SlideShare a Scribd company logo
1 of 84
Download to read offline
Inequality: the enemy between us

          Richard Wilkinson
     Emeritus Professor of Social Epidemiology
             University of Nottingham

                        &

               Kate Pickett
          Senior Lecturer in Epidemiology
                 University of York


    http://www.equalitytrust.org.uk
Income per head and life-expectancy: rich & poor countries




Source: Wilkinson & Pickett, The Spirit Level (2009)     www.equalitytrust.org.uk
Health is related to income differences within rich societies
                            but not to those between them


              Between (rich) societies                                                                Within societies
                                                                                        80
                                                                                        79
                                                                                        78
                                                                                        77




                                                       Life expectancy (years)
                                                                                        76
                                                                                        75
                                                                                        74
                                                                                        73
                                                                                        72
                                                                                        71
                                                                                        70




                                                                                          ed
                                                                                      riv
                                                                                      ep                                                          Most
                                                                                   td
                                                                                 as

                                                                                                                                                deprived
                                                                                 Le



                                                                                               Electoral wards in England & Wales ranked by deprivation score




Source: Wilkinson & Pickett, The Spirit Level (2009)                                                                 www.equalitytrust.org.uk
How much richer are the richest
           20% than the poorest 20%?




Source: Wilkinson & Pickett, The Spirit Level (2009)   www.equalitytrust.org.uk
Inst ph ireland short
Health and Social Problems are Worse in More Unequal
                                         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
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
Child Well-being is Better in More Equal Rich Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)   www.equalitytrust.org.uk
Child-Wellbeing is Unrelated to Average Incomes in Rich
                                     Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)      www.equalitytrust.org.uk
Levels of Trust are Higher in More Equal Rich Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)
The Prevalence of Mental Illness is Higher in More
                                Unequal Rich Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)           www.equalitytrust.org.uk
Drug Use is More Common in More Unequal Countries




                   Index of use of: opiates, cocaine, cannabis, ecstasy, amphetamines

Source: Wilkinson & Pickett, The Spirit Level (2009)                       www.equalitytrust.org.uk
Infant Mortality Rates are Higher in More Unequal Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)      www.equalitytrust.org.uk
More Adults are Obese in More Unequal Rich Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)    www.equalitytrust.org.uk
Teenage Birth Rates are Higher in More Unequal Rich Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)   www.equalitytrust.org.uk
Homicide and income inequality:
                                      US States and Canadian Provinces
                               180



                               150
Homicides per million people




                               120



                               90



                               60



                               30



                                0
                                 0.35             0.38               0.41                 0.44            0.47
                                     More equal                Income Inequality (Gini)          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.
Rates of Imprisonment are Higher in More Unequal Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)     www.equalitytrust.org.uk
Almost everyone benefits from
greater equality.


Usually the benefits are greatest
among the poor but extend to the
majority of the population
Infant Mortality by Social Class:
                                                Sweden and England & Wales
                                 18
                                               E& W
                                 16
                                               Sweden
         Infant Mortality rate




                                 14
                                 12
                                 10
                                 8
                                 6
                                 4
                                 2
                                 0
                                      I   II       IIIN   IIIM   IV    V    Single Unclass.
                                                                             Prnt




Source: Leon DA, Vagero D, Olausson PO. BMJ 1992; 305; 687-91
Literacy Scores of 16-25 year olds by
                              1                   Parents' Education

                            0.5
                                       Sweden
           Literacy score




                              0


                                       Canada
                            -0.5




                             -1
                                       United States


                            -1.5
                                   2     3   4   5     6   7   8   9   10   11   12   13   14   15   16   17
                                                       Parents' Education (years)




Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
Health and Social Problems are Worse in More Unequal
                                         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
Why are we so sensitive to inequality?
Psychosocial risk factors for ill health


 Low social status

 Weak social affiliations


 Stress in early life (pre- and postnatally)
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)
"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
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
Stereotype Threat
              The effect of caste on children's performance

                                                    6

                                                                              High Caste
                                                    5
                           Number of mazes solved
                                                                              Low Caste


                                                    4



                                                    3



                                                    2



                                                    1



                                                    0

                                                           Caste        Caste
                                                        Unannounced   Announced



Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004
Inequality affects us in two stages


   1. Adult experience of inequality
   2. Passed on to children (epigenetics?)
Working hours are longer in more unequal countries




Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005.
Overdeveloped countries?
High life expectancy can be achieved with low CO2 emissions




                                               www.equalitytrust.org.uk
“Growth is a substitute for equality of
income. So long as there is growth,
(people feel) there is hope, and that
makes large income differences
tolerable.”
Henry Wallich, a former governor of America’s
Federal Reserve Bank and later professor of
economics at Yale.
In more equal countries business leaders give a higher priority
   to complying with international environmental agreements




           With permission from R De Vogli & D Gimeno
More equal countries recycle a higher
   proportion of waste materials
More equal societies are more innovative




                              www.equalitytrust.org.uk
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.
Inst ph ireland short
For more information:
  a book …
             … and a website




http://www.equalitytrust.org.uk
Inst ph ireland short
Inst ph ireland short
Inst ph ireland short
Inst ph ireland short
Inst ph ireland short
How does your pay compare with an MP?
The L-Curve: A graph of US
        income distribution by David
                 Chandler




http://www.lcurve.org
The L-Curve: A graph of US
        income distribution by David
                 Chandler




http://www.lcurve.org
The L-Curve: A graph of US
        income distribution by David
                 Chandler




http://www.lcurve.org
The L-Curve: A graph of US
        income distribution by David
                 Chandler




http://www.lcurve.org
The L-Curve: A graph of US
        income distribution by David
                 Chandler




http://www.lcurve.org
Sources of data for the Index of Health and Social problems

Component            International data                                             US state data
Trust                Percent of people who respond positively to the statement      Percent of people who respond positively to the statement “most
                     “most people can be trusted”                                   people can be trusted”
                     1999-2001                                                      1999
                     World Values Survey Reverse-coded                              General Social Survey Reverse-coded
Life expectancy      Life expectancy at birth for men and women                     Life expectancy at birth for men and women
                     2004                                                           2000
                     United Nations Human Development Report Reverse-coded          US Census Bureau, Population Division Reverse-coded

