Inequality is no longer "just" a philosophical, or a moral issue: it is now a medical, actuarial and (soon perhaps) a legal issue. If we tolerate huge gaps in wealth, we condemn some members of our society to entirely predictable forms of suffering and early death. In the USA as a whole death comes 16 years earlier for the poorest than it does for the richest. In Oxford the difference is 6 years. In the UK civil service, the death-rate is 3 times greater for the lowest grades than it is for the highest.
The impact of inequality is felt by everyone: the rich as well as the poor (although the poor overwhelmingly bear the brunt of the damage) which is why apparently-poor but more-equal societies and groups often outperform the richest (but less-equal) societies on health.
The effects of inequality not only drown out those of other, well-known factors such as diet, drug and alcohol abuse, and smoking - those factors (and many others) turn out themselves to be consequences of inequality. Other consequences include repression of women and minorities, violence and self-harm, and even environmental degradation (caused by the excess consumption that goes with inequality).
Inequality is moving to centre-stage, as the most important and immediate threat to well being that we face. But unlike other threats, such as aids, terrorism or global warming, it is one that we can do something about, even on a local scale and in a fairly short time-frame: any diminution in inequality is beneficial, and we have a host of metrics with which to monitor the effects.
Equality when? We need a timetable.
I believe it is time for Trade Unions to move beyond pay-disputes, and demand absolute equality. There is no reason to demand anything less. Of course, any reduction in inequality is beneficial - so if the thought of immediately giving everyone the same pay is too frightening, then we can take a gentler approach, introducing a maximum wage as well as a minimum one, adjusting these over time so that they converge in a certain number of years, and meanwhile devoting as much energy as possible to reducing and repairing the kinds of suffering that are caused by inequality.
The important thing is to recognise that inequality and its consequences are now a choice that we make - and we cannot escape responsibility for that choice any more. Any group or organisation that continues to tolerate (or actively encourage) big differences in wealth is damaging the health of its employees and their familes and communities, in predictable and very unpleasant ways, and may eventually have to pay for that damage - just like companies that have poisoned their workers and neighbourhoods with toxic materials.
Even holding a public debate about this has some effect, because it puts the creators of inequality on notice that their behaviour is under a serious new challenge.
The goal, however, has to be equality. All "civilised societies" pay lip service to it, and all societies that have ever practised it have been significantly happier, healthier and better for the planet than the ones that don't.
Bob Hughes, Oxford Brookes University, 26/1/2007
bob at dustormagic dot net
Some references:
Much of the evidence is presented with great clarity in Richard Wilkinson's "The Impact of Inequality" (Routledge 2005).
An early landmark was Amartya Sen's 1981 study of gains in life-expectancy in poor countries, based on World Bank statistics: "Public action and the quality of life in developing countries" Oxford Bulletin of Economics and Statisics 43:287-319
Michael Marmot's 2 "Whitehall studies" - of life-expectancy in the UK Civil Service demonstrated conclusively the importance of status for health: Marmot M. Status Syndrome - how your social standing directly affects your health and life expectancy. London: Bloomsbury & Henry Holt New York, 2004.
See also Professor Danny Dorling's numerous publications: http://www.sheffield.ac.uk/geography/staff/dorling_danny/
