Tuesday, April 14, 2009

The Spirit Level: Why More Equal Societies Almost Always Do Better - by Richard Wilkinson and Kate Pickett

This is a very interesting book to me - it seems, however, not be available yet in the states. Here are a variety of reviews, most of which seem fairly supportive of the book. I want to read this, so I hope it finds a publisher on this side of the Atlantic.

From the Guardian UK:

The way we live now

A hard-hitting study of the social effects of inequality has profound implications, says Lynsey Hanley

By Lynsey Hanley
Saturday 14 March 2009

We are rich enough. Economic growth has done as much as it can to improve material conditions in the developed countries, and in some cases appears to be damaging health. If Britain were instead to concentrate on making its citizens' incomes as equal as those of people in Japan and Scandinavia, we could each have seven extra weeks' holiday a year, we would be thinner, we would each live a year or so longer, and we'd trust each other more.

Epidemiologists Richard Wilkinson and Kate Pickett don't soft-soap their message. It is brave to write a book arguing that economies should stop growing when millions of jobs are being lost, though they may be pushing at an open door in public consciousness. We know there is something wrong, and this book goes a long way towards explaining what and why.

The authors point out that the life-diminishing results of valuing growth above equality in rich societies can be seen all around us. Inequality causes shorter, unhealthier and unhappier lives; it increases the rate of teenage pregnancy, violence, obesity, imprisonment and addiction; it destroys relationships between individuals born in the same society but into different classes; and its function as a driver of consumption depletes the planet's resources.

Wilkinson, a public health researcher of 30 years' standing, has written numerous books and articles on the physical and mental effects of social differentiation. He and Pickett have compiled information from around 200 different sets of data, using reputable sources such as the United Nations, the World Bank, the World Health Organisation and the US Census, to form a bank of evidence against inequality that is impossible to deny.

They use the information to create a series of scatter-graphs whose patterns look nearly identical, yet which document the prevalence of a vast range of social ills. On almost every index of quality of life, or wellness, or deprivation, there is a gradient showing a strong correlation between a country's level of economic inequality and its social outcomes. Almost always, Japan and the Scandinavian countries are at the favourable "low" end, and almost always, the UK, the US and Portugal are at the unfavourable "high" end, with Canada, Australasia and continental European countries in between.

This has nothing to do with total wealth or even the average per-capita income. America is one of the world's richest nations, with among the highest figures for income per person, but has the lowest longevity of the developed nations, and a level of violence - murder, in particular - that is off the scale. Of all crimes, those involving violence are most closely related to high levels of inequality - within a country, within states and even within cities. For some, mainly young, men with no economic or educational route to achieving the high status and earnings required for full citizenship, the experience of daily life at the bottom of a steep social hierarchy is enraging.

The graphs also reveal that it is not just the poor, but whole societies, from top to bottom, that are adversely affected by inequality. Although the UK fares badly when compared with most other OECD countries (and is the worst developed nation in which to be a child according to both Unicef and the Good Childhood Inquiry), its social problems are not as pronounced as in the US.

Rates of illness are lower for English people of all classes than for Americans, but working-age Swedish men fare better still. Diabetes affects twice as many American as English people, whether they have a high or a low level of education. Wherever you look, evidence favouring greater equality piles up. As the authors write, "the relationships between inequality and poor health and social problems are too strong to be attributable to chance".

But perhaps the most troubling aspect of reading this book is the revelation that the way we live in Britain is a serious danger to our mental health. Around a quarter of British people, and more than a quarter of Americans, experience mental problems in any given year, compared with fewer than 10 per cent in Japan, Germany, Sweden and Italy.

Wilkinson and Pickett's description of unequal societies as "dysfunctional" suggests implicit criticism of the approach taken by Britain's "happiness tsar" Richard Layard, who recommended that the poor mental health of many Britons be "fixed" or improved by making cognitive behavioural therapy more easily available. Consumerism, isolation, alienation, social estrangement and anxiety all follow from inequality, they argue, and so cannot rightly be made a matter of individual management.

There's an almost pleading quality to some of Wilkinson and Pickett's assertions, as though they feel they've spent their careers banging their heads against a brick wall. It's impossible to overstate the implications of their thesis: that the societies of Britain and the US have institutionalised economic and social inequality to the extent that, at any one time, a quarter of their respective populations are mentally ill. What kind of "growth" is that, other than a malignant one?

