Kate Pickett is a Senior Lecturer in Epidemiology at the University of York and co-author with Richard Wilkinson of The Spirit Level, a book which uses evidence to demonstrate how inequality is causing many of the problems affecting our societies today. She tells the Equity Channel how inequality affects us all and why it’s time to think outside the box.
Why should we take a fresh look at the inequalities which exist in society?
The links between inequality and health, and problems such as violence have been known and debated for quite some time, but this knowledge has tended to be restricted to particular academic fields. What we are doing is taking a much broader look, helped by access to internationally comparable data, at a much wider range of health and social problems. In The Spirit Level we look at mental health, drug use, social mobility and education levels, teenage births and other issues. The fact that income inequality has not been thought of as such a deep-root cause of such a broad range of problems is simply because nobody’s looked at such a range before.
In The Spirit Level you emphasis looking across society as whole. Why is this?
Clearly all of the health and social problems are worse in the most deprived areas, and they are more prevalent among the poor and the most disadvantaged in all societies, but the level of differences can’t be explained just by the proportion of poor people. For example, in the US about 12% of the population are defined as below the federal poverty line, but 1 in 4 have had a mental illness in the past year. We have also known for a long time that it matters to your health to be just a little bit below the top [levels of income], it doesn’t only matter at some sort of threshold of poverty at the bottom.
Using data from several sources, we can show that if you live in a more unequal country, your health and well-being is worse than if you were living at the same level of income or education or social class in a more equal country. The effects of inequality seem to run all the way across society.
Is inequality something that the general public are concerned about?
Most people sense that inequality isn’t a good thing for society. We’re currently at a point where we can actually have a public debate about income inequality that we’ve not been able to have for quite a long time. I think some of the facts to do with the economic crisis and the scandal over the bankers’ bonuses have opened up a chink in the debate about salaries. The same is true when it comes to green issues and issues about climate change in needing to constrain growth in some aspects, leading to some sort of a shared sense that we’re all in this together.
Now is a good time to talk about equality, and in fact surveys have shown that the public appetite for this is there and has been there for quite some time. It’s now a chance for politicians to capitalise on what is going on in the economy at the moment and in public opinion, and to come up with something concrete.
Do we need major policy changes to address these issues?
Almost everything that governments do can either exacerbate inequalities or reduce them a bit. Even small changes in tax changes in taxation and redistribution can make a difference. Any government can put in place a particular policy, but when you are dealing with these policy changes they can quite easily be changed or tweaked or overturned by successive governments. It’s more important for a society to have a shared political vision about where they want their society to go; whether people want to see growth at all costs or whether they want to see a transformation to a better quality of life for everybody.
If that will is there in the populous, it’s not a party political issue. Successive governments might disagree about how to achieve a particular level of equality but it could be a shared goal for everybody.
How can governments take effective action to meet this goal?
If we look at all the different health and social problems that we are examining in The Spirit Level, what we tend to do as societies to address them is to put a lot of money into either prevention of that particular problem, or treatment of that particular problem, rather than cross-sector primary prevention and thinking about the causes.
I was very impressed by a story I heard from a woman who works for the police force in Glasgow, dealing with youth justice, who said that when her department were asked to set some budget priorities, they responded by saying that the city should have more health visitors, rather to the shock of their police colleagues, who themselves wanted more police. I thought this was a rather unique example of people thinking outside of their own box, focusing away from needing as big a piece of the pie for our own sector, our own concerns, and recognising that we have to be willing not only to be collaborative with our time and with our information, but also from a budget point of view.
Are there any particular key areas where government investment would be well spent?
Early childhood, for example, would be an area where increased investment would have payoffs across a whole range of health and social problems later on. The Nurse-Family Partnership in the US, for example, has produced not just early benefits in terms of birth weight or mothers being less likely to smoke; as the years go on, it’s been shown to delay women having a subsequent pregnancy, they’re more likely to get back into the workforce or finish education, their children do better at school. It’s a cost-effective measure and the benefits seem to accumulate as time goes on.
How would you describe the characteristics of an equal society?
It’s the equality itself which is the characteristic of society that matters. If you try to look at other characteristics to try to explain the relationships we’ve outlined in The Spirit Level, it’s very difficult. You can’t just point to the Scandinavian countries and say that there’s something peculiar about their culture, because Japan is also equal and very different. Spain and Portugal are culturally similar and at opposite ends of the spectrum in terms of inequalities and the level of health and social problems. It is the inequalities that are linked to these health and social problems, not the only factor of course, but certainly a major one.
The Spirit Level can be purchased from penguin Books here.
If you would like to get involved in a movement to take action on inequalities, please visit the Equality Trust website.