gapsHow many times richer are the richest fifth than the poorest fifth?
Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk
Inequality...How much richer are the richest 20% in each country than the poorest 20%?
Wilkinson & Pickett, The Spirit Level
Index of: • Life expectancy• Math & Literacy
• Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness
– incl. drug & alcohol addiction
• Social mobility
www.equalitytrust.org.uk
Health and social problems are worse in more unequal countries
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www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Neither health nor social problems are related to national income per head
Index of: • Life expectancy• Math & Literacy
• Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness
– incl. drug & alcohol addiction
• Social mobility
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www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Child well-being is better in more equal countries
www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
The UNICEF Index of Child Wellbeing is not related to National Income per head
Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk
People in more unequal countries trust each other less
Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk
People in more unequal states of the USA trust each other less
www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Mental illness is more common in more unequal societies
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Infant Mortality Rates are Higher in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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30
60
90
120
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Income Inequality
Ho
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mill
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pe
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Low High
Daly M, Wilson M, Vasdev S. Income inequality and homicide rates in Canada and the United States. Can J Crim 2001; 43: 219-36.
Homicide rates are higher in more unequal
US states and Canadian provinces USA states
Canadian provinces
www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Imprisonment rates are higher in more unequal countries
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Teenage Birth Rates are Higher in More Unequal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Social mobility is lower in more unequal countries
Social Relations
• Child conflict• Homicide• Imprisonment• Social capital• Trust
Bigger income gaps lead to deteriorations in:-
Human Capital
• Child wellbeing• High school drop outs• Math & literacy scores• Social mobility• Teenage births
Health
• Drug abuse• Infant mortality• Life expectancy• Mental illness • Obesity
Indicator International US 50 StatesCensus GiniUN 20:20 OECD Gini
r p r p r p
Child wellbeing -071 <0.01 -0.68 0.01 - -
Trust -0.66 <0.01 -0.66 0.03 -0.70 <0.01
Life expectancy -0.44 0.04 -0.27 0.24 -0.45 <0.01
Infant mortality 0.42 0.04 0.54 0.01 0.43 <0.01
Obesity 0.57 <0.01 0.41 0.06 0.47 <0.01
Mental illness 0.73 <0.01 0.32 0.30 0.18 0.12
Education score -0.45 0.04 -0.46 0.05 -0.47 .01
Teen birth rate 0.73 <0.01 0.64 <0.01 0.46 <0.01
Homicides 0.47 0.02 0.44 0.04 0.42 <0.01
Imprisonment 0.75 <0.01 0.51 0.02 0.48 <0.01
Social mobility 0.93 <0.01 0.83 <0.01 - -
Index 0.87 <0.01 0.75 <0.01 0.59 <0.01
Correlations: different measures and settings
Zheng H. Social Science & Medicine 2012; 75: 36-45.
Mo
rtal
ity:
Od
ds
Rat
io
Lag time - Years
Lag times: marginal impact of a 0.01-unit increase in the Gini on individual mortality risk over time
Kondo et al, BMJ, 2009; 339: b4471
Inequality and mortality over time: meta-analysis of multilevel cohort studies
Wilkinson & Pickett, The Spirit Level
Index of: • Life expectancy• Math & Literacy
• Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness
– incl. drug & alcohol addiction
• Social mobility
www.equalitytrust.org.uk
Health and social problems are worse in more unequal countries
Ind
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ealt
h a
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so
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pro
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ms
0
5
10
15
Singlemothers
Low HighFather's occupational class
Infa
nt
dea
ths
per
100
0
England & Wales
Sweden
Leon, D. A., D. Vagero, et al. (1992). "Social class differences in infant mortality in Sweden: comparison with England and Wales." Brit Med J 305(6855): 687-91.
The benefits of greater equality are not confined to the poor but extend to all social classes
Infant mortality by class: Sweden compared with England & Wales
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Literacy Scores of 16-25 year olds by Parents' Education
-1.5
-1
-0.5
0
0.5
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2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Parents' Education (years)
Lit
era
cy
sc
ore
Sweden
Canada
United States
Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
More inequality
• More superiority and inferiority• More status competition and consumerism
• More status insecurity
• More worry about how we are seen and judged
• More “social evaluation anxiety”(threats to self-esteem & social
status, fear of negative judgements
Valued or Devalued?
Social Status and Friendship
Opposite sides of the same coin:
Social status (dominance hierarchies, pecking orders) are orderings based on power, coercion and privileged access to resources – regardless of the needs of others.
Friendship, in contrast, is based on reciprocity, mutuality, social obligations, sharing and a recognition of each other’s needs.
Companion Spanish: Compañero; French: Copain
from the Latin “Con” (with) and “Pan” (bread)
- someone with whom you eat bread
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Psychosocial risk factors for ill health
Low social status
Weak social connections
Stress in early life (pre- and postnatally)
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0.8
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Other tasks
Tasks with ‘social evaluative threat’ (uncontrollable)
Co
rtis
ol
resp
on
se (
effe
ct
size
)
Dickerson SS, Kemeny ME. Acute stressors and cortisol responses. Psychological Bulletin 2004; 130(3): 355-91.
What kind of stressful tasks raise stress hormones most?
Loughnan S, et al. Economic Inequality is linked to biased self-perception. Psychological Science, 2011; 22: 1254
Self enhancement increases in more unequal societies
Rising narcissism among American college students(meta-analysis of 85 samples 1979-2006)
Nar
ciss
istic
Per
sona
lity
Inve
ntor
y
Twenge JM, Konrath S, Foster JD, Campbell WK, Bushman BJ. Egos inflating over time. J Personality 2008; 76(4): 875-901.
Mishel L, Sabadish N. Economic Policy Institute Brief #331. Washington, May 2012
Changing ratio of CEO pay to average pay of production & non-supervisory workers in top 350 US companies
Between 1979-2007 the income of the:-Top 0.1% increased by 362%Top 1% increased by 156%Bottom 90% increased by17%
Rising income inequality in Britain 1979-2011In
equ
alit
y (G
ini)
Cribb J, Joyce R, Phillips D. Living standards, poverty and inequality in the UK: 2012. Institute for Fiscal Studies, London 2012
What can be done?
Taxes & benefits
• Stop tax avoidance
• End tax havens
• Make taxation progressive again
Income differences before tax
• Stronger Trade Unions
• Increase company democracy - employee ownership etc
• Promote more directors from within companies
Sustainability needs greater equality
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http://www.equalitytrust.org.uk
For more information:
… a book
and a website…