In my last post I summarised the morning session of the York inequality workshop I attended last week. Today I’ll cover the main event of the day, the plenary session by Kate Pickett and Danny Dorling.
Kate is well known as one of the co-authors of The Spirit Level, a book about the many and varied impacts of inequality in society that received major publicity a few years ago. Danny Dorling has written several books on the topic, including Inequality and the 1% and Unequal Health: The Scandal of Our Times. They delivered the talk jointly, framing it as somewhat of a contrast — with Danny offering a fairly sobering perspective on inequality, followed by Kate with a slightly more optimistic picture.
Inequality in the UK
Danny opened by showing us some graphs which showed a worrying trend. The National Health Service here in the UK tracks a statistic on its success in reducing premature death from preventable causes — it’s referred to as statistic 1A, perhaps the single most important indicator of the health service’s performance. The graph showed that in recent years, progress has stalled on this all-important indicator. This has coincided with a general rise in health inequality in the UK and ever-increasing economic inequality.
In terms of the broader picture, the UK is at the bottom of the league tables in terms of equality in Europe. Infant mortality is among the highest in Europe — our figures are closer to Europe than to Sweden. Our income inequality is the highest in Europe, with the best-off 10% of the population taking home 28% of the country’s income.
Danny argued that research shows income inequality has a disastrous effect on everyday life and culture in highly unequal countries. People in unequal countries tend to trust each other less, and tend to think of other people as less deserving of help. Social classes become stratified, and culture begins to separate along economic lines. Health inequality gets more severe as economic inequality grows — and that leads to disturbing outcomes. For example, here in the UK two times more children die each year than in Sweden, a country with much greater equality.
Do we care enough?
By way of demonstration, Danny presented us with a number of comments from GPs on a story about the growing number of requests from patients for referrals to food banks. In comment after comment, GPs offered comments that were shockingly unconcerned about the fact that their patients found themselves unable to put food on the table. These patients were described as irresponsible, their problems seen as medically irrelevant or simply not the GP’s responsibility — despite the very clear and obvious link between poverty and poor health.
Danny presented these as evidence that even amongst members of our society trained specifically to look after others, the predominant view in recent years is that there are a substantial portion of people who do not deserve our help. We are inclined to see people around us as irresponsible or lazy, rather than victims of circumstance, even despite the evidence that the vast majority of people in poverty spend enormous amounts of time and energy trying to escape it.
He argued that this predominant mindset leads to a culture in which we simply don’t care enough about the circumstances of others, and as a consequence we don’t act to prevent unnecessary death and misery in our society. He pointed to figures showing the link between economic inequality and traffic deaths — two times more children die crossing the street than in more equal societies like France, the Netherlands or Norway. Deaths due to suicide or drug poisoning are also far higher in the UK. Overall we have a much higher incidence of mental illness in the UK than in Europe, second only to the US.
The political view
Danny closed by discussing how these damaging views on equality in our society are promoted and perpetuated by those in power. Statistics show that the UK spends less on a per-capita basis for healthcare than any comparable country — in some cases drastically less (on the order of 28-40% lower than most countries in Europe, and half or less the spend of some countries like Denmark). The fact that the NHS is able to demonstrate as many good health outcomes as it does is remarkable, given how little we spend compared to our neighbours.
When we zoom out and look at state spending in the UK as a whole, the trend continues. The current Conservative government is presiding over a drastic shrinking of the state, to a level not seen since 1918. Children in private education have 4.5 times more money spent on them than state schoolkids. Once again when we compare state spending on health and welfare in the UK as a proportion of the overall budget, we are way down at the bottom of the league table.
Yet despite all this, the current government continues to paint a picture of the UK as a country where state spending is out of control. George Osborne tells us that we’re a reckless tax-and-spend country, painting a dire picture of overspending leading to a precarious economy that could collapse at any moment (despite so many experts disagreeing with both his assessment and his predictions of the consequences of the sovereign debt).
So, Danny asks, does Osborne and the rest of the government actually believe this? Are they so steeped in this economic view that they fail to see the myriad statistics that show the opposite? How do they fail to see that these merciless budget cuts, so often levelled at the poor, the sick, and the disabled, push us further down the road toward deep inequality that will damage our health and further divide our society?
Kate’s response — Is it as bad as all that?
After Danny’s presentation the mood in the room was understandably severe. He painted a picture of severe and growing inequality in the UK, and a government that appears totally uninterested in addressing it. With our own views seeming fundamentally warped by inequality, is it even possible that we can get things back on track?
Kate started off by saying that she was going to try to offer a more optimistic picture than Danny — but that in fact everything he said was right and she didn’t disagree fundamentally with any of it.
She started off by highlighting the issue of wealth inequality, which has been a topic of much greater interest in recent years due to movements such as Occupy Wall Street. She showed some graphs confirming the stratospheric rise in the share of wealth going to the top 1% of society in the US and UK since 1980 — a direct consequence of the policies of the Reagan/Thatcher era. Post-1985 we’ve also seen a massive rise in pay for CEOs relative to their employees — we’re now at a point where CEOs tend to make 300-400 times what their average employee makes. The UK historically was much less bad than the US on this measure, but in recent years has caught up.
