Richard G Wilkinson is a prominent British researcher in social inequalities in health and the social determinants of health. His work shows that societies with more equal distribution of income have better health outcomes than ones in which the gap between the richest and poorest in society is greater. Iain Ferguson spoke to him for International Socialism about his most recent book (with Kate Pickett) The Spirit Level: Why Equality is Better for Everyone (Allen Lane, 2009).
The dominant idea of governments pursuing neoliberal policies, whether Conservative or New Labour in Britain or their foreign counterparts, has been that, as long as minimum poverty levels are addressed, then income inequality doesn’t matter. In Peter Mandelson’s notorious phrase, “we are intensely relaxed about people becoming filthy rich”. Your book The Spirit Level effectively demolishes that argument and has helped to transform the terms of the debate around inequality. Why, in your view, is inequality so important?
I think we might start by saying why inequality fell off the agenda, why Blair probably regarded it as part of the “old Labour” baggage he could get rid of. I think that was probably because he thought inequality only mattered when there were people, as in the 1930s, without basic necessities—shoes, clothes, adequate housing and food. But now almost everyone is adequately housed and clothed, I think they thought that maybe it didn’t matter, that it’s only wrong for some people to be living in great luxury when other people don’t have basic necessities. But most of our book is about the psychosocial effects of inequality, not the material effects. It’s more to do with feelings of superiority and inferiority, feelings of being devalued, disrespected, