Sunday, August 28, 2005

The problem of excessive inequality

From a review by Polly Toynbee of "The Impact of Inequality: How to Make Sick Societies Healthier" by Richard G. Wilkinson:

"Equality has gone out of fashion. Social justice under Labour means heaving the poorest over the poverty threshold and lifting the life chances of children from lower social classes. Tony Blair said early on that he was not bothered about wealth, only about abolishing poverty. Talk of inequality sounds like the old politics of envy. Equality of opportunity, yes, but equality for its own sake, why?

Here is the answer. Richard Wilkinson is a professor of social epidemiology, an expert in public health. From that vantage point he sees the world in terms of its physical and psychological wellbeing, surveying great sweeps of health statistics through sociological eyes. He has assembled a mountain of irrefutable evidence from all over the world showing the damage done by extreme inequality. However rich a country is, it will still be more dysfunctional, violent, sick and sad if the gap between social classes grows too wide. Poorer countries with fairer wealth distribution are healthier and happier than richer, more unequal nations."


"Life expectancy in rich nations correlates precisely with levels of equality. So Greece, with half the GDP per head, has longer life expectancy than the US, the richest and most unequal country with the lowest life expectancy in the developed world. The people of Harlem live shorter lives than the people of Bangladesh. When you take out the violence and drugs, two-thirds of the reason is heart disease. Is that bad diet? No, says Wilkinson, it is mainly stress, the stress of living at the bottom of the pecking order, on the lowest rung, the stress of disrespect and lack of esteem. Bad nutrition does less harm than depression."

This runs exactly counter to the praises of excessive capitalism that is all we hear churned out by the usual propaganda machines that seem to be run by the corpse of Ayn Rand. From a discussion of Wilkinson's work by James Lardner (and see here):

"If inequality damages health, it probably operates through a variety of pathways. As George Kaplan and John Lynch at the University of Michigan point out, low income (even if it isn't low enough to meet the official definition of poverty) means limited access to education, health care, and other services, with long-term consequences for health. At the University of British Columbia in Vancouver, Clyde Hertzman has done extensive work on the latent effects of socioeconomically influenced differences in prenatal care and early childhood development. In the June 3rd issue of The Journal of the American Medical Association, Paula Lantz and James House, who work with Kaplan and Lynch at the University of Michigan, analyze the link between income and such forms of self-destructive behavior as smoking, alcohol abuse, and over-eating.

But as Lantz and House point out, these specific risk factors explain only a comparatively small part of the socioeconomic gradient in health, which Wilkinson himself believes may, at bottom, have more to do with psychosocial factors - with what inequality does, for example, to friendship and the will to take part in social and community activities. 'I think that social relations -friendships and alliances - should be seen as horizontal relations between equals in contrast to the vertical hierarchy of power relations,' he says. 'Friendship and hierarchy are opposite principles of social organization. In friendship one is talking about mutuality and reciprocity - your needs being my needs. Hierarchy is about power, coercion, and access to resources regardless of other people's needs . . It's strength and power that determine who gets what, and I think that's the fundamental reason why as inequality increases the social environment deteriorates.' We have much to learn, he says, from the 'vigilant sharing' of hunter-gatherer societies, where people 'don't compete for the essentials of life.'"

In the current climate of the dog-eat-dog world it is like farting in church to even mention it, but the single most important thing that those who set public policy can do to improve the health and happiness of society is to reduce inequality. The two ways to do this are through income redistribution through tax policy, and the public funding of education and health care (and in particular an early childhood development strategy). In the current political climate of the United States it is impossible to conceive of how these type of policies would be possible, but all those countries not suffering from the current American political malaise should be hopping to it. This issue is directly connected to the issue of social mobility.