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

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




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

• Summary and implications

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


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



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)






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


Present state(My condition)

Desired state(Others’ condition)



Present state

Desired state



Present state

Desired state



Present state

Desired state



Present state

Desired state



Present state

Desired state

LOW DISPARITY



HIGH DISPARITY

Present state

Desired state


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?



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?



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?



Disparity and risk

-0.5

-0.4

-0.3

-0.2

-0.1

0

0.1

0.2

0.3

0.4

0.5

-0.5 -0.4 -0.3 -0.2 -0.1 0 0.1 0.2 0.3 0.4 0.5

Deci

sion

Tend

ency

Ri

sk P

refe

renc

e

Risk

Avo

idan

ce

Risk Preference Best Risk Avoidance BestProbability of Meeting Need

Mishra & Lalumière (2010) J Exp Soc Psyc

Disparity and risk

-0.5

-0.4

-0.3

-0.2

-0.1

0

0.1

0.2

0.3

0.4

0.5

-0.5 -0.4 -0.3 -0.2 -0.1 0 0.1 0.2 0.3 0.4 0.5

Deci

sion

Tend

ency

Ri

sk P

refe

renc

e

Risk

Avo

idan

ce

Risk Preference Best Risk Avoidance BestProbability of Meeting Need

r = .88, p < .001

Mishra & Lalumière (2010) J Exp Soc Psyc


• 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

0.5

1

1.5

2

2.5

3

3.5

4

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

Risk

y C

hoic

es (C

T)



0

0.5

1

1.5

2

2.5

3

3.5

4

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

Risk

y C

hoic

es (C

T)


★


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


Same-sex pairs, 2 part study






Experimental design

Same-sex pairs, 2 part study






0

0.5

1

1.5

2

2.5

3

3.5

4

Inequality-Amelioration

Inequality-Maintenance



Risk

y C

hoic

es (C

T)

Initial Victim Initial Beneficiary



0

0.5

1

1.5

2

2.5

3

3.5

4





Risk

y C

hoic

es (C

T)

First DecisionSecond Decision



★


0

0.5

1

1.5

2

2.5

3

3.5

4





Risk

y C

hoic

es (C

T)

First DecisionSecond Decision


★



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






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


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


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


• 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


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

-1

-0.5

0

0.5

1

1.5

2

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


0

0.1

0.2

0.3

0.4

0.5

0.6

High Need Low Need

Prop

ortio

n Ri

sky

Dec

isio

ns



0

0.1

0.2

0.3

0.4

0.5

0.6

High Need Low Need

Prop

ortio

n Ri

sky

Dec

isio

nsCommunity/studentRisk-Persistent



0

0.1

0.2

0.3

0.4

0.5

0.6

High Need Low Need

Prop

ortio

n Ri

sky

Dec

isio

nsCommunity/studentRisk-Persistent


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?

Date post:	14-Apr-2018
Category:	Documents
Upload:	duongbao
View:	219 times
Download:	2 times

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

Documents