PERSONAL HEALTH  
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What Makes the Healthiest and Happiest Societies? Hint: It's Not Wealth

Epidemiologist Richard Wilkinson explains why it's equality, and not high income, that makes a society thrive.
 
 
 
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We live in a world of deep inequality, and the gap between the rich and the poor is widening. We in the rich world generally agree that this is a problem we ought to help fix—but that the real beneficiaries will be the billions of people living in poverty. After all, inequality has little impact on the lives of those who find themselves on top of the pile. Right?

Not exactly, says British epidemiologist Richard Wilkinson.

For decades, Wilkinson has studied why some societies are healthier than others. He found that what the healthiest societies have in common is not that they have more—more income, more education, or more wealth—but that what they have is more equitably shared.

In fact, it turns out that not only disease, but a whole host of social problems ranging from mental illness to drug use are worse in unequal societies. In his latest book, The Spirit Level: Why More Equal Societies Almost Always Do Better, co-written with Kate Pickett, Wilkinson details the pernicious effects that inequality has on societies: eroding trust, increasing anxiety and illness, encouraging excessive consumption.

The good news is that increased equality has the opposite effect: statistics show that communities without large gaps between rich and poor are more resilient and their members live longer, happier lives.

YES! Magazine web editor Brooke Jarvis sat down with Richard Wilkinson to discuss the surprising importance of equality—and the best ways to build it.


Brooke Jarvis: You've studied the impact of inequality on public health for a long time. Did any of your recent findings surprise you?

Richard Wilkinson: Oh, all of them. In fact, the relationship is weaker for health than for many other problems—we looked at life expectancy, mental illness, teen birthrates, violence, the percent of populations in prison, and drug use. They were all not just a little bit worse, but much worse, in more unequal countries. If I'd known how strong those connections would be, I would have looked for them a decade earlier. In fact, I'm still surprised that no one did look at them earlier.

There's nothing complicated in what we've done. Epidemiologists and people working in public health have been doing this work for some time, not only controlling for relative poverty, but for all the income levels within, for instance, an American state. So once you know the relationship between income and death rates, for example, you should be able to predict what a state's death rate will be. Actually, though, that doesn't produce a good prediction; what matters aren't the incomes themselves but how unequal they are. If you're a more unequal state, the same level of income produces a higher death rate.

In fact, in more unequal societies, these problems aren't higher by ten or twenty percent. There are perhaps eight times the number of teenage births per capita, ten times the homicide rate, three times the rate of mental illness. Huge differences. If social mobility were a perfect sorting system and everyone was sorted by ability, that wouldn't make the number of problems in the society greater. It wouldn't change the overall IQ of the population; it would just change the social distribution of IQ. We know from the findings that it's the status divisions themselves that create the problems. We're not making a great leap to say that this is causal. We, I think, show that it's almost impossible to find any other consistent explanation.

BJ: It seems possible that this link hasn't been explored because we're so used to thinking of these problems as linked to poverty. To find out that they're tied not to the level of income but to the stratification of income—it's sort of an unexpected conclusion.

RW: We show that these problems aren't affected by rich countries getting still richer. There are problems that we think of as problems of poverty because they're in the poorest areas of society, but a country like the U.S. can be twice as rich as Greece, Portugal, or Israel—the poorer of the rich, developed countries we look at—and the problems are no better even though Americans are able to buy twice as much of everything as the poorer developed societies. That doesn't make any difference; it's only the gaps between us that matter now. And that's really quite a striking thing to learn about ourselves and the effects of the social structure on us.

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