Infant mortality     Deaths in the first year of life per 1000 live births          Deaths in the first year of life per 1000 live births
                     2000                                                           2002
                     World Bank                                                     US National Center for Health Statistics
Obesity              Percentage of the population with BMI > 30, averaged for men   Percentage of the population with BMI > 30, averaged for men and
                     and women                                                      women, 1999-2002
                     2002                                                           Estimates from Prof Ezzati, Harvard University, based on NHANES
                     International Obesity TaskForce                                and BRFSS surveys
Mental health        Prevalence of mental illness                                   Average number of days in past month when mental health was not
                     2001-2003                                                      good
                     WHO                                                            1993-2001, BRFSS
Education            Combined average of maths literacy and reading literacy        Combined average of maths and reading scores for 8 graders
                                                                                                                                            th


                     scores of 15-year olds                                         2003
                     2000                                                           US Department of Education, National Center for Education
                     OECD PISA Reverse-coded                                        Statistics Reverse coded
Teenage birth rate   Births per 1000 women aged 15-19 years                         Births per 1000 women aged 15-19 years
                     1998                                                           2000
                     UNICEF                                                         US National Vital Statistics
Homicides            Homicide rate per 100,000                                      Homicide rate per 100,000
                     Period average for 1990-2000                                   1999
                     United Nations                                                 FBI
Imprisonment         Log of prisoners per 100,000                                   Prisoners per 100,000
                     United Nations                                                 1997-8, US Department of Justice

Social mobility      Correlation between father and son’s income                    N/A
                     30-year period data from 8 cohort studies
                     London School of Economics
Institutional change?

• Transforming the social environment – people
  feeling valued
• Economic democracy – from companies as
  pieces of property to communities
• Other successful institutional structures
• An ethical consumer movement - supporting
  other forms of ownership & control
Health and social problems which
are substantially worse in more unequal societies
      Data available for countries and for states of the USA:-
        • Low birth weight             • Mental illness
        • Infant mortality             • Imprisonment rates
        • Life expectancy              • Teenage birth rates
        • Obesity                      • Maths & literacy scores
        • Homicides                    • Trust
        • Drug abuse                   • Social capital
  International data:
  •   Social Mobility                     US states data:
                                          •   High school drop-out rate
  •   Hours worked
  •   Child conflict
  •   UNICEF Child well-being Index

[Smoking and suicide are the only counter examples we have found]
Living conditions & Poverty: USA 2005

  The poorest 12.6% (below Federal poverty line):-
            •80% have air conditioning
            •78% have a VCR or DVD player
            •73% own a car or truck
            •31% own more than one car
            •55% have two or more TVs
            •36% have a dishwasher
            •36% have a computer
            •43% own their homes
            •10% in mobile homes
            • 6% over-crowded (>1 per room)
• Children’s protein intake: 100% above recommended
• Most vitamins & minerals: well over recommended
More equal countries are more generous foreign aid donors
Correlations & p-values: Index of Health & Social Problems

 Indicator            International data           US data
                      r         p-value      r           p-value
 Trust              -0.66        <0.01     -0.70         <0.01
 Life expectancy    -0.44         0.04     -0.45         <0.01
 Infant mortality   0.42          0.04     0.43          <0.01
 Obesity            0.57         <0.01     0.47          <0.01
 Mental illness     0.73         <0.01     0.18              0.12
 Education score    -0.45         0.04     -0.47             .01
 Teen birth rate    0.73         <0.01     0.46          <0.01
 Homicides          0.47          0.02     0.42          <0.01
 Imprisonment       0.75         <0.01     0.48          <0.01
 Social mobility    0.93         <0.01       -                -
 Index              0.87         <0.01     0.59          <0.01
Additional Correlations Coefficients & p-values
Indicator                        International data            US data
                                  r          p-value     r          p-value
Drugs index                     0.63          <0.01
Pugnacity                                              0.47          <0.01
Recycling                       -0.82         <0.01
Spending on foreign aid         -0.61         <0.01
Peace index                     -0.51          0.01
Women’s status                  -0.44          0.04    -0.30             0.03
Child well-being                -0.71         <0.01    -0.51         <0.01
Overweight children             0.59           0.01    0.57          <0.01
Child mental illlness                                  0.36              0.01
Juvenile homicides                                     0.29          <0.05
Child conflict                  0.62          <0.01
High school drop-outs                                  0.79          <0.01
Public expend. health care      -0.54          0.01
Social expenditure              -0.45          0.04
Police                          0.52           0.04
Robert Sapolsky, A primate’s memoir.


                 Fights (trials of strength?
                 social comparisons?)
                 tend to be between near
                 neighbours in the ranking
                 system, so number 7 will
                 tend to conflict with 6
                 and 8 – not with
                 numbers 1 or 20.
Causality?

• Problems move          • Reverse causality?
  together - a common
  cause?                   political ideology affects
                           inequality, but social
                           problems are unintended
• Bigger status            consequences
  differences increase
  problems related to
  social status?         • Many of the causal
                           pathways are known
Review of 168 analyses of the relation
          between income inequality and health.