One question that comes to mind is whether the world's most equal developed nations, Japan and Sweden, make sufficient allowance for individuals to express themselves without being regarded as a threat to the health of the collective. Critics of the two societies would argue that both make it intensely difficult for individual citizens to protest against the conformity both produced by, and required to sustain, equality. The inclination to dismiss or neuter individuals' complaints may, Wilkinson and Pickett suggest, go some way towards explaining the higher suicide rates in both countries compared with their more unequal counterparts. Those who feel wrong, or whose lives go wrong, may feel as though they really do have no one to blame but themselves.

What Japan and Sweden do show is that equality is a matter of political will. There are belated signs - shown in the recent establishment of a National Equalities Panel and in Trevor Phil lips's public pronouncements on the central place of class in the landscape of British inequality - that Labour recognises that its relaxed attitude to people "getting filthy rich" has come back to bite it on the rear.

Twelve years in power is long enough to reverse all the trends towards greater social and economic stratification that have occurred since 1970; instead they have continued on their merry way towards segregation. Teenage pregnancy rates have begun to rise after a period of decline; there is a 30-year gap in male life expectancy between central Glasgow and parts of southern England; and child poverty won't be halved by next year after all (though it wouldn't make as much difference as making their parents more equal).

There are times when the book feels rather too overwhelmingly grim. Even if you allow for the fact that it was written before Barack Obama won the US presidency on a premise of trust and optimism, its opening pages are depressing enough to make you want to shut it fast: "We find ourselves anxiety-ridden, prone to depression, driven to consume and with little or no community life." Taking the statistics broadly, they may be correct, but many readers simply won't feel like that.

However, the book does end on an optimistic note, with a transformative, rather than revolutionary, programme for making sick societies more healthy. A society in which all citizens feel free to look each other in the eye can only come into being once those in the lower echelons feel more valued than at present. The authors argue that removal of economic impediments to feeling valued - such as low wages, low benefits and low public spending on education, for instance - will allow a flourishing of human potential.

There is a growing inventory of serious, compellingly argued books detailing the social destruction wrought by inequality. Wilkinson and Pickett have produced a companion to recent bestsellers such as Oliver James's Affluenza and Alain de Botton's Status Anxiety . But The Spirit Level also contributes to a longer view, sitting alongside Richard Sennett's 2003 book Respect: The Formation of Character in an Age of Inequality , and the epidemiologist Michael Marmot's Status Syndrome , from 2005.

Anyone who believes that society is the result of what we do, rather than who we are, should read these books; they should start with The Spirit Level because of its inarguable battery of evidence, and because its conclusion is simple: we do better when we're equal.

• Lynsey Hanley's Estates: An Intimate History is published by Granta

This brief review is from The Economist:

Always with us?

Feb 26th 2009
From The Economist print edition

SOME men steal out of need or avarice; others kill themselves out of despair, or murder for revenge or gain. These episodes in individual tales display such striking regularities in aggregate that some of the social scientists who first applied the rules of probability to human affairs questioned the very notion of free will. “Society prepares the crime,” wrote Adolphe Quetelet, a Belgian statistician, in 1835, “and the guilty person is only the instrument.”

The findings of those statisticians’ successors—that poor children are more likely to fail at school, poor adults to commit crimes and die young, and so on—are nowadays uncontroversial. And policymakers mostly eschew metaphysics. Instead, they try to break such links by spending to “end child poverty” and by targeting health and education initiatives on the neediest. Yet such attempts are doomed to disappoint, say British social scientists, Richard Wilkinson and Kate Pickett, because they conceive of each social ill in isolation, rather than treating their shared root cause. Moreover, they misidentify that cause: it is not poverty as such, but inequality.

It is a sweeping claim, yet the evidence, here painstakingly marshalled, is hard to dispute. Within the rich world, where destitution is rare, countries where incomes are more evenly distributed have longer-lived citizens and lower rates of obesity, delinquency, depression and teenage pregnancy than richer countries where wealth is more concentrated. Studies of British civil servants find that senior ones enjoy better health than their immediate subordinates, who in turn do better than those further down the ladder.

And the evidence is that the differences in status cause these “gradients”. Low-caste Indian children do worse on cognitive tests if they must state their identities beforehand. High-status baboons bred in captivity show elevated levels of stress hormones and become ill more often when they are moved to groups where they no longer dominate.

