0
1
Richard Wilkinson
Emeritus Professor of
Social Epidemiology
University of Nottingham
&
Kate Pickett
Professor of Epidemi...
2
Income per head and life-expectancy: rich & poor countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equa...
3
Among the rich countries life expectancy is not related to
national differences in average income
Source: Wilkinson & Pi...
4
…but life expectancy is related to income
within rich societies
Source: Wilkinson & Pickett, The Spirit Level (2009)
70
...
5
How much richer are the richest
20% than the poorest 20%?
www.equalitytrust.org.ukSource: Wilkinson & Pickett, The Spiri...
6
7
Index of:
• Life expectancy
• Math & Literacy
• Infant mortality
• Homicides
• Imprisonment
• Teenage births
• Trust
• O...
8
Health and Social Problems are not Related to Average
Income in Rich Countries
Index of:
• Life expectancy
• Math & Lite...
9
Child Well-being is Better in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalit...
10
Child-Wellbeing is Unrelated to Average Incomes in Rich
Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) ...
11
Levels of Trust are Higher in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009)
12
Levels of Trust are Higher in More Equal US States
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytru...
13
The Prevalence of Mental Illness is Higher in More
Unequal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level...
14
Infant Mortality Rates are Higher in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.eq...
15
Drug Use is More Common in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009)
Index of use of:...
16
Teenage Birth Rates are Higher in More Unequal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www....
17
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...
18
Rates of Imprisonment are Higher in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equ...
19
Social mobility is higher in more equal countries
www.equalitytrust.org.uk
Intergenerational income mobility data from:...
20
Almost everyone benefits from
greater equality.
Usually the benefits are greatest
among the poor but extend to the
majo...
21
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 Single
Prnt
U...
22
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
P...
23
Index of:
• Life expectancy
• Math & Literacy
• Infant mortality
• Homicides
• Imprisonment
• Teenage births
• Trust
• ...
24
Why are we so sensitive to inequality?
25
Psychosocial risk factors for ill health
 Low social status
 Weak social affiliations
 Stress in early life (pre- an...
26
ACTH
Cortisol
Tasks with both
social-evaluative
threat and
uncontrollability
Other tasks
Effectsize
Source: Dickerson S...
27
Gilligan J. Violence: Our Deadly Epidemic and its Causes.
(G .P. Putnam 1996)
" ...the prison inmates I work with have ...
Social Status and Friendship
Two sides of the same coin:
Social status (dominance hierarchies, pecking
orders) are orderin...
29
Stereotype Threat
The effect of caste identity on children's performance
Caste
Unannounced
Caste
Announced
0
1
2
3
4
5
...
30
The effects of inequality - a two stage process
1. adult experience of inequality
2. passed on to children – epigenetic...
Trends in income inequality 1979-2005/6
(Gini coefficient, Great Britain.)
Brewer M, Goodman A, Muriel A, Sibieta L. Pover...
32
http://www.equalitytrust.org.uk
For more information:
… a book
and a website…
33
35
More Adults are Obese in More Unequal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalityt...
The public and policy response?
more:-
Police
Doctors
Social Workers
Drug rehabilitation units
Educational Psychologists
B...
Dunbar R. Brains on two legs: group size and the evolution
of intelligence In: Tree of Origin: F de Waal. (ed) 2001.
The S...
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...
Cognitive Score: Socioeconomic status more important than starting point
High Cognitive Score at 22 months
Low Cognitive S...
Educational Scores are Higher in More Equal Rich
Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equali...
43
Australia
Austria
Belgium Canada
Denmark
Finland
France
Germany
Greece
Ireland
Israel
Italy
Japan
Netherlands
New Zeala...
