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.