Professor Kate Pickett has just returned from a combined work and pleasure trip to Chile and is a little dry in her throat when she answers the telephone at the university in York. She is coming to Stockholm in the beginning of March to lecture at the Forte Talks, a multidisciplinary conference on health, work and welfare.
Invitations have been frequent since the two epidemiologists Kate Pickett and Richard Wilkinson published The Spirit Level in 2009, demonstrating that everyone feels better in egalitarian societies. The message caused a sensation during the financial crisis and the book quickly became a best-seller – heralded by the left wing, hated by the right wing. Neo-liberals and conservative economists did not hesitate in their attack.
“The criticism was more politically than academically motivated. Thomas Piketty and other progressive economists have not raised any objections,” notes Kate Pickett.
More happy people in equal countries
Many researchers, both before and after this book, have shown how people with small resources suffer from physical and mental ill-health. Kate Pickett and Richard Wilkinson asked why conditions become worse every notch down the social ladder. The poor have worse health than the middle class, which in turn feel worse than the upper ranks of society.
The researchers looked at data from national and supranational surveys and independent research teams, creating graphs that reveal the relationship between income inequality and health, crime, education and other parameters in 21 of the richest countries in the world.
The results confirm that it is not the amount of income, but the position on the social ranking scale which is vital to people’s well-being. The feeling of subordination creates a social stress, which leads to physical and mental illnesses.
Teenage pregnancies are more widespread in countries with an uneven distribution of income, for example. More people are suffering from obesity and more fail in school. More people are in prison and social mobility is lower.
In more egalitarian societies people are happier, women have a higher status and children feel better. There is more trust in other people, as well as generosity.
Inequality creates ill health
The United States illustrates the idea. It is one of the richest countries in the world, but the money is unevenly distributed. Living conditions on the national level are worse as a result. Life expectancy is lower, infant mortality is higher, adults and children become obese. Mental illness is more common, as is the use of illegal drugs.
The murder rate is considerably higher in the USA than in countries with more equality. Within the USA, the pattern is the same: more murders in states with bigger gaps in income.
“The problem is not that society is not rich enough, but that material differences between people are too large,” explains Kate Pickett.
Japan has a more equal distribution of resources, its life expectancy is higher, infant mortality is lower and only a few adults suffer from obesity. Mental disorders are unusual, as is the use of illegal drugs.
Sweden is also high in the charts. Infant mortality is lower than England and Wales. The mortality rate for men of working age is also lower.
“Sweden is a more tolerant society than the UK, although inequalities have increased recently,” comments Kate Pickett.
Social factors crucial to health
As a student, Kate Pickett started out reading biological anthropology and nutritional physiology and dreamed of doing research in the third world, until she discovered an uncharted dynamic in developed countries.
“It was when I was studying in the United States that I realized the problems were on my own doorstep. I was interested in the significance of social factors on health,” she explains.
She studied epidemiology and began to work with Richard Wilkinson. They have been married for several years now.
“It enriches our work, living and working together. We can continue discussions when we come home.”
Kate Pickett is now Professor of Epidemiology at the University of York and researcher at the National Institute for Health Research. Richard Wilkinson is Emeritus Professor at the University of Nottingham Medical School.
“I have a full-time job with PhD students and research funds, primarily to study what happens during a child’s first year of life.” Richard has retired and can now focus on our own research.
The rich live twenty years longer
The two scientists have continued to study the importance of equality for people’s health. On International Women’s Day last year they published an article in the Guardian newspaper, in which they pointed out that women in the wealthier areas of England live two decades longer than their poorer sisters. The differences are almost as large for men.
Those who are born in the poorest parts of England can’t expect more healthy years than people born in war-torn countries such as Liberia, Ethiopia and Rwanda.
“Our results have been confirmed more and more with time,” says Kate Pickett.
She is concerned that Britain has adopted a culture of inequality, with the wealthy described in terms of talent or welfare engines and the rest of the population are seen as labour costs.
“But it feels like the political wind has turned. The Labour party’s newly elected leader, Jeremy Corbyn, is very progressive and won by a large majority. And the left-leaning candidate Bernie Sanders in America kept pace with Hilary Clinton in the primaries in Iowa,” comments Kate Pickett.
Created the Equality Trust
Kate Pickett and Richard Wilkinson were once asked whether there was an organisation for equality. That prompted them to create The Equality Trust.
“We have been working for six years with this, educating both politicians and the general public. We will soon publish a report on low income earners, showing that they lose financially if they work more,” says Kate Pickett.
She doesn’t have as much space for a private life any more, but feels privileged that she is able to work with research and advocacy. She can also count her work at The Equality Trust in the quality audits that are carried out regularly by HEIs in Britain.
“Not that many researchers are good at communicating, but I think it’s necessary. The purpose of science is to increase knowledge – but then it has to be passed on. I am an optimist and I believe in change,” says Kate Pickett.