Richard Wilkinson Emeritus Professor of  Social Epidemiology University of Nottingham & Kate Pickett Professor of Epidemio...
Health is related to income differences  within  rich societies  but not to those  between  them Within societies Between ...
Income per head and life-expectancy: rich & poor countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equali...
How much richer are the richest 20% than the poorest 20%? Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalit...
 
Health and Social Problems are Worse in More Unequal Countries <ul><li>Index of:  </li></ul><ul><li>Life expectancy </li><...
Health and Social Problems are not Related to Average Income in Rich Countries <ul><li>Index of:  </li></ul><ul><li>Life e...
Index of Health and Social Problems in relation to Inequality among US states Wilkinson & Pickett, 2009, forthcoming.
Child Well-being is Better in More Equal Rich Countries  Source: Wilkinson & Pickett, The Spirit Level (2009) www.equality...
Child-Wellbeing is Unrelated to Average Incomes in Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www...
 
 
Levels of Trust are Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009)
Levels of Trust are Higher in More Equal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust....
The Prevalence of Mental Illness is Higher in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2...
Male mortality (25-64 yrs) and income inequality in US states and Canadian provinces.   Source:  Ross NA, Wolfson MC, Dunn...
Source: Daly M, Wilson M, Vasdev S. Income inequality and homicide rates in Canada and the United States.  Canadian Journa...
Teenage Birth Rates are Higher in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equ...
Drug Use is More Common in More Unequal Countries Source: Wilkinson & Pickett, The Spirit Level (2009) Index of use of: op...
Rates of Imprisonment are Higher in More Unequal Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equali...
Rate of Imprisonment are Higher in More Unequal US States Death Penalty:   Red = retained  Blue = abolished Source: Wilkin...
Children Experience More Conflict in More Unequal Societies Source: Wilkinson & Pickett, The Spirit Level (2009) 11, 13 & ...
More Children Drop Out of High School in More Unequal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.e...
Social Mobility is Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytr...
<ul><ul><li>Almost everyone benefits from greater equality. </li></ul></ul><ul><ul><li>Usually the benefits are greatest a...
Diabetes  Hypertension  Cancer  Lung disease  Heart disease Self-reported prevalence of illness by education % Source: Ban...
Source: Wilkinson & Pickett, The Spirit Level (2009)
Source:  Willms JD. 1997. Data from OECD Programme for International Student Assessment. Literacy Scores of 16-25 year old...
Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005. Working hours are longer in more unequal coun...
More equal countries are more generous foreign aid donors
More equal countries recycle more waste Source: Wilkinson & Pickett, The Spirit Level (2009)
More equal societies are more innovative www.equalitytrust.org.uk
 
Health and Social Problems are Worse in More Unequal Countries <ul><li>Index of:  </li></ul><ul><li>Life expectancy </li><...
Single parents and child wellbeing
Why are we so sensitive to inequality?
<ul><ul><li>Psychosocial risk factors for ill health </li></ul></ul><ul><ul><li>Low social status  </li></ul></ul><ul><ul>...
What kind of stress most reliably raises cortisol levels? Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 1...
Gilligan J.  Violence: Our Deadly Epidemic and its Causes.   (G .P. Putnam 1996) &quot; ...the prison inmates I work with ...
Stereotype Threat The effect of caste identity on children's performance Number of mazes solved Source:  Hoff K, Pandey P,...
What kind of stress most reliably raises cortisol levels? A meta-analysis of 208 laboratory studies of cortisol responses ...
<ul><li>The effects of inequality - a two stage process </li></ul><ul><ul><ul><li>adult experience of inequality </li></ul...
Trends in US income inequality 1975-2005 Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
http://www.equalitytrust.org.uk <ul><li>For more information: </li></ul><ul><li>a book … </li></ul><ul><ul><ul><li>…  and ...
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"The Spirit Level: Why Greater Equality Makes Societies Stronger"

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1/8/2010
Richard Wilkinson, Professor of Epidemiology at Nottingham University

Kate Pickett, Professor of Epidemiology at York University

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  • The public and policy response? more:- Police Doctors Social Workers Drug rehabilitation units Educational Psychologists But…services are expensive and only partially effective.
  • Most important sources of chronic stress – relative risks and population attributable risk Pointer – underlying source of stress: Social anxiety Eyes of others Social Gateway
  • A meta-analysis of 208 laboratory studies of cortisol responses to acute stressors found that “Tasks that included social-evaluative threat (such as threats to self-esteem or social status), in which others could negatively judge performance, particularly when the outcome of the performance was uncontrollable, provoked larger and more reliable cortisol changes than stressors without these particular threats.” (p.377) &amp;quot;Humans are driven to preserve the social self and are vigilant to threats that may jeopardize their social esteem or status.” (p.357)
  • Transcript of ""The Spirit Level: Why Greater Equality Makes Societies Stronger""

