As the gap between rich and poor widens, epidemiologist Richard Wilkinson, author, with Kate Pickett, of the ground breaking book, The Spirit Level, explains to Prabhjit Bains that more unequal societies are bad for almost everyone within them – not just those at the bottom, and suggests steps that need to be taken for the good of all of us. The book is the culmination of 30 years of research and Prabhjit started by asking Professor Wilkinson what was the focus of his research.
Richard Wilkinson: I’m an epidemiologist which means I have spent my career looking at the health in populations rather than clinically in individuals or in the laboratory. So, most of the causes of ill health – you know when you discover that a Cancer is due to people working with some chemical or another – that kind of work is epidemiology.
I’ve been particularly interested in health inequalities – the big social class differences in health. One of the big changes in our understanding of what drives population health in the rich developed countries is how important psycho-social things are. Things that make you feel stressed and anxious and so on. It’s become increasingly clear that there’s a whole range of problems like health that are worse at the bottom of the social ladder and really what we’ve added to that picture is that societies with bigger income differences between rich and poor do worse on all the kind of problems that have those social gradients i.e. they are more common at the bottom of the social ladder.
When I say ‘psycho-social factors affecting your levels of stress and anxiety’, I mean all sorts of things like low social status, difficult early childhood, insecurities and so on. We know now how these affect the immune system and the cardiovascular system and so on.
Prabhjit Bains: At the beginning of the The Spirit Level, as you mentioned, we learn that low incomes have a huge impact not just on developing countries and not just amongst the lowest in society but right across the board. You say that the benefits of economic growth reach an optimum levels – but above this, there is a plateau whether it’s in health benefits or reductions in crime, and so on.
RW: You can see that very clearly. There are rapid rises in life expectancy, in measures of well being and so on in the early stages of economic development and then it levels out. So whether countries are as rich as the poorer rich developed countries like Portugal, Israel and Greece or whether they are as rich as the richest (twice as rich) like USA and Norway makes no difference to life expectancy, or infant mortality or whatever. You see the same pattern for other measures of wellbeing and for happiness.
So although economic growth is what has transformed the real quality of our lives, it’s done its work. It’s not only when you look cross sectionally and see that further economic growth no longer produces additional benefits, it’s also that if you look over time within any of our societies, national income per head may double but measures of wellbeing are flat-lining. This is not rhetoric, its good scientific evidence. As we become more aware of the problems of climate change and the costs of economic growth, we are rgoing to have to take that on board. So far most politicians are not willing to do that.
PB: So you feel that the discussion hasn’t taken hold in the public domain as you would have liked?
RW: No, and the reason of course why people go on talking about the need for economic growth is that business profits goes up in times of growth and unemployment goes down.
But we will need to solve the problems of unemployment in quite a different way. The New Economics Foundation was suggesting that we need to move towards a 21 hour week. Instead of taking the benefit of improvements in productivity by pushing up material standards of consumption, we need instead to take the benefits of increased productivity in terms of having more leisure. We can now produce the same amount in less time, so let’s all have more time for friends, family, each other.
Actually, before industrialisation, pre industrial society was typically what they used to call ‘leisure preference society’ so when standards of living went up people took the benefit of that in terms of more leisure. We’ve got to go back to that. Rather than more economic growth let’s just have more time for each other.
PB: As you say, people take the view that economic growth is the way to develop, the way to prosperity for everyone. But you also talk about relative and absolute poverty, in particular how economic growth lifts people out of absolute poverty.
RW: You can look at a whole range of health and social problems; levels of violence, teenage births, obesity, drug abuse, mental health, physical health in terms of life expectancy – and in rich countries that get richer still, it makes no difference to those things. Even measures of child wellbeing are not helped if one of our rich countries gets twice as rich. What matters at this point is the scale of income differences between us. How much inequality there is.
However, although I say economic growth now makes no difference in the rich countries to our levels of life expectancy, life expectancy within our countries is extraordinarily closely related to income or social status. That is because we are dealing with relativities- it’s where you are in society and how big the gaps are between us that really matters and those problems get much worse in more unequal societies.
PB: But some may argue that equalising that gap would make things difficult, it would drag everyone back.
RW: There is absolutely no evidence of that, if you look at levels of inequality, and if you are interested in economic growth, greater inequalities seem to actually hamper growth. There have been recent reports, I can’t remember if from the IMF or the World Bank, showing that more unequal countries have bigger booms and slumps and less sustained periods of growth.
But as I have said, growth is not what we want. Economic growth in the past is what has transformed the real quality of our lives but it’s really important to remember it’s finished its work and no longer carries the very important benefits it used to carry. What we have to do now to improve the real quality of our lives is to reduce the income differences between us.
I think many people are aware of the contrast between the material success of our societies and their many social failings. Measures of depression and so on are going up, measures of mental illness are going up- there’s a number of problems – the levels of self harm amongst teenage girls at school are appalling and there is a whole range of problems like that and people are failing to understand what going on. However, if you look at inequality you find that more unequal countries like the United States, Britain, Portugal, have ten times the level of some of these problems, as the more equal societies like Scandinavia or Japan. The differences are simply huge. For example, the proportion of people in prison, the levels of violence, teenage births – there are tenfold differences in some of those outcomes. If you look at levels of mental illness or infant mortality perhaps two or threefold differences but we are not talking about 10% more of a problem, or 20% more – we are talking about anything from two or three times as much of any of these problems to ten times as much and that is a major reflection of what inequality does to the quality of people’s lives.
PB: You touched on this material success, and I quote from the book ‘second rate goods are assumed to reflect second rate people’.
RW: One of the things that seems to happen in more unequal societies is there is more status competition, more insecurity. If some people seem worth more, or seem hugely important, and other people are apparently almost worthless failures, then where you come (or where people think you come) seems very important. We all get more twitchy about that.
PB: So does consumerism mediate the identification of our place in society? Are we buying into ‘first rate’ brands in order to alleviate our social anxiety?
RW: A lot of studies show that people are more into consumerism and shopping and so on – people talk about it as retail therapy, though it doesn’t actually help much. It signals insecurity about how you are seen and judged.
We talk about consumerism as if it were a reflection of a basic acquisitive human nature, but it isn’t. It’s how we are trying to represent ourselves to other people. We want to be seen in a good light, we want to be seen as successful, as part of the society. I remember a man who was unemployed and spent hundreds of pounds he hadn’t really got on a mobile phone and he said that girls wouldn’t talk to him if he didn’t have the right stuff – it’s why these status differences hurt, because they are seen as a measure of ability. We think of people at the top as hugely capable and the ones at the bottom as failures. We thought the Bankers were brilliant until the crash. It’s because we read off ability from social status that it hurt so much. We do that less in a more equal society; we are more likely to take each other at face value.
PB: So do you think the Bankers identity has been re-branded as a result of the financial crash? Are they still seen as successful by society?
RW: Well, you know there was lot anger about the Bankers and people are suddenly astonished to learn of the level of income they were giving themselves. When people heard of it occasionally before the crash they thought that somehow the Bankers earned these sums – they don’t. They just give it to themselves despite the appalling mistakes they were making and the risks they were running. Risk taking that was probably increased in order to get these big bonuses and so on.
PB: So we feel that income and being able to ‘flash your cash’ is an indication of your social standing. But since the 60s and 70s social mobility in the UK has decreased, it is really, really stagnant. Can that change?
RW: There are good studies of levels of social mobility in different countries and the evidence is pretty clear now that societies with bigger income differences between rich and poor have lower social mobility. For example, the USA, one of the most unequal countries, has the lowest social mobility. We took that relationship seriously even when we had rather little data because we knew that Britain and the States, while they became more unequal, social mobility had slowed – whether you regard bigger income differences as meaning that the social ladder is steeper or that the rungs on the ladder are farther apart which means it’s harder to get up and down.
We sometimes joke that if Americans really want to live the ‘American Dream’, rather than just dream it, they should go to a country like Denmark where there’s a much bigger chance of getting from the bottom to the top.
PB: Do you feel that the public expenditure on education has a huge impact on social mobility?