      100                               Wholly Supportive
       90                               Unsupportive
       80
Percent


       70
       60
       50
       40
       30
       20
       10
        0
             Nations       States,     Small areas
                          Regions,
                           Cities
Wilkinson RG, Pickett KE. Income inequality and health: a review
and explanation of the evidence. Social Science and Medicine
2006; 62: 1768-84.
Improvements in health and reductions in
 social problems if the UK were as equal as
    Japan, Sweden, Finland and Norway
Health or Social            Current data for   If inequality were
Indicator                   London             halved…
Life expectancy (years)     80.1               80.9 +

Infant mortality per 1000   4.9                4.0

Obesity (%)                 18.3               9.0

Mental illness (%)          17.9               5.6

Teenage births per 1000     27.8               7.5

Homicides per million       22.4               11.5

Trust (% who trust          23.0               42.6 +
others)
Inst ph ireland short
Life Expectancy is Longer in More Equal Rich Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)       www.equalitytrust.org.uk
Social Mobility is Higher in More Equal Rich Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)          www.equalitytrust.org.uk
More Equal Countries Rank Better (1 is best) on Recycling




Source: Wilkinson & Pickett, The Spirit Level (2009)       www.equalitytrust.org.uk
Levels of Trust are Higher in More Equal US States




Source: Wilkinson & Pickett, The Spirit Level (2009)          www.equalitytrust.org.uk
More Children Drop Out of High School in More Unequal US States




Source: Wilkinson & Pickett, The Spirit Level (2009)   www.equalitytrust.org.uk
Teen Pregnancy Rates are Higher in More Unequal US States




Source: Wilkinson & Pickett, The Spirit Level (2009)    www.equalitytrust.org.uk
Children Experience More Conflict in More Unequal Societies




                      11, 13 & 15 yr olds fighting, bullying, and finding peers not kind & helpful

Source: Wilkinson & Pickett, The Spirit Level (2009)                                     www.equalitytrust.org.uk
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
Rising gap between rich and poor, relative to 1975




                                                                      0.8
                                                                                               1.2
                                                                                                           1.4
                                                                                                                           1.6




                                                                                       1
                                                              19
                                                                75
                                                              19
                                                                76
                                                              19
                                                                77
                                                              19
                                                                78
                                                              19
                                                                79
                                                              19
                                                                80
                                                              19
                                                                81
                                                              19
                                                                82
                                                              19
                                                                83




                                                                            Thatcher
                                                              19
                                                                84
                                                              19
                                                                85
                                                              19
                                                                86




     Source: Wilkinson & Pickett, The Spirit Level (2009)
                                                              19
                                                                87
                                                              19
                                                                88
                                                              19
                                                                89
                                                              19
                                                                90
                                                              19
                                                                91
                                                              19
                                                                9
                                                            19 2
                                                              93
                                                                 -4
                                                            19
                                                                            Major


                                                              94
                                                                 -5
                                                            19
                                                              95
                                                                 -
                                                            19 6
                                                              96
                                                                 -7
                                                            19
                                                              97
                                                                 -8
                                                            19
                                                              98
                                                                 -
                                                            19 9
                                                              99
                                                                 -0
                                                            20
                                                              00
                                                                 -1
                                                            20
                                                              01
                                                                 -
                                                            20 2
                                                              02
                                                                            Blair




                                                                 -3
                                                            20
                                                              03
                                                                 -4
                                                            20
                                                              04
                                                                 -
www.equalitytrust.org.uk




                                                            20 5
                                                              05
                                                                                                                                 Trends in UK income inequality 1979-2005/6




                                                                 -6
Rising gap between rich and poor, relative to 1975




                                                                    0.8
                                                                                    1
                                                                                            1.2
                                                                                                         1.4
                                                                                                                         1.6
                                                            19
                                                              75
                                                            19
                                                               76




                                                                          Ford
                                                            19
                                                               77
                                                            19
                                                               78
                                                            19
                                                               79
                                                            19




                                                                          Carter
                                                              80
                                                            19
                                                               81
                                                            19
                                                               82
                                                            19
                                                              83
                                                            19
                                                               84
                                                            19
                                                               85
                                                            19




     Source: Wilkinson & Pickett, The Spirit Level (2009)
                                                               86




                                                                          Reagan
                                                            19
                                                               87
                                                            19
                                                              88
                                                            19
                                                               89
                                                            19
                                                               90
                                                            19
                                                              91
                                                                          Bush
                                                            19
                                                               92
                                                            19
                                                               93
                                                            19
                                                               94
                                                            19
                                                               95
                                                            19
                                                               96
                                                            19
                                                               97
                                                                          Clinton




                                                            19
                                                              98
                                                            19
                                                               99
                                                            20
                                                               00
                                                            20
                                                              01
                                                            20
                                                               02
                                                            20
                                                               03
                                                                                                                               Trends in US income inequality 1975-2005




                                                                          Bush




www.equalitytrust.org.uk




                                                            20
                                                               04
Health and Social Problems are Worse in More Unequal US
                                     States




Source: Wilkinson & Pickett, The Spirit Level (2009)    www.equalitytrust.org.uk
Health & Social Problems are Only Weakly Related to
                              Average Income in US States




Source: Wilkinson & Pickett, The Spirit Level (2009)        www.equalitytrust.org.uk
Child wellbeing and income inequality in US States




       Kids Count 10 Item Index of Child Wellbeing
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
Inst ph ireland short
Dropping out of high school & inequality




Source: Wilkinson & Pickett, The Spirit Level (2009)
Educational Scores are Higher in More Equal Rich
                                     Countries




Source: Wilkinson & Pickett, The Spirit Level (2009)        www.equalitytrust.org.uk
Source: Wilkinson & Pickett, The Spirit Level (2009)
Self-reported prevalence of illness by education

50 %
40                                                England USA
30
20
10
 0   Low         High   Low     High    Low      High   Low         High     Low         High
                                                                                                England




           Diabetes      Hypertension         Cancer          Lung disease         Heart disease


              Source: Banks et al. JAMA 2006; 295: 2037-2045
Distribution of household income (US 1990) and
         Relative risk of dying at each level of income




Wolfson M, Kaplan G, Lynch J, Ross N, Backlund E. BMJ; 1999. 319:953-955
Social status affect brain chemistry and behaviour in monkeys



                                                                    •   Living in social groups
                                                                        increased “happy” brain
                                                                        chemicals in dominant
                                                                        monkeys but produced
                                                                        no change in subordinate
                                                                        monkeys.

