Health and other inequalities - why should they matter to you?


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The kind of society we live in is said to effect who we are and what happens to us, helping even to determine how long on average we live. In this talk I'll make the case for the importance of inequalities and present some results comparing different countries. I'll talk quite a lot about health, but I think all these issues are closely connected. I'll end by mentioning racism and the theory that it is something akin to racism that divides us most deeply.

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Health and other inequalities - why should they matter to you?

  1. 1. Health and other inequalities - why should they matter to you?Danny Dorling Sheffield University 18/3/2013 Discover andUnderstand Lecture series, Monday morning.
  2. 2. Here is one way of presenting the top 25 countries’ Rich World Inequality LeagueRatio of the income of the best-off tenth to worse of tenth of households17.7 Singapore 15.9 US 15.0 Portugal 13.8 UK13.4 Israel 12.5 Australia 12.5 New Zealand 11.6 Italy10.3 Spain 10.2 Greece 9.4 Canada 9.4 Ireland9.2 Netherlands 9.1 France 9.0 Switzerland 8.2 Belgium8.1 Denmark 7.8 S. Korea 7.3 Slovenia 6.9 Austria6.9 Germany 6.2 Sweden 6.1 Norway 5.6 Finland4.5 Japan (countries in black are in Europe, 18 of the richest 25) The 25 richest countries in the world with a population of 1 million+Source, UNDP world development report 2009, not updated since then.
  3. 3. This is the most reliable leaguetable I can find on that shows justhow very different some affluentcountries are from others.The Netherlands is the country ofaverage inequality by thismeasure (or was). It is unusual inthat is richest 1% receive lessthan in similar countries.In general the more equitable acountry the more that people areconcerned about inequality andsuggest that child poverty is toohigh in their country.It may be more widespread lackof concern that allows inequalitiesto grow (Norway exemplifiesconcern, USA is the opposite).
  4. 4. Inequalities are everywhere – take within London
  5. 5. Social visualization is partly viewing the invisible sociallandscape, all kinds of things matter, the next slideconcerns how much we use cars as an example and theeffects that can have on our health…
  6. 6. In the 1970s different choices were made in each country of the rich world –some chose inequality (Graphs from the No-nonsense guide to equality, NI: 2012)
  7. 7. GDP, inequality, voting, health: THE UK (Graphs from: Injustice: why social inequality persists, 2011). GDP (10 year) The 1% (+ after tax) One measure of voting inequalities One measure of health inequalities
  8. 8. Somecountries are more equitable becauseequality wasforced upon them (Graphs from the No-nonsense guide to equality, NI: 2012)
  9. 9. Some countries still havean aristocracy (old and new)
  10. 10. And some, not too far away, and not too Scandinavian(or East Asian) are verydifferent to thePortugal & UK(Graphs from the No-nonsense guide to equality, NI: 2012)
  11. 11. People behave differently in regimes of differing inequality“In the UK, a parallel but more isolated push is evident in the coalition’s decision to use government debt problems as the thinnest of veils for raising university fees to the highest levels in the western world, removing direct state subsidies from most university teaching. Deliberately picking a ‘strategic’ fight with the weakest of the state-dependent ‘vested interests’ (in this case young people) is a classic ‘shock doctrine’ tactic. And Cameron, Clegg and Cable clearly appreciate that privatising university finances will have long-run implications. If the changeover sticks, it will inevitably create a future electorate in England where the same high personal debt burdens as in the US sustain a public opinion believing in ‘self-reliance’ and calling for the state’s share of GDP to be pushed down” Patrick Dunleavey page 6 of Political Insight Dunleavy, P. (2011). "The backlash against the State." Political Insight 2(1): 4-9.
  12. 12. Portugal looksgood on thismeasureNowatzki, N. R.(2012) WealthInequality andHealth: APoliticalEconomyPerspective,InternationalJournal ofHealthServices, 42, 3,403–424,
  13. 13. Inequality and health is most studiedThe Broad Street Pump, Safe &Sound, Penguin, 1971
  14. 14. Take a step back: The period 1851-1971was when the population explosion,which began earlier in Europe, globalised.For 40 yearswe have haddeceleration.
  15. 15. There are temporaryblips in long term patterns, such as inthe UK andRussia right now as inequalityand fertility rises.
  16. 16. suggestions – what’s so good about greater equality; 1: religion• Religions are very often tales of good triumphing over evil in times of great inequality. You probably know all of these tales, one of the oldest recorded is Zoroaster’s triumph over, amongst much else, obstacles imposed by the ruling class*. Many world religions began in times and places of greater inequality, always advocating more equality in one way or another (NNGE pages 88-92). * For a map of Zoroastrians see: http://
  17. 17. 2: creativity, patents, papers• There is a growing body of evidence suggesting that creativity is enhanced under conditions of greater equality. This ranges from work finding a strong correlation between high cultural activity in those European countries with higher equality to reports that Leonardo da Vinci’s artistry was encouraged by his working in an atmosphere of higher than usual equality fostered by his sponsors (NNGE pages 94-95).
  18. 18. 3. Scientists and footballers work and play- better and harder• Scientists today are at their most productive, publishing most academic papers, when they work in more equal countries such as in Sweden and Finland (NNGE page 124). Precisely why they are more creative is hard to judge, but it may well be linked to the same factors involved in recent suggestions that top football players are more successful in clubs that pay players more equally (Bucciol and Piovesan 2012), see
