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Inequality and child wellbeing
Kate E Pickett, PhD FRSA FFPH
Fig 1 All cause mortality in children aged 0-14 years in European countries (three year moving average)10.
Wolfe I et al. BMJ 2011;342:bmj.d1277
©2011 by British Medical Journal Publishing Group
The UNICEF Index of Child Well-being, 2007
Child Well-being is Better in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Child wellbeing and income inequality in US States
Correlations and p-values
Foundation for Child Development 25-item index Kids Count 10-item index (shown in graph) Income inequality 0.43
(0.002) 0.51
(<0.001) Average income -0.61
(<0.001) -0.53
(<0.001)
Child outcomes related to income inequality
• In rich countries – Infant mortality – Low birth weight – Overweight – Educational achievement – Peer relations – Bullying – Teenage births – Social mobility • In US states – Infant mortality – Low birth weight – Overweight – Educational achievement – Mental health problems – Teenage pregnancy – Juvenile homicides
More children are overweight in more unequal countries
Source: Wilkinson & Pickett, The Spirit Level (2009)
Income inequality and school bullying by 11 year-olds in 37 countries (
r
= .62)
Elgar FJ, Craig W, Boyce W, Morgan A, Vella-Zarb R. Income inequality and school bullying: multilevel study of adolescents in 37 countries. J Adolesc Health. Oct 2009;45(4):351-359.
Social mobility is lower in more unequal countries
Wilkinson & Pickett, The Spirit Level
www.equalitytrust.org.uk
Infant mortality rates by social class
Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
1
Literacy Scores of 16-25 year olds by Parents' Education
0.5
Sweden
0
Canada
-0.5
-1
United States
-1.5
2 3 4 5 6 7 8 9 10 11 12 13
Parents' Education (years)
14 15 16 17 Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
Why are children so sensitive to inequality?
• Effects of relative poverty on material resources?
• Impact on family life and relationships?
• Direct experience of increased status differentiation?
Inequality affects family life & relationships
Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Inequality affects family life & relationships
Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397 –F412. 2005.
Iacoviello M. Household Debt and Income Inequality, 1963 –2003.
Journal of Money, Credit and Banking 2008;40(5):929-65.
Status differentiation has a direct effect on cognitive performance
The Effect of Caste Identity on Children's Performance 6 5
High Caste Low Caste
4 3 2 1 0
Caste Unannounc ed Caste Announce d
Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004
Inequalities become entrenched early in life
• Cognitive scores at 3 years of age (MCS) • Children with the most educated parents 12 months with the least educated parents ahead of those • Children in families with incomes below our poverty line had scores about 8 months behind those with incomes above it • White children about half a month ahead of the all-UK average, followed by children from a mixed ethnic background, about half a month behind • Bangladeshi and Pakistani children lowest vocabulary scores, with averages around 35, characteristic of the lowest tenth in the population at large http://www.cls.ioe.ac.uk
Prenatal exposures have long-term effects
• PRENATAL STRESS – Alcohol – Nutrition – Cigarette smoke – Breastfeeding – BIRTH WEIGHT/GESTATION Cardiovascular disease Diabetes Mental health/behaviour IQ and education Reproductive health Social status (marriage) Birth weight of next generation Health-related behaviours Birth weight of next generation
Postnatal exposures have long-term effects
• Poor attachment • Maternal depression • Breastfeeding • Poor parenting Failure to thrive Mental health/behaviour IQ and education Social mobility Health-related behaviours
A two stage process: parental experiences of inequality shape child development Parenting styles prepare children for the kind of social relations they may have to deal with in adulthood Preparation for a society dependent on:-
•
trust, cooperation, reciprocity, empathy?
or:
•
fending for yourself, not trusting others?
Inequality and Child Wellbeing (UNICEF Rpt 2013) Low Income Inequality (Gini) High Pickett & Wilkinson, Pediatrics. (forthcoming)
Changes in inequality and child wellbeing (UNICEF Index) Inequality change 2000-2010 (gini) Pickett & Wilkinson, Pediatrics. (forthcoming)