Inequality Makes Us Ill

Across all the Western democracies, there is a consistent pattern in which outcomes worsen as inequality increases


A Review of The Spirit Level: Why More Equal Societies Almost Always Do Better, by Richard Wilkinson and Kate Pickett, Allen Lane, 331 pages


Will Kymlicka, a noted Canadian scholar on politics and multiculturalism, has provided a well-written and thought-provoking review of a book by Richard Wilkinson and Kate Pickett. Their book addresses a topic – inequality – which remains on the fringes of economic and political discussion, even though I believe it’s at the center of our current economic malaise.

Kymlicka discusses Wilkinson and Pickett’s point that inequality is not just a moral issue. It has real human costs and tangible impacts.

… Once a country reaches a per capita income of around $25,000, there is simply no correlation between levels of national wealth or health spending and levels of health and human development….

…So what explains why some countries do better than others? A growing consensus points to the quality of people’s social relationships, whether in the home, the neighbourhood or at work. In some societies, these relationships are toxic, putting health-damaging stresses on individuals. In other societies, these relationships are supportive, helping individuals deal with life’s challenges.

However, Wilkinson and Pickett argue that these different factors are all symptoms of a deeper issue — namely, inequality. Among wealthy countries, Norway and Japan do better than the United States or Switzerland because the gap between rich and poor is smaller. Among less affluent countries, Spain and Greece do better than Portugal because they have less inequality.

This is true of rates of infant mortality, illiteracy, obesity, mental illness, incarceration, homicide, drug use and teenage pregnancy (although not, interestingly, of suicide). Similarly, as inequality rises, social trust and social mobility decline while violence increases. This is true not only between Western countries, but also within them. For example, if we compare the 50 states of the United States, these indicators are worse in states with greater inequality….

…The result is an impressive body of evidence, presented in an easily digestible form, which is highly relevant for debates here in Canada. Polls show that most people believe that inequalities have grown too large in recent years, and this book will surely reinforce that sentiment. Many of us feel that the growing level of inequality is unfair, and harmful to a sense of shared citizenship and community cohesion. But as Wilkinson and Pickett show, it is also harmful to our health….

Kymlicka responds that there are many issues that help determine social stability and community health:

[I]t’s not just income inequality that matters, but also the nature of the labour market, the stability of people’s jobs and housing, the strength of community organizations and so on.

Moreover, there are many sources of status anxieties in modern societies — such as racism or homophobia (or attitudes toward beauty) — that are only indirectly related to income inequalities. So, income inequality seems a very crude measure for the almost infinitely complex array of status hierarchies in our society, and the link between the two is something of a black box in the book.

Kymlicka then concedes that many of these problems, though not a necessary outcome of inequality, usually do arise in unequal societies if other mitigating factors do not appear.

The authors would probably respond that, whatever these complexities, the data show a clear tendency for income inequality to generate worse health outcomes. So for practical policy purposes, we should just focus on inequality.


So here we have another argument in favour of tackling inequality. It has real and debilitating effects. We are not made stronger by inequality; as a tendency, it retards and constricts, and is a real threat to our belief in the equality of opportunity. Moreover, equality in this sense is a relative concept that bespeaks of our social nature. Unlike the Fraser Institute, which argues that equality should be measured in absolute terms, Richard Wilkinson and Kate Pickett show that social interaction defines equality in relative terms. It’s cold comfort, and largely irrelevant, that a poor person in Chilliwack is surviving on the same caloric intake of a person in Haiti. Social trust, social mobility and violence are realities that make sense only in social terms, with the people who live in our own community or nation.

Posted by Colin Welch at 2:19 PM
Edited on: Saturday, May 23, 2009 1:31 PM
Categories: Canadian Politics, Global Issues, The Economy


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