"ALL ANIMALS ARE EQUAL, BUT SOME ANIMALS ARE MORE EQUAL THAN OTHERS"
This book ("The spirit level" by R.Wilkinson and K.Pickett) charts the level of health and social problems — as many as the authors could find reliable figures for — against the level of income inequality in 20 of the world’s richest nations, and in each of the 50 United States. Richard Wilkinson and Kate Pickett allocate a brief chapter to each problem, supplying graphs that display the evidence starkly and unarguably. What they find is that, in states and countries where there is a big gap between the incomes of rich and poor, mental illness, drug and alcohol abuse, obesity and teenage pregnancy are more common, the homicide rate is higher, life expectancy is shorter, and children’s educational performance and literacy scores are worse. The Scandinavian countries and Japan consistently come at the positive end of this spectrum. They have the smallest differences between higher and lower incomes, and the best record of psycho-social health. The countries with the widest gulf between rich and poor, and the highest incidence of most health and social problems, are Britain, America and Portugal.
Richard Wilkinson, a professor of medical epidemiology at Nottingham University, and Kate Pickett, a lecturer in epidemiology at York University, emphasise that it is not only the poor who suffer from the effects of inequality, but the majority of the population. For example, rates of mental illness are five times higher across the whole population in the most unequal than in the least unequal societies in their survey. One explanation, they suggest, is that inequality increases stress right across society, not just among the least advantaged. Much research has been done on the stress hormone cortisol, which can be measured in saliva or blood, and it emerges that chronic stress affects the neural system and in turn the immune system. When stressed, we are more prone to depression and anxiety, and more likely to develop a host of bodily ills including heart disease, obesity, drug addiction, liability to infection and rapid ageing.
Societies where incomes are relatively equal have low levels of stress and high levels of trust, so that people feel secure and see others as co-operative. In unequal societies, by contrast, the rich suffer from fear of the poor, while those lower down the social order experience status anxiety, looking upon those who are more successful with bitterness and upon themselves with shame. In the 1980s and 1990s, when inequality was rapidly rising in Britain and America, the rich bought homesecurity systems, and started to drive 4x4s with names such as Defender and Crossfire, reflecting a need to intimidate attackers. Meanwhile the poor grew obese on comfort foods and took more legal and illegal drugs. In 2005, doctors in England alone wrote 29m prescriptions for antidepressants, costing the NHS £400m.
The different social problems that stem from income inequality often, Wilkinson and Pickett show, form circuits or spirals. Babies born to teenage mothers are at greater risk, as they grow up, of educational failure, juvenile crime, and becoming teenage parents themselves. In societies with greater income inequality, more people are sent to prison, and less is spent on education and welfare. In Britain the prison population has doubled since 1990; in America it has quadrupled since the late 1970s. American states with a wide gap between rich and poor are likelier to retain the death penalty, and to hand out long sentences for minor crimes. In California in 2004, there were 360 people serving life sentences for shoplifting. California has built only one new college since 1984, but 21 new prisons. Whereas societies with high income differentials are exceptionally punitive, in Japan imprisonment rates are low and offenders who confess their crimes and express a desire to reform are generally trusted to do so by the judiciary and the public.
The authors’ method is objective and scientific, so that the human distress behind their statistics mostly remains hidden. But when they quote from interviews conducted by social researchers, passion and resentment flood into their book. A working-class man in Rotherham tells of the shame he felt having to sit next to a middle-class woman (“this stuck-up cow, you know, slim, attractive”); how he felt overweight and started sweating; how he imagined her thinking, “listen, low-life, don’t even come near me. We pay to get away from scum like you”. In half a page it tells you more about the pain of inequality than any play or novel could.
It might be said that The Spirit Level merely formulates what everyone has always felt. Western European utopias have almost all been egalitarian. Polls in Britain over the past 20 years show that the proportion of the population who think income differences too big is on average 80%. But what is new about their book, the authors insist, is that it turns personal intuitions into publicly demonstrable facts. With the evidence they have supplied, politicians now have a chance to “do genuine good”. By reducing income inequality, they can improve the health and wellbeing of the whole population. How this should be effected, Wilkinson and Pickett do not think it is their job to say, but increasing top tax rates or legislating to limit maximum pay are possibilities they suggest. They warn, though, that short-term remedies like this could be reversed by a change of government, and that we need to find ways of rooting greater equality more deeply in our society. This is their book’s mission, and they have set up a not-for-profit trust (equalitytrust.org) to make the evidence they set out better known. One illusion that, cheeringly, they hope to dispel is that the super-rich are some kind of asset we should all cherish, rather than, from the viewpoint of social health, the equivalent of the seven plagues of Egypt.
