How Inequality Is Killing Us

If a book’s value can be measured by its ability to antagonize right-wing ‘think-tanks,’ then this book is priceless.

spiritlevel_DVThe Spirit Level: Why Greater Equality Makes Societies Stronger by R. Wilkinson & K. Pickett (2009/2011) challenges everything we’ve been told about why people get sick and what it takes to be healthy.

While public campaigns lecture us to eat right, stop smoking, exercise more, etc., in fact, our well-being has very little to do with our individual choices and everything to do with how society is structured. Put simply, inequality is extremely bad for our health.

The United States ranks as the world’s most unequal nation, far outstripping all other nations. The top one percent of Americans have a combined net worth that is more than triple the net worth of the other 99 percent combined. And the bottom 40 percent of Americans own less than nothing, because they are sinking in debt. ((Wolff, E.N., “The asset price meltdown and the wealth of the middle class” National Bureau of Economic Research Working Paper 18559 (2012).))

The high cost of inequality

Wilkinson and Pickett compare income inequality within 23 of the world’s richest nations and all fifty US states. They found that, at every income level, people living in more unequal nations and states suffer:

  • lower life expectancy
  • higher infant mortality
  • more homicides
  • more anxiety
  • more mental illness
  • more drug and alcohol addiction
  • more obesity
  • higher rates of imprisonment
  • less social mobility
  • more teen pregnancies
  • more high-school dropouts
  • poorer school performance
  • more school-age bullying

And the extent to which people at every income level suffer these problems is directly related to how unequal is the society in which they live.

In contrast, people living in more equal societies and states enjoy better mental, physical and social health – at every income level. And the more equal their societies, the more they enjoy these benefits.

Once everyone has the basic necessities of life, your health and social well-being is determined less by how rich you are than how unequal is the society in which you live. In other words, poorer people in more equal societies are healthier and happier than richer people in more unequal societies.

The difference is significant. A 1990s study of 282 metropolitan areas in the United States found that the greater the difference in income, the more the death rate rose for all income levels, not just for the poor. ((Lynch, J.W. et al. (1998). “Income inequality and mortality in metropolitan areas of the United States.” Am J Public Health. Vol. 88, pp.1074-1080.))

Researchers calculated that reducing income inequality to the lowest level found in those areas would save as many lives as would be saved by eradicating heart disease or by preventing all deaths from lung cancer, diabetes, motor vehicle crashes, HIV infection, suicide and homicide combined.

Inequality divides us

Why would inequality, in and of itself, have such a profound impact? The answer lies in our mammalian biology. As the most social animals on the planet, we are hard-wired to function best in an embracing community.

More than 95 percent of human existence has been spent in egalitarian societies. Because the survival of the group depends on collaboration, all primitive societies developed rules and customs to prevent anyone from rising too high or sinking too low.

However, for the past 10,000 years, most people have lived in class-divided, hierarchical societies. We have adapted to social inequality, but we pay a terrible price.

Consider this statement, “Most people can be trusted.” Would you agree or disagree?

The probability that you would disagree is directly related to the level of income inequality in your society. Wilkinson and Pickett show that people in the most equal nations, Scandinavia and the Netherlands, are six times more likely to trust each other than those in the most unequal nations – Portugal, Singapore and the United States. In short, inequality makes people distrustful.

When society does not take care of us, when we are abandoned to struggle individually, then we distrust others and fear for our safety. As a result, more unequal societies are characterized by more inter-personal competition, more emphasis on individual status and success, less social security, more envy of those above and more disdain for those below.

Fearful distrust compelled George Zimmerman to kill Trayvon Martin. Fearful distrust prompts us to warn our children about strangers, suspect those who are different, purchase security systems for our homes, view the poor and unemployed as ‘cheaters,’ applaud more spending on police and prisons, and support harsher penalties.

Fearful distrust provides a mass audience for TV shows and movies about traitors, torturers, rapists, sadists, and serial killers. When I asked one person why she followed a particularly gruesome TV serial about psychopathic murderers, she replied, “I want to know what’s out there.” Fearful distrust keeps us isolated and unable to recognize our common interests.

The Spirit Level is rich in information about the benefits of greater equality – enough to convince anyone who cares about human welfare. For that reason, I recommend it most highly. (The book’s facts, charts, and more resources can be found here).

Unfortunately, the book falls short when it comes to solutions.

Can inequality be legislated away?

The book’s primary weakness is revealed in Robert Reich’s Foreword, “By and large, ‘the market’ is generating these outlandish results. But the market is a creation of public policies. And public policies, as the authors make clear, can reorganize the market to reverse these trends.” (p.xii)

In reality, capitalism is based on a fundamental inequality: the capitalist class owns the means of production and all that is produced, so it has the power to shape society. The rest of us, who do the actual work of producing, get virtually no say in how society is run. This two-class society cannot be simply legislated away.

Most important, the capitalist system is based on the accumulation of capital which, by its very nature, increases inequality.

Every capitalist is committed to raising productivity – increasing the amount of capital that can be squeezed from each worker and confiscated by the employer. As more wealth is extracted from the working class and concentrated in the hands of the one percent, society becomes increasingly unequal. Counter-measures can slow the twin process of capital accumulation and growing inequality, but it can be stopped only by eliminating capitalism.

Could we all live in Sweden?

As Wilkinson and Pickett explain, there are two ways that countries offset rising inequality: by capping higher incomes; and by imposing higher taxes on the rich to pay for social programs. In other words, by holding the very rich down and by elevating everyone else. So it might seem that the solution to inequality could lie in redistributive public policies. However, wanting and needing such policies has never been enough – it’s always required a fight. As the authors explain,

“Sweden’s greater equality originated in the Social Democratic Party’s electoral victory in 1932 which had been preceded by violent labor disputes in which troops had opened fire on sawmill workers.” (p.242)

The book offers more examples of governments that implemented social programs for fear of revolution if they didn’t: the New Deal in the 1930s, the revolutionary wave that struck Europe in the 1840s, the post-war ‘social contract’ in England, the radicalism of the 1960s, etc.

Wilkinson and Pickett recount how income inequality in the United States reached a peak before the Great Crash of 1929. Beginning in the later 1930s, income inequality decreased as workers organized and fought to divert more social wealth to the people who produced it.

Beginning in the 1970s, income inequality began to rise again. This change was marked by an employers’ offensive against unions. As the proportion of workers in unions fell, income inequality rose until it is now similar to the level of inequality that preceded the 1929 crash.

The authors point out that the American example is not unique,

“A study which analysed trends in inequality during the 1980s and 1990s in Australia, Canada, Germany, Japan, Sweden, the United Kingdom and the United States found that the most important single factor was trade union membership…[D]eclines in trade union membership were most closely associated with widening income differences.” (p.244)

The lesson from these examples is clear: when the working class is ascendant, inequality decreases and society becomes more fair; when the capitalist class is ascendant, inequality increases and society becomes less fair.

Despite their own evidence, the authors do not call for a working-class uprising to reduce, if not eliminate, class inequality. Instead, they state that,

“The transformation of our society is a project in which we all have a shared interest.” (p.237)

This is a fundamental error, because we do not all have a shared interest. Greater equality would require the capitalist class to give up a substantial amount of its wealth and power. History shows that they never do this willingly.

Individual capitalists might see the value of a fairer society, but any who chose to slow the rate of capital accumulation would be replaced by others with no such concern. Moreover, those who accumulate the most capital can ‘buy’ as many politicians as necessary to shape public policies.

Instead of challenging the two-class capitalist system, the authors want to make it more humane by building a network of worker-co-operatives.

“The key is to map out ways in which the new society can begin to grow within and alongside the institutions it may gradually marginalise and replace. That is what making change is really about… What we need is not one big revolution but a continuous stream of small changes in a consistent direction.” (p.236)

Mondragon Corporation in Spain is offered as an example. Mondragon encompasses 120 employee-owned co-ops, 40,000 worker-owners and sales of $4.8 billion US dollars. However, despite being home to one of the world’s largest co-op networks, Spain ranks midway between the most equal and the most unequal nations. And it has recently implemented severe austerity policies that dramatically increase inequality.

Despite their many benefits, worker-owned co-operatives cannot transform society. As Rosa Luxemburg pointed out more than 100 years ago,

“Producers’ co-operatives are excluded from the most important branches of capital production — the textile, mining, metallurgical and petroleum industries, machine construction, locomotive and shipbuilding. For this reason alone, co-operatives in the field of production cannot be seriously considered as the instrument of a general social transformation…Within the framework of present society, producers’ co-operatives are limited to the role of simple annexes to consumers’ co-operatives.” ((Luxemburg, R. (1900/1908). Reform or revolution. London: Bookmarks, p.66.))

And one cannot imagine the global military-industrial complex becoming a worker-owned co-op.

To their credit, the authors acknowledge, “The truth is that modern inequality exists because democracy is excluded from the economic sphere. It needs therefore to be dealt with by an extension of democracy into the workplace.” (p.264)

Realistically, there’s only one way to achieve workplace democracy across the whole of society – a global working-class revolution that takes collective control of production and eliminates the two-class system of capitalism. Then we could build a truly cooperative society in which everyone is equally worthy to share life’s work and life’s rewards.

Susan Rosenthal is a life-long socialist, retired physician, union member, and the author of POWER and Powerlessness (2006). Sick and Sicker: Essays on Class, Health and Health Care (2010), and Rebel Minds: Class War, Mass Suffering, and the Urgent Need for Socialism (2019). She can be reached at: susan@susanrosenthal.com. Read other articles by Susan.