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Source: Fajnzylber P, Lederman D, Loayza N. Inequality and violent crime. The Journal of
Law and Economics 2002; 45 (1): 1-40.
0.20 0.25 0.30 0.35 0.40 0.45 0.50 0.55 0.60
0.1
1
10
100
Ho
micidesper100,00
0population
(logscale)
Income Inequality (Gini)
Latin America
Sub-Saharan AfricaSouth & East Asia
OECD Countries
International relation between homicide and income inequality
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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
micidespermillionpeople
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 Criminology2001; 43: 219-36.
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Elgar et al. Journal of Adolescent Health 45 (2009) 351359
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6
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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 Journal2000;320:898-902
http://www.bmj.com/content/vol320/issue7239/images/large/rosn4890.f1.jpeg8/9/2019 Kate Pickett and Richard Wilkinson Presentation to the RSA. July 2010
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M
Marmot & Bobak, BMJ 2000;131:1124-8
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Income per person and life-expectancy: rich & poor countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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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 differences
within rich societies
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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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
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Social Mobility is Higher in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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Social Mobility Continues to be Higher in More Equal Rich Countries
www.equalitytrust.org.uk
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Levels of Trust are Higher in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009)
r= -0.66, p
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Levels of Trust are Higher in More Equal Rich Countries, even with
the Nordic countries excluded
r= -0.47, p=0.045
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The murder rate in US states has mirrored
changes in income inequality
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Income Inequality
Trust
Homicides
r = -0.65p
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Income Inequality
Trust
Healthy lifeexpectancy
b = -0.01p=0.004
b = 13.2p=0.001
b = -0.31
p=0.02
Mediation analysis of income
inequality and health
ELGAR, F. J. (in press) Income inequality, trust and population health in 33 countries.Am J Public Health.
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Daly M, Annual meeting of the Homicide ResearchWorking Group, 2010
Homicide is related to inequality among both southernand northern states even when inequality is measured
just among white males
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http://www.equalitytrust.org.uk
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Infant Mortality Rates are Higher in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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The age of criminal responsibility is lower in
more unequal societies
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Equal Society
Unequal Society
side from inequality, people in one society may be differe
rom people elsewhere multilevel studies adjust for this
Multilevel Analyses of Income Inequality and Health
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How much richer are the richest
20% than the poorest 20%?
www.equalitytrust.org.ukSource: Wilkinson & Pickett, The Spirit Level (2009)
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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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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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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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More Adults are Obese in More Unequal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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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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Life Expectancy is Longer in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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Rates of Imprisonment are Higher in More Unequal Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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Rate of Imprisonment are Higher in More Unequal US States
Death Penalty:Red = retainedBlue = abolished
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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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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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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Teen Pregnancy Rates are Higher in More Unequal US States
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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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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Child wellbeing and income inequality in US States
Kids Count 10 Item Index of Child Wellbeing
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Health and Social Problems are Worse in More Unequal US
States
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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Health & Social Problems are Only Weakly Related to
Average Income in US States
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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In fan t Mortality by S oc ial C
Sw eden and Eng land & W
0
2
46
8
10
12
1416
18
I II IIIN IIIM IV V Single
Prnt
Unclass.
E & W
S w e de
Source: Leon DA, Vagero D, Olausson PO. BMJ 1992; 305; 687-91
Infa
ntMortality
r
ate
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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)
Literacys
core
Sweden
Canada
United States
Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
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0
1 0
2 0
3 0
4 0
5 0
L o w Hig h L o w H ig h L o w H ig h L o w H ig h L o w Hig h
En g lan d
E n g l a n d U S
Diabetes Hypertension Cancer Lung disease Heart disease
Self-reported prevalence of illness by education
%
Source: Banks et al. JAMA 2006; 295: 2037-2045
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Source: Wilkinson & Pickett, The Spirit Level (2009)
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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
UNICEFindexofchildwell-being
0 10 20 30Lone parents as % of all households with dependent children
Single parents and child wellbeing
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ACTH
Cortisol
Tasks with both
social-evaluative
threat and
uncontrollability
Other tasks
Effect
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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Stereotype Threat
The effect of caste identity on children's performance
Caste
Unannounced
Caste
Announced0
1
2
3
4
5
6
High Caste
Low Caste
Number
ofmaze s
solved
Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004
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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 ofthese 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 affect brain chemistry and behaviour in monkeys
Living in social groupsincreased happy brainchemicals in dominantmonkeys but producedno change in subordinatemonkeys.
