Effects of High Income Inequality on Health & Social Problems

By John BristowNo Comments
Richard Wilkinson

Richard Wilkinson

Wilkinson and Pickett studied income inequality in richer countries and have shown that in these countries there is now a body of evidence that income inequality, not the average income of a society, has harmful effects on the health, well being and quality of life in a society, and leads to a variety of social problems. This affects both high and low income groups: everyone is better off if there is a lower gap. Their study focused on 23 of the World Bank listed richest societies, and the income of the top 20% was 8 – 9.8 times higher than the bottom 20% in the more unequal societies and 3.7 – 4.0 times higher in the more equal.

Kate Pickett

Kate Pickett

Keeping within a healthy degree of income inequality can be more important than economic growth once material standards of living are at a good enough level. After this it is relative rather than absolute income or deprivation that makes the difference. Wilkinson argues that the level of income is important up to a point after which other needs are key. What is considered enough to live on and for people to participate in society varies between societies and their economies of course, and generally increases over time. The data shows that life expectancy for example improves rapidly in the early stages of economic growth and then tails off; it is no longer related to national income per person after around $25K in the 1990’s (World Bank Report). It is the same with happiness and wellbeing, which are more to do with culture. It seems that we now have the first generation in the richer countries that have got to the end of the benefits of economic growth. Having more and more material wealth makes less difference; if there is slower growth we are not making great sacrifices.

They developed an Index of Health (Disease) and Social Problems – using internationally comparable data on: level of trust, mental illness (including drug and alcohol addiction), life expectancy and infant mortality, obesity, children’s educational performance, teenage births, homicides, imprisonment rates and crime, social mobility (reflecting equal opportunity). So data on a range of social problems was included. They could look at each health or social problem by itself or in combination. They also linked income inequality to other measures not included in the index such as women’s status and child wellbeing (UNICEF). Always the same countries were at the top and bottom across these separate measures, with most things going wrong – though different problems may be more prevalent.

For example:

Trust: In more equal societies most people can be trusted – 65%, compared with 15% in the more unequal. With less trust people feel less safe and are less involved in community life. When there is more trust leads there is more co-operation and reciprocity.

Ethnic discrimination and divisions increases where there are bigger income and status differences.

Status of women is lower where there are higher status differences, and often a more masculine culture and society.

Homicide ranges between 15 or less per million in the population in more equal societies to up to 150 per million with higher inequality of income

Imprisonment and punishment ranges between 40 per 100K in the population 400.

This is due to harsher sentencing more than the actual amount of crime: the death penalty is more common in the more unequal societies.

Violence and disrespect: in more unequal societies more people feel humiliated and turn to violence in response.

Domestic conflict and divorce is higher with greater income inequality. Boys with absent fathers can be hyper-masculine, with fewer alternative ways of getting respect. Youth gangs can be more common. In more equal societies where people see others as generally trustworthy there are more stable family relationships and young people are longer in education and their transition into adulthood.

Teenage pregnancies: Births per 1000 teenage women is less than 5 where there is less income inequality to up to 25 – 30 or 50 where there is more. Young fathers are unable to provide.

Infant mortality is higher in more unequal societies – with Singapore being an exception. It is worse too amongst the richer income group.

Child wellbeing (UNICEF data) is clearly linked to greater income inequality.

 Physical health and life expectancy Chronic diseases replace infectious diseases in the transition to a developed economy.

Chronic Stress is higher with greater income and status differences, and stress affects the Immune system. Being looked down on or feeling excluded is known to increase self-doubt and affect attainments, and having less control over one’s fate creates feelings of powerlessness and despair. Parental stress can also lead to early life trauma and deprivation in their children, and parents can pass on their lack of trust in other parts of society to them too. With epigenetics affecting gene expression, pregnant mothers who are undernourished can create a womb environment that releases the obesity gene in the infant to equip them to cope with a future lack of food. Stress leads to and hypertension and over or under eating.

Obesity: In more unequal societies those lower in status take more calories, eat cheap energy-intense food, and take less exercise. Chronic stress and arousal can lead to central or abdominal obesity. Comfort eating can have similar effect on the brain as drugs. There are also associations with food – home, love and loving, status. In the richer countries poorer people are more obese whereas in poorer countries that are more likely to be undernourished.

Mental illness: The same diagnostic interview was given to a random sample from the whole population by the World Health Organisation. 8% of the population suffered from this in more equal societies, 25% in more unequal

Drug abuse is more common in unequal

 Social mobility: There is low or slower social mobility when income differences widen. Culture, social taste and snobbery inhibits mobility right down the hierarchy. There is more segregation too: people pay to move into other areas.

Segregation of rich and poor is higher where there is inequality, and intergroup prejudices too: feelings of superiority and inferiority particularly. The poor can be seen as stupid and lazy where the rungs of the ladder are wider apart

Literacy amongst children much more common amongst low income groups in more equal societies, and bit better in the top income group too. Educational performance is related to what family background as children do better when they have parents with a higher level of education and more income, who can provide them with the space and resources and who are more involved in their children’s education. What life is like at home, how families interact, how stressed the parents are, how they organize their life, and how much time they give to their children, and how far they create a responsive and stimulating environment is not necessarily dependent on income and status; some parents can be more resilient in the face of relative poverty. Nevertheless more unequal societies have poorer educational attainment. Children stressed or insecure at home are less able to give attention to learning at school. Where there is greater income inequality, there is more family conflict, divorce, and disruption, and children are more likely to witness violence and living in a crowded and noisy space. Where there is support for parents of young children – parental leave, child support, early childhood education etc – the stresses can be ameliorated. As Paul Tough shows in his book Helping Children Succeed: What works and Why” how parental guidance in home visits can make a big difference to children and their futures.

Also when children expect to be seen as inferior they have less confidence when they feel they are being judged or assessed, and perform less well at school; humans learn better when they are not under stress. The families in lower socio-economic groups put less emphasis on education too, and may resist it. Aspirations and expectations of children and young people however can be higher in more unequal societies but are unrealistic as they have less educational attainments; they have been found to be lower in more equal societies – possible as there is no stigma attached to low skilled work.



Economics, Rich and Poor Gap
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