Today obesity, tomorrow teenage pregnancy, the day after crime figures. Social problems operate a revolving-door policy these days. As soon as one goes away, another turns up. For the most part, these problems are regarded as entirely separate from each other. Obesity is a health issue, crime a policing issue and so on. So the government launches new initiatives here, there and everywhere, builds new hospitals, puts more money into the police and prisons. And there's little real hope of improvement.
Until now, maybe. Quietly spoken, late middle-aged and quintessentially English, Richard Wilkinson is the last person you would expect to come up with a sweeping theory of everything. Yet that's precisely what this retired professor from Nottingham medical school, in collaboration with his partner, Kate Pickett, a lecturer at the University of York, has done.
The opening sentence of their new book, The Spirit Level, cautions, "People usually exaggerate the importance of their own work and we worry about claiming too much" - yet by the time you reach the end you wonder how they could have claimed any more. After all, they argue that almost every social problem common in developed societies - reduced life expectancy, child mortality, drugs, crime, homicide rates, mental illness and obesity - has a single root cause: inequality.
And, they say, it's not just the deprived underclass that loses out in an unequal society: everyone does, even the better off. Because it's not absolute levels of poverty that create the social problems, but the differentials in income between rich and poor. Just as someone from the lowest-earning 20% of a more equal society is more likely to live longer than their counterpart from a less equal society, so too someone from the highest-earning 20% has a longer life expectancy than their alter ego in a less equal society.
Take these random headline statistics. The US is wealthier and spends more on health care than any other country, yet a baby born in Greece, where average income levels are about half that of the US, has a lower risk of infant mortality and longer life expectancy than an American baby. Obesity is twice as common in the UK as the more equal societies of Sweden and Norway, and six times more common in the US than in Japan. Teenage birth rates are six times higher in the UK than in more equal societies; mental illness is three times as common in the US as in Japan; murder rates are three times higher in more unequal countries. The examples are almost endless.
Inequality, it seems, is an equal-opportunity disease, something that has a direct impact on everyone. But doesn't that mean
equality is no longer a matter of morality or altruism for the better off, but naked self-interest? There's a brief hiatus before Pickett says, "I'm not sure that's quite the message we're trying to get across." Then there's another brief pause, before Wilkinson adds, "But it is still true."
Pickett is more alert to the political implications of their findings, while Wilkinson is more happy to follow an argument to its conclusion, however uncomfortable that may be. You can understand Pickett's concern. If self-interest and greed create inequality, then you don't necessarily want to give the impression that the solution lies in more of the same. On the other hand, there's a pleasing irony to the idea that the well-off may have mistaken their self-interest for so long, and it's not often that bleeding-heart liberals get to combine their morality and self-interest. So, as Wilkinson points out, we should make the most of it.
They insist The Spirit Level is a collaborative effort, but some collaborations are more equal than others. While Pickett, in her early 40s, is a comparative newcomer, having completed her PhD in 1999, Wilkinson has been working on the social determinants of public health with varying levels of success and frustration for years. The spark for The Spirit Level came five years ago when extensive data first became available from the World Bank, and he realised that the phenomenon he had observed within his field - that health was driven by relative difference rather than absolute material standards - applied in other areas of social policy.
"It became clear," Wilkinson says, "that countries such as the US, the UK and Portugal, where the top 20% earn seven, eight or nine times more than the lowest 20%, scored noticeably higher on all social problems at every level of society than in countries such as Sweden and Japan, where the differential is only two or three times higher at the top."
The statistics came from the World Bank's list of 50 richest countries, but Wilkinson suggests their conclusions apply more broadly. To ensure their findings weren't explainable by cultural differences, they analysed the data from all 50 US states and found the same pattern. In states where income differentials were greatest, so were the social problems and lack of cohesion.
Two things immediately became clear to Wilkinson. "While I'd always assumed that an equal society must score better on social cohesion," he says, "I'd always imagined you could only observe a noticeable effect in some kind of utopia. I never expected to find such clear differences between existing market economies."