    1. 1. Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham & Kate Pickett Professor of Epidemiology University of York http://www.equalitytrust.org.uk
    2. 2. Health is related to income differences within rich societies but not to those between them Within societies Between (rich) societies Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk Davey Smith et al., AJPH 1996
    3. 3. Income per head and life-expectancy: rich & poor countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    4. 4. How much richer are the richest 20% than the poorest 20%? Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    5. 6. Health and Social Problems are Worse in More Unequal Countries <ul><li>Index of: </li></ul><ul><li>Life expectancy </li></ul><ul><li>Math & Literacy </li></ul><ul><li>Infant mortality </li></ul><ul><li>Homicides </li></ul><ul><li>Imprisonment </li></ul><ul><li>Teenage births </li></ul><ul><li>Trust </li></ul><ul><li>Obesity </li></ul><ul><li>Mental illness – incl. drug & alcohol addiction </li></ul><ul><li>Social mobility </li></ul>Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    6. 7. Health and Social Problems are not Related to Average Income in Rich Countries <ul><li>Index of: </li></ul><ul><li>Life expectancy </li></ul><ul><li>Math & Literacy </li></ul><ul><li>Infant mortality </li></ul><ul><li>Homicides </li></ul><ul><li>Imprisonment </li></ul><ul><li>Teenage births </li></ul><ul><li>Trust </li></ul><ul><li>Obesity </li></ul><ul><li>Mental illness – incl. drug & alcohol addiction </li></ul><ul><li>Social mobility </li></ul>Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    7. 8. Index of Health and Social Problems in relation to Inequality among US states Wilkinson & Pickett, 2009, forthcoming.
    8. 9. Child Well-being is Better in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    9. 10. Child-Wellbeing is Unrelated to Average Incomes in Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    10. 13. Levels of Trust are Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009)
    11. 14. Levels of Trust are Higher in More Equal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    12. 15. The Prevalence of Mental Illness is Higher in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    13. 16. 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
    14. 17. 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.
    15. 18. Teenage Birth Rates are Higher in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    16. 19. Drug Use is More Common in More Unequal Countries Source: Wilkinson & Pickett, The Spirit Level (2009) Index of use of: opiates, cocaine, cannabis, ecstasy, amphetamines www.equalitytrust.org.uk
    17. 20. Rates of Imprisonment are Higher in More Unequal Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    18. 21. Rate of Imprisonment are Higher in More Unequal US States Death Penalty: Red = retained Blue = abolished Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    19. 22. Children Experience More Conflict in More Unequal Societies Source: Wilkinson & Pickett, The Spirit Level (2009) 11, 13 & 15 yr olds fighting, bullying, and finding peers not kind & helpful www.equalitytrust.org.uk
    20. 23. More Children Drop Out of High School in More Unequal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    21. 24. Social Mobility is Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    22. 25. <ul><ul><li>Almost everyone benefits from greater equality. </li></ul></ul><ul><ul><li>Usually the benefits are greatest among the poor but extend to the majority of the population </li></ul></ul>
    23. 26. Diabetes Hypertension Cancer Lung disease Heart disease Self-reported prevalence of illness by education % Source: Banks et al. JAMA 2006; 295: 2037-2045
    24. 27. Source: Wilkinson & Pickett, The Spirit Level (2009)
    25. 28. Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment. 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) Literacy score Sweden Canada United States
    26. 29. Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005. Working hours are longer in more unequal countries
    27. 30. More equal countries are more generous foreign aid donors
    28. 31. More equal countries recycle more waste Source: Wilkinson & Pickett, The Spirit Level (2009)
    29. 32. More equal societies are more innovative www.equalitytrust.org.uk
    30. 34. Health and Social Problems are Worse in More Unequal Countries <ul><li>Index of: </li></ul><ul><li>Life expectancy </li></ul><ul><li>Math & Literacy </li></ul><ul><li>Infant mortality </li></ul><ul><li>Homicides </li></ul><ul><li>Imprisonment </li></ul><ul><li>Teenage births </li></ul><ul><li>Trust </li></ul><ul><li>Obesity </li></ul><ul><li>Mental illness – incl. drug & alcohol addiction </li></ul><ul><li>Social mobility </li></ul>Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    31. 35. Single parents and child wellbeing
    32. 36. Why are we so sensitive to inequality?
    33. 37. <ul><ul><li>Psychosocial risk factors for ill health </li></ul></ul><ul><ul><li>Low social status </li></ul></ul><ul><ul><li>Weak social affiliations </li></ul></ul><ul><ul><li>Stress in early life (pre- and postnatally) </li></ul></ul>
    34. 38. What kind of stress most reliably raises cortisol levels? Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 130(3): 355-91 ACTH Cortisol Tasks with social-evaluative threat, e.g, to self-esteem & social status Other tasks Effect size
    35. 39. Gilligan J. Violence: Our Deadly Epidemic and its Causes. (G .P. Putnam 1996) &quot; ...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.&quot; p.106 A few pages further on Gilligan continues:- &quot;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 &quot;loss of face &quot; - no matter how severe the punishment, even if it includes death.&quot; p.110
    36. 40. Stereotype Threat The effect of caste identity on children's performance Number of mazes solved Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004 Caste Unannounced Caste Announced
    37. 41. What kind of stress most reliably raises cortisol levels? A meta-analysis of 208 laboratory studies of cortisol responses to acute stressors found that “Tasks that included social-evaluative threat (such as threats to self-esteem or social status), in which others could negatively judge performance, particularly when the outcome of the performance was uncontrollable, provoked larger and more reliable cortisol changes than stressors without these particular threats.” (p.377) &quot;Humans are driven to preserve the social self and are vigilant to threats that may jeopardize their social esteem or status.” (p.357) Source: Dickerson SS, Kemeny ME. Acute stressors and cortisol responses: a theoretical integration and synthesis of laboratory research. Psychological Bulletin 2004; 130(3): 355-91
    38. 42. <ul><li>The effects of inequality - a two stage process </li></ul><ul><ul><ul><li>adult experience of inequality </li></ul></ul></ul><ul><ul><ul><li>passed on to children – epigenetics? </li></ul></ul></ul>
    39. 43. Trends in US income inequality 1975-2005 Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    40. 44. http://www.equalitytrust.org.uk <ul><li>For more information: </li></ul><ul><li>a book … </li></ul><ul><ul><ul><li>… and a website </li></ul></ul></ul>

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