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![Page 1: 1 Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham & Kate Pickett Professor of Epidemiology University of York .](https://reader031.fdocuments.in/reader031/viewer/2022013100/551509d55503465e608b48a4/html5/thumbnails/1.jpg)
1
Richard WilkinsonEmeritus Professor of Social Epidemiology
University of Nottingham
&
Kate PickettProfessor of Epidemiology
University of York
http://www.equalitytrust.org.uk
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2
Income per head and life-expectancy: rich & poor countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
![Page 3: 1 Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham & Kate Pickett Professor of Epidemiology University of York .](https://reader031.fdocuments.in/reader031/viewer/2022013100/551509d55503465e608b48a4/html5/thumbnails/3.jpg)
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Among the rich countries life expectancy is not related to national differences in average income
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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…but life expectancy is related to income within rich societies
Source: Wilkinson & Pickett, The Spirit Level (2009)
70
71
72
73
74
75
76
77
78
79
80
Electoral wards in England & Wales by deprivation score
Life
exp
ecta
ncy
(yea
rs)
www.equalitytrust.org.uk
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5
How much richer are the richest 20% than the poorest 20%?
www.equalitytrust.org.ukSource: Wilkinson & Pickett, The Spirit Level (2009)
![Page 6: 1 Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham & Kate Pickett Professor of Epidemiology University of York .](https://reader031.fdocuments.in/reader031/viewer/2022013100/551509d55503465e608b48a4/html5/thumbnails/6.jpg)
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7
Index of: • Life expectancy• Math & Literacy • Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness – incl.
drug & alcohol addiction
• Social mobility
Health and Social Problems are Worse in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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8
Health and Social Problems are not Related to Average Income in Rich Countries
Index of: • Life expectancy• Math & Literacy • Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness – incl.
drug & alcohol addiction
• Social mobility
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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Child Well-being is Better in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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10
Child-Wellbeing is Unrelated to Average Incomes in Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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12
Levels of Trust are Higher in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009)
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13
Levels of Trust are Higher in More Equal US States
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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14
The Prevalence of Mental Illness is Higher in More Unequal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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15
Infant Mortality Rates are Higher in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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16
Drug Use is More Common in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009)
Index of use of: opiates, cocaine, cannabis, ecstasy, amphetamines
www.equalitytrust.org.uk
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17
Teenage Birth Rates are Higher in More Unequal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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18
Homicide and income inequality: US States and Canadian Provinces
0
30
60
90
120
150
180
0.35 0.38 0.41 0.44 0.47
Income Inequality (Gini)
Ho
mic
ide
s p
er
mill
ion
pe
op
le
More equal More unequal
Source: Daly M, Wilson M, Vasdev S. Income inequality and homicide rates in Canada and the United States. Canadian Journal of Criminology 2001; 43: 219-36.
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19
Rates of Imprisonment are Higher in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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20
Social mobility is higher in more equal countries
www.equalitytrust.org.uk
Intergenerational income mobility data from: Blanden J. (2009) Centre for Economic Performance, LSE. Paper No' CEEDP0111.
Intergenerational income mobility data from: Blanden J. (2009) Centre for Economic Performance, LSE. Paper No' CEEDP0111.
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21
Almost everyone benefits from greater equality.
Usually the benefits are greatest among the poor but extend to the majority of the population
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22
Infant Mortality by Social Class: Sweden and England & Wales
0
2
4
6
8
10
12
14
16
18
I II IIIN IIIM IV V SinglePrnt
Unclass.
E & W
Sweden
Source: Leon DA, Vagero D, Olausson PO. BMJ 1992; 305; 687-91
Infa
nt
Mo
rta
lity
rate
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23
Literacy Scores of 16-25 year olds by Parents' Education
-1.5
-1
-0.5
0
0.5
1
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Parents' Education (years)
Lit
era
cy
sc
ore
Sweden
Canada
United States
Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
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Index of: • Life expectancy• Math & Literacy • Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness – incl.
drug & alcohol addiction
• Social mobility
Health and Social Problems are Worse in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
![Page 25: 1 Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham & Kate Pickett Professor of Epidemiology University of York .](https://reader031.fdocuments.in/reader031/viewer/2022013100/551509d55503465e608b48a4/html5/thumbnails/25.jpg)
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Australia
Austria
Belgium Canada
Denmark
Finland
France
Germany
Greece
Ireland
Israel
Italy
Japan
Netherlands
New Zealand
Norway
Portugal
Spain
Sweden
UK
USA
Worse
Better
UN
ICE
F in
dex
of c
hild
wel
l-bei
ng
0 10 20 30Lone parents as % of all households with dependent children
Single parents and child wellbeing
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26
Why are we so sensitive to inequality?
