Transcript Slide 1

Richard Wilkinson
Emeritus Professor of
Social Epidemiology
University of Nottingham
&
Kate Pickett
Professor of Epidemiology
University of York
http://www.equalitytrust.org.uk
1
Income per head and life-expectancy: rich & poor countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Among the rich countries life expectancy is not related to
national differences in average income
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
…but life expectancy is related to income
within rich societies
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Life expectancy (years)
79
78
77
76
75
74
73
72
71
d
de
p
Mo
st
Le
as
riv
e
Electoral wards in England & Wales by deprivation score
td
ep
riv
ed
70
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
How much richer are the richest
20% than the poorest 20%?
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
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Health and Social Problems are Worse in More Unequal Countries
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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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Health and Social Problems are not Related to Average
Income in Rich Countries
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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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Child Well-being is Better in More Equal Rich Countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Child-Wellbeing is Unrelated to Average Incomes in Rich
Countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Levels of Trust are Higher in More Equal Rich Countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
Levels of Trust are Higher in More Equal US States
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
The Prevalence of Mental Illness is Higher in More
Unequal Rich Countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Drug Use is More Common in More Unequal Countries
Index of use of: opiates, cocaine, cannabis, ecstasy, amphetamines
Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
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Infant Mortality Rates are Higher in More Unequal Countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
More Adults are Obese in More Unequal Rich Countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Teenage Birth Rates are Higher in More Unequal Rich Countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Homicide and income inequality:
US States and Canadian Provinces
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Homicides per million people
150
120
90
60
30
0
0.35
More equal
0.38
0.41
Income Inequality (Gini)
0.44
0.47
More unequal
Source: Daly M, Wilson M, Vasdev S. Income inequality and homicide rates in
Canada and the United States. Canadian Journal of Criminology 2001; 43: 219-36.
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Rates of Imprisonment are Higher in More Unequal Countries
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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Social mobility is higher in more equal countries
Intergenerational income mobility data from: Blanden J. (2009)
Centre for Economic Performance, LSE. Paper No' CEEDP0111.
www.equalitytrust.org.uk
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Almost everyone benefits from
greater equality.
Usually the benefits are greatest
among the poor but extend to the
majority of the population
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Infant Mortality by Social Class:
Sweden and England & Wales
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E& W
Infant Mortality rate
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Sweden
14
12
10
8
6
4
2
0
I
II
IIIN
IIIM
IV
V
Single Unclass.
Prnt
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Source: Leon DA, Vagero D, Olausson PO. BMJ 1992; 305; 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
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3
4
5
6
7
8
9
10
11
12
13
14
15
16
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Parents' Education (years)
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Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
Health and Social Problems are Worse in More Unequal Countries
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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Source: Wilkinson & Pickett, The Spirit Level (2009)
www.equalitytrust.org.uk
Why are we so sensitive to inequality?
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Psychosocial risk factors for ill health
 Low social status
 Weak social affiliations
 Stress in early life (pre- and postnatally)
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What kind of stress most reliably raises cortisol levels?
ACTH
Effect size
Cortisol
Tasks with both
social-evaluative
threat and
uncontrollability
Other tasks
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Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 130(3): 355-91
Stereotype Threat
The effect of caste identity on children's performance
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Number of mazes solved
High Caste
5
Low Caste
4
3
2
1
0
Caste
Unannounced
Caste
Announced
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Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004
Gilligan J. Violence: Our Deadly Epidemic and its Causes.
(G .P. Putnam 1996)
" ...the prison inmates I work with have told me repeatedly,
when I asked them why they had assaulted someone, that it
was because 'he disrespected me', or 'he disrespected my
visit' (meaning 'visitor'). The word 'disrespect' is central in the
vocabulary, moral value system, and psychodynamics of
these chronically violent men that they have abbreviated it
into the slang term, 'he dis'ed me." p.106
A few pages further on Gilligan continues:"I have yet to see a serious act of violence that was not
provoked by the experience of feeling shamed and humiliated,
disrespected and ridiculed, and that did not represent the
attempt to prevent or undo this "loss of face " - no matter how
severe the punishment, even if it includes death." p.110
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Working hours are longer in more unequal countries
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Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005.
More equal countries are more generous foreign aid donors
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More equal countries recycle more waste
Best
Japan
Sweden
Germany
Switzerland
France
Australia
Italy
Portugal
Spain
USA
UK
Worst
Low
High
Income Inequality
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Source: Wilkinson & Pickett, The Spirit Level (2009)
In more equal countries business leaders give a higher priority
to complying with international environmental agreements
With permission from R De Vogli & D Gimeno
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Five fallacies which support
injustice and inequality
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



Elitism is efficient
Prejudice is natural
Exclusion is necessary
Greed is good
Despair is inevitable
D. Dorling, Injustice: why social inequality persists
(Policy Press 2010)
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For more information:
… a book
and a website…
http://www.equalitytrust.org.uk
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Single parents and child wellbeing
Sweden
Better
Netherlands
Finland
Norway
Denmark
Spain
Italy
Greece
Belgium
Ireland
Portugal
Canada
Germany
Austria
France
Japan
Australia
USA
Israel
New Zealand
UK
Worse
0
10
20
Lone parents as % of all households with dependent children
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The effects of inequality - a two stage process
1.
adult experience of inequality
2.
passed on to children – epigenetics?
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Relation between infant mortality and GNP p.c.
at high, medium and low income inequality
Source: Hales S, Howden-Chapman P, Salmond C, Woodward A,
Mackenbach J.. Lancet 1999; 354: 2047
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Source: Bagehot, On equality. The Economist, 19th August 2010
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Causality?
•
•
Not a big causal leap:
- problems related
to social status get
worse when status
differences increase
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Reverse causality?
•
Many of the causal
pathways are known
Problems move
together - a common
cause
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Trends in income inequality 1979-2005/6
(Gini coefficient, Great Britain.)
Brewer M, Goodman A, Muriel A, Sibieta L. Poverty and
Inequality in the UK: 2007. Institute of Fiscal Studies, London.
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