January 12, 2010

by Jeff Ritterman, MD

My partner Vivien and I had the rare pleasure of hosting Professors Richard Wilkinson and Kate Pickett during the San Francisco leg of their U.S. book tour promoting their recently released book, “The Spirit Level: Why Greater Equality Makes Societies Stronger”, Bloomsbury Press.

Professor Wilkinson has been researching the impact of income inequality on health outcome for several decades.  Seven years ago, he began working with Professor Kate Pickett and broadened the analysis to include quality of life as well as health.

What Wilkinson and Pickett have uncovered is both truly remarkable and intuitively obvious.  Rising income inequality impacts health and quality of life profoundly.  As societies become more unequal a generalized social dysfunction sets in.  We trust each other less, social cohesion breaks down and with it life expectancy suffers, homicides increase, teen pregnancy rates rise, more of us drop out of high school, in fact just about everything goes wrong.  We become fatter, our children score worse on math and literacy tests, our prisoner population swells, more of us suffer mental illness, our children bully each other more and there is less chance of advancement based on merit.

It appears that we, who live in the developed world, are the first generation to face the problem that more material wealth no longer results in a longer or better life.  People in the US have twice the wealth and buying power of their counterparts in Greece, for example, but the Greeks live longer lives with fewer social ills.  Why?  Once a country is no longer poor and chronic illnesses like heart attacks and stokes replace infectious diseases as the leading cases of death, life expectancy and social well being are not related to wealth, but rather to how equally that wealth is shared.  The more equal the income distribution, the longer the life span and the fewer the social ills.

So how does the U.S. compare to the other wealthy nations.  We are at the bottom of the heap.  In the 1950s we were the most equal, had the longest life expectancy and the highest quality of life.  For the last 30 years our social and political decisions have resulted in the US becoming more unequal than any other rich nation with the exception of Singapore.  Our poor showing in health outcomes and our apparently intractable social ills are due to this maldistribution of wealth and income.

There is also an important tie in between the threat of climate chaos and income inequality.  Consumerism itself is fed largely by concerns about status.  More unequal societies promote consumerism as everyone tries desperately to keep up with those above them in the social hierarchy.  Curbing our unbridled consumerism is now a matter of species survival.  Income inequality also promotes a callous disregard for the environment.  More unequal societies recycle less and their business leaders are less concerned about the environment.

I thank Professors Wilkinson and Pickett for their diligent research proving what we all should have already known; we all do better when we all do better.  Now we also know that the planet does better also when societies are are structured to promote greater equality.

To learn more go to their website www.equalitytrust.org.

Richard and Kate have given us the knowledge.  Now it us up to us to redress the imbalances of wealth, income and power.  It is only by doing so that we will improve our health and social well being and create the conditions necessary to meet the challenge of climate change.