The spirit level   why equality is better for everyone - richard wilkinson
The spirit level   why equality is better for everyone - richard wilkinson
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The spirit level why equality is better for everyone - richard wilkinson

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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)
    "Humans are driven to preserve the social self and are vigilant to threats that may jeopardize their social esteem or status.” (p.357)
  • Len Syme – MRFIT – smoking
  • Transcript of "The spirit level why equality is better for everyone - richard wilkinson"

    1. 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. 2 Income per head and life-expectancy: rich & poor countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    3. 3. 3 Among the rich countries life expectancy is not related to national differences in average income Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    4. 4. 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 Leastdeprived Mostdeprived Electoral wards in England & Wales by deprivation score Lifeexpectancy(years) www.equalitytrust.org.uk
    5. 5. 5 How much richer are the richest 20% than the poorest 20%? www.equalitytrust.org.ukSource: Wilkinson & Pickett, The Spirit Level (2009)
    6. 6. 6
    7. 7. 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 Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    8. 8. 8 Health and Social Problems are not Related to Average Income in Rich Countries Index of: • Life expectancy • Math & Literacy • Infant mortality • Homicides • Imprisonment • Teenage births • Trust • Obesity • Mental illness – incl. drug & alcohol addiction • Social mobility Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    9. 9. 9 Child Well-being is Better in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    10. 10. 10 Child-Wellbeing is Unrelated to Average Incomes in Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    11. 11. 11 Levels of Trust are Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009)
    12. 12. 12 Levels of Trust are Higher in More Equal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    13. 13. 13 The Prevalence of Mental Illness is Higher in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    14. 14. 14 Infant Mortality Rates are Higher in More Unequal Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    15. 15. 15 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
    16. 16. 16 Teenage Birth Rates are Higher in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    17. 17. 17 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) Homicidespermillionpeople 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.
    18. 18. 18 Rates of Imprisonment are Higher in More Unequal Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    19. 19. 19 Social mobility is higher in more equal countries www.equalitytrust.org.uk Intergenerational income mobility data from: Blanden J. (2009) Centre for Economic Performance, LSE. Paper No' CEEDP0111.
    20. 20. 20 Almost everyone benefits from greater equality. Usually the benefits are greatest among the poor but extend to the majority of the population
    21. 21. 21 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 Single Prnt Unclass. E& W Sweden Source: Leon DA, Vagero D, Olausson PO. BMJ 1992; 305; 687-91 InfantMortalityrate
    22. 22. 22 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) Literacyscore Sweden Canada United States Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
    23. 23. 23 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 Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    24. 24. 24 Why are we so sensitive to inequality?
    25. 25. 25 Psychosocial risk factors for ill health  Low social status  Weak social affiliations  Stress in early life (pre- and postnatally)
    26. 26. 26 ACTH Cortisol Tasks with both social-evaluative threat and uncontrollability Other tasks Effectsize Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 130(3): 355-91 What kind of stress most reliably raises cortisol levels?
    27. 27. 27 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
    28. 28. 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.
    29. 29. 29 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 Numberofmazessolved Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004
    30. 30. 30 The effects of inequality - a two stage process 1. adult experience of inequality 2. passed on to children – epigenetics?
    31. 31. 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.
    32. 32. 32 http://www.equalitytrust.org.uk For more information: … a book and a website…
    33. 33. 33
    34. 34. 35 More Adults are Obese in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    35. 35. The public and policy response? more:- Police Doctors Social Workers Drug rehabilitation units Educational Psychologists But…services are expensive and only partially effective.
    36. 36. Dunbar R. Brains on two legs: group size and the evolution of intelligence In: Tree of Origin: F de Waal. (ed) 2001. The Social Brain: the neocortex is a larger proportion of the brain in primate species with larger social groupsAveragesocialgroupsize Neocortex ratio
    37. 37. 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
    38. 38. More Children Drop Out of High School in More Unequal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    39. 39. Cognitive Score: Socioeconomic status more important than starting point High Cognitive Score at 22 months Low Cognitive Score at 22 months 2 3 4 5 6 7 8 9 10 Child’s age (years) Cognitivescore percentilepositionateachage (I Feinstein. Inequality in cognitive development. 1970 British Births. Economica 2003; 70: 3-97) (from The Marmot Review 2010)
    40. 40. Educational Scores are Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
    41. 41. 43 Australia Austria Belgium Canada Denmark Finland France Germany Greece Ireland Israel Italy Japan Netherlands New Zealand Norway Portugal Spain Sweden UK USA Worse Better UNICEFindexofchildwell-being 0 10 20 30 Lone parents as % of all households with dependent children Single parents and child wellbeing
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