Bridging the Income Gap

Self-harm: A British disease

Via The Independent, a disturbing report on the effect of inequality:  Self-harm: A British disease. Excerpt:

The number of people harming themselves deliberately has leapt by a third in the past five years, according to new figures seen by The Independent on Sunday. 

The biggest rise in self-harm and attempted suicide has been among young women between the ages of 16 and 24 as they struggle to cope with the pressures of modern living in Britain. 

There were 97,871 hospital admissions for deliberate self-harm in England in 2007-08 – 4,337 of them for children under the age of 14. 

Meanwhile, one in eight young women admitted to self-harm in 2007 – an 80 per cent increase since 2000. 

According to new research published by the World Health Organisation (WHO), the growing gap between rich and poor has led to an increase in mental health problems such as depression and self-harm in countries including the UK and US. 

People are surrounded by stories about the rich and famous – lifestyles that are unattainable for the majority. These inequalities cause psychological and physical stress which leads to mental and physical health problems, the report concludes.

The theory of everything

Via the Guardian, a review of The Spirit Level, a book I hope we get in North America soon: Almost every social problem stems from one root cause - inequality, argue two British academics. Excerpt:

Another day, another headline: today obesity, tomorrow teenage pregnancy, the day after crime figures. Social problems operate a revolving-door policy these days. As soon as one goes away, another turns up. 

For the most part, these problems are regarded as entirely separate from each other. Obesity is a health issue, crime a policing issue and so on. So the government launches new initiatives here, there and everywhere, builds new hospitals, puts more money into the police and prisons. And there's little real hope of improvement. Until now, maybe. 

Quietly spoken, late middle-aged and quintessentially English, Richard Wilkinson is the last person you would expect to come up with a sweeping theory of everything. Yet that's precisely what this retired professor from Nottingham medical school, in collaboration with his partner, Kate Pickett, a lecturer at the University of York, has done. 

The opening sentence of their new book, The Spirit Level, cautions, "People usually exaggerate the importance of their own work and we worry about claiming too much" - yet by the time you reach the end you wonder how they could have claimed any more. 

After all, they argue that almost every social problem common in developed societies - reduced life expectancy, child mortality, drugs, crime, homicide rates, mental illness and obesity - has a single root cause: inequality.

The review mentions The Equality Trust, which I'm linking to.

Baby's gestures reflect family's wealth

Via the Globe and Mail: Baby's gestures reflect family's wealth. Excerpt:

Using and understanding hand gestures is one way babies start to flex their communication muscles before they can speak. 

New evidence suggests that the better a baby is at grasping the meanings of these hand gestures, the better his or her vocabulary will be by preschool age - which is itself a known predictor of future academic success. 

The new study out of the University of Chicago, which appears today in the journal Science, also found that children from higher socio-economic backgrounds have a distinct advantage over those from lower-income backgrounds. They gesture more as babies and have larger vocabularies at age 4½. 

Study co-author and developmental psychologist Meredith Rowe said more research is needed to determine whether it's possible to manipulate how frequently parents and babies are inclined to gesture, but the potential implications are intriguing. 

"Can you get parents and young children to gesture more when they're communicating? And if you can, will it lead to an increase in children's vocabulary?" said Dr. Rowe, a postdoctoral scholar at the university.

The abstract of the article is here.

The second edition of Social Determinants of Health

Dennis Raphael has kindly sent me an excerpt from the beginning of the new edition of Social Determinants of Health. You can download it here as a PDF. Download Sample Pages-Chapter-SDOH-revised.

Lift Kids Out of Poverty, Protect Their Brains

In The Tyee, Tom Sandborn has an excellent article based on the research mentioned in the previous post: Lift Kids Out of Poverty, Protect Their Brains.

Poverty affects way brain works, study suggests

Via The Globe and Mail:  Poverty affects way brain works, study suggests. Excerpt:

A B.C. pediatrician has co-authored a new study that researchers believe shows that the brains of children from low-income backgrounds function differently from the brains of kids from high-income environments. 

Tom Boyce, who serves as the B.C. Leadership Chair of Child Development at the University of British Columbia, said the study found certain deficits in the functioning of the prefrontal cortex in kids from low-income environments. 

The prefrontal cortex is the region of the brain that is critical for problem solving and creativity. 