RW: It makes a difference but it can work either way around. You can have an educational system that cements social differentiation and I think that is probably what we have got in this country with the private schools.
I was astonished to see that the new Archbishop of Canterbury is an Etonian like so much of the Conservative Cabinet – it’s bizarre that this whole slice of the top layer of the population have been to the same school. In some of the more equal countries, private education hardly exists and where it does, it’s not regarded as higher status but as something that people with some peculiar ideology want to do for some strange social or religious reason. We shouldn’t regard just pouring money into education is a necessary route, but rather changing the structure of the educational system and getting rid of, or enormously reducing, the private sector.
I have spent most of my time trying to understand these social gradients in health and other social problems and then trying to understand why they all become so much more common in unequal societies. Incidentally, one thing I haven’t said is that in more unequal societies these problems are not just more common amongst the poor; they are more common amongst all of us. If you take an individual with a given level of education and income and position in the job hierarchy, if that same person lived in a more equal society they’d probably live a wee bit longer, their kids are likely to do a bit better at school in terms of these international maths and literacy scores, you’d be less likely to become a victim of violence and your kids are less likely to become teenage parents or get involved in drugs.
So in that sense we all do better in a more equal society. The effect of inequality is greatest at the bottom, but even far up the social scale you do better in a more equal society. And so this is really about the quality of life for the vast majority of society.
The way we should be improving the quality of life now is not by pushing up the material standards in a status competition, consumerist fashion. We’ve got to the end of what we can achieve as a society like that. What we must now do is improve the quality of the social environment and the really exciting thing is that we can improve the social environment by reducing the scale of income differences between us. That’s really important.
PB: How do we get that message across? What is impeding that understanding amongst the decision makers, the policy makers, the law makers? How do you get laws that close the inequality gap? What is stopping that?
RW: Well, I should say there are quite different ways of becoming a more equal society. Some do it through re-distribution, taxes and benefits and so on. Others start off with smaller income differences before taxes and do much less re-distribution. I think we probably have to use both methods.
I have no doubt that we’ve got to tackle the problems of tax evasion, the tax havens and so on, both by companies and rich individuals. It’s just appalling that some big companies pay virtually no tax and that many rich individuals pay less tax than much poorer people, or have a smaller proportion of their income in tax than poorer people. We used to think of income tax as being progressive and we must re-instate that, but the problem with relying on re-distribution is twofold. One is that people feel it’s their money being taken away from them by this nasty Government. The other is that a new incoming Government can undo at the stroke of a pen, any progressive changes that have been made.
So we have to get greater equality more deeply rooted in our society. The bonus culture, the top incomes that have run away from us, that’s why we’ve become more unequal societies over the last few decades – it is because the rich have run away from the rest of us rather than because the poor have fallen further behind.
The reason why the top incomes have taken off is because the people at the top felt that they could do whatever they liked. They didn’t feel that they had to be accountable to anyone. We must answer that by making them accountable, whether it’s by having employee representatives on the boards of companies or whether it’s by having more employee owned companies, more Mutual’s, more Friendly Societies, more Co-operatives. All those kinds of more democratic companies have small income differences between top and bottom. In the FTSE 100 companies the typical ratio of income from the top to the bottom is 300 to 1. Whereas in the public sector its 10, 15 sometimes 20 to 1. In the more democratic companies, it’s more like the public sector.
The elephants in the living room are the huge undemocratic centres of power in multi-nationals which often act extraordinarily anti-socially. Think of the response of the tobacco companies to finding it harder to sell cigarettes, with declining sales in the rich countries as people became more aware of the dangers of smoking. They opened up the markets in the third world knowing they are going to kill millions. We have had that time and time again. For example, the danger of some chemical is discovered and research begins to point the finger at it – so, of course, whatever company is being affected fights it tooth and claw simply to defend its profits. We must get rid of that kind of thing. The more democratic companies tend to do better in ethical terms and in environmental terms. Even the Co-operative Bank for instance gets awards for environmental and ethical things. It’s partly because the employees are not absolved from responsibility for what their companies are doing. If you are working for a multi-national it’s not your business to think of the morality of what’s going on.
PB: KMPG released a report earlier this year saying that employees are no longer looking just for a job with a healthy pay check, they also want one that gives a social meaning to their life. Are you suggesting having more ethical businesses, more empathetic businesses.
RW: Well they must be more democratic in terms of their constitution. Things change when management become responsible to the body of employees and it’s not only the benefits in terms of smaller pay differences. Studies show that you’ll get better productivity in more democratic structures. I was going to do some research on employee owned companies, employee owned and controlled companies and I visited a couple that had been through employee buy outs and people were saying that it turns a company from being a piece of property into a community. We have lost community in residential areas – people don’t know their neighbours. Yet it is at work that we are most involved with each other but at the same time it is at work that we are most divided by hierarchy and pay differences and so on. We must change that.
PB: Big Society people have been quoting some research mentioned in the ‘Spirit Level’ from epidemiologist Ichiro Kawachi from the Harvard School of Public Health that found people who are part of voluntary organisations have lower death rates.
RW: There are several things there. One is that more equal societies are more cohesive and not only is community life stronger, but people trust each other more and people are more involved in voluntary associations and so on. If you want a Big Society the most effective way of producing it is reducing the divisive income differences. People have known for centuries that inequality is divisive and socially corrosive and in a way that’s all the data shows us. What we also know now is that more cohesive societies are healthier societies. It looks as if at a very fundamental level we as human beings need that social contact and so on. We know about the importance of early childhood, of social status and friendship, how important those are to health – it’s just as the early studies showed – babies need more than just food putting into them to gain weight, they need that loving interaction, the eye contact, the handling from a parent.
In a way, the epidemiology is telling us that these psycho-social influences on health are about the social needs of adults. Friendship is one of the most powerful influences on health. A study which reviewed or combined data from about 150 studies of friendship and health showed that friendship was as important or slightly more important than whether or not you smoke to survival over a follow up period. Basically the picture of why social status friendship, and early childhood are important psychosocially – influencing health and all sorts of other outcomes – is because of the insecurities you can have from a difficult early childhood. Anxieties, feeling you are not valued and so on are rather like the insecurities and feeling you’re not valued that you get from low social status – friendship fits into that pattern because if you’ve got friends there are people that value you. Whereas if you feel people exclude you, they don’t invite you to things, they choose not to sit next to you, we all know how these insecurities come flooding in – maybe I’m boring, unattractive, socially gauche- all that kind of thing. Basically, those major groups of risk factors – low social status, lack of social contacts and difficult early childhood – are telling us about the same underlying problem of negotiating relationships with others and you see we all get more twitchy about those issues in a more unequal society because instead of just being accepted as a fellow human being, we start thinking –is she worth anything in terms of her status? where does this person fit in?
I think that in unequal societies the problems of low self esteem, social anxieties, feeling that social contact is a bit of an ordeal – all those kinds of problems – increase. And we also see people going under faced with those kinds of worries about how they are seen and judged.
But there’s another end of it, where people respond to what psychologists call ‘social evaluative threat’ by becoming more narcissistic – by talking themselves up, ‘I’m really good at this that and the other’. One of the costs of greater inequality is people can no longer afford to be modest about their achievements and abilities – you have to flaunt them, often as a cover for great insecurity. So it’s not only that all those problems that I mentioned like violence, drugs, ill health get worse in more unequal societies, but it is also these worries about how we are seen and judged and those are important things that affect our intimate lives.
PB: So the American philosophy of ‘ You’re fantastic, you can achieve anything no matter what your social background, or where you started off in life, whether your parents were involved in your education, whether there were higher crime rates in your community, it doesn’t matter – you can rise above it, you can step out.” Is that something which is more conducive towards social mobility or does it hinder it?
RW: Well what people have often been challenged to rise above is the disadvantages of inequality and so you set up the hurdles and tell people to jump. The damage done by inequality in terms of lower social mobility, lower maths and literacy scores, more drug problems and so on, more people in prison – you know it’s not a good society.
PB: No, and it become a rarity when people do rise above it rather than it being the norm. Thank you for such an enlightening talk.
Transcript prepared by Sheena Bateman