The Spirit Level

We have now seen that almost all problems which are more common at the bottom of the social ladder are more common in more unequal societies.

We have now seen that almost all problems which are more common at the bottom of the social ladder are more common in more unequal societies. Pervasive impact: Income inequality affects a wide range of social and health outcomes, including: Life expectancy Mental health Drug abuse Educational performance Teenage births Obesity Violence and crime rates Social mobility Magnitude of effects: The differences between more and less equal societies are substantial: Problems can be 3-10 times more common in unequal countries These effects apply across entire populations, not just to the poor Even small reductions in inequality can lead to significant improvements Evidence base: The relationship between inequality and social problems is supported by: Comparisons across rich, developed countries Data from the 50 U.S. states Consistent patterns across multiple health and social issues

Greater equality seems to strengthen community life, people trust each other more and are more engaged in social or community activities, and less violence. Erosion of trust: As income differences widen, people are less likely to trust one another: In Sweden, 66% of people feel they can trust others In Portugal, only 10% believe most people can be trusted Similar patterns are seen across U.S. states Community breakdown: Inequality weakens social bonds and civic engagement: People become less involved in community activities Social support networks deteriorate Sense of shared identity and common purpose diminishes Consequences: Low trust and weak social cohesion lead to: Increased social isolation Higher crime rates Reduced social mobility Less effective democratic institutions

The populations of rich countries have got to the end of a long historical journey. Prevalence of mental illness: More unequal societies have significantly higher rates of mental health problems: In the most unequal countries, up to 26% of adults experience mental illness annually This is more than three times the rate in the most equal countries (8%) Types of disorders: Inequality is strongly associated with: Anxiety disorders Mood disorders Substance abuse Drug use patterns: Illegal drug use is more common in unequal societies: This holds true for opiates, cocaine, cannabis, and other substances The relationship is seen both internationally and among U.S. states Underlying factors: Increased mental health and drug issues may be driven by: Greater social stress and status anxiety Weaker social support systems Reduced access to mental health resources

The big idea is that what matters in determining mortality and health in a society is less the overall wealth of that society and more how evenly wealth is distributed. Life expectancy: More equal societies have longer average lifespans: In the U.S., life expectancy…