Photo by kind permission of Matt Stuart Social Dysfunction: why inequality matters Richard Wilkinson...

Photo by kind permission of Matt Stuart

Social Dysfunction: why inequality matters

Richard Wilkinson Emeritus Professor of Social Epidemiology

2

3

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

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

www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level

Life expectancy in rich countries is no longer related to National Income per head

5

Poor Rich Median income of Zip code areas

MRFIT data from Davey Smith et al. AJPH 1996

Mortality is related to income differences within societies

3.7 3.94.3 4.6 4.8

5.2 5.3 5.6 5.6 5.6 5.76.1 6.2

6.7 6.8 6.87.2

8.5

9.7

4.0

8.0

7.0

3.4

Income gapsHow many times richer are the richest fifth than the poorest fifth?

Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk

Inequality...How much richer are the richest 20% in each country than the poorest 20%?

Wilkinson & Pickett, The Spirit Level

Index of: • Life expectancy• Math & Literacy

• Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness

– incl. drug & alcohol addiction

• Social mobility

www.equalitytrust.org.uk

Health and social problems are worse in more unequal countries

Ind

ex o

f h

ealt

h a

nd

so

cial

pro

ble

ms


Neither health nor social problems are related to national income per head




• Social mobility

Ind

ex o

f h

ealt

h a

nd

so

cial

pro

ble

ms


Child well-being is better in more equal countries


The UNICEF Index of Child Wellbeing is not related to National Income per head


People in more unequal countries trust each other less


People in more unequal states of the USA trust each other less


Mental illness is more common in more unequal societies

15

Infant Mortality Rates are Higher in More Unequal Countries


Male mortality (25-64 yrs) and income inequality in US

states and Canadian provinces.

Source: Ross NA, Wolfson MC, Dunn JR, Berthelot JM, Kaplan GA, Lynch JW. British Medical Journal 2000;320:898-902

http://www.bmj.com/content/vol320/issue7239/images/large/rosn4890.f1.jpeg

0

30

60

90

120

150

180

Income Inequality

Ho

mic

ide

s p

er

mill

ion

pe

op

le

Low High

Daly M, Wilson M, Vasdev S. Income inequality and homicide rates in Canada and the United States. Can J Crim 2001; 43: 219-36.

Homicide rates are higher in more unequal

US states and Canadian provinces USA states

Canadian provinces

18

Teenage Birth Rates are Higher in More Unequal Rich Countries



Imprisonment rates are higher in more unequal countries


More children drop out of High School in more unequal US states

Educational Scores are Higher in More Equal Rich Countries



Social mobility is lower in more unequal countries

Social Relations

• Child conflict• Homicide• Imprisonment• Social capital• Trust

In summary... bigger income gaps lead to deteriorations in:-

Human Capital

• Child wellbeing• High school drop outs• Math & literacy scores• Social mobility• Teenage births

Health

• Drug abuse• Infant mortality• Life expectancy• Mental illness • Obesity

...but not suicide...


Death rates are lower in more equal States for both richer and poorer Americans

0

10

20

30

40

50

Low High Low High Low High Low High Low High

England

England USA

Diabetes Hypertension Cancer Lung disease Heart disease

Self-reported prevalence of illness by education

%

Source: Banks et al. JAMA 2006; 295: 2037-2045

26

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.

Wilkinson & Pickett, The Spirit Level




• Social mobility

www.equalitytrust.org.uk

Health and social problems are worse in more unequal countries

Ind

ex o

f h

ealt

h a

nd

so

cial

pro

ble

ms

More inequality

• More superiority and inferiority• More status competition and consumerism

• More status insecurity

• More worry about how we are seen and judged

• More “social evaluation anxiety”(threats to self-esteem & social

status, fear of negative judgements

Valued or Devalued?

29

Psychosocial risk factors for ill health

Low social status

Weak social affiliations

Stress in early life (pre- and postnatally)

0

0.2

0.4

0.6

0.8

1

Other tasks

Tasks with ‘social evaluative threat’ (uncontrollable)

Co

rtis

ol

resp

on

se (e

ffec

t si

ze)

Dickerson SS, Kemeny ME. Acute stressors and cortisol responses. Psychological Bulletin 2004; 130(3): 355-91.

What kind of stressful tasks raise stress hormones most?

31

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

Social Status and Friendship

Two sides of the same coin:

Social status (dominance hierarchies, pecking orders) are orderings based on power, coercion and privileged access to resources – regardless of the needs of others.

Friendship, in contrast, is based on reciprocity, mutuality, social obligations, sharing and a recognition of each other’s needs.

“Not a test of ability”

5

6

7

8

9

10 High SES

Low SES

“Test of ability”

Stereotype threat. High & low socioeconomic statusgroups given ‘Advanced Progressive Matrices’ test

Croizeta JC; Dutrevis M. Socioeconomic Status and Intelligence. J Poverty 2004; 8(3): 91-107.

Num

ber o

f ite

ms

corr

ect

Richest 10%, Income Percentage

Data from: Piketty & Saez

35

http://www.equalitytrust.org.uk

For more information:

a book …

… and a website

Date post:	14-Dec-2015
Category:	Documents
Upload:	cassandra-fincham
View:	219 times
Download:	0 times

Photo by kind permission of Matt Stuart Social Dysfunction: why inequality matters Richard Wilkinson...

Documents