WHY INEQUALITY MAKES US ALL SICK

When talking about poverty, it is important to first define it. All specialists agree: poverty is not defined as the absolute amount of what a household receives each year (an accessible unit of measurement since it is defined on the basis of the tax returns of households, sometimes composed of only one person). Notably at the level of European authorities, researchers, sociologists and politicians have agreed: a poor person is « any person living in a household whose net income per consumption unit is less than 60% of the median net income per consumption unit ». Poverty is therefore not material misery, which is fortunately no longer the lot of a minority (in the West). Poverty is a relative concept, the gap that separates some people from the median standard of living in a society. 

WEALTH DOES NOT MAKE YOU HAPPY 

Poverty and its effects on societies have been best studied by British researchers. Let us first mention Tim Jackson who, in 2009, published Prosperity without Growth. Economics For a Finite Planet ⁽¹⁾. Commissioned by public authorities, this economist has led researchers who have analyzed thousands of studies. It is impossible to summarize here the richness of the results of these scientists (notably the impossibility of decoupling economic growth and environmental damage) but let’s look at poverty. The technique used is to compare the monetary wealth (GDP) of a society with other more significant parameters (lifespan, health status, literacy/education, subjective feeling of happiness). Placing these data on the x‑axis and y‑axis of a table, we see similar curves each time: depending on the country (entities where reliable statistics are available), the parameters improve with the increase in per capita income, pass through a maximum and then stabilize, or even fall. There is therefore an optimum of between €15,000 and €20,000 per inhabitant per year. By comparing wealth and ecological footprint (a marker of the destruction of terrestrial ecosystems), we have, in the same way, a measure of the efficiency of different countries. It is thus verified that the people of poor countries live badly but spare our planet and that the people of rich countries live in a certain (average) opulence but systematically destroy the environment which should ensure our survival in the long term. The only country that has a correct human development index and does not overconsume our planet is… Cuba. 

THE EFFECT OF INEQUALITIES WITHIN SOCIETIES 

Richard Wilkinson, a British epidemiologist, went further and tried to evaluate the impact of inequalities on health in various societies. He published his results in English in 2009⁽²⁾ and was translated into French in 2013⁽³⁾. His group of researchers compiled hundreds of health studies conducted in the so-called developed countries, those that have exceeded Jackson’s measured optimum of $15,000/capita/year. If he compares the medical parameters in these countries from Portugal at $16,000/capita/year to the United States at $38,000/capita/year, he finds no concordance. Similarly, health expenditures that vary by a factor of 1 to 5 have almost no impact on life expectancy or various health problems, quite the contrary: the United States, which spends at least twice as much as all other countries, is the worst off. What Wilkinson and his colleagues have found, however, is that inequality has a strong impact on health. They ranked the countries in order of inequality, for example by calculating how many times the richest 20% are richer than the poorest 20% (this ranges from 1/3.8 in Japan to 1/8.7 in the US to 1/4.8 in Belgium). When they compared these numbers to health and social problems, they found a consistent relationship: the more unequal countries are, the greater the difficulties. They multiplied comparisons with parameters such as the Unicef index of child well-being, infant mortality, mental illness, overweight adolescents, homicide rate, number of people incarcerated… And always, countries lined up on the same curve: fewer problems in egalitarian countries, with Japan and Sweden at one end, and many problems in unegalitarian countries, with the United States, Singapore or the United Kingdom on the wrong side. 

IT IS THE SOCIAL FABRIC THAT IS SICK 

But our epidemiologists wanted to understand why inequalities make people sick. By studying certain health factors, this time over time, they found a steady increase in one specific problem: anxiety levels. In the United States, 269 studies were compiled that demonstrated this steady growth. This is reflected in the figures and tables in Wilkinson’s book, but he commented on his research in an interview he had with François Ruffin, editor and founder of the newspaper Fakir. In the book⁽⁴⁾ which summarizes this interview, he says, « …mind-boggling: by the late 1980s, the average American child was more anxious than those undergoing psychiatric care in the 1950s. The deterioration of mental health is a constant in all developed countries. Wilkinson attributes this development to an increase in anxiety about the judgments of others. In the society of generalized competition imposed by productivism/consumerism, most people, especially in the professional world, are subjected to continuous pressure of evaluation. You have to perform well, meet goals on which you are judged. This induces permanent stress. Stress is positive when it responds to a sudden event and allows you to react (running away from an unexpected danger such as the arrival of a wild animal that threatens to devour you) but when it is continuous and you are threatened for 8 hours a day by the arrival of a ferocious little boss, it causes a continuous increase in hormones such as cortisol, which has very negative effects on your general health. Moreover, this critical look has now spread to the whole society: everyone feels obliged to worry about his social image, his appearance in the eyes of others. Wilkinson notes: « We have become extremely self-conscious, obsessed with what we show to others, worried about looking unattractive, boring or stupid, and constantly busy managing the impressions we leave. How do these strangers judge us? Have we put on a good show? This vulnerability is part of the modern psychological condition. »⁽⁵⁾. Here he is in line with what Richard Gregg, in his 1936 book The Value of Voluntary Simplicity⁽⁶⁾ , was already denouncing under the American term « keep up with the Joneses » : wanting to look better than the neighbors. Wilkinson also considers that « the external symbols of success — income, car, housing, clothing, vacations — all influence the image that one gives of oneself, and that one has of oneself ». We can see that it is the whole social body that is going wrong and the inequalities explain this malaise in the community. Wilkinson has charts that show that « The greater the inequalities, the more distrust prevails, the more community involvement declines, as does reciprocity, the desire to help others. One must first take care of oneself, manage to get one’s share of the cake. (…) Benevolence between fellow human beings is eclipsed: we can only feel empathy towards those whom we see as ‘equals’  ».. When the gap between the social classes widens under the effect of growing inequalities, mistrust, even hostility grows, with the drift of those who, rather than attacking those who despise them, direct their anger towards others, the poorest, the immigrants, the unemployed… The extreme right fosters this rejection of the other among the victims of class injustice. 

RETURN TO THE WISDOM OF SHARING 

Wilkinson’s research also confirms that the poor die 5 to 10 years earlier than the rich, but shows that it is not only material causes that are responsible for this excess mortality. It is also the psychologically destructive feeling of being at the bottom of the hierarchy. 

The last interesting graphs of Wilkinson’s studies: social mobility is greater in an egalitarian society (as one might expect: the steps are less steep to climb) but they are also more innovative. Basically it is logical, high level researchers, true artists are not motivated by the perpetual search for more money but by a passion, by the love of their work. 

Isn’t it sad that it takes long and expensive studies to prove what popular wisdom has been telling us for a long time: « Money doesn’t make you happy… but it contributes to it »⁽⁷⁾ (below 15 000€/year), « Money is a good servant and a bad master »⁽⁸⁾? The materialism that has invaded our societies is justified, according to utilitarian logic, by the search for material well-being for the greatest number. Unfortunately, this logic has now largely exceeded its optimum and, as Illich has shown for other societal phenomena, has become counterproductive. 

Alain Adriaens