  19. 19. 4: The Structure of Society is stable under greater equality• Recently, in the USA, the average black family saw their assets fall in value to have recourse to as little as 19 times less wealth than the average white family. This is possibly the highest monetary inequality recorded in the United States at any time since slavery (NNGE page 111). There is evidence that the growth of housing bubble in the states was partly fuelled by rising inequality there. Poorer people tried harder to move nearer richer people (see Robert Frank’s work on “How Rising Inequality Harms the Middle Class”)
  20. 20. 5: The most fundamental aspects of our lives improve fasterGreater equality is not just possible. For many people in many parts of the world, rich and poor, it is a reality.Infant mortality falls fasters in times and places of greatest equality (from 42 to 40 per 1000 in the last year, possibly the fastest drop ever).Population growth slows most quickly when equality rises and consumption is lower per person (especially of food in rich countries).
  21. 21. 6: Greater equality is essential for non- coerced full employment • In unions like the UK or USA, where incomes are now so incredibly unevenly distributed, there is enough money to employ every young person, full-time, who is out of work under the age of 25 on living wages at least ten times over! The money is to be found in the extra incomes that the very richest 10% of the populations (in unions like these) have secured for themselves over the course of the last four decades. It is not that we don’t have enough money spent in the pay bill to employ everyone anymore – we just spend it badly.
  22. 22. 7: In countries of Greater equality you can walk to school• When inequalities are less the differences between groups living in different areas are less. Parents have less fear of the local schools. More children can go to their nearest school. More are friends with those who live near them. Less cars are driven (including to schools). There is better motherhood, fatherhood and more apple pie can be shared by all. These are all statements of principals and values few disagree with.But some people still argue: pavements=socialism!
  23. 23. Conclusions and more ideas• We need to better control a psychotic minority. We need new collective mechanisms of defence. We’ve reinvented these for centuries.• We need to recognise that most people can become less violent but still violence increases overall due to the (ideologically encouraged) actions of a few.• Our world is changing very quickly 1492, 1544, 1607, … , 1755, 1789, 1848, 1917, 1968… todayIt takes only 16 generations before my generation (generation ‘X’), to get back to when a new world was discovered and everything changed – don’t despair at our slow adaptation to rapidly changing circumstance.
  24. 24. The wealth of the11 million richest people on earth fell, not just in2008, but also in 2011. In the UK it fellfrom 1912 all the way through to1978. In 1912 no one recognised ‘peak wealth’.
  25. 25. The wider effects of the effects... of inequality (to end with)We are going to look at Meat consumption Water consumption Waste production Number of Flights Ecological impactin each of the most affluent countries. You might think: "Surely, if a few people hold most of the wealth we all consume less?"
  26. 26. Inequality and meatMeat consumption in kg per year per person USA Spain France Portugal Germany UK Japan Inequality Not if you are concerned about how much meat we farm and consume
  27. 27. Inequality and waterwater in m3 per year per person USA Spain Portugal France Germany UK Japan Inequality Not if you are concerned about how much water we use (apart from the UK!)
  28. 28. Inequality and waste 1100 SingaporeMunicipal waste collected (kg per capita per year) USA Spain Germany France UK Portugal Japan Inequality Not if you are concerned about how much waste we each produce
  29. 29. Inequality and flights New Zealand 60 Ireland Norwayannual aircraft departures per thousand Canada USA people UK Spain France Germany Portugal Japan Italy Inequality Not if you are concerned about how many flights we each take (on average)
  30. 30. Inequality and ecologyEcological footprint in global hectares per USA capita Spain UK Japan France Portugal Singapore Germany Inequality Not if you are concerned about how many planets we might need to exist: An Ecological Footprint of 2.1 global hectares per capita equals one-planet living
  31. 31. Data sourcesUNDP/FAO Bank World Development Indicators 2005 (IS.AIR.DPRT)WWF Living Planet Index 2008 More and more geographical data is becoming available, often for the first time.
  32. 32. Ecological FootprintThe map shows the ecological footprint (EF), a measure of the resources used per head in each country. A EF of 2.1 global hectares per capita equals one-planet living on the basis that everyone is entitled to thesame amount of the planet’s natural resources. - Source: New Economics Foundation, Happy Planet Index
  33. 33. Ecological FootprintWhen we draw the same map upon the world population cartogram it may not initially appear to be so bad. The countries that consume too much contain fewer people, so not such a problem? However...This map is misleading – we need to reproject the basemap again for a fair picture
  34. 34. Ecological Footprint Germany UK Japan USA France Spain If we reproject the globe again so that the area of each grid cell is drawn in proportion to the ecologicalimpact of the people who live in that area, then we see that most of the damage is being caused by the rich world and more of that (per capita) by the most unequal countries of the rich world (which China services).
  35. 35. Thank you ----------------