These neurobiologicalchanges had an importantbehaviouralinfluence
When given access tococaine, dominant monkeystook less than subordinates
Source: Morgan, D et al. Nature Neuroscience 2002; 5(2), 169-174.
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Plasma fibrinogen by employment grade
among Civil Servants, Whitehall II.
Source:Brunner E, Davey Smith G, Marmot M, et al. Lancet 1996; 347: 1008-1013
Deviations in plasma fibringen from means for men and women with 95% CI.
Means adjusted for age and ethnic origin (and menopausal status in women)
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Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397F412. 2005.
Working hours are longer in more unequal countries
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More equal countries are more generous foreign aid donors
In more equal countries business leaders give a higher priority
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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
Index of Health and Social Problems in relation
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Australia
Austria
Belgium
Canada
Denmark
Finland
FranceGermany
Greece
Ireland
Italy
Japan
Netherlands
New Zealand
Norway
Portugal
Spain
Sweden
Switzerland
UK
USA
Better
Worse
Indexofhealthandsocialproblems
Low High
Inequality (Gini coefficients from OECD, mid-2000s)
Index of Health and Social Problems in relation
to Inequality - using Gini coefficients from OECD
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Di t ib ti f h h ld i (US 1990) d
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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
National infant mortality rates and GNPpc
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National infant mortality rates and GNPpc
at three levels of inequality
Source: Hales S, Howden-Chapman P, Salmond C, Woodward A,
Mackenbach J. . Lancet 1999; 354: 2047
Income inequality and mortality in 282 metropolitan areas
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Income inequality and mortality in 282 metropolitan areas
of the United States925.8
879.2
840.2
812.4
944.9
897.5
857.6
829.2
923.7
877.3
838.4
810.6
895.5
850.5
812.8
785.9
750
800
850
900
950
4th
(high)
3rd 2nd 1st
(low)
4th (high)3rd
2nd
1st (low)
Per capita
income
(quartiles)
Income inequality (quartiles)
Mortalit
yrate
per100
, 000
Quartiles of income inequality and per capita income, adjusted for median household size, and age-
adjusted total mortality (per 100,000): 282 US metropolitan areas, 1989 - 1991.
Source: Lynch J, Kaplan G, et al., Am J Public Health, 1998;88:1074-1080
Quartiles of income inequality and per capita income, adjusted for median household size, and age-
adjusted total mortality (per 100,000): 282 US metropolitan areas, 1989 - 1991.