”The conclusion was that something about the early environments of children growing up in less well-off families fundamentally affects the growth and development of that region of the brain,” Dr. Boyce said. 

”And that is concerning because we want all kids to have equal chances and it looks as though, because of this, that there may be some deficits in the development of the low-income kids.”

The original article isn't yet available online. I'll link to it when it's published.

Roy Romanow on poverty and health

Via The Star, a great Canadian politician and health expert argues: Fight poverty to improve economic and social health. Excerpt:

The loud bang of the global economic crisis has drowned out the quieter sounds of many other pressing and related concerns.

As governments search for solutions to shore up our economic health in the short term, they must resist the temptation to put all other issues on the back-burner. The choices are very difficult and painful. I know, I've been there. But we need to think long-term, not just short-term.

Let's consider poverty. It is one fundamental example of how social and economic policy must go hand in hand generally, but especially in these difficult times. Yet, since the global economy started tumbling, three critical reports linking poverty and our overall well-being have been released to scant attention by media and too many governments.

The first, Growing Unequal? by the Organization for Economic Cooperation and Development (OECD) reported that Canada's growing inequality and entrenched poverty rates are now higher than any other OECD country, except Germany. The OECD noted, in particular, that Canada spends less than most countries on cash transfers such as unemployment and family benefits.

The second report, Toronto Public Heath's The Unequal City, found a clear link between poverty and poor health. Among its sweeping findings, it reported that the top 20 per cent of male earners live 4.5 years longer than the bottom 20 per cent; females live 2.0 years longer.

The results are consistent with findings in other jurisdictions. In fact, early last week, a landmark report by the Saskatoon Health Region found a yawning health gap between the poor and the rich in that city.

More recently, a team of economists, bankers and food bank directors released a study about the cost of poverty showing that poverty taxes both the health of those in its grasp and the wallets of all of us in society. The study found that Canadians could save $7.6 billion per year in health-care expenditures by elevating the health status of the bottom 20 per cent to that of the next-to-bottom 20 per cent on the income ladder.

Together, these reports point to one inescapable conclusion: If we want to improve the overall health of Canadians and reduce health costs, then one of the most effective and efficient places to start is by reducing poverty. An investment in a deliberate long-term commitment to poverty-reduction is key.

Larry Summers on inequality

Via the New York Times, in a profile of Barack Obama's new economic adviser: The Return of Larry Summers. Excerpt:

Mr. Summers has spent much of his career tweaking fellow liberals with arguments he considers unpleasant truths — on the dangers of budget deficits, the benefits of capitalism and other subjects.

But he seems to have decided that conservative orthodoxies have become a vastly bigger threat to good economic policy than liberal ones. His favorite argument today is one that instead drives some conservatives nuts.

It goes like this: To undo the rise in income inequality since the late ’70s, every household in the top 1 percent of the distribution, which makes $1.7 million on average, would need to write a check for $800,000.

This money could then be pooled and used to send out a $10,000 check to every household in the bottom 80 percent of the distribution, those making less than $120,000. Only then would the country be as economically equal as it was three decades ago.

The lack of middle-class income growth during that span is “the defining issue of our time,” Mr. Summers has said, in a tacit admission that liberals were ahead of him on this issue.

Canada: Poor more likely to end up in hospital

Via The Star: Poor more likely to end up in hospital: study finds. Excerpt:

The poorer you are, the sicker you're likely to be, suggests a new study comparing illness and hospitalization rates for low-income and well-off Canadians living in major cities.

The research by the Canadian Institute for Health Information found lower-income people are more likely to be hospitalized for a wide range of health problems, both physical and psychological.

The report also found that some of the diseases that put the poor in hospital could just as easily be treated in the community.

For example, people from lower-income groups were 2.4 times more likely to be hospitalized for diabetes, and children from such groups had 56 per cent higher hospitalization rates for asthma.

Hospital admission rates for mental illness in lower socio-economic groups were 2.3 times those in higher groups, while admissions for substance abuse were 3.4 times higher among the poor.

"These differences are real, they're significant, and they're present throughout Canada's large cities," said Dr. David McKeown, medical officer of health for Toronto.

"A country that places value on equity and access to health should find these differences unacceptable."

