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1 Richard Wilkinson Emeritus Professor of Social Epidemiology University of Nottingham & Kate Pickett Professor of Epidemiology University of York http://www.equalitytrust.org.uk

Wilkinson Presentation 110111

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Page 1: Wilkinson Presentation 110111

1

Richard WilkinsonEmeritus Professor of Social Epidemiology

University of Nottingham

&

Kate PickettProfessor of Epidemiology

University of York

http://www.equalitytrust.org.uk

Page 2: Wilkinson Presentation 110111

2

Income per head and life-expectancy: rich & poor countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 3: Wilkinson Presentation 110111

3

Among the rich countries life expectancy is not related to national differences in average income

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 4: Wilkinson Presentation 110111

4

…but life expectancy is related to income within rich societies

Source: Wilkinson & Pickett, The Spirit Level (2009)

70

71

72

73

74

75

76

77

78

79

80

Least d

epriv

ed

Most d

epriv

edElectoral wards in England & Wales by deprivation score

Life

exp

ecta

ncy

(yea

rs)

www.equalitytrust.org.uk

Page 5: Wilkinson Presentation 110111

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How much richer are the richest 20% than the poorest 20%?

www.equalitytrust.org.ukSource: Wilkinson & Pickett, The Spirit Level (2009)

Page 6: Wilkinson Presentation 110111

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Page 7: Wilkinson Presentation 110111

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Index of: • Life expectancy• Math & Literacy • Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness – incl.

drug & alcohol addiction

• Social mobility

Health and Social Problems are Worse in More Unequal Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 8: Wilkinson Presentation 110111

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Health and Social Problems are not Related to Average Income in Rich Countries

Index of: • Life expectancy• Math & Literacy • Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness – incl.

drug & alcohol addiction

• Social mobility

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 9: Wilkinson Presentation 110111

9

Child Well-being is Better in More Equal Rich Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 10: Wilkinson Presentation 110111

10

Child-Wellbeing is Unrelated to Average Incomes in Rich Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 11: Wilkinson Presentation 110111
Page 12: Wilkinson Presentation 110111

12

Levels of Trust are Higher in More Equal Rich Countries

Source: Wilkinson & Pickett, The Spirit Level (2009)

Page 13: Wilkinson Presentation 110111

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Levels of Trust are Higher in More Equal US States

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 14: Wilkinson Presentation 110111

14

The Prevalence of Mental Illness is Higher in More Unequal Rich Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 15: Wilkinson Presentation 110111

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Infant Mortality Rates are Higher in More Unequal Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 16: Wilkinson Presentation 110111

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Drug Use is More Common in More Unequal Countries

Source: Wilkinson & Pickett, The Spirit Level (2009)

Index of use of: opiates, cocaine, cannabis, ecstasy, amphetamines

www.equalitytrust.org.uk

Page 17: Wilkinson Presentation 110111

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Teenage Birth Rates are Higher in More Unequal Rich Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 18: Wilkinson Presentation 110111

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Homicide and income inequality: US States and Canadian Provinces

0

30

60

90

120

150

180

0.35 0.38 0.41 0.44 0.47

Income Inequality (Gini)

Ho

mic

ide

s p

er

mill

ion

pe

op

le

More equal More unequal

Source: Daly M, Wilson M, Vasdev S. Income inequality and homicide rates in Canada and the United States. Canadian Journal of Criminology 2001; 43: 219-36.

Page 19: Wilkinson Presentation 110111

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Rates of Imprisonment are Higher in More Unequal Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 20: Wilkinson Presentation 110111

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Social mobility is higher in more equal countries

www.equalitytrust.org.uk

Intergenerational income mobility data from: Blanden J. (2009) Centre for Economic Performance, LSE. Paper No' CEEDP0111.

Page 21: Wilkinson Presentation 110111

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Almost everyone benefits from greater equality.

Usually the benefits are greatest among the poor but extend to the majority of the population

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Infant Mortality by Social Class: Sweden and England & Wales

0

2

4

6

8

10

12

14

16

18

I II IIIN IIIM IV V SinglePrnt

Unclass.

E & W

Sweden

Source: Leon DA, Vagero D, Olausson PO. BMJ 1992; 305; 687-91

Infa

nt

Mo

rta

lity

rate

Page 23: Wilkinson Presentation 110111

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Literacy Scores of 16-25 year olds by Parents' Education

-1.5

-1

-0.5

0

0.5

1

2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Parents' Education (years)

Lit

era

cy

sc

ore

Sweden

Canada

United States

Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.

Page 24: Wilkinson Presentation 110111

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Index of: • Life expectancy• Math & Literacy • Infant mortality• Homicides• Imprisonment• Teenage births • Trust• Obesity• Mental illness – incl.

drug & alcohol addiction

• Social mobility

Health and Social Problems are Worse in More Unequal Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 25: Wilkinson Presentation 110111

25

Australia

Austria

Belgium Canada

Denmark

Finland

France

Germany

Greece

Ireland

Israel

Italy

Japan

Netherlands

New Zealand

Norway

Portugal

Spain

Sweden

UK

USA

Worse

Better

UN

ICE

F in

dex

of c

hild

wel

l-bei

ng

0 10 20 30Lone parents as % of all households with dependent children

Single parents and child wellbeing

Page 26: Wilkinson Presentation 110111

26

Why are we so sensitive to inequality?