                                                                    •   These neurobiological
                                                                        changes had an important
                                                                        behavioural
                                                                        influence

                                                                    •   When given access to
                                                                        cocaine, dominant monkeys
                                                                        took less than subordinates



Source: Morgan, D et al. Nature Neuroscience 2002; 5(2), 169-174.
Recycling and Inequality




Source: Wilkinson & Pickett, The Spirit Level (2009)
Index of Health and Social Problems and inequality among
                                    US states




Source: Wilkinson & Pickett, The Spirit Level (2009)
Index of Health & Social Problems and average income
                                      in US states




Source: Wilkinson & Pickett, The Spirit Level (2009)
What kind of stress most reliably raises cortisol levels?




                                                                        ACTH

                                                                        Cortisol
                      Effect size




                                       Tasks with both                Other tasks
                                       social-evaluative
                                          threat and
                                        uncontrollability




Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 130(3): 355-91

More Related Content

Viewers also liked

East Sussex Health & Social Inequalities
East Sussex Health & Social InequalitiesEast Sussex Health & Social Inequalities
East Sussex Health & Social InequalitiesGavin Barker
 
Inequality In Health Care
Inequality In Health CareInequality In Health Care
Inequality In Health Carehollyabney
 
HeLa: Structural violence
HeLa: Structural violenceHeLa: Structural violence
HeLa: Structural violenceKacee Garner
 
The Spirit Level - slides from The Equality Trust
The Spirit Level - slides from The Equality TrustThe Spirit Level - slides from The Equality Trust
The Spirit Level - slides from The Equality TrustThe Equality Trust
 
Social Inequality Essay
Social Inequality EssaySocial Inequality Essay
Social Inequality EssayIndia Simmons
 
Peace education
Peace educationPeace education
Peace educationErwin Ted
 
Theories of peace and conflict and their relationship
Theories of peace and conflict and their relationshipTheories of peace and conflict and their relationship
Theories of peace and conflict and their relationshipCamila Araújo
 
Inequality, social inequality and gender inequality: where is the women's pos...
Inequality, social inequality and gender inequality: where is the women's pos...Inequality, social inequality and gender inequality: where is the women's pos...
Inequality, social inequality and gender inequality: where is the women's pos...Zakiul Alam
 
Sociology Unit 5 Social Inequality
Sociology Unit 5 Social InequalitySociology Unit 5 Social Inequality
Sociology Unit 5 Social InequalityMrTimBradley
 

Viewers also liked (14)

East Sussex Health & Social Inequalities
East Sussex Health & Social InequalitiesEast Sussex Health & Social Inequalities
East Sussex Health & Social Inequalities
 
Inequality In Health Care
Inequality In Health CareInequality In Health Care
Inequality In Health Care
 
HeLa: Structural violence
HeLa: Structural violenceHeLa: Structural violence
HeLa: Structural violence
 
The Spirit Level - slides from The Equality Trust
The Spirit Level - slides from The Equality TrustThe Spirit Level - slides from The Equality Trust
The Spirit Level - slides from The Equality Trust
 
Social Inequality Essay
Social Inequality EssaySocial Inequality Essay
Social Inequality Essay
 
Structural violence -
Structural violence - Structural violence -
Structural violence -
 
Social inequality
Social inequality Social inequality
Social inequality
 
Peace education
Peace educationPeace education
Peace education
 
Theories of peace and conflict and their relationship
Theories of peace and conflict and their relationshipTheories of peace and conflict and their relationship
Theories of peace and conflict and their relationship
 
Inequality, social inequality and gender inequality: where is the women's pos...
Inequality, social inequality and gender inequality: where is the women's pos...Inequality, social inequality and gender inequality: where is the women's pos...
Inequality, social inequality and gender inequality: where is the women's pos...
 
Sociology Unit 5 Social Inequality
Sociology Unit 5 Social InequalitySociology Unit 5 Social Inequality
Sociology Unit 5 Social Inequality
 
Inequality
InequalityInequality
Inequality
 
Social Inequality
Social  InequalitySocial  Inequality
Social Inequality
 
Peace Education
Peace EducationPeace Education
Peace Education
 

More from Socialist Health Association

Health and well being seen from the ground march 13
Health and well being seen from the ground march 13Health and well being seen from the ground march 13
Health and well being seen from the ground march 13Socialist Health Association
 
Health and well being seen from the ground march 13
Health and well being seen from the ground march 13Health and well being seen from the ground march 13
Health and well being seen from the ground march 13Socialist Health Association
 
How can our Labour government’s health inequalities targets become achievable?
How can our Labour government’s  health inequalities targets become achievable?How can our Labour government’s  health inequalities targets become achievable?
How can our Labour government’s health inequalities targets become achievable?Socialist Health Association
 
Sha spa seminar york local authority and nhs integration 121012
Sha spa seminar york local authority and nhs integration 121012Sha spa seminar york local authority and nhs integration 121012
Sha spa seminar york local authority and nhs integration 121012Socialist Health Association
 
Community development, transformation and deprived communities
Community development, transformation and deprived communitiesCommunity development, transformation and deprived communities
Community development, transformation and deprived communitiesSocialist Health Association
 
Community development, transformation and deprived communities
Community development, transformation and deprived communitiesCommunity development, transformation and deprived communities
Community development, transformation and deprived communitiesSocialist Health Association
 

More from Socialist Health Association (20)

NHS Diagrams
NHS DiagramsNHS Diagrams
NHS Diagrams
 
Nhsplc
NhsplcNhsplc
Nhsplc
 
Health and well being seen from the ground march 13
Health and well being seen from the ground march 13Health and well being seen from the ground march 13
Health and well being seen from the ground march 13
 
Health and well being seen from the ground march 13
Health and well being seen from the ground march 13Health and well being seen from the ground march 13
Health and well being seen from the ground march 13
 
Community Development and Health
Community Development and HealthCommunity Development and Health
Community Development and Health
 
Nhs diagrams
Nhs diagramsNhs diagrams
Nhs diagrams
 
How can our Labour government’s health inequalities targets become achievable?
How can our Labour government’s  health inequalities targets become achievable?How can our Labour government’s  health inequalities targets become achievable?
How can our Labour government’s health inequalities targets become achievable?
 
