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The spirit level : why greater equality makes societies stronger

TL;DR: The strong version of Richard Wilkinson and Kate Pickett's argument in The Spirit Level implies that President Obama's fight to reform health care was pointless as discussed by the authors, and that extending the availability of health insurance cannot substantially improve Americans’ health.
Abstract: The strong version of Richard Wilkinson and Kate Pickett’s argument in The Spirit Level implies that President Obama’s fight to reform health care was pointless. Extending the availability of health insurance cannot substantially improve Americans’ health. Instead, the president would make us all happier, healthier, and longer-lived, their logic suggests, if he could get the richest, say, 5 percent of Americans to leave the country.
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Journal ArticleDOI
TL;DR: This work provides illustrative evidence on the health consequences of stigma and presents a conceptual framework describing the psychological and structural pathways through which stigma influences health.
Abstract: Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health.

1,768 citations

Journal ArticleDOI
TL;DR: It is illustrated how a better understanding of the mechanisms of effect by which poverty impacts children's mental, emotional, and behavioral health is valuable in designing effective preventive interventions for those in poverty.
Abstract: This article considers the implications for prevention science of recent advances in research on family poverty and children's mental, emotional, and behavioral health. First, we describe definitions of poverty and the conceptual and empirical challenges to estimating the causal effects of poverty on children's mental, emotional, and behavioral health. Second, we offer a conceptual framework that incorporates selection processes that affect who becomes poor as well as mechanisms through which poverty appears to influence child and youth mental health. Third, we use this conceptual framework to selectively review the growing literatures on the mechanisms through which family poverty influences the mental, emotional, and behavioral health of children. We illustrate how a better understanding of the mechanisms of effect by which poverty impacts children's mental, emotional, and behavioral health is valuable in designing effective preventive interventions for those in poverty. Fourth, we describe strategies to directly reduce poverty and the implications of these strategies for prevention. This article is one of three in a special section (see also Biglan, Flay, Embry, & Sandler, 2012; Munoz, Beardslee, & Leykin, 2012) representing an elaboration on a theme for prevention science developed by the 2009 report of the National Research Council and Institute of Medicine.

832 citations


Cites background from "The spirit level : why greater equa..."

  • ...Using a large series of analyses based primarily on countrywide economic and health, educational, and other outcome data, Wilkinson and Pickett (2009) argued that above and beyond the absolute amount of money in a society above a certain minimum, levels of inequality in the distribution of those…...

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  • ...From the point of view of mechanisms, Wilkinson and Pickett (2009) suggested that differences in status, in access, in culture, and in behavior in social hierarchies explain the effect of societal inequality on average outcomes....

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Journal ArticleDOI
17 Feb 2014
TL;DR: In this paper, the authors show that from the perspective of the best available macroeconomic data, there is not a lot of evidence that redistribution has in fact undercut economic growth (except in extreme cases).
Abstract: The Fund has recognized in recent years that one cannot separate issues of economic growth and stability on one hand and equality on the other. Indeed, there is a strong case for considering inequality and an inability to sustain economic growth as two sides of the same coin. Central to the Fund’s mandate is providing advice that will enable members’ economies to grow on a sustained basis. But the Fund has rightly been cautious about recommending the use of redistributive policies given that such policies may themselves undercut economic efficiency and the prospects for sustained growth (the so-called “leaky bucket” hypothesis written about by the famous Yale economist Arthur Okun in the 1970s). This SDN follows up the previous SDN on inequality and growth by focusing on the role of redistribution. It finds that, from the perspective of the best available macroeconomic data, there is not a lot of evidence that redistribution has in fact undercut economic growth (except in extreme cases). One should be careful not to assume therefore—as Okun and others have—that there is a big tradeoff between redistribution and growth. The best available macroeconomic data do not support such a conclusion.

816 citations

Journal ArticleDOI
TL;DR: All demographic groups—even those not usually associated with wealth redistribution such as Republicans and the wealthy—desired a more equal distribution of wealth than the status quo, according to a nationally representative online panel.
Abstract: Disagreements about the optimal level of wealth inequality underlie policy debates ranging from taxation to welfare. We attempt to insert the desires of "regular" Americans into these debates, by asking a nationally representative online panel to estimate the current distribution of wealth in the United States and to "build a better America" by constructing distributions with their ideal level of inequality. First, respondents dramatically underestimated the current level of wealth inequality. Second, respondents constructed ideal wealth distributions that were far more equitable than even their erroneously low estimates of the actual distribution. Most important from a policy perspective, we observed a surprising level of consensus: All demographic groups-even those not usually associated with wealth redistribution such as Republicans and the wealthy-desired a more equal distribution of wealth than the status quo.

788 citations


Cites background from "The spirit level : why greater equa..."

  • ...Although some evidence suggests that economic inequality is associated with decreased well-being and health (Napier & Jost, 2008; Wilkinson & Pickett, 2009), creating a society with the precise level of inequality that our respondents report as ideal may not be optimal from an economic or public…...

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Journal ArticleDOI
TL;DR: In this article, the Genuine Progress Indicator (GPI) has been used as an economic welfare indicator for 17 countries for which GPI has been estimated over the 1950-2003 time period.

564 citations


Cites background from "The spirit level : why greater equa..."

  • ...GDP also does not account for the distribution of income among individuals, which has a considerable effect on individual and social well-being (Wilkinson and Pickett, 2009)....

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References
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Book
27 Jan 2005
TL;DR: In this new edition of his landmark book, Richard Layard shows that there is a paradox at the heart of our lives as discussed by the authors, which is not just anecdotally true, it is the story told by countless pieces of scientific research.
Abstract: In this new edition of his landmark book, Richard Layard shows that there is a paradox at the heart of our lives. Most people want more income. Yet as societies become richer, they do not become happier. This is not just anecdotally true, it is the story told by countless pieces of scientific research. We now have sophisticated ways of measuring how happy people are, and all the evidence shows that on average people have grown no happier in the last fifty years, even as average incomes have more than doubled. In fact, the First World has more depression, more alcoholism and more crime than fifty years ago. This paradox is true of Britain, the United States, continental Europe, and Japan. What is going on? Now fully revised and updated to include developments since first publication, Layard answers his critics in what is still the key book in 'happiness studies'.

3,564 citations

Journal ArticleDOI
03 May 2006-JAMA
TL;DR: The US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer.
Abstract: ContextThe United States spends considerably more money on health care than the United Kingdom, but whether that translates to better health outcomes is unknown.ObjectiveTo assess the relative heath status of older individuals in England and the United States, especially how their health status varies by important indicators of socioeconomic position.Design, Setting, and ParticipantsWe analyzed representative samples of residents aged 55 to 64 years from both countries using 2002 data from the US Health and Retirement Survey (n = 4386) and the English Longitudinal Study of Aging (n = 3681), which were designed to have directly comparable measures of health, income, and education. This analysis is supplemented by samples of those aged 40 to 70 years from the 1999-2002 waves of National Health and Nutrition Examination Survey (n = 2097) and the 2003 wave of the Health Survey for England (n = 5526). These surveys contain extensive and comparable biological disease markers on respondents, which are used to determine whether differential propensities to report illness can explain these health differences. To ensure that health differences are not solely due to health issues in the black or Latino populations in the United States, the analysis is limited to non-Hispanic whites in both countries.Main Outcome MeasureSelf-reported prevalence rates of several chronic diseases related to diabetes and heart disease, adjusted for age and health behavior risk factors, were compared between the 2 countries and across education and income classes within each country.ResultsThe US population in late middle age is less healthy than the equivalent British population for diabetes, hypertension, heart disease, myocardial infarction, stroke, lung disease, and cancer. Within each country, there exists a pronounced negative socioeconomic status (SES) gradient with self-reported disease so that health disparities are largest at the bottom of the education or income variants of the SES hierarchy. This conclusion is generally robust to control for a standard set of behavioral risk factors, including smoking, overweight, obesity, and alcohol drinking, which explain very little of these health differences. These differences between countries or across SES groups within each country are not due to biases in self-reported disease because biological markers of disease exhibit exactly the same patterns. To illustrate, among those aged 55 to 64 years, diabetes prevalence is twice as high in the United States and only one fifth of this difference can be explained by a common set of risk factors. Similarly, among middle-aged adults, mean levels of C-reactive protein are 20% higher in the United States compared with England and mean high-density lipoprotein cholesterol levels are 14% lower. These differences are not solely driven by the bottom of the SES distribution. In many diseases, the top of the SES distribution is less healthy in the United States as well.ConclusionBased on self-reported illnesses and biological markers of disease, US residents are much less healthy than their English counterparts and these differences exist at all points of the SES distribution.

768 citations

Posted Content
TL;DR: In this paper, the authors explore a wide range of cross-country determinants of life satisfaction exploiting a database of 90,000 observations in 70 countries and show that only a small number of factors, such as openness, business climate, postcommunism, the number of chambers in parliament, Christian majority, and infant mortality robustly influence life satisfaction across countries.
Abstract: This paper explores a wide range of cross-country determinants of life satisfaction exploiting a database of 90,000 observations in 70 countries. We distinguish four groups of aggregate variables as potential determinants of satisfaction: political, economic, institutional, and human development and culture. We use ordered probit to investigate the importance of these variables on individual life satisfaction and test the robustness of our results with Extreme Bounds Analysis. The results show that only a small number of factors, such as openness, business climate, postcommunism, the number of chambers in parliament, Christian majority, and infant mortality robustly influence life satisfaction across countries while the importance of many variables suggested in the previous literature is not confirmed. This remains largely true when the analysis splits national populations according to gender, income and political orientation also.

286 citations

Journal ArticleDOI
TL;DR: In this paper, the importance of fractionalization for the creation of social trust is examined and the determinants of trust can be divided into two categories: those affecting individuals' trust radii and those affecting social polarization.
Abstract: This paper takes a closer look at the importance of fractionalization for the creation of social trust. It first argues that the determinants of trust can be divided into two categories: those affecting individuals' trust radii and those affecting social polarization. A series of estimates using a much larger country sample than in previous literature confirms that fractionalization in the form of income inequality and political diversity adversely affects social trust while ethnic diversity does not. However, these effects differ systematically across countries, questioning standard interpretations of the influence of fractionalization on trust.

191 citations

Journal ArticleDOI
TL;DR: The authors found that open international trade policies, low-inflation macroeconomic environments, and market-oriented property rights regimes promote human development across the world, even when controlling for countries' economic performance.
Abstract: Do neoliberal economic policies help or hinder human development? Many have argued that such policies promote economic stability and growth, which may have indirect positive effects on human welfare. Others claim that neoliberal policies retard human development. We argue that neoliberal economic policies may improve the human welfare in ways that are independent of their effects on economic performance. Specifically, this paper hypothesizes that open international trade policies, low-inflation macroeconomic environments, and market-oriented property rights regimes promote human development across the world. We test this argument by examining the impact of several measures of neoliberal policies on infant mortality rates across the world between 1960 and 1999. Results suggest that openness to imports, long-term membership in the GATT and WTO, low rates of inflation, and effective contract enforcement are each associated with lower rates of infant mortality across the world, even when controlling for countries' economic performance.

24 citations