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The Inner Level: how more equal societies reduce stress, restore sanity and improve wellbeing
#LSEinnerlevel
Kate Pickett
Professor of Epidemiology in the Department of Health Sciences at the University of York, and the University's Research Champion for Justice and Equality
Chair: Beverley Skeggs
A feminist sociologist and the Academic Director of the Atlantic Fellows for Social and Economic Equity based in the LSE International Inequalities Institute.
Hosted by LSE International Inequalities Institute
Richard Wilkinson
Professor Emeritus of Social Epidemiology at the University of Nottingham Medical School, Honorary Professor at University College London and Visiting Professor at the University of York.
How More Equal Societies Reduce Stress, Restore Sanity and Improve Wellbeing
Photo by kind permission of Matt Stuart
Mental Health Foundation Survey, UK 2018
74% of adults (83% of 18-24 year-olds) felt so stressed they were overwhelmed or unable to cope sometime in the past year. 32% of adults (39% of 18-24 year-olds) had suicidal feelings as a result of stress. 16% of adults (29% of 18-24 year olds) had self-harmed as a result of stress.
Income Inequality
The naïve view: Inequality only matters if it creates poverty or if income differences seem unfair. A more accurate view: Inequality brings out features of our evolved psychology to do with dominance and subordination, superiority and inferiority. That affects how we treat each other and feel about ourselves. Inequality increases status competition and status insecurity. It increases anxieties about self-worth, and intensifies worries about how we are seen and judged – whether as attractive or unattractive, interesting or boring etc…
3.7 3.94.3
4.6 4.85.2 5.3
5.6 5.6 5.6 5.76.1 6.2
6.7 6.8 6.87.2
8.5
9.7
4.0
8.0
7.0
3.4
Japan
Fin
land
No
rway
Sw
eden
Denm
ark
Belg
ium
Au
str
iaG
erm
an
yN
eth
erl
ands
Sp
ain
Fra
nce
Canada
Sw
izte
rland
Irela
nd
Gre
ece
Italy
Isra
el
New
Zeala
nd
Au
str
alia
UK
Po
rtugal
US
AS
ingap
ore
Income gaps
How many times richer
are the richest fifth than
the poorest fifth?
Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk
Inequality...
How much richer are the richest 20% in
each country than the poorest 20%?
7
Social Relations
• School bullying
• Homicide
• Imprisonment
• Community life
• Trust
Bigger income gaps lead to
deteriorations in:-
Human Capital
• Child wellbeing
• High school drop outs
• Math & literacy scores
• Social mobility
• Teenage births
Health
• Drug abuse
• Infant mortality
• Life expectancy
• Mental illness
• Obesity
Robert Walker et al.
Poverty in global
perspective
Journal of Social Policy
2013; 42, 215-233
Bigger material differences create bigger social distances and increase social status
differentiation
Lancee B, Van de Werfhorst HG. Income inequality and participation: A comparison
of 24 European countries. Social Science Research. 2012; 41(5):1166-78.
Participation in local groups and voluntary organisations
is lower in more unequal societies
Civ
ic
part
icip
ati
on
sco
re
Income inequality (MDMI)
Wilkinson & Pickett, The Spirit Level www.equalitytrust.org.uk
People in more unequal countries trust each other less
0
30
60
90
120
150
180
Income Inequality
Ho
mic
ide
s p
er
millio
n p
eo
ple
Low High
Daly M, Wilson M, Vasdev S. Income inequality and homicide rates in Canada and the United States. Can J Crim 2001; 43: 219-36.
Homicide rates are higher in more unequal
US states and Canadian provinces
USA states
Canadian provinces
Cuernavaca, Mexico
‘Armed Response’ - Pretoria, South Africa.
Bowles & Jayadev, NYT 2014
’Gu
ard
La
bo
ur’
(p
er
10,0
00 e
mp
loyees)
More unequal societies need more “guard labor”
The proportion of
‘guard’ labor grew
with inequality.
USA 1979-2000
Inequality (Gini)
The Jekyll & Hyde of
Public Health?
• Friendship in contrast, is based on
reciprocity, mutuality, social
obligations, sharing and a recognition
of each other’s needs.
• Social status (dominance hierarchies,
pecking orders) are orderings based on
power, coercion and privileged access to
resources – regardless of the needs of
others.
Companion Spanish: Compañero;
French: Copain
from the Latin “Con” (with)
and “Pan” (bread)
- someone with whom you eat bread
Marshall Sahlins, Stone Age Economics (1974)
“Gifts make friends and
friends make gifts”
Wilkinson & Pickett, The Spirit Level
Index of:
• Life expectancy
• Math & Literacy
• Infant mortality
• Homicides
• Imprisonment
• Teenage births
• Trust
• Obesity
• Mental illness
– incl. drug &
alcohol
addiction
• Social mobility
www.equalitytrust.org.uk
Health and social problems are worse
in more unequal countries
Ind
ex o
f h
ealt
h a
nd
so
cia
l p
rob
lem
s
Low Income Inequality (Gini) High
UN
ICE
F I
nd
ex o
f C
hil
d W
ellb
ein
g
Child Wellbeing is lower in more unequal countries
Pickett & Wilkinson, Pediatrics 2015; 135 (1): S39-S47
Data from Corak (2013), World Bank (2013)
Where income inequalities are larger,
there is less social mobility
There is more mental illness in unequal societies
Italy
UK
GermanySpain
Belgium
Netherlands
USA
Australia
New Zealand
Canada
Japan
France
5.0
10.0
15.0
20.0
25.0
Perc
ent w
ith a
ny m
enta
l ill
ness
Low HighIncome Inequality
Inequality increases anxieties about status, making
people doubt their self-worth
Redrawn from data kindly provided by Richard Layte: Layte R, Whelan C. Who feels inferior? A test of the status anxiety hypothesis
of social inequalities in health. European Sociological Review. 2014;30:525-535
Messias E, Eaton WW, et al. . Economic grand rounds: Income inequality and depression
across the United States: an ecological study." Psychiatric Services, 2011; 62(7): 710-2.
Depression is more common in more unequal states
Perc
en
t o
f p
op
ula
tio
n
dep
res
sed
in
past
2 w
eeks
Income Inequality (Gini)
More people exaggerate their self-importance…
Redrawn from data kindly provided by Peter Kuppens and Steve Loughnan et al . Economic inequality is linked to biased self-
perception. Psychological science. 2011;22(10):1254-1258.
Australia
Belgium
ChinaEstonia
Germany
Hungary
Italy
Japan
Korea
Peru
South Africa
Singapore
Spain
USA
Venezuela
Low
High
Self e
nha
nce
men
t
Low HighIncome inequality
….and become more narcissistic
Income Inequality
Narcissm
20
25
30
35
To
p 5
% inco
me s
ha
re
15
16
17
18N
PI S
co
re
1975 1980 1985 1990 1995 2000 2005
College students’ Narcissistic Personality Inventory scores over time reflect the rise in US income inequality
Burns JK, et al.. Int J Soc Psychiatry, 2013; 60(2), 185–96.
…there is more schizophrenia
Addictive behaviour increases: e.g., gambling
Italy
Norway
UK
Germany
Denmark
Belgium
Netherlands
USA
Australia
Finland
New Zealand
Sweden
Canada
Switzerland
France
Singapore
0
1
2
3
4
Pre
va
lence
of pro
ble
m g
am
blin
g (
%)
Low HighIncome Inequality
There is more advertising in more unequal
countries
Iacoviello M. Household Debt and Income Inequality, 1963–2003. Journal of Money, Credit
and Banking 2008;40(5):929-65.
Household Debt and Income Inequality USA
The Effects of Income inequality
EVIDENCE OF CAUSALITY
Pickett KE, Wilkinson RG. Income inequality
and health: a causal review. Social Science &
Medicine 2015;128: 316-26
THEORY & PSYCHOSOCIAL PROCESSES
Wilkinson RG, Pickett KE. The enemy
between us: The psychological and social
costs of inequality.
European Journal of Social Psychology, 2017;
47, 11-24. http://dx.doi.org/10.1002/ejsp.2275
The Inner Level: how more equal societies reduce stress, restore sanity and improve wellbeing
#LSEinnerlevel
Kate Pickett
Professor of Epidemiology in the Department of Health Sciences at the University of York, and the University's Research Champion for Justice and Equality
Chair: Beverley Skeggs
A feminist sociologist and the Academic Director of the Atlantic Fellows for Social and Economic Equity based in the LSE International Inequalities Institute.
Hosted by LSE International Inequalities Institute
Richard Wilkinson
Professor Emeritus of Social Epidemiology at the University of Nottingham Medical School, Honorary Professor at University College London and Visiting Professor at the University of York.
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