25 years after the Black report
25 years after the Black report25 years after the Black report
25 years after the Black report
 
2011 survey article_chartpack
2011 survey article_chartpack2011 survey article_chartpack
2011 survey article_chartpack
 
Integration hsca 2012
Integration hsca 2012Integration hsca 2012
Integration hsca 2012
 
Integration presentation spa sha oct 2012 cameron
Integration presentation spa sha oct 2012 cameronIntegration presentation spa sha oct 2012 cameron
Integration presentation spa sha oct 2012 cameron
 
York integration seminar [5.4.12] (c brand et al)
York integration seminar [5.4.12] (c brand et al)York integration seminar [5.4.12] (c brand et al)
York integration seminar [5.4.12] (c brand et al)
 
Sha spa seminar york local authority and nhs integration 121012
Sha spa seminar york local authority and nhs integration 121012Sha spa seminar york local authority and nhs integration 121012
Sha spa seminar york local authority and nhs integration 121012
 
Community development, transformation and deprived communities
Community development, transformation and deprived communitiesCommunity development, transformation and deprived communities
Community development, transformation and deprived communities
 
Community development, transformation and deprived communities
Community development, transformation and deprived communitiesCommunity development, transformation and deprived communities
Community development, transformation and deprived communities
 
Disparaties in access sha
Disparaties in access shaDisparaties in access sha
Disparaties in access sha
 
Sha sustrans presentation final
Sha sustrans presentation finalSha sustrans presentation final
Sha sustrans presentation final
 
Groningen 2006 12 mar07
Groningen 2006 12 mar07Groningen 2006 12 mar07
Groningen 2006 12 mar07
 
Groningen2006
Groningen2006Groningen2006
Groningen2006
 
Reintroductioncompetition
ReintroductioncompetitionReintroductioncompetition
Reintroductioncompetition
 

Recently uploaded

Hungarys economy made by Robert Miklos
Hungarys economy   made by Robert MiklosHungarys economy   made by Robert Miklos
Hungarys economy made by Robert Miklosbeduinpower135
 
RWA Report 2024: Rise of Real-World Assets in Crypto | CoinGecko
RWA Report 2024: Rise of Real-World Assets in Crypto | CoinGeckoRWA Report 2024: Rise of Real-World Assets in Crypto | CoinGecko
RWA Report 2024: Rise of Real-World Assets in Crypto | CoinGeckoCoinGecko
 
India Economic Survey Complete for the year of 2022 to 2023
India Economic Survey Complete for the year of 2022 to 2023India Economic Survey Complete for the year of 2022 to 2023
India Economic Survey Complete for the year of 2022 to 2023SkillCircle
 
Monthly Market Risk Update: March 2024 [SlideShare]
Monthly Market Risk Update: March 2024 [SlideShare]Monthly Market Risk Update: March 2024 [SlideShare]
Monthly Market Risk Update: March 2024 [SlideShare]Commonwealth
 
Sarlat Advisory - Corporate Brochure - 2024
Sarlat Advisory - Corporate Brochure - 2024Sarlat Advisory - Corporate Brochure - 2024
Sarlat Advisory - Corporate Brochure - 2024Guillaume Ⓥ Sarlat
 
20240315 _E-Invoicing Digiteal. .pptx
20240315 _E-Invoicing Digiteal.    .pptx20240315 _E-Invoicing Digiteal.    .pptx
20240315 _E-Invoicing Digiteal. .pptxFinTech Belgium
 
Contracts with Interdependent Preferences
Contracts with Interdependent PreferencesContracts with Interdependent Preferences
Contracts with Interdependent PreferencesGRAPE
 
Work and Pensions report into UK corporate DB funding
Work and Pensions report into UK corporate DB fundingWork and Pensions report into UK corporate DB funding
Work and Pensions report into UK corporate DB fundingHenry Tapper
 
Mphasis - Schwab Newsletter PDF - Sample 8707
Mphasis - Schwab Newsletter PDF - Sample 8707Mphasis - Schwab Newsletter PDF - Sample 8707
Mphasis - Schwab Newsletter PDF - Sample 8707harshan90
 
2024.03 Strategic Resources Presentation
2024.03 Strategic Resources Presentation2024.03 Strategic Resources Presentation
2024.03 Strategic Resources PresentationAdnet Communications
 
LIC PRIVATISATION its a bane or boon.pptx
LIC PRIVATISATION its a bane or boon.pptxLIC PRIVATISATION its a bane or boon.pptx
LIC PRIVATISATION its a bane or boon.pptxsonamyadav7097
 
Stock Market Brief Deck for March 19 2024.pdf
Stock Market Brief Deck for March 19 2024.pdfStock Market Brief Deck for March 19 2024.pdf
Stock Market Brief Deck for March 19 2024.pdfMichael Silva
 
What Key Factors Should Risk Officers Consider When Using Generative AI
What Key Factors Should Risk Officers Consider When Using Generative AIWhat Key Factors Should Risk Officers Consider When Using Generative AI
What Key Factors Should Risk Officers Consider When Using Generative AI360factors
 
Lundin Gold March 2024 Corporate Presentation - PDAC v1.pdf
Lundin Gold March 2024 Corporate Presentation - PDAC v1.pdfLundin Gold March 2024 Corporate Presentation - PDAC v1.pdf
Lundin Gold March 2024 Corporate Presentation - PDAC v1.pdfAdnet Communications
 
The Power Laws of Bitcoin: How can an S-curve be a power law?
The Power Laws of Bitcoin: How can an S-curve be a power law?The Power Laws of Bitcoin: How can an S-curve be a power law?
The Power Laws of Bitcoin: How can an S-curve be a power law?Stephen Perrenod
 
Stock Market Brief Deck for 3/22/2024.pdf
Stock Market Brief Deck for 3/22/2024.pdfStock Market Brief Deck for 3/22/2024.pdf
Stock Market Brief Deck for 3/22/2024.pdfMichael Silva
 

Recently uploaded (20)

New Monthly Enterprises Survey. Issue 21. (01.2024) Ukrainian Business in War...
New Monthly Enterprises Survey. Issue 21. (01.2024) Ukrainian Business in War...New Monthly Enterprises Survey. Issue 21. (01.2024) Ukrainian Business in War...
New Monthly Enterprises Survey. Issue 21. (01.2024) Ukrainian Business in War...
 
