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)