There are anomalies. Suicide and smoking levels are both higher in more equal societies. "Violence tends to be directed towards other people or yourself," Wilkinson says, "and it is our guess that in societies with a higher sense of community responsibility, people tend to blame themselves rather than other people when things go wrong. Smoking is a little different: all countries seem to follow a similar trajectory. It starts among upper-class men, then moves to upper-class women and then down the social ladder; quitting smoking seems to follow a similar pattern."
Even so, the correlation between inequality and social problems remains startling. And it is the differential rather than any notional baseline of poverty that's critical. The US has its own benchmarked poverty line, with some 13% of the population falling below it: yet of those who come into this category, 80% have air-conditioning, 33% have a dishwasher and 50% have two or more cars. Which is not quite what some other countries might call poverty.
In Britain, the Labour government, despite its protestations to the contrary, has only maintained inequality at the level at which it inherited it. "They've taken some positive action at the bottom income levels for pensioners and young families," says Pickett. "But the damage has all been done at the other end. Peter Mandelson said early in the Labour administration, 'We are intensely relaxed about people getting filthy rich,' and he's been as good as his word."
What is it about unequal societies that causes the damage? Wilkinson believes the answer lies in the psycho-social areas of hierarchy and status. The greater the differential between the haves and have-nots, the greater importance everyone places on the material aspects of consumption; what brand of car you drive carries far more meaning in a more hierarchical society than in a flatter one. It's the knock-on effects of this status anxiety that finds socially corrosive expression in crime, ill-health and mistrust.
Wilkinson draws on some eclectic illustrations. When monkeys are kept in a hierarchical environment, those at the bottom self-medicate with more cocaine; a caste gap opens in the performance of Hindu children when they have to announce their caste before exams; the stress hormone, cortisol, rises most when people face the evaluation of others; and so on. The result is always the same: fear of falling foul of the wealth gap gets under everyone's skin by making them anxious about their status.
For a while, Wilkinson and Pickett wondered if the correlations were too good to be true. The links were so strong, they almost couldn't believe no one had spotted them before, so they asked colleagues to come up with any other explanations. They looked at the religiosity of a society, multiculturalism, anything they could think of. They even looked at the possibility they had got it the wrong way round and it was the social problems that were causing the inequality. But nothing else stood up to statistical analysis.
Wilkinson openly admits The Spirit Level is his swan-song. He feels that as an academic he has fulfilled his side of the bargain by identifying the problem; it's up to activists and politicians to work out the solutions. Pickett doesn't see things quite that way, and is largely the driving force behind the creation of the Equality Trust website to campaign for change. "There must be a possibility of change," she says. "Everything stacks up. Reducing inequality fits in with the environmental agenda; it benefits the developing world, as more equal societies give more in overseas aid; and most significantly, everyone is fed up with the corporate greed and bonus culture that have caused the current financial crisis, so if ever a government had the electorate's goodwill to act, it's now."
Wilkinson is fairly blunt about where government should start. "It has got to limit pay at the top end," he says. "It's the rich that got us into this mess and the rich who should get us out of it." Whether Labour has the nerve to upset those whom it has most assiduously courted is another matter. But he can always dream, and in the meantime he is off home to watch TV.
"I've become gripped by Paris Hilton's Best Friend," he laughs. "It's the perfect example of a dysfunctional, hierarchical society."
Philip Birch, Assistant Editor, on The Spirit Level:
'This is one of the most interesting and important books I have ever read. It is driven by a simple idea: that inequality is the root cause of all societies’ ills. It doesn’t matter if the average level of income is very low or very high, it is the gap between rich and poor that is important. It is why, when polled, more Indonesians, Vietnamese, Finnish and Japanese will claim to be more happy than Brits and Americans. And it isn’t just the poorest in the most unequal societies that suffer but the richest too. In London on the one hand we hear regularly about teenagers from poorer communities stabbing each other, but on the other more and more apparently successful, university educated, richer young people suffer from anxiety, depression and are open to casual drug use than ever before. Violence, crime, low educational achievement, poor health; and status anxiety and the misery of having too much money and too much choice go hand in hand, because of inequality. This is not necessarily a new idea but it is proved here for the first time. The graphs are quite remarkable.'