Rising awareness of inequality
Kate said that one positive aspect of this is that most of these facts and figures are by now quite familiar to many of us — in no small part due to the efforts of Occupy Wall Street and similar movements. She argued that wealth inequality has become part of the conversation now, after the economic crisis. She gave several examples of how wealth inequality is now a target for major charities, including Oxfam.
She pointed to a particular campaign from Oxfam which offered the statistic that the world’s richest 85 people hold the same wealth as the poorest 3.5 billion people. As it turns out, they got the figures wrong and had to present a correction — in fact, the richest 83 people hold the same wealth as the poorest 3.5 billion.
As it happens, Oxfam has updated those numbers just a few hours ago — and things have become even worse. Now the top 62 wealthiest people hold the same wealth as the poorest 3.6 billion people on Earth — the bottom 50%.
As far as the UK is concerned, Kate discussed the case of the Sustainable Development Goals panel at the United Nations. This panel, of which the Prime Minister David Cameron was a member, was tasked with producing a series of key goals for all countries leading up to the year 2030. Kate in her capacity as equality campaigner and co-founder of The Equality Trust wrote to all the world leaders on this panel to urge them to include reducing inequality as one of the development goals. She received a positive response from every leader on the panel (including President Barack Obama) — except for David Cameron. He delegated his response to one of his cabinet ministers, who told her that inequality is not a policy priority in the UK.
Fortunately the other world leaders overruled Cameron’s objections, and the Sustainable Development Goals explicitly include reducing inequality (see #10). This whole scenario very much backs up Danny Dorling’s assertions about the UK government’s views on inequality — they seem more than happy to ignore the evidence of the impact of inequality and continue their efforts to widen these gaps in society.
Can we reduce the impact of inequality and greed?
As a way of offering a more positive perspective, Kate discussed an interesting study about the behaviour of wealthy people. She highlighted the work of Paul K Piff, a social psychologist who studies the behaviour of the wealthy. He found that higher social class is a strong predictor of unethical behaviour — in laboratory studies wealthy people are more likely than poorer people to break the law while driving, steal valuable items from others, lie during negotiations, and so on (see the 2012 PNAS paper). One of his studies actually, seriously involved taking candy from children — and yes, the wealthy subjects were far more likely to do it.
Follow-up studies have shown something interesting, however — when the wealthy subjects are asked to ponder some facts and statistics regarding inequality before engaging in these tests, their behaviour becomes markedly more moderated. They become less likely to make unethical decisions once they’re asked to keep those ideas in mind.
So, in Kate’s view, this means that there’s a real, demonstrable impact from spreading the word about the problems caused by inequality, and from making these ideas part of the public debate. The more people ponder these ideas, the more they may moderate their own behaviour — and perhaps become motivated to start their own efforts to address the problem. She noted the recent spread of Fairness Commissions in local authorities throughout the UK, and suggested that these are a consequence of far greater numbers of people contemplating inequality and wanting to take direct action to address it locally.
Conclusions and thoughts
As is often the case with these kinds of presentations, I came away from the session feeling rather overwhelmed, exhausted and depressed — despite already knowing most of these figures. There’s something about being shown the whole grim picture at once that makes it feel like a real gut-punch of hopelessness and despair. All I could think was how powerless we all seem to be to stop the endless march toward inequality and division, how the entire power structure of the world seems oriented toward consolidating wealth and power at the very top of society while the rest of us are left with poverty and desperation.
In that respect I appreciated Kate’s perspective — she did offer some hope by presenting a possible future in which keeping inequality in the public conversation leads to changes in our behaviour, which eventually will be reflected in the structure of our societies. She showed us that world leaders — well, except for David Cameron — do consider inequality a problem at least on some level, and are willing to commit to addressing it in the coming years.
However, I do feel that us academics need to do more here. While I was comforted somewhat by what Kate had to say, I don’t think things are moving in the correct direction at all currently — as evidenced by the updated Oxfam report above. On top of that, for every year these trends toward inequality continue, many many thousands more people across the world will die unnecessarily due to preventable causes, many of them attributable to inequality. While it seems true that our community’s efforts to raise the profile of these issues are bearing fruit, we can’t hope to make a dent in these things by offering the occasional nugget of info every so often. We should be taking sustained, concerted action.
That’s my view, anyway — and as anyone who knows me can testify, I’m always of the opinion that academics shouldn’t be afraid to step out of the ivory tower and cause a ruckus when we have something important to say. In my mind, these studies of inequality are exactly that sort of thing — by pushing for action on these issues, which our community has studied a great deal, we can make a huge difference, even save many lives. So we should follow up on this great work and keep up the pressure.
Dr Eric Silverman 