Don't expect Obama to bridge the gap

Via McClatchy Washington Bureau: Economists say Obama, McCain can't do much to close wealth gap. Long excerpt from an even longer story:

The gap between rich and poor in America has grown bigger in recent years than any time since the 1920s, and there are no easy ways for the presidential candidates to close it.

Barack Obama and John McCain both say their economic plans can narrow the income gap, and although Obama's tax plan offers a classic way to do that by raising taxes on the rich, economists think neither is likely to bring dramatic changes.

"Taxes are not going to solve the income gap problem," said Roberton Williams, principal research associate at the nonpartisan Tax Policy Center. "Nobody's going to stand for the kind of confiscatory taxes you would need."

He and others said there are many other factors affecting income — including the tumultuous financial markets, technological change, global competition, the erosion of labor unions and corporate pensions, as well as federal tax and regulatory policies. Changing those policies to reduce income inequality could involve politically difficult measures, such as higher taxes, or higher minimum wages and other subsidies.

Obama and McCain offer the kind of income strategies their political parties have been championing for years. Obama, the Democrat, sees a role for government in helping people get opportunities for education, training and work, while the wealthy who benefit most from society have an obligation to contribute more to the collective good.

McCain, the Republican, espouses a version of what some call the "trickle down" theory that allows the rich to keep more of their income, on the theory that they'll invest and spend, thereby creating more jobs and wealth.

Republican loyalists argue that this concept worked well during the Reagan presidency, as the three-year tax cut that began in October 1981 helped pull the nation out of its worst recession since the Great Depression and triggered eight years of prosperity.

Democrats counter that too many lower-income earners never enjoyed the benefits of that boom, which was sustained in part by collapsing oil prices and record federal budget deficits.

Obama wants to return the two top income tax rates to pre-2001 levels in 2011 — the same rates during as the Clinton era, which saw the longest sustained economic expansion in U.S. history.

That would mean a top income-tax rate of 39.6 percent, far below the 70 percent top rate that existed until 1981, or even the 50 percent top rate of 1982-86 — not to mention the top rates of more than 90 percent that prevailed from the end of World War II until 1963.

The nation's top 1 percent of earners, those making more than $603,402 in 2008, had a 22.9 percent share of all pretax income in 2006, according to a March study by University of California-Berkeley economist Emmanuel Saez.

The top 1 percent's share of the national income pie had hovered around 9 to 10 percent from the 1950s through the 1970s, then began climbing in the 1980s. While Americans at all income levels saw their wealth increase during the 1990s, the top 1 percent's income exploded. Since George W. Bush became president, their share kept growing while everyone else's income barely rose.

Canada's growing inequality

The Tyee has published my article on the new OECD report, "Growing Unequal?"—Will Crash Pry Canada's Wealth Divide Even Wider?

Rich-poor gap widens in Canada

Via The Globe and Mail: Rich-poor gap widens in Canada. Excerpt:

The gap between the rich and poor in Canada widened significantly in a recent 10-year period partly because Ottawa spent less on cash benefits than many other developed countries, the OECD says.

It was a reversal of the trend in the two previous decades when the gap was narrowing, the Organization for Economic Co-Operation and Development said in a report.

The report said Canada's poverty and income inequality rates both spiked between 1995 and 2005 until they each exceeded the 30-member organization's average.

The organization said Canada experienced an especially rapid increase in both numbers; only Germany's gap widened at a comparable rate.

The study, released Tuesday, found that Canada's well-to-do enjoyed a more substantial income than their counterparts in other developed countries. The report said Canadians in the top 10-per-cent income bracket were earning an average equivalent to $71,000 (U.S.), more than 30 per cent higher than the OECD average of $54,000 (U.S).

While the average incomes for Canada's middle and lower classes also exceeded the OECD average, the margin was less pronounced at 18 per cent.

The OECD attributed the widening gap in part to the Canadian government's spending policies.

“Canada spends less on cash benefits such as unemployment benefits and family benefits than most OECD countries,” the report said. “Partly as a result, taxes and transfers do not reduce inequality by as much as in many other countries. Furthermore, their effect on inequality has been declining over time.”

You can find the complete report here.

A major report on inequality

Via The Guardian: Social injustice cutting life expectancy, UN report says. Excerpt:

The UK has a long way to go to improve the health and life expectancy of the poorest people in society, according to a major United Nations report today that blames "a toxic combination" of government policies around the world for the unjust life chances many children are born with.

In every society, there is a substantial gap between the life expectancy of the children of the most affluent and those who are born into deprivation and get fewer chances as they grow up. But some countries do better at shrinking the gap than others.

The report, by a World Health Organisation commission headed by the British professor Sir Michael Marmot, shows that the ill health and shorter lives of the least lucky has brought down life expectancy in the UK to 79 years, trailing Japan, with an average of 83, and also behind Australia, Sweden, Canada and Italy.

Low incomes, poor education, bad housing and a failure to curb junk food and adopt healthy transport policies are all contributory factors, says the report. "Social injustice is killing people on a grand scale," it says, putting forward a blueprint to eradicate health inequalities within a generation.

The report highlights stark disparities within the UK, as in most countries in the world. A boy in the suburb of Calton, Glasgow, can expect to live 28 years less than one brought up in Lenzie, a few miles away. One born in Hampstead, London, will live around 11 years longer than a boy from St Pancras, five stops down the underground Northern line.

The health secretary, Alan Johnson, today defended the government's record and said he thought the UK target to reduce health inequalities within the next two years was "achievable". It has undertaken to narrow the gap in life expectancy and infant mortality between rich and poor by 10% by 2010.

Here's the full WHO report. And here's a summary of some of the disparities in life expectancy in different countries around the world.

The elitism problem

In The Star, Linda McQuaig talks about inequality and elitism in the US presidential election: Twisting the concept of 'elite.' Excerpt:

A fundamental problem in the last few decades – both in Canada and the United States – has been the relentless campaign waged by the financial elite to overturn postwar social and economic policies that provided significant gains for the middle and lower classes in the decades following World War II.

The campaign has been phenomenally successful. As a result, the poor have lost ground, while the middle class have barely held their own or made small advances – by working longer hours or having two-income families.

Only the rich have thrived. And they have truly thrived. A group of international economists, including McMaster University's Michael Veall, has tracked the spectacular gains of the top 1 per cent of income earners, who now, in both Canada and the U.S., enjoy over 15 per cent of national income – a level not seen since the days of the idle rich in the Roaring '20s.

Yet even as the rich have redirected income towards themselves, they've managed to remove the issue of economic inequality from the agenda. Part of the strategy – honed by media-savvy conservative think-tanks and commentators – has been to redefine the notion of elitism to refer to those who belong to the liberal elite, and do things like drink lattes, maintain an international outlook and speak articulately.

Accordingly, Democrat Al Gore, with his commanding grasp of issues in presidential debates, was accused of being an elitist. Similarly, Democrat John Kerry was branded elitist for being able to speak French.

In the same breath, Conservatives somehow presented George W. Bush, a rich kid who'd barely held a job before running for president, as a populist and down-to-earth guy who'd be fun to have a beer with – presumably because he was inarticulate and barely functional in even one language.

Whether McCain drinks beer, latte or Ovaltine doesn't alter the fact that he supports Bush's massive favouritism towards the real elite – the powerful financial one that runs his country. That alone should prevent McCain from adding to his housing inventory the large white edifice on Pennsylvania Ave.

Taking on inequality

Via The Nation, a column by editor Katrina Vanden Heuvel: Taking On Inequality. Excerpt:

The good news is that Democratic presidential nominee, Senator Barack Obama, quickly spoke out against the decision by Democrats not to take on the loophole after more than twenty lobbying firms worked to preserve it.

At the time the campaign issued a statement saying, "If there was ever a doubt that Washington lobbyists don't actually represent real Americans, it's the fact that they stopped leaders of both parties from requiring elite investment firms to pay their fair share of taxes, even as middle-class families struggle to pay theirs. When I'm President, the American people won't have to spend record amounts on lobbying to get their voice heard in Washington. I will close tax loopholes for big corporations...."

But it will take a lot more than closing an obscene tax loophole to reverse thirty years of tax cuts for the rich, union-busting, and deregulation that promoted corporate interests at the expense of consumers--all of this bankrolled by conservatives and corporations to instill blind faith in the market as a magic elixir that can solve any problem.

