Richard Wilkinson ... Source: Wilkinson & Pickett, The Spirit Level (2009) ... G erm
an y. N etherlands. S p ain. France. C anada. S w izterland. Ireland G reece.
Why we need to talk about inequality Richard Wilkinson Emeritus Professor of Social Epidemiology
Photo by kind permission of Matt Stuart
3
Income per head and life-expectancy: rich & poor countries
4 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.
Life expectancy
Life expectancy and CO2 emissions per head
CO2 emissions per head (tonnes) Wilkinson R, Pickett K & De Vogli R. BMJ 2010; 341:1138-1140
Life expectancy in rich countries is no longer related to National Income per head
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Life expectancy is strongly related to income within rich countries 80
Life expectancy (years)
79 78 77 76 75 74 73 72 71 70
Richest
Poorest
Local Neighbourhoods (in England & Wales) Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Relative risk of death by income group Men and women aged 25-65 Insured population of Mettman, Nordrhein-Westfalen (2473 deaths) 4,0 Unadjusted
Relative risk of death
3,5 3,0
Adj. for Occupation & education
2,5 2,0 1,5 1,0 0,5 0,0
Income groups Richest 20%
Upper Middle 20% Lower middle 20% middle 20%
Poorest 20%
Geyer, Hemström, Peter, Vågerö, J.Epidemiology & Community Health 2006; 60: 804-10
Inequality... How much richer are the richest 20% in each country than the poorest 20%? Income gaps How many times richer are the richest fifth than the poorest fifth?
8.0
Wilkinson & Pickett, The Spirit Level
Sin ga po re
ug al US A
UK
Po rt
Isr ae l Ze ala nd Au str ali a Ne w
6.1 6.2
8.5
7.2 6.7 6.8 6.8 7.0
Ita ly
5.6 5.6 5.6 5.7 5.2 5.3
Ja pa n Fin lan d No rw ay Sw ed en De nm ark Be lgi um Au str ia Ge rm an Ne y the rla nd s Sp ain Fra nc e Ca na da Sw izt erl an d Ire lan d Gr ee ce
4.6 4.8 4.3 3.9 4.0 3.7 3.4
9.7
www.equalitytrust.org.uk
Health and social problems with social gradients and internationally comparable data • • • • • • • • •
Life expectancy Math & Literacy Infant mortality Homicides Imprisonment Teenage births Trust Obesity Mental illness – incl. drug & alcohol addiction • Social mobility
Index of: • Life expectancy • Math & Literacy • Infant mortality • Homicides • Imprisonment • Teenage births • Trust • Obesity • Mental illness – incl. drug & alcohol addiction • Social mobility
Index of health and social problems
Health and social problems are worse in more unequal countries
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Index of: • Life expectancy • Math & Literacy • Infant mortality • Homicides • Imprisonment • Teenage births • Trust • Obesity • Mental illness – incl. drug & alcohol addiction • Social mobility
Index of health and social problems
Neither health nor social problems are related to national income per head
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Child well-being is better in more equal countries
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
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
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Mental illness is more common in more unequal societies
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Infant Mortality Rates are Higher in More Unequal Countries
19 Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Homicide rates are higher in more unequal US states and Canadian provinces 180
USA states Canadian provinces
Homicides per million people
150
120
90
60
30
0
Low
Income Inequality
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.
Imprisonment rates are higher in more unequal countries
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Teenage Birth Rates are Higher in More Unequal Rich Countries
22 Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Social mobility is lower in more unequal countries
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Influence of fathers on sons incomes (intergenerational earnings elasticity)
Fathers’ and sons’ incomes are less closely related in more equal countries
Corak M. Inequality from generation to generation. The Economics of Inequality, Poverty, and Discrimination in the 21st Century, ABC-CLIO. 2012.
Index of: • Life expectancy • Math & Literacy • Infant mortality • Homicides • Imprisonment • Teenage births • Trust • Obesity • Mental illness – incl. drug & alcohol addiction • Social mobility
Index of health and social problems
Health and social problems are worse in more unequal countries
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Mortality: Odds Ratio
Lag times: marginal impact of a 0.01-unit increase in the Gini on individual mortality risk over time
Lag time - Years Zheng H. Social Science & Medicine 2012; 75: 36-45.
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 Infant deaths per 1000
15 England & Wales Sweden
10
5
0 Single mothers
Low
Father's occupational class
High
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.
Literacy Scores of 16-25 year olds by Parents' Education
1
0.5
Literacy score
Sweden
0
Canada -0.5
-1
United States
-1.5 2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
Parents' Education (years)
28 Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
Income differences increase social class differentiation Bigger income differences make:• • •
Class more important The social pyramid higher and more hierarchical The quality of social relations deteriorates
Psychosocial risk factors for ill health Low social status Weak social connections Stress in early life (pre- and postnatally)
30
Cortisol response (effect size)
What kind of stressful tasks raise stress hormones most? 1 0.8 0.6 0.4 0.2 0
Tasks with „social evaluative threat‟ (uncontrollable)
Other tasks
Dickerson SS, Kemeny ME. Acute stressors and cortisol responses. Psychological Bulletin 2004; 130(3): 355-91.
Self enhancement increases in more unequal societies
Loughnan S, et al. Economic Inequality is linked to biased self-perception. Psychological Science, 2011; 22: 1254
Rising narcissism among American college students
Narcissistic Personality Inventory
(meta-analysis of 85 samples 1979-2006)
Twenge JM, Konrath S, Foster JD, Campbell WK, Bushman BJ. Egos inflating over time. J Personality 2008; 76(4): 875-901.
Trends in income in equality and poverty Germany and OECD: c.1985-2005
Valued or Devalued?
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
What can be done? Taxes & benefits Income differences before tax
• Stop tax avoidance
• Increase company democracy employee ownership etc
• End tax havens
• Promote more directors from within companies
• Make taxation progressive again
Sustainability needs greater equality
Photo by kind permission of Matt Stuart
For more information: … a book and a website…
http://www.equalitytrust.org.uk