Source: Lynch J, Kaplan G, et al., Am J Public Health, 1998;88:1074-1080
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Life expectancy and income per capita for
selected countries and periods
Reproduced from World Bank, World Development Report 1993
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80% have air conditioning78% have a VCR or DVD player73% own a car or truck31% own more than one car
55% have two or more TVs36% have a dishwasher36% have a computer43% own their homes
10% in mobile homes 6% over-crowded (>1 per room)
Childrens protein intake: 100% above recommended Most vitamins & minerals: well over recommended
Living conditions & Poverty: USA 2005
The poorest 12.6% (below Federal poverty line):-
Income share of richest 1% in Anglo Saxon countries 1921 2002
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Source: Atkinson AB, Leigh A. (2004) Understanding the Distribution of
Top Incomes in Anglo-Saxon Countries over the Twentieth Century
Income share of richest 1% in Anglo-Saxon countries 1921-2002
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Trends in UK income inequality 1979-2005/6
0.8
1
1.2
1.4
1.6
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
-4
1994
-5
1995
-6
1996
-7
1997
-8
1998
-9
1999
-0
2000
-1
2001
-2
2002
-3
2003
-4
2004
-5
2005
-6
Thatcher Major Blair
Risinggapbetween
richandpoor,relativ
eto1975
www.equalitytrust.org.ukSource: Wilkinson & Pickett, The Spirit Level (2009)
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Trends in US income inequality 1975-2005
www.equalitytrust.org.ukSource: Wilkinson & Pickett, The Spirit Level (2009)
Health and social problems which
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Health and social problems which
are substantially worse in more unequal societies
International data:
Social Mobility
Hours worked Child conflict
UNICEF Child well-being Index
US states data:
High school drop-out rate
Data available for countries and for states of the USA:-
Social capital Drug abuse
Trust Homicides
Maths & literacy scores Obesity
Teenage birth rates Life expectancy
Imprisonment rates Infant mortality
Mental illness Low birth weight
[Smoking and suicide are the only counter examples we have found]
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C l ti & l I d f H lth & S i l P bl
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Indicator International data US data
r p-value r p-value
Trust -0.66
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Indicator International data US data
r p-value r p-value
Drugs index 0.63
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Component International data US state data
Trust Percent of people who respond positively to the statement mostpeople can be trusted1999-2001World Values Survey Reverse-coded
Percent of people who respond positively to the statement most peoplecan be trusted1999General Social Survey Reverse-coded
Life expectancy Life expectancy at birth for men and women
2004United Nations Human Development Report Reverse-coded
Life expectancy at birth for men and women
2000US Census Bureau, Population Division Reverse-coded
Infant mortality Deaths in the first year of life per 1000 live births2000World Bank
Deaths in the first year of life per 1000 live births2002US National Center for Health Statistics
Obesity Percentage of the population with BMI > 30, averaged for men andwomen2002International Obesity TaskForce
Percentage of the population with BMI > 30, averaged for men andwomen, 1999-2002Estimates from Prof Ezzati, Harvard University, based on NHANES andBRFSS surveys
Mental health Prevalence of mental illness2001-2003WHO
Average number of days in past month when mental health was notgood1993-2001, BRFSS
Education Combined average of maths literacy and reading literacy scores of15-year olds2000OECD PISA Reverse-coded
Combined average of maths and reading scores for 8 th graders2003US Department of Education, National Center for EducationStatistics Reverse coded
Teenage birth rate Births per 1000 women aged 15-19 years1998
UNICEF
Births per 1000 women aged 15-19 years2000
US National Vital Statistics
Homicides Homicide rate per 100,000Period average for 1990-2000United Nations
Homicide rate per 100,0001999FBI
Imprisonment Log of prisoners per 100,000United Nations
Prisoners per 100,0001997-8, US Department of Justice
Social mobility Correlation between father and sons income30-year period data from 8 cohort studies
London School of Economics
N/A
Five fallacies which support
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Five fallacies which support
injustice and inequality
Elitism is efficient
Prejudice is natural
Exclusion is necessary
Greed is good
Despair is inevitable
D. Dorling, Injustice: why social inequality persists
(Policy Press 2010)
Educational Scores are Higher in More Equal Rich
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Educational Scores are Higher in More Equal Rich
Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
R li d I lit
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Recycling and Inequality
Source: Wilkinson & Pickett, The Spirit Level (2009)
Index of Health and Social Problems and inequality among
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q y g
US states
Source: Wilkinson & Pickett, The Spirit Level (2009)
Index of Health & Social Problems and average income
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Index of Health & Social Problems and average income
in US states
Source: Wilkinson & Pickett, The Spirit Level (2009)
If all countries converged on the world average CO2
emissions high life expectancy could be achieved for all
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Wo
rlda
verageCO
2
emissions, high life expectancy could be achieved for all
- even on the basis of existing technology
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