The result is that we now live in a Second Gilded Age. (And The Nation will hold a name Name Our Epoch! contest starting next week. The winner will be selected by our all-star progressive panel of judges--historian Howard Zinn, journalist Barbara Ehrenreich and novelist Walter Mosley.)

The richest 1 percent of Americans currently hold wealth worth nearly $16.8 trillion, $2 trillion more than the bottom 90 percent. According to the Center for American Progress, since 1979 the average income for the bottom half of American households has grown by 6 percent. In contrast, the top 1 percent of earners have seen their incomes rise by 229 percent during that same period.

With less money available, Americans are forced to make tough choices on how to spend diminishing disposable incomes. The largest increases in consumer spending between 2006 and 2007 was on necessities: fuel, food staples, and medical bills. Medical bills now account for almost one-fifth of average family income. The divide is so huge, the Wall Street Journal now dedicates a full-time reporter to cover what the reporter calls "Richistan."

In January 2007, Congressman Barney Frank said dealing with income inequality was his top priority as chairman of the House Financial Services Committee. He summarized the impact of conservative, free-market ideology run amuck this way:

"The rising tide lifts all boats has always been a problem. If you think about that analogy, the rising tide is a very good idea if you have a boat. But if you are too poor to afford a boat and you are standing tiptoe in the water, the rising tide goes up to your nose."

Next week, The Nation will publish a special issue on income inequality, exploring how rising extreme inequality is undermining our common good. It will include a 12-step blueprint for action for citizens and smart elected officials who care about reducing concentrations of wealth, reducing poverty and rebuilding our infrastructure.

I'll post on this blueprint as soon as it's published.

Inequality and health in Europe

Via The New England Journal of Medicine: Socioeconomic Inequalities in Health in 22 European Countries. The abstract, re-paragraphed:

Background Comparisons among countries can help to identify opportunities for the reduction of inequalities in health. We compared the magnitude of inequalities in mortality and self-assessed health among 22 countries in all parts of Europe.

Methods We obtained data on mortality according to education level and occupational class from census-based mortality studies. Deaths were classified according to cause, including common causes, such as cardiovascular disease and cancer; causes related to smoking; causes related to alcohol use; and causes amenable to medical intervention, such as tuberculosis and hypertension.

Data on self-assessed health, smoking, and obesity according to education and income were obtained from health or multipurpose surveys. For each country, the association between socioeconomic status and health outcomes was measured with the use of regression-based inequality indexes.

Results In almost all countries, the rates of death and poorer self-assessments of health were substantially higher in groups of lower socioeconomic status, but the magnitude of the inequalities between groups of higher and lower socioeconomic status was much larger in some countries than in others.

Inequalities in mortality were small in some southern European countries and very large in most countries in the eastern and Baltic regions. These variations among countries appeared to be attributable in part to causes of death related to smoking or alcohol use or amenable to medical intervention. The magnitude of inequalities in self-assessed health also varied substantially among countries, but in a different pattern.

Conclusions We observed variation across Europe in the magnitude of inequalities in health associated with socioeconomic status. These inequalities might be reduced by improving educational opportunities, income distribution, health-related behavior, or access to health care.

Canada: We're more egalitarian than we thought

Via The Globe and Mail: Tiny pay gap reflects egalitarian attitude.

The gap between the pay of managers and workers in Canada is the second smallest in the world, an annual global survey by Hay Group has found.

The average Canadian manager garners 2.6 times the salary of the average worker, the survey noted - the smallest gap after Norway. In the United States that gap is 3.7 times, while it's 10 times or more in emerging markets such as Thailand.

"The Canadian gap is a reflection of a more egalitarian philosophy than most countries," Karl Aboud, Hay Group's director of reward consulting in Canada, said in a report released yesterday.

The result reflects less extremes at both ends of the wage scale, added David Sissons, vice-president of the consulting firm.

"In Canada, we tend to have a well-paid lower floor and not as high of a ceiling," he said in an interview.

Other reasons for Canada's low pay gap include the higher preponderance of public service jobs, as well as a relatively small number of highly-competitive global multinationals, he said.

Hay Group's report analyzes data on over 12 million employees to measure the gap in 61 countries. To calculate its rankings, Hay used the market-median base salary for a clerical level worker and for a standard middle-management job.

