By Barbara Rose
Street News Service
Why do citizens of some countries live longer, healthier lives than others? It’s easy to compare health disparities between the United States and a developing nation devastated by civil conflict. We know we live longer than the average Rwandan. But how do we explain the differences between us and our economic peers? We spend more than twice as much as other wealthy nations on health care, but fare worse in critical areas like life expectancy and infant mortality. So, why do the Japanese live longer than us? Why do we have higher rates of mental illness than the Canadians? A quick eye roll and a reference to “our fast food culture” is not sufficient explanation.
British research duo Richard Wilkinson and Kate Pickett present a simple answer with classic British understatement in their new book “The Spirit Level: Why Greater Equality Makes Societies Stronger.” Countries (and U.S. states) with higher levels of income inequality have poorer health and more social problems. More equal societies almost always do better. They report lower obesity, homicide and high school dropout rates. They give more in foreign aid and have higher levels of trust. They save more. They even recycle more. Even if we can’t agree on redistributive taxes or government-run health care systems, we can all agree on how good that sounds.
Financial disasters provide a reality check. One year ago, it was easier to believe that we could be happy and healthy if we worked hard, invested and saved. However, the recent Wall Street crisis and increasing unemployment remind us how inextricably our health and wealth are tied. Today, chief executives in 365 U.S. companies make 500 times more than their average employee. This rising income inequality debunks the myth of the American dream. The U.S. actually has the lowest levels of social mobility when compared to other wealthy nations. Singapore is the only country with a greater income gap than us. Australia, the U.K. and Portugal are our peers in inequity. So, despite working two or three months more each year than those in more equal countries, we will probably not pull ourselves up by our bootstraps to do better than our parents.
Money itself isn’t bad. In fact, a certain amount of economic development is necessary to raise standards of living. But Wilkinson and Pickett suggest that after earning a certain amount, our happiness levels off. Then what? Higher levels of death and disease are not science fiction for a futuristic dystopia. Disparities already persist among us, the wealthiest nation in the history of the world. According to the American Human Development Report 2008-09, Asian-American females live 13.1 years longer than white males and 19.4 years longer than African-American males.
The effects of inequality are not just felt by those at the bottom of the class and economic ladders. It is not as if the poorest Americans die sooner while the wealthier remain untouched. Death rates for white Americans alone are worse than in other developed nations. Gating communities and ignoring welfare lines will not insulate someone from an environment rampant with murder, life-threatening obesity and mental illness. Income equality makes bigger differences for the poor but distributing resources equitably turns out to be better for everyone.
On some instinctual level we all recognize inequalities even if we don’t know how to alleviate them. Wilkinson and Pickett remind us that for much of human prehistory, we lived in more egalitarian societies. We can redirect our course.
Health insurance reform is on the cusp of happening. Good. It’s important. But let’s remind our elected officials that we want them working on ways to improve health, not just access to health care. Let’s tell our representatives to support legislation that reduces the income gap between the rich and the poor and promotes health equity.
Barbara Rose is a Master of Public Health student at the University of Washington. Reprinted from Real Change, Seattle, Wash © Street News Service: www.street-papers.org