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How inequality facilitates poorer social and health … - Mind the Gap...Why does risk matter? •...

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Mind the gap How inequality facilitates poorer social and health outcomes Sandeep Mishra [email protected]
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Mind the gapHow inequality facilitates poorer

social and health outcomes

Sandeep [email protected]

Inequality, risk, and health

• Why do inequality and risk matter?

• Individual-level effects of inequality– Disparity, risk-taking, and deprivation– Deprivation, risk, and health in a community sample

• Implications for policy– Social mobility and inequality of opportunity– Policy changes

• Summary

Inequality, risk, and health

• Why do inequality and risk matter?

• Individual-level effects of inequality– Disparity, risk-taking, and deprivation– Deprivation, risk, and health in a community sample

• Environmental-level effects of inequality– Inequality and health in the workplace

• Summary and implications

Why does inequality matter?

Why does inequality matter?

• The richest 20% control 69% of wealth in Canada, 85% of wealth in the US (pre-recession)

Source: Mother Jones Magazine; StatsCan; US Federal Reserve, US Bureau of Labor Statistics

Why does inequality matter?

Source: Mother Jones Magazine; US Congressional Budget Office Data

Inequality has social consequences

Social capitalTrust

Community supportWomen’s status

Foreign aidFamily integrity

Educational outcomesImprisonment

Wilkinson & Pickett (2009) The Spirit Level

Inequality has health consequences

HomicideMental health/well-beingIllegal drug usePhysical healthLife expectancyMorbidity and mortalityTeen pregnanciesObesity

Wilkinson & Pickett (2009) The Spirit Level

Wilkinson & Pickett (2009) The Spirit Level

Why do relative outcomes matter?

• Poverty vs. inequality– Absolute vs. relative

outcomesWilkinson & Pickett (2009)

• Individual-level effects– Social comparisons– Relative deprivation– Stress and tension

• Environmental-level effects– Sensitivity to the treatment of others– Effects at the top and the bottom

Why does risk matter?

• Risk-taking may underlie many social and health-related outcomes– Antisocial behavior Mishra & Lalumière (2009) Soc Sci Med,

Mishra et al. (2011) J Gamb Stud

– Gambling/problem gambling Mishra et al. (2010) Pers Indiv Diff

– Health and well-being Byrnes et al. (1999) Psyc Bull

• The generality of risk and health Osgood et al. (1988) Am Sociol Rev, Hirschi & Gottfredson (1994) The Generality of Deviance, Mishra (2014) Pers Soc Psyc Rev, Mishra & Carleton (2015) Soc Sci Med

– Shared instigative/protective factors Stinchfield (2004)

Inequality, risk, and health

• Why do inequality and risk matter?

• Individual-level effects of inequality– Disparity, risk-taking, and deprivation– Deprivation, risk, and health in a community sample

• Environmental-level effects of inequality– Inequality and health in the workplace

• Summary and implications

Risk-taking

Risk is outcome variance

Risk-taking

• Risk-taking is typically considered “irrational” and reckless….

• …. But there are circumstances where risk-taking is “rational” and adaptive

Disparity and risk

• Disparity may facilitate risk-taking– Obtaining otherwise unavailable/unattainable desirable

outcomes Mishra (2014) Pers Soc Psyc Rev

Imagine you have an immediate $5,000 debt: Would you rather choose a sure payout of $500, or a gamble offering a 10% chance at $5,000?

• Risk-sensitivity theory Gonzales, Mishra, & Camp (under review) J BehavDec Mak, Mishra, Barclay, & Lalumière (2014) Evol Hum Behav, Mishra, Barclay & Sparks (under review) Pers Soc Psyc Rev, Mishra & Fiddick (2012) J Pers Soc Psyc, Mishra & Lalumière (2010) J Exp Soc Psyc, Mishra, Son Hing, & Lalumière (2015) Ev Psyc, Mishra & Novakowski (2016) Pers Indiv Diff, Mishra (2014) Pers Soc Psyc Rev

Risk-sensitivity theory

• Decision-makers shift from risk-aversion to risk-proneness under situations of need

• Need à disparity between an individual’s present and desired (goal) states– High need = large disparity– Low need = small disparity

Reviewed in Mishra (2014) Pers Soc Psyc Rev

Risk-sensitivity theory

Present state(My condition)

Desired state(Others’ condition)