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27
Psychosocial risk factors for ill health
Low social status
Weak social affiliations
Stress in early life (pre- and postnatally)
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28
ACTH
Cortisol
Tasks with both social-evaluative
threat and uncontrollability
Other tasks
Eff
ect
size
Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 130(3): 355-91
What kind of stress most reliably raises cortisol levels?
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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
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Social Status and Friendship
Two sides of the same coin:
Social status (dominance hierarchies, pecking orders) are orderings based on power, coercion and privileged access to resources – regardless of the needs of others.
Friendship, in contrast, is based on reciprocity, mutuality, social obligations, sharing and a recognition of each other’s needs.
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31
Stereotype Threat
The effect of caste identity on children's performance
Caste Unannounced
Caste Announced
0
1
2
3
4
5
6
High Caste
Low Caste
Num
ber
of m
azes
sol
ved
Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004
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Dunbar R. Brains on two legs: group size and the evolution of intelligence In: Tree of Origin: F de Waal. (ed) 2001.
The Social Brain: the neocortex is a larger proportion of the brain in primate species with larger social groups
Ave
rag
e so
cial
gro
up
siz
e
Neocortex ratio
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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.
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34
http://www.equalitytrust.org.uk
For more information:
… a book
and a website…
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Equality and Sustainability
. . . a convenient truth
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www.equalitytrust.org.uk
Wo
rld
ave
rag
e C
O2
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Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005.
Working hours are longer in more unequal countries
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More equal countries are more generous foreign aid donors
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More equal countries recycle more waste
Source: Wilkinson & Pickett, The Spirit Level (2009)
Australia
France
Germany
Italy
Japan
Portugal
Spain
Sweden
Switzerland
UK
USA
Best
Worst
Re
cycl
ing
(a
vera
ge
ra
nk)
Low HighIncome Inequality
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In more equal countries business leaders give a higher priority to complying with international environmental agreements
With permission from R De Vogli & D Gimeno
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41
Inequality InequalityDebtDebt
DebtDebt
P. Krugman Inequality and Crisis: coincidence or causation? Data from: Picketty-Saez, Historical Statistics, Federal Reserve.
P. Krugman Inequality and Crisis: coincidence or causation? Data from: Picketty-Saez, Historical Statistics, Federal Reserve.
Inequality and Household Debt 1913-2007Inequality and Household Debt 1913-2007H
ou
seh
old
deb
t as
% o
f in
com
eH
ou
seh
old
deb
t as
% o
f in
com
e
Ineq
ual
ity:
ric
hes
t 1%
sh
are
Ineq
ual
ity:
ric
hes
t 1%
sh
are
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More equal societies are more innovative
www.equalitytrust.org.uk
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43
More Adults are Obese in More Unequal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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The public and policy response?
more:-
Police
Doctors
Social Workers
Drug rehabilitation units
Educational Psychologists
But…services are expensive and only partially effective.
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Children Experience More Conflict in More Unequal Societies
Source: Wilkinson & Pickett, The Spirit Level (2009)
11, 13 & 15 yr olds fighting, bullying, and finding peers not kind & helpful
www.equalitytrust.org.uk
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More Children Drop Out of High School in More Unequal US States
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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Cognitive Score: Socioeconomic status more important than starting point
High Cognitive Score at 22 months
Low Cognitive Score at 22 months
2 3 4 5 6 7 8 9 10 Child’s age (years)
Co
gn
itiv
e sc
ore
p
erc
enti
le p
osi
tio
n a
t e
ach
ag
e
(I Feinstein. Inequality in cognitive development. 1970 British Births. Economica 2003; 70: 3-97) (from The Marmot Review 2010)
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Educational Scores are Higher in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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50
The effects of inequality - a two stage process
1. adult experience of inequality
2. passed on to children – epigenetics?