Canada's pay gap didn't budge between 2006 and 2007, though its ranking moved to second spot from third, and Mr. Sissons doesn't foresee a big shift in the coming year.

The much-ballyhooed U.S. pay gap, meantime, has soared. The disparity between the salaries of managers and clerical workers jumped nearly 20 per cent, making it the third-fastest growing pay gap in the world.

Trying to bring down a government over the income gap

It won't succeed, but at least Canada's New Democrats have tried. Via The Star: NDP to move today to topple Tories. Excerpt:

Federal New Democrats will make a last-gasp bid today to topple the minority Conservatives, citing the country's growing "prosperity gap" as the reason Canadians should go to the polls.

But the political move is destined to fail, all but eliminating the chance of an election in the coming weeks and opening the door to a summer of campaigning by all political leaders in preparation for a possible federal campaign this fall.

"This could be certainly one of our last opportunities, if not our last opportunity, to say we think that the Harper government is wrong," NDP Leader Jack Layton said.

The New Democrats' motion calls on the Commons to acknowledge that the growing income gap is having a harmful effect on working and middle-income families.

And it says those woes have been "fostered by this government's unbalanced economic agenda, including its failure to reform employment insurance to ensure that people who lose their jobs during economic downturns are protected and trained."

"We think that it's important to show that ultimately you can't have confidence in a government that can't manage the economy for the average middle-class family and working-class individuals," Layton said last week.

But Layton's push for an election will have to wait because like the other confidence votes this parliamentary session, the Liberals aren't ready to bring down the government. That means they won't support the NDP's election manoeuvring.

"We'll not trigger an election through an NDP motion," Liberal Leader Stéphane Dion said last week.

Not that Dion's reluctance to go to the polls is a great disappointment to Layton. After all, the NDP's confidence motion is aimed at the Liberals too, a bid to once more embarrass Dion and highlight the refusal of Liberal MPs to defeat a Tory government they regularly condemn.

Dying for the Rich

The Tyee has published my article Dying for the Rich.

Professor Dennis Raphael sends along some links to related material:

Poverty and Policy in Canada: Implications for Health and Quality of Life, by Dennis Raphael.

Staying Alive: Critical Perspectives on Health, Illness, and Health Care ed. Dennis Raphael, Toba Bryant, and Marcia Rioux.

Social Determinants of Health, ed. Dennis Raphael.

And two videos:
The Politics of Population Health, about 45 minutes long, and a 50-minute presentation on Politics and Health at the Center for Health Disparities in Cleveland, Ohio.

David Olive on the census: A country divided

Via The Star, David Olive weighs in on the new StatsCan report on Canada's income gap: A country divided. Excerpt:

"An imbalance between rich and poor is the oldest and most fatal ailment of all republics."– Plutarch, Greek historian

We have a compassion gap in Canada, a land that by tradition celebrates mutual health and happiness and not the accumulation of wealth. Yet governments, particularly Ottawa, vacated the field of compassion decades ago rather than building on social-equity innovations of past generations.

Statscan's report yesterday on income trends between 1980 and 2005 reveals a Canada that would be unrecognizable to social-justice pioneers Tommy Douglas, Lester Pearson and Pierre Trudeau.

Most shameful is that 3.5 million Canadians, or 11.4 per cent of the population, live in poverty, almost 900,000 of them children. That's not much better than the 12.3 per cent of Americans in poverty.

Despite more than a decade of robust economic growth, the earnings of middle-income Canadians have stagnated since 1980.

By any definition that's a crisis. A large and growing middle class of increasing affluence is the bedrock of a nation's social stability, its industrial and cultural prowess, and its prospects of raising future generations able to take a nation to a higher level of success.

It is encouraging that the one-fifth most affluent among us have seen a 16.4 per cent rise in inflation-adjusted earnings – a sign of Canada's ability to reward high achievers and stem a brain drain. But it is morally indefensible that the poorest one-fifth have seen incomes drop 20.6 per cent.

It is whispered that America, with 36.5 million poor and hundreds of billionaires, is becoming the world's richest Third World nation.

It could happen to us.

"Compassion" has nothing to do with it. Sheer self-interest should encourage us to narrow the income gap—thereby increasing social stability, reducing individual and group stress, and improving health and longevity.