Hungarys economy made by Robert Miklos
Hungarys economy   made by Robert MiklosHungarys economy   made by Robert Miklos
Hungarys economy made by Robert Miklos
 
Commercial Bank Economic Capsule - March 2024
Commercial Bank Economic Capsule - March 2024Commercial Bank Economic Capsule - March 2024
Commercial Bank Economic Capsule - March 2024
 
RWA Report 2024: Rise of Real-World Assets in Crypto | CoinGecko
RWA Report 2024: Rise of Real-World Assets in Crypto | CoinGeckoRWA Report 2024: Rise of Real-World Assets in Crypto | CoinGecko
RWA Report 2024: Rise of Real-World Assets in Crypto | CoinGecko
 
India Economic Survey Complete for the year of 2022 to 2023
India Economic Survey Complete for the year of 2022 to 2023India Economic Survey Complete for the year of 2022 to 2023
India Economic Survey Complete for the year of 2022 to 2023
 
Monthly Market Risk Update: March 2024 [SlideShare]
Monthly Market Risk Update: March 2024 [SlideShare]Monthly Market Risk Update: March 2024 [SlideShare]
Monthly Market Risk Update: March 2024 [SlideShare]
 
Sarlat Advisory - Corporate Brochure - 2024
Sarlat Advisory - Corporate Brochure - 2024Sarlat Advisory - Corporate Brochure - 2024
Sarlat Advisory - Corporate Brochure - 2024
 
20240315 _E-Invoicing Digiteal. .pptx
20240315 _E-Invoicing Digiteal.    .pptx20240315 _E-Invoicing Digiteal.    .pptx
20240315 _E-Invoicing Digiteal. .pptx
 
Contracts with Interdependent Preferences
Contracts with Interdependent PreferencesContracts with Interdependent Preferences
Contracts with Interdependent Preferences
 
Work and Pensions report into UK corporate DB funding
Work and Pensions report into UK corporate DB fundingWork and Pensions report into UK corporate DB funding
Work and Pensions report into UK corporate DB funding
 
Mphasis - Schwab Newsletter PDF - Sample 8707
Mphasis - Schwab Newsletter PDF - Sample 8707Mphasis - Schwab Newsletter PDF - Sample 8707
Mphasis - Schwab Newsletter PDF - Sample 8707
 
2024.03 Strategic Resources Presentation
2024.03 Strategic Resources Presentation2024.03 Strategic Resources Presentation
2024.03 Strategic Resources Presentation
 
LIC PRIVATISATION its a bane or boon.pptx
LIC PRIVATISATION its a bane or boon.pptxLIC PRIVATISATION its a bane or boon.pptx
LIC PRIVATISATION its a bane or boon.pptx
 
Stock Market Brief Deck for March 19 2024.pdf
Stock Market Brief Deck for March 19 2024.pdfStock Market Brief Deck for March 19 2024.pdf
Stock Market Brief Deck for March 19 2024.pdf
 
What Key Factors Should Risk Officers Consider When Using Generative AI
What Key Factors Should Risk Officers Consider When Using Generative AIWhat Key Factors Should Risk Officers Consider When Using Generative AI
What Key Factors Should Risk Officers Consider When Using Generative AI
 
Monthly Economic Monitoring of Ukraine No.230, March 2024
Monthly Economic Monitoring of Ukraine No.230, March 2024Monthly Economic Monitoring of Ukraine No.230, March 2024
Monthly Economic Monitoring of Ukraine No.230, March 2024
 
Lundin Gold March 2024 Corporate Presentation - PDAC v1.pdf
Lundin Gold March 2024 Corporate Presentation - PDAC v1.pdfLundin Gold March 2024 Corporate Presentation - PDAC v1.pdf
Lundin Gold March 2024 Corporate Presentation - PDAC v1.pdf
 
The Power Laws of Bitcoin: How can an S-curve be a power law?
The Power Laws of Bitcoin: How can an S-curve be a power law?The Power Laws of Bitcoin: How can an S-curve be a power law?
The Power Laws of Bitcoin: How can an S-curve be a power law?
 
Stock Market Brief Deck for 3/22/2024.pdf
Stock Market Brief Deck for 3/22/2024.pdfStock Market Brief Deck for 3/22/2024.pdf
Stock Market Brief Deck for 3/22/2024.pdf
 
Effects & Policies Of Bank Consolidation
Effects & Policies Of Bank ConsolidationEffects & Policies Of Bank Consolidation
Effects & Policies Of Bank Consolidation
 