What to do about this sickness caused by other people’s wealth? Swingeing taxes on the rich, or smaller differences in pay in the first place, say the authors, citing Sweden and Japan as instances of the two alternatives. A decade ago even left-wing politicians were “intensely relaxed about people getting filthy rich”. Now, as it becomes clearer that some of the rich got that way by theft, the idea that they have also caused injury more subtly will gain a readier hearing.

Too ready, perhaps: what if the price of greater equality is lower growth? The received wisdom—admittedly looking a little threadbare right now—is that rich rewards are necessary to stimulate the innovation on which growth depends. No loss, say the authors: “We have got close to the end of what economic growth can do for us.” But that is a claim that needs to be supported, rather than simply made in a few sentences. If our ancestors had declared themselves thus satisfied, we would be without many things that we value—and that they would have valued too, could they have imagined them. Should we be ready to dismiss joys we have never known?

And this is another one from The Guardian UK, by a different author.

The theory of everything

These two British academics argue that almost every social problem, from crime to obesity, stems from one root cause: inequality. John Crace meets the authors of what might be the most important book of the year

By John Crace
The Guardian, Thursday 12 March 2009

Richard Wilkinson and Kate Pickett

Richard Wilkinson and Kate Pickett have written a book called the Spirit Level about equal societies. Photograph: Linda Nylind

Another day, another headline: today obesity, tomorrow teenage pregnancy, the day after crime figures. Social problems operate a revolving-door policy these days. As soon as one goes away, another turns up. For the most part, these problems are regarded as entirely separate from each other. Obesity is a health issue, crime a policing issue and so on. So the government launches new initiatives here, there and everywhere, builds new hospitals, puts more money into the police and prisons. And there's little real hope of improvement.

Until now, maybe. Quietly spoken, late middle-aged and quintessentially English, Richard Wilkinson is the last person you would expect to come up with a sweeping theory of everything. Yet that's precisely what this retired professor from Nottingham medical school, in collaboration with his partner, Kate Pickett, a lecturer at the University of York, has done.

The opening sentence of their new book, The Spirit Level, cautions, "People usually exaggerate the importance of their own work and we worry about claiming too much" - yet by the time you reach the end you wonder how they could have claimed any more. After all, they argue that almost every social problem common in developed societies - reduced life expectancy, child mortality, drugs, crime, homicide rates, mental illness and obesity - has a single root cause: inequality.

And, they say, it's not just the deprived underclass that loses out in an unequal society: everyone does, even the better off. Because it's not absolute levels of poverty that create the social problems, but the differentials in income between rich and poor. Just as someone from the lowest-earning 20% of a more equal society is more likely to live longer than their counterpart from a less equal society, so too someone from the highest-earning 20% has a longer life expectancy than their alter ego in a less equal society.

Take these random headline statistics. The US is wealthier and spends more on health care than any other country, yet a baby born in Greece, where average income levels are about half that of the US, has a lower risk of infant mortality and longer life expectancy than an American baby. Obesity is twice as common in the UK as the more equal societies of Sweden and Norway, and six times more common in the US than in Japan. Teenage birth rates are six times higher in the UK than in more equal societies; mental illness is three times as common in the US as in Japan; murder rates are three times higher in more unequal countries. The examples are almost endless.

Inequality, it seems, is an equal-opportunity disease, something that has a direct impact on everyone. But doesn't that mean equality is no longer a matter of morality or altruism for the better off, but naked self-interest? There's a brief hiatus before Pickett says, "I'm not sure that's quite the message we're trying to get across." Then there's another brief pause, before Wilkinson adds, "But it is still true."

Pickett is more alert to the political implications of their findings, while Wilkinson is more happy to follow an argument to its conclusion, however uncomfortable that may be. You can understand Pickett's concern. If self-interest and greed create inequality, then you don't necessarily want to give the impression that the solution lies in more of the same. On the other hand, there's a pleasing irony to the idea that the well-off may have mistaken their self-interest for so long, and it's not often that bleeding-heart liberals get to combine their morality and self-interest. So, as Wilkinson points out, we should make the most of it.

They insist The Spirit Level is a collaborative effort, but some collaborations are more equal than others. While Pickett, in her early 40s, is a comparative newcomer, having completed her PhD in 1999, Wilkinson has been working on the social determinants of public health with varying levels of success and frustration for years. The spark for The Spirit Level came five years ago when extensive data first became available from the World Bank, and he realised that the phenomenon he had observed within his field - that health was driven by relative difference rather than absolute material standards - applied in other areas of social policy.

