Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham &

1

Richard WilkinsonEmeritus Professor of Social Epidemiology

University of Nottingham

&

Kate PickettProfessor of Epidemiology

University of York

http://www.equalitytrust.org.uk

http://www.equalitytrust.org.uk/

2

Income per head and life-expectancy: rich & poor countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

3

Among the rich countries life expectancy is not related to national differences in average income


4

…but life expectancy is related to income within rich societies

Source: Wilkinson & Pickett, The Spirit Level (2009)

70

71

72

73

74

75

76

77

78

79

80

Electoral wards in England & Wales by deprivation score

Life

exp

ecta

ncy

(yea

rs)

www.equalitytrust.org.uk

5

How much richer are the richest 20% than the poorest 20%?

www.equalitytrust.org.ukSource: Wilkinson & Pickett, The Spirit Level (2009)

7

Index of: • Life expectancy• Math & Literacy • Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness – incl.

drug & alcohol addiction

• Social mobility

Health and Social Problems are Worse in More Unequal Countries


8

Health and Social Problems are not Related to Average Income in Rich Countries



• Social mobility


9

Child Well-being is Better in More Equal Rich Countries


10

Child-Wellbeing is Unrelated to Average Incomes in Rich Countries


11

Levels of Trust are Higher in More Equal Rich Countries


12

Levels of Trust are Higher in More Equal US States


13

The Prevalence of Mental Illness is Higher in More Unequal Rich Countries


14

Drug Use is More Common in More Unequal Countries


Index of use of: opiates, cocaine, cannabis, ecstasy, amphetamines


15

Infant Mortality Rates are Higher in More Unequal Countries


16

More Adults are Obese in More Unequal Rich Countries


17

Teenage Birth Rates are Higher in More Unequal Rich Countries


18

Homicide and income inequality: US States and Canadian Provinces

0

30

60

90

120

150

180

0.35 0.38 0.41 0.44 0.47

Income Inequality (Gini)

Ho

mic

ide

s p

er

mill

ion

pe

op

le

More equal 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.

19

Rates of Imprisonment are Higher in More Unequal Countries


20

Social mobility is higher in more equal countries


Intergenerational income mobility data from: Blanden J. (2009) Centre for Economic Performance, LSE. Paper No' CEEDP0111.

Intergenerational income mobility data from: Blanden J. (2009) Centre for Economic Performance, LSE. Paper No' CEEDP0111.

21

Almost everyone benefits from greater equality.

Usually the benefits are greatest among the poor but extend to the majority of the population

22

Infant Mortality by Social Class: Sweden and England & Wales

0

2

4

6

8

10

12

14

16

18

I II IIIN IIIM IV V SinglePrnt

Unclass.

E & W

Sweden

Source: Leon DA, Vagero D, Olausson PO. BMJ 1992; 305; 687-91

Infa

nt

Mo

rta

lity

rate

23

Literacy Scores of 16-25 year olds by Parents' Education

-1.5

-1

-0.5

0

0.5

1

2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Parents' Education (years)

Lit

era

cy

sc

ore

Sweden

Canada

United States

Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.

24



• Social mobility

Health and Social Problems are Worse in More Unequal Countries


25

Why are we so sensitive to inequality?

26

Psychosocial risk factors for ill health

Low social status

Weak social affiliations

Stress in early life (pre- and postnatally)

27

ACTH

Cortisol

Tasks with both social-evaluative

threat and uncontrollability

Other tasks

Eff

ect

size

Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 130(3): 355-91

What kind of stress most reliably raises cortisol levels?

28

Stereotype Threat

The effect of caste identity on children's performance

Caste Unannounced

Caste Announced

0

1

2

3

4

5

6

High Caste

Low Caste

Num

ber

of m

azes

sol

ved

Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004

29

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

30

Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005.

Working hours are longer in more unequal countries

31

More equal countries are more generous foreign aid donors

32

More equal countries recycle more waste


Australia

France

Germany

Italy

Japan

Portugal

Spain

Sweden

Switzerland

UK

USA

Best

Worst

Re

cycl

ing

(a

vera

ge

ra

nk)

Low HighIncome Inequality

33

In more equal countries business leaders give a higher priority to complying with international environmental agreements

With permission from R De Vogli & D Gimeno

35

Five fallacies which support injustice and inequality

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)

36

http://www.equalitytrust.org.uk

For more information:

… a book

and a website…

37

Australia

Austria

Belgium Canada

Denmark

Finland

France

Germany

Greece

Ireland

Israel

Italy

Japan

Netherlands

New Zealand

Norway

Portugal

Spain

Sweden

UK

USA

Worse

Better

UN

ICE

F in

dex

of c

hild

wel

l-bei

ng

0 10 20 30Lone parents as % of all households with dependent children

Single parents and child wellbeing

38

The effects of inequality - a two stage process

1. adult experience of inequality

2. passed on to children – epigenetics?

39

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

40Source: Bagehot, On equality. The Economist, 19th August 2010

41

Causality?

• Not a big causal leap: - problems related to social status get worse when status differences increase

• Problems move together - a common cause

• Reverse causality?

• Many of the causal pathways are known

42

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.

Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham &

Documents

Transcript of Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham &