March 19, 2010

The Source Of Society's Ills


hint: it's the guy on the right

(Part 1 here)

Richard Wilkinson, epidemiologist, looked at data to determine if numerous social ills-- from crime to teen pregnancy to mental illness-- are caused by any one single factor.

In fairness, he knew in advance what he wanted the answer to be, so when he found it it wasn't so much a surprise as a potential 350 page book available at Amazon.  But data is data.

One might accuse me of misrepresenting people's ideas, so I'll give Wilkinson the first word:

[Aside: did this make you angry?  Realize your anger is directed at the people, not specifically the ideas even though you disagree; you hate the kind of people you imagine this video represents.  Empty political discourse reinforces a division among people, not ideas.  Not only did Wilkinson fail at winning you over, he's made it impossible for you to even consider listening.]

The single cause that he found isn't poverty or a lack of economic growth.  What Wilkinson did not find-- and what too many other intelligent people think that he found-- is that income inequality is the cause of society's ills.  The problem is not that your country has too many poor people:

50 percent poverty.JPG

The single cause is relative inequality. Those 25% Americans who live 50% below the average income still have a lot compared to Slovakians; but they're sicker/unhappier than most Slovakians because they are poorer than other Americans

Wilkinson makes explicit that the relationship of relative inequality to social ills is 

  • nation specific (Americans compare themselves to other Americans, not Slovakians)
  • in one direction: crime/obesity/unhappiness is caused by income inequality, not the other way around

and implicitly that the issue is not necessarily an inability to access services (e.g. health care) but a relative inability to participate in that society. By analogy that is not at all a joke: the problem isn't that you don't have a million dollars, the problem is that the other guy does, and now he doesn't want to hang out with you.

Wilkinson has numerous solutions, previously discussed at Starbucks, of varying levels of efficacy or insanity, depending:

  • progressive income and property taxes
  • good labour law, protection of union rights
  • more generous pensions
  • higher minimum wages
  • ceiling/maximum wage


It's important to point out three things:

  1. Why he titled his book, "The Spirit Level:"  Not a reference to living free of materialism, but rather a carpenter's tool to check and see if things are level.  There's no "invisible hand" at work here.
  2. Wilkinson is not just another academic social policy theorist who references Marx; he is also the editor of the 2003 version of the WHO report on social justice.  
  3. Despite Wilkinson's explicit reference to inequality being judged within a specific country, the WHO report extends it to cover all countries-- so it doesn't just call for income redistribution within your nation, it calls for it across the world.
So we're back to the beginning: what does income redistribution have to do with medicine?  Since it is apparently the cause of numerous social ills including crime and war, why is it the role of one of them (health) to start the process, and not, say, the Department of Corrections or the military??

What, you think doctors are just better humanitarians?

Part 3 here