"It became clear," Wilkinson says, "that countries such as the US, the UK and Portugal, where the top 20% earn seven, eight or nine times more than the lowest 20%, scored noticeably higher on all social problems at every level of society than in countries such as Sweden and Japan, where the differential is only two or three times higher at the top."

The statistics came from the World Bank's list of 50 richest countries, but Wilkinson suggests their conclusions apply more broadly. To ensure their findings weren't explainable by cultural differences, they analysed the data from all 50 US states and found the same pattern. In states where income differentials were greatest, so were the social problems and lack of cohesion.

Two things immediately became clear to Wilkinson. "While I'd always assumed that an equal society must score better on social cohesion," he says, "I'd always imagined you could only observe a noticeable effect in some kind of utopia. I never expected to find such clear differences between existing market economies."

There are anomalies. Suicide and smoking levels are both higher in more equal societies. "Violence tends to be directed towards other people or yourself," Wilkinson says, "and it is our guess that in societies with a higher sense of community responsibility, people tend to blame themselves rather than other people when things go wrong. Smoking is a little different: all countries seem to follow a similar trajectory. It starts among upper-class men, then moves to upper-class women and then down the social ladder; quitting smoking seems to follow a similar pattern."

Even so, the correlation between inequality and social problems remains startling. And it is the differential rather than any notional baseline of poverty that's critical. The US has its own benchmarked poverty line, with some 13% of the population falling below it: yet of those who come into this category, 80% have air-conditioning, 33% have a dishwasher and 50% have two or more cars. Which is not quite what some other countries might call poverty.

In Britain, the Labour government, despite its protestations to the contrary, has only maintained inequality at the level at which it inherited it. "They've taken some positive action at the bottom income levels for pensioners and young families," says Pickett. "But the damage has all been done at the other end. Peter Mandelson said early in the Labour administration, 'We are intensely relaxed about people getting filthy rich,' and he's been as good as his word."

What is it about unequal societies that causes the damage? Wilkinson believes the answer lies in the psycho-social areas of hierarchy and status. The greater the differential between the haves and have-nots, the greater importance everyone places on the material aspects of consumption; what brand of car you drive carries far more meaning in a more hierarchical society than in a flatter one. It's the knock-on effects of this status anxiety that finds socially corrosive expression in crime, ill-health and mistrust.

Wilkinson draws on some eclectic illustrations. When monkeys are kept in a hierarchical environment, those at the bottom self-medicate with more cocaine; a caste gap opens in the performance of Hindu children when they have to announce their caste before exams; the stress hormone, cortisol, rises most when people face the evaluation of others; and so on. The result is always the same: fear of falling foul of the wealth gap gets under everyone's skin by making them anxious about their status.

For a while, Wilkinson and Pickett wondered if the correlations were too good to be true. The links were so strong, they almost couldn't believe no one had spotted them before, so they asked colleagues to come up with any other explanations. They looked at the religiosity of a society, multiculturalism, anything they could think of. They even looked at the possibility they had got it the wrong way round and it was the social problems that were causing the inequality. But nothing else stood up to statistical analysis.

Wilkinson openly admits The Spirit Level is his swan-song. He feels that as an academic he has fulfilled his side of the bargain by identifying the problem; it's up to activists and politicians to work out the solutions. Pickett doesn't see things quite that way, and is largely the driving force behind the creation of the Equality Trust website to campaign for change. "There must be a possibility of change," she says. "Everything stacks up. Reducing inequality fits in with the environmental agenda; it benefits the developing world, as more equal societies give more in overseas aid; and most significantly, everyone is fed up with the corporate greed and bonus culture that have caused the current financial crisis, so if ever a government had the electorate's goodwill to act, it's now."

Wilkinson is fairly blunt about where government should start. "It has got to limit pay at the top end," he says. "It's the rich that got us into this mess and the rich who should get us out of it." Whether Labour has the nerve to upset those whom it has most assiduously courted is another matter. But he can always dream, and in the meantime he is off home to watch TV.

"I've become gripped by Paris Hilton's Best Friend," he laughs. "It's the perfect example of a dysfunctional, hierarchical society."



1 comment:

Don said...

This is very important research and I tend to agree with the conclusions. The social quadrant must be healed and transformed (allowed to transform "upwards") as well as individual holons (medication [if necessary at first or continuing], psychotherapy, yoga, meditation, etc.).

You can buy this book and others by Wilkinson here -

http://www.amazon.co.uk/s/ref=nb_ss_b?url=search-alias%3Dstripbooks&field-keywords=Richard+Wilkinson&x=0&y=0