Page 27: Wilkinson Presentation 110111

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Psychosocial risk factors for ill health

Low social status

Weak social affiliations

Stress in early life (pre- and postnatally)

Page 28: Wilkinson Presentation 110111

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ACTH

Cortisol

Tasks with both social-evaluative

threat and uncontrollability

Other tasks

Eff

ect

size

Source: Dickerson SS & Kemeny ME. Psychological Bulletin 2004; 130(3): 355-91

What kind of stress most reliably raises cortisol levels?

Page 29: Wilkinson Presentation 110111

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Gilligan J. Violence: Our Deadly Epidemic and its Causes. (G .P. Putnam 1996)

" ...the prison inmates I work with have told me repeatedly, when I asked them why they had assaulted someone, that it was because 'he disrespected me', or 'he disrespected my visit' (meaning 'visitor'). The word 'disrespect' is central in the vocabulary, moral value system, and psychodynamics of these chronically violent men that they have abbreviated it into the slang term, 'he dis'ed me." p.106

A few pages further on Gilligan continues:- "I have yet to see a serious act of violence that was not provoked by the experience of feeling shamed and humiliated, disrespected and ridiculed, and that did not represent the attempt to prevent or undo this "loss of face " - no matter how severe the punishment, even if it includes death." p.110

Page 30: Wilkinson Presentation 110111

Social Status and Friendship

Two sides of the same coin:

Social status (dominance hierarchies, pecking orders) are orderings based on power, coercion and privileged access to resources – regardless of the needs of others.

Friendship, in contrast, is based on reciprocity, mutuality, social obligations, sharing and a recognition of each other’s needs.

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Stereotype Threat

The effect of caste identity on children's performance

Caste Unannounced

Caste Announced

0

1

2

3

4

5

6

High Caste

Low Caste

Num

ber

of m

azes

sol

ved

Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004

Page 32: Wilkinson Presentation 110111

Dunbar R. Brains on two legs: group size and the evolution of intelligence In: Tree of Origin: F de Waal. (ed) 2001.

The Social Brain: the neocortex is a larger proportion of the brain in primate species with larger social groups

Ave

rag

e so

cial

gro

up

siz

e

Neocortex ratio

Page 33: Wilkinson Presentation 110111

Trends in income inequality 1979-2005/6 (Gini coefficient, Great Britain.)

Brewer M, Goodman A, Muriel A, Sibieta L. Poverty and Inequality in the UK: 2007. Institute of Fiscal Studies, London.

Page 34: Wilkinson Presentation 110111

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http://www.equalitytrust.org.uk

For more information:

… a book

and a website…

Page 35: Wilkinson Presentation 110111

Equality and Sustainability

. . . a convenient truth

Page 36: Wilkinson Presentation 110111

www.equalitytrust.org.uk

Wo

rld

ave

rag

e C

O2

Page 37: Wilkinson Presentation 110111

Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005.

Working hours are longer in more unequal countries

Page 38: Wilkinson Presentation 110111

More equal countries are more generous foreign aid donors

Page 39: Wilkinson Presentation 110111

More equal countries recycle more waste

Source: Wilkinson & Pickett, The Spirit Level (2009)

Australia

France

Germany

Italy

Japan

Portugal

Spain

Sweden

Switzerland

UK

USA

Best

Worst

Re

cycl

ing

(a

vera

ge

ra

nk)

Low HighIncome Inequality

Page 40: Wilkinson Presentation 110111

In more equal countries business leaders give a higher priority to complying with international environmental agreements

With permission from R De Vogli & D Gimeno

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InequalityDebt

Debt

P. Krugman Inequality and Crisis: coincidence or causation? Data from: Picketty-Saez, Historical Statistics, Federal Reserve.

Inequality and Household Debt 1913-2007H

ou

seh

old

deb

t as

% o

f in

com

e

Ineq

ual

ity:

ric

hes

t 1%

sh

are

Page 42: Wilkinson Presentation 110111

More equal societies are more innovative

www.equalitytrust.org.uk

Page 43: Wilkinson Presentation 110111

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More Adults are Obese in More Unequal Rich Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 44: Wilkinson Presentation 110111

The public and policy response?

more:-

Police

Doctors

Social Workers

Drug rehabilitation units

Educational Psychologists

But…services are expensive and only partially effective.

Page 45: Wilkinson Presentation 110111
Page 46: Wilkinson Presentation 110111

Children Experience More Conflict in More Unequal Societies

Source: Wilkinson & Pickett, The Spirit Level (2009)

11, 13 & 15 yr olds fighting, bullying, and finding peers not kind & helpful

www.equalitytrust.org.uk

Page 47: Wilkinson Presentation 110111

More Children Drop Out of High School in More Unequal US States

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

Page 48: Wilkinson Presentation 110111

Cognitive Score: Socioeconomic status more important than starting point

High Cognitive Score at 22 months

Low Cognitive Score at 22 months

2 3 4 5 6 7 8 9 10 Child’s age (years)

Co

gn

itiv

e sc

ore

p

erce

nti

le p

osi

tio

n a

t ea

ch a

ge

(I Feinstein. Inequality in cognitive development. 1970 British Births. Economica 2003; 70: 3-97) (from The Marmot Review 2010)

Page 49: Wilkinson Presentation 110111

Educational Scores are Higher in More Equal Rich Countries

Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk

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The effects of inequality - a two stage process

1. adult experience of inequality

2. passed on to children – epigenetics?