Inst ph ireland short

  • 1. Inequality: the enemy between us Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham & Kate Pickett Senior Lecturer in Epidemiology University of York http://www.equalitytrust.org.uk
  • 2. Income per head and life-expectancy: rich & poor countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 3. Health is related to income differences within rich societies but not to those between them Between (rich) societies Within societies 80 79 78 77 Life expectancy (years) 76 75 74 73 72 71 70 ed riv ep Most td as deprived Le Electoral wards in England & Wales ranked by deprivation score Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 4. How much richer are the richest 20% than the poorest 20%? Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 6. Health and Social Problems are Worse in More Unequal 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
  • 7. 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
  • 8. Child Well-being is Better in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 9. Child-Wellbeing is Unrelated to Average Incomes in Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 10. Levels of Trust are Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009)
  • 11. The Prevalence of Mental Illness is Higher in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 12. Drug Use is More Common in More Unequal Countries Index of use of: opiates, cocaine, cannabis, ecstasy, amphetamines Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 13. Infant Mortality Rates are Higher in More Unequal Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 14. More Adults are Obese in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 15. Teenage Birth Rates are Higher in More Unequal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 16. Homicide and income inequality: US States and Canadian Provinces 180 150 Homicides per million people 120 90 60 30 0 0.35 0.38 0.41 0.44 0.47 More equal Income Inequality (Gini) 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.
  • 17. Rates of Imprisonment are Higher in More Unequal Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 18. Almost everyone benefits from greater equality. Usually the benefits are greatest among the poor but extend to the majority of the population
  • 19. Infant Mortality by Social Class: Sweden and England & Wales 18 E& W 16 Sweden Infant Mortality rate 14 12 10 8 6 4 2 0 I II IIIN IIIM IV V Single Unclass. Prnt Source: Leon DA, Vagero D, Olausson PO. BMJ 1992; 305; 687-91
  • 20. Literacy Scores of 16-25 year olds by 1 Parents' Education 0.5 Sweden Literacy score 0 Canada -0.5 -1 United States -1.5 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Parents' Education (years) Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
  • 21. Health and Social Problems are Worse in More Unequal 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
  • 22. Why are we so sensitive to inequality?
  • 23. Psychosocial risk factors for ill health  Low social status  Weak social affiliations  Stress in early life (pre- and postnatally)
  • 24. 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) "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
  • 25. 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
  • 26. Stereotype Threat The effect of caste on children's performance 6 High Caste 5 Number of mazes solved Low Caste 4 3 2 1 0 Caste Caste Unannounced Announced Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004
  • 27. Inequality affects us in two stages 1. Adult experience of inequality 2. Passed on to children (epigenetics?)
  • 28. Working hours are longer in more unequal countries Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005.
  • 29. Overdeveloped countries? High life expectancy can be achieved with low CO2 emissions www.equalitytrust.org.uk
  • 30. “Growth is a substitute for equality of income. So long as there is growth, (people feel) there is hope, and that makes large income differences tolerable.” Henry Wallich, a former governor of America’s Federal Reserve Bank and later professor of economics at Yale.
  • 31. In more equal countries business leaders give a higher priority to complying with international environmental agreements With permission from R De Vogli & D Gimeno
  • 32. More equal countries recycle a higher proportion of waste materials
  • 33. More equal societies are more innovative www.equalitytrust.org.uk
  • 34. 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.
  • 36. For more information: a book … … and a website http://www.equalitytrust.org.uk
  • 42. How does your pay compare with an MP?
  • 43. The L-Curve: A graph of US income distribution by David Chandler http://www.lcurve.org
  • 44. The L-Curve: A graph of US income distribution by David Chandler http://www.lcurve.org
  • 45. The L-Curve: A graph of US income distribution by David Chandler http://www.lcurve.org
  • 46. The L-Curve: A graph of US income distribution by David Chandler http://www.lcurve.org
  • 47. The L-Curve: A graph of US income distribution by David Chandler http://www.lcurve.org
  • 48. Sources of data for the Index of Health and Social problems Component International data US state data Trust Percent of people who respond positively to the statement Percent of people who respond positively to the statement “most “most people can be trusted” people can be trusted” 1999-2001 1999 World Values Survey Reverse-coded General Social Survey Reverse-coded Life expectancy Life expectancy at birth for men and women Life expectancy at birth for men and women 2004 2000 United Nations Human Development Report Reverse-coded US Census Bureau, Population Division Reverse-coded Infant mortality Deaths in the first year of life per 1000 live births Deaths in the first year of life per 1000 live births 2000 2002 World Bank US National Center for Health Statistics Obesity Percentage of the population with BMI > 30, averaged for men Percentage of the population with BMI > 30, averaged for men and and women women, 1999-2002 2002 Estimates from Prof Ezzati, Harvard University, based on NHANES International Obesity TaskForce and BRFSS surveys Mental health Prevalence of mental illness Average number of days in past month when mental health was not 2001-2003 good WHO 1993-2001, BRFSS Education Combined average of maths literacy and reading literacy Combined average of maths and reading scores for 8 graders th scores of 15-year olds 2003 2000 US Department of Education, National Center for Education OECD PISA Reverse-coded Statistics Reverse coded Teenage birth rate Births per 1000 women aged 15-19 years Births per 1000 women aged 15-19 years 1998 2000 UNICEF US National Vital Statistics Homicides Homicide rate per 100,000 Homicide rate per 100,000 Period average for 1990-2000 1999 United Nations FBI Imprisonment Log of prisoners per 100,000 Prisoners per 100,000 United Nations 1997-8, US Department of Justice Social mobility Correlation between father and son’s income N/A 30-year period data from 8 cohort studies London School of Economics
  • 49. Institutional change? • Transforming the social environment – people feeling valued • Economic democracy – from companies as pieces of property to communities • Other successful institutional structures • An ethical consumer movement - supporting other forms of ownership & control
  • 50. Health and social problems which are substantially worse in more unequal societies Data available for countries and for states of the USA:- • Low birth weight • Mental illness • Infant mortality • Imprisonment rates • Life expectancy • Teenage birth rates • Obesity • Maths & literacy scores • Homicides • Trust • Drug abuse • Social capital International data: • Social Mobility US states data: • High school drop-out rate • Hours worked • Child conflict • UNICEF Child well-being Index [Smoking and suicide are the only counter examples we have found]
  • 51. Living conditions & Poverty: USA 2005 The poorest 12.6% (below Federal poverty line):- •80% have air conditioning •78% have a VCR or DVD player •73% own a car or truck •31% own more than one car •55% have two or more TVs •36% have a dishwasher •36% have a computer •43% own their homes •10% in mobile homes • 6% over-crowded (>1 per room) • Children’s protein intake: 100% above recommended • Most vitamins & minerals: well over recommended
  • 52. More equal countries are more generous foreign aid donors
  • 53. Correlations & p-values: Index of Health & Social Problems Indicator International data US data r p-value r p-value Trust -0.66 <0.01 -0.70 <0.01 Life expectancy -0.44 0.04 -0.45 <0.01 Infant mortality 0.42 0.04 0.43 <0.01 Obesity 0.57 <0.01 0.47 <0.01 Mental illness 0.73 <0.01 0.18 0.12 Education score -0.45 0.04 -0.47 .01 Teen birth rate 0.73 <0.01 0.46 <0.01 Homicides 0.47 0.02 0.42 <0.01 Imprisonment 0.75 <0.01 0.48 <0.01 Social mobility 0.93 <0.01 - - Index 0.87 <0.01 0.59 <0.01
  • 54. Additional Correlations Coefficients & p-values Indicator International data US data r p-value r p-value Drugs index 0.63 <0.01 Pugnacity 0.47 <0.01 Recycling -0.82 <0.01 Spending on foreign aid -0.61 <0.01 Peace index -0.51 0.01 Women’s status -0.44 0.04 -0.30 0.03 Child well-being -0.71 <0.01 -0.51 <0.01 Overweight children 0.59 0.01 0.57 <0.01 Child mental illlness 0.36 0.01 Juvenile homicides 0.29 <0.05 Child conflict 0.62 <0.01 High school drop-outs 0.79 <0.01 Public expend. health care -0.54 0.01 Social expenditure -0.45 0.04 Police 0.52 0.04
  • 55. Robert Sapolsky, A primate’s memoir. Fights (trials of strength? social comparisons?) tend to be between near neighbours in the ranking system, so number 7 will tend to conflict with 6 and 8 – not with numbers 1 or 20.
  • 56. Causality? • Problems move • Reverse causality? together - a common cause? political ideology affects inequality, but social problems are unintended • Bigger status consequences differences increase problems related to social status? • Many of the causal pathways are known
  • 57. Review of 168 analyses of the relation between income inequality and health. 100 Wholly Supportive 90 Unsupportive 80 Percent 70 60 50 40 30 20 10 0 Nations States, Small areas Regions, Cities Wilkinson RG, Pickett KE. Income inequality and health: a review and explanation of the evidence. Social Science and Medicine 2006; 62: 1768-84.
  • 58. Improvements in health and reductions in social problems if the UK were as equal as Japan, Sweden, Finland and Norway Health or Social Current data for If inequality were Indicator London halved… Life expectancy (years) 80.1 80.9 + Infant mortality per 1000 4.9 4.0 Obesity (%) 18.3 9.0 Mental illness (%) 17.9 5.6 Teenage births per 1000 27.8 7.5 Homicides per million 22.4 11.5 Trust (% who trust 23.0 42.6 + others)
  • 60. Life Expectancy is Longer in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 61. Social Mobility is Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 62. More Equal Countries Rank Better (1 is best) on Recycling Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 63. Levels of Trust are Higher in More Equal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 64. More Children Drop Out of High School in More Unequal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 65. Teen Pregnancy Rates are Higher in More Unequal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 66. Children Experience More Conflict in More Unequal Societies 11, 13 & 15 yr olds fighting, bullying, and finding peers not kind & helpful Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 67. 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
  • 68. Rising gap between rich and poor, relative to 1975 0.8 1.2 1.4 1.6 1 19 75 19 76 19 77 19 78 19 79 19 80 19 81 19 82 19 83 Thatcher 19 84 19 85 19 86 Source: Wilkinson & Pickett, The Spirit Level (2009) 19 87 19 88 19 89 19 90 19 91 19 9 19 2 93 -4 19 Major 94 -5 19 95 - 19 6 96 -7 19 97 -8 19 98 - 19 9 99 -0 20 00 -1 20 01 - 20 2 02 Blair -3 20 03 -4 20 04 - www.equalitytrust.org.uk 20 5 05 Trends in UK income inequality 1979-2005/6 -6
  • 69. Rising gap between rich and poor, relative to 1975 0.8 1 1.2 1.4 1.6 19 75 19 76 Ford 19 77 19 78 19 79 19 Carter 80 19 81 19 82 19 83 19 84 19 85 19 Source: Wilkinson & Pickett, The Spirit Level (2009) 86 Reagan 19 87 19 88 19 89 19 90 19 91 Bush 19 92 19 93 19 94 19 95 19 96 19 97 Clinton 19 98 19 99 20 00 20 01 20 02 20 03 Trends in US income inequality 1975-2005 Bush www.equalitytrust.org.uk 20 04
  • 70. Health and Social Problems are Worse in More Unequal US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 71. Health & Social Problems are Only Weakly Related to Average Income in US States Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 72. Child wellbeing and income inequality in US States Kids Count 10 Item Index of Child Wellbeing
  • 73. 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
  • 75. Dropping out of high school & inequality Source: Wilkinson & Pickett, The Spirit Level (2009)
  • 76. Educational Scores are Higher in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
  • 77. Source: Wilkinson & Pickett, The Spirit Level (2009)
  • 78. Self-reported prevalence of illness by education 50 % 40 England USA 30 20 10 0 Low High Low High Low High Low High Low High England Diabetes Hypertension Cancer Lung disease Heart disease Source: Banks et al. JAMA 2006; 295: 2037-2045
  • 79. Distribution of household income (US 1990) and Relative risk of dying at each level of income Wolfson M, Kaplan G, Lynch J, Ross N, Backlund E. BMJ; 1999. 319:953-955
  • 80. Social status affect brain chemistry and behaviour in monkeys • Living in social groups increased “happy” brain chemicals in dominant monkeys but produced no change in subordinate monkeys. • These neurobiological changes had an important behavioural influence • When given access to cocaine, dominant monkeys took less than subordinates Source: Morgan, D et al. Nature Neuroscience 2002; 5(2), 169-174.
  • 81. Recycling and Inequality Source: Wilkinson & Pickett, The Spirit Level (2009)
  • 82. Index of Health and Social Problems and inequality among US states Source: Wilkinson & Pickett, The Spirit Level (2009)
  • 83. Index of Health & Social Problems and average income in US states Source: Wilkinson & Pickett, The Spirit Level (2009)
  • 84. What kind of stress most reliably raises cortisol levels? ACTH Cortisol Effect size Tasks with both Other tasks social-evaluative threat and uncontrollability Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 130(3): 355-91

Editor's Notes

  1. The public and policy response? more:- Police Doctors Social Workers Drug rehabilitation units Educational Psychologists But…services are expensive and only partially effective.
  2. Most important sources of chronic stress – relative risks and population attributable risk Pointer – underlying source of stress: Social anxiety Eyes of others Social Gateway
  3. 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)