Richard Wilkinson, is the Professor of Medical Epidemiology at Nottingham University. Kate Pickett is a Lecturer in Epidemiology at the University of York. Within the 400+ pages of this book, they emphasise that it is not the poor and the deprived in isolation who suffer from the effects of inequality, but also the bulk of that nation's population. According to their findings. incidences of mental illness, for example, are 500% higher across the whole population spectrum in the most unequal societies than they in the most 'eqaul' ones. So this book is a book for all classes and it makes for a pretty good - if not dynamic - reading experience. Given half a chance, it will certainly set you thinking and musing over the values of a variety of societies, near and afar, but not least of all the society we live, work, and take our leisure in. The co-authors tried to identify why the health of a population worsens as one slides further down the social scale. It is a s simple as that. They reckon that they have, together, amassed in excess of fifty years procuring and collating data from around the world. This data was then placed in juxtaposition to related medical data. Credit where credit is due; the authors were the first to synchronise these two vital, but hitherto separate, fields of research. . Simply put, their method is to plot the level of health related/social problems against the difference in income of the world's twenty richest countries. Cleverly, this is repeated for each of the fifty United States. Each problem is dealt with separartely, the data being represented in graphic form. Wherever there is a large differential betwixt the two ends of the income scale, drug abuse, alcohol abuse, obesity, mental problems, and even teenage pregnancy occur more frequently, people live for a shorter period and commit suicide more regularly. Additionally, but just as damningly, children are not as well educated and less literate . So which countries score well on this scale? Interestingly, if not entirely surprisingly, Scandanavia and Japan have can be seen to have the narrowest of divergence betwixt highest and lowest incomes and, indeed, boast the best psychological health of all. Conversely and rather predictably, those nations with the widest gulf between rich and poor, are thus plagued by the highest occurrence of health-related and social problems. Here's the rub; those countries are, in fact, Britain, the USA and Portugal. Why is this? Well, their answer is simple, profound and disquieting; they argue that inequality, ipso facto, breeds stress across the full spectrum of society, not just among down trodden. Indeed, whilst subject to stress, individuals become far more susceptible to syndromes like depression, phobias of divers sorts, and basic anxiety This fact renders the individual far more likely to develop one of a range of physical potentially perilous conditions such as obesity, accompanying heart disease, addictions, immune deficiency as well as premature ageing. The super-rich thus become demons, a drain and a plague on society rather than a super-hero class of noble society saving investors, or the like. If you're worried by all of this, have a good read of this book and act upon it! And on that very point, the authors themselves urge that greater equality becomes grounded and 'built in' to the models of present and future societies. Moreover, they have actually taken the commendable step of putting their actions where their thoughts are and have founded a non-profit making trust - entitled 'equalitytrust.org' - so that the data and evidence, which is presented within the pages of their book, can be better distributed and accessed on a broader scale; good thinking, guys!
Michael Calum Jacques :
This is a great book. The fact that many poor outcomes are linked with poverty is well known. What the authors point out is that there is strong evidence showing that the level of poverty is much less important than the level of inequality in a society. Inequality causes health and social problems to people at the bottom but also at the top of the spectrum. So inequality is a lose lose situation. I've read many science books recently. This is the best book I've read in many respects. It is very well written, very well documented, it deals with possibly the most serious political issue of our time, it is never patronising to the reader, and finally I was impressed by its scope: evidence comes from epidemiology, psychology, economics, sociology and more. We should really send a copy of this book to each and every politician in the country. In recent times politicians have become obsessed with wealth creation. But wealth is a means not an end, and they are missing the forest for the trees.I actually think this book has a rather hopeful message. Whilst the scale of the problems caused by inequality are vast and sobering, it is made clear by the authors (who are known to me) that relatively small moves towards greater equality can yield great benefits - and it doesn't really matter how you achieve that greater equality, just as long as you do. This has profound implications for politics showing that tax and spend is not the only solution, narrowing the gap in incomes before tax can work as well. Therefore, a real chance for a broad political consensus in favour of equality exists here - a hopeful message if ever there was one. The book also points out that all the levers necessary to move towards more equal societies already exist and can easily be grasped given political will. We don't have to aim for utopia, we don't have to have a full-blown revolution to massively increase well-being and sustainability throughout the world - and not just the developed world. The authors point out that more equal developed countries are more nurturing and collaborative, so they give far more to the developing world in terms of overseas aid and score better on the Global Peace Index and are more likely to abide by international treaties. This book poses the big questions about what it means to be human and what we now need to do to survive. These are the big ideas that the world's current leaders are failing to seize upon. This is much more than an academic book; it is a call to action.