Reviewed in Mishra (2014) Pers Soc Psyc Rev

Risk-sensitivity theory

Present state

Desired state

Reviewed in Mishra (2014) Pers Soc Psyc Rev

Risk-sensitivity theory

Present state

Desired state

Reviewed in Mishra (2014) Pers Soc Psyc Rev

Risk-sensitivity theory

Present state

Desired state

Reviewed in Mishra (2014) Pers Soc Psyc Rev

Risk-sensitivity theory

Present state

Desired state

Reviewed in Mishra (2014) Pers Soc Psyc Rev

Risk-sensitivity theory

Present state

Desired state

LOW DISPARITY

Reviewed in Mishra (2014) Pers Soc Psyc Rev

Risk-sensitivity theory

HIGH DISPARITY

Present state

Desired state

Reviewed in Mishra (2014) Pers Soc Psyc Rev

Does risk-sensitivity theory predict risky decision-making in people?

Disparity and risk

• Descriptive decision-making Rode et al. (1999) Cognition

• 20 decisions: low-risk vs. high-risk

• Each decision made under a condition of either high disparity or low disparity

Disparity and risk

You need to draw one black bead out of ten. You will earn $1 if you meet your target. Which option would you like to draw from?

(a) A cup containing 5 white and 5 black beads.

(b) A cup containing a random combination of 10 black and white beads.

Disparity and risk

You need to draw one black bead out of ten. You will earn $1 if you meet your target. Which option would you like to draw from?

(a) A cup containing 5 white and 5 black beads.

(b) A cup containing a random combination of 10 black and white beads.

Disparity and risk

You need to draw nine black beads out of ten. You will earn $1 if you meet your target. Which option would you like to draw from?

(a) A cup containing 5 white and 5 black beads.

(b) A cup containing a random combination of 10 black and white beads.

Disparity and risk

You need to draw nine black beads out of ten. You will earn $1 if you meet your target. Which option would you like to draw from?

(a) A cup containing 5 white and 5 black beads.

(b) A cup containing a random combination of 10 black and white beads.

Disparity and risk

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Deci

sion

Tend

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refe

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Risk

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Risk Preference Best Risk Avoidance BestProbability of Meeting Need

Mishra & Lalumière (2010) J Exp Soc Psyc

Disparity and risk

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Deci

sion

Tend

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refe

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Risk

Avo

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Risk Preference Best Risk Avoidance BestProbability of Meeting Need

r = .88, p < .001

Mishra & Lalumière (2010) J Exp Soc Psyc

Risk-sensitivity theory

• Growing research shows risk-sensitivity theory predicts risk-taking in various domains…– Status Mishra et al. (2014) Evol Hum Behav; Ermer et al. (2008) Evol Hum Behav

– Monetary Mishra et al. (2015) Ev Psyc; Mishra et al. (2012) Brit J Psyc

– Finance/Investment Mishra et al. (2012) Brit J Psyc

– Social Mishra & Fiddick (2012) J Pers Soc Psyc

– Ecological Mishra & Lalumière (2010) J Exp Soc Psyc

…and using different measures– Descriptive/explicit Mishra & Fiddick (2012); Mishra et al. (2012, under review)

– Experiential/implicit Mishra & Lalumière (2010), Mishra et al. (2012)

Pay inequality and risk

• Inequality is a condition of disparity– Comparison of one’s own

situation to situations of (often privileged) others

• Pay inequality should motivate risk-taking– Risk-sensitivity theory– Epidemiological evidence

Does inequality affect risk-taking at the individual level?

Dependent measure

• Choice task Mishra & Lalumière (2010) J Exp Soc Psyc

6 choices between low-risk and high-risk options

Would you rather choose:[1] $3 guaranteed, or[2] 10% chance of $30?

Participants received $$ from one of their choices

Income inequality and risk

94 participants

Run in same-sex pairs

No-inequality (control) conditionsPair members given $0 each Pair members given $10 each

Inequality (experimental) conditionOne member of pair given $10, the other, $0

Mishra, Son Hing, & Lalumière (2015) Ev Psyc

0

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Victim Beneficiary Equal ($0) Equal ($10)

Risk

y C

hoic

es (C

T)

Income inequality and risk

Mishra, Son Hing, & Lalumière (2015) Ev Psyc

0

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1

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Victim Beneficiary Equal ($0) Equal ($10)

Risk

y C

hoic

es (C

T)

Income inequality and risk

Mishra, Son Hing, & Lalumière (2015) Ev Psyc

Inequality and situational cues

• Unnecessary risk-taking is costly

• Most beneficial to modulate risk-taking based on immediate situational cues

Can the effects of inequality be eliminated by modifying people’s

immediate situations?

Income inequality stability and risk

96 participants in same-sex pairs, 2 part study

Inequality either ameliorated or maintained

Inequality-amelioration

Inequality-maintenance

Initial Beneficiary à à

Initial Victim à à

Income inequality stability and risk

Same-sex pairs, 2 part study

Inequality either ameliorated or maintained

Inequality-amelioration

Inequality-maintenance

Initial Beneficiary à à

Initial Victim à à

Experimental design

Same-sex pairs, 2 part study

Inequality either ameliorated or maintained

Inequality-amelioration

Inequality-maintenance

Initial Beneficiary à à

Initial Victim à à

0

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Inequality-Amelioration

Inequality-Maintenance

Inequality-Amelioration

Inequality-Maintenance

Risk

y C

hoic

es (C

T)

Initial Victim Initial Beneficiary

Income inequality stability and risk

Mishra, Son Hing, & Lalumière (2015) Ev Psyc

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Inequality-Amelioration

Inequality-Maintenance

Inequality-Amelioration

Inequality-Maintenance

Risk

y C

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First DecisionSecond Decision

Initial Victim Initial Beneficiary

Income inequality stability and risk

Mishra, Son Hing, & Lalumière (2015) Ev Psyc

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Inequality-Amelioration

Inequality-Maintenance

Inequality-Amelioration

Inequality-Maintenance

Risk

y C

hoic

es (C

T)

First DecisionSecond Decision

Initial Victim Initial Beneficiary

Income inequality stability and risk

Mishra, Son Hing, & Lalumière (2015) Ev Psyc

Competitive disadvantage and risk

• Income inequality is an extrinsicsource of inequality

• Same pattern of results found for intrinsic inequality– Perceived competitive disadvantage

relative to peers

Mishra, Barclay, & Lalumière (2015) Evol Hum Behav

Summary | Disparity and risk

• Inequality motivates risk-taking consistent with risk-sensitivity theory– Income inequality (extrinsic)– Competitive disadvantage (intrinsic)

• Effects of inequality on risk-taking are modifiable

Inequality, risk, and health

• Why do inequality and risk matter?

• Individual-level effects of inequality– Disparity, risk-taking, and deprivation– Deprivation, risk, and health in a community sample

• Environmental-level effects of inequality– Inequality and health in the workplace

• Summary and implications

Relative deprivation

• Relative deprivation hypothesis– Effects of inequality manifest through individual-

level relative deprivation Wilkinson & Pickett (2007) Soc Sci Med

• Epidemiological evidence links relative deprivation to risk and health broadly– Mental and physical health Wilkinson (1997) Brit Med J

– Antisocial behavior Kawachi et al. (1999) Soc Sci Med

• Do these effects extend to individuals?

Community sample details

• Relationships with community organizations– Lethbridge Homeless Shelter– Womanspace Resource Center (office)– Drug rehabilitation centers– Family services, immigrant services, food banks

• N = 328 (age: M = 31.0, SD = 12.5, Range = 16 to 73)– Includes drug addicts, gambling addicts, the homeless, convicts, ex-

convicts, affluent community members, “average” community members, students

Mishra et al. (2012) OPGRC Research Report

Measures

• Predictor measures– Feelings of relative deprivation

• Outcome measures– Behavioral risk-taking (future discounting)– Health related risk-taking– Mental and physical health– Gambling addiction and behavior

• Participants paid for participation plus earnings from decision-making tasks

Mishra et al. (2012) OPGRC Research Report

Are feelings of relative deprivation associated with risk and health-related

outcomes?

Deprivation and risk

• Future discounting: behavioral impulsivity– “Would you rather have $16 tonight or $30 in 35 days?”

• Health/safety related risk-taking– “How likely are you to engage in unprotected sex?”

r = .20, p < .001

rho = .25, p < .001

Mishra & Novakowski (2016) Pers Indiv Diff

Deprivation and antisocial tendencies

• Antisocial behavior in the last year– Property crime, violence/aggression, misdemeanors,

social transgressions

• Antisocial behavior over the lifetime

rho = .19, p = .001

rho = .16, p = .005

Mishra & Novakowski (2016) Pers Indiv Diff

Deprivation and antisocial tendencies

0

2

4

6

8

10

12

14

16

18

Arrested Charged Convicted Incarcerated

Feel

ings

of R

elat

ive

Dep

rivat

ion

Yes No

Mishra & Novakowski (2016) Pers Indiv Diff

Deprivation and health

• Mental health: anxiety and mood

• Physical health (absolute)

• Physical health (relative)

r = -.38, p < .001

r = -.19, p = .001

r = -.29, p < .001 Mishra & Carleton (2015) Soc Sci Med

Are feelings of relative deprivation associated with gambling and problem

gambling?

Deprivation and gambling

• $13B in annual Canadian gambling revenue

• 30-40% of revenue derived from problem gamblers Williams & Wood (2005) AGRI Report

• Problem gamblers represent 1-4% of population Mishra et al. (2011) J Gamb Stud

Deprivation and gambling

• General gambling involvement– Frequency and variety of gambling in last year

• Problem gambling severity index (PGSI)

rho = .28, p < .001

rho = .12, p = .03

Mishra, Meadows, & Carleton (under review) J Exp Soc Psyc

Deprivation and gambling

0

2

4

6

8

10

12

14

16

18

Non-Problem Low-Risk Moderate Problem

Feel

ings

of R

elat

ive

Dep

rivat

ion

Categorical Problem Gambling SeverityMishra, Meadows, & Carleton (under review) J Exp Soc Psyc

Risk-persistence and risk-sensitivity

• Risk-persistent populations engage in risk-taking behavior consistently– “Generality of deviance”– Non-specialization of offenders

• Why are people risk-persistent?

• Environments may require risk-taking to obtain reasonable outcomes (e.g., high inequality)– Sensitivity to immediate costs/benefits

Mishra et al. (under review) J Gamb Stud, Mishra et al. (2011) Pers Indiv Diff, Mishra et al. (2009) Soc Sci Med

Inequality and situational cues

• If risk-persistence is stable (via personality, developmental environment, socialization, low embodied capital, etc.) individuals from risk-persistent populations will consistently engage in risk-taking

• If risk-persistence is environmentally modulated individuals from risk-persistent populations will engage in risk-sensitive choice

Are risk-persistent individuals risk-sensitive decision makers?

Community sample

• Risk-persistent populations (antisocial) – Convicts (usually also problem gamblers, drug

addicts, delinquents), n = 85

• Control populations– Community controls, students, n = 243

Risk-propensity

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Community (General)

Students Problem Gamblers

Ex-convicts

Self-

Rep

orte

d R

isk

Prop

ensi

ty

(Com

posi

te)

Mishra (under review) Psyc Sci

Decision-making from description

• Decision-making from explicit descriptions Rode et al. (1999) Cognition

• 20 decisions: low-risk vs. high-risk

• Each decision made under a condition of either high disparity or low disparity

Decision-making from description

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High Need Low Need

Prop

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sky

Dec

isio

ns

Mishra (under review) Psyc Sci

Decision-making from description

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High Need Low Need

Prop

ortio

n Ri

sky

Dec

isio

nsCommunity/studentRisk-Persistent

Mishra (under review) Psyc Sci

Decision-making from description

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High Need Low Need

Prop

ortio

n Ri

sky

Dec

isio

nsCommunity/studentRisk-Persistent

Mishra (under review) Psyc Sci

Summary | Deprivation, risk, and health

• Relative deprivation associated with risk, health, and gambling at individual level

• Risk-persistent populations are risk-sensitive– People sensitive to immediate costs/benefits, on average,

regardless of stable traits– Risk-persistence may be product of consistent exposure to

disparity cues (inequality)

• Convergent evidence from experimental and survey studies

Executive summary

• Inequality has individual-level effects on risk-taking

• Risk-taking is acutely influenced by inequality

• Feelings of relative deprivation are associated with risk and health outcomes

• “Risk-persistent” people are rational, risk-sensitive decision makers

Executive summary

• Inequality has individual-level effects on risk-taking

• Risk-taking is acutely influenced by inequality

• Feelings of relative deprivation are associated with risk and health outcomes

• “Risk-persistent” people are rational, risk-sensitive decision makers

Implications

• The environment and situational cues matter in affecting risk and health behavior– Plasticity of behavior

• Targeting modifiable conditions facilitating relative deprivation and inequality– Equal access to health care, education, social

support– Social mobility

Inequality is a justice issue

What kind of society do we want to live in?

• Normative ethical question: Emphasis on status and individual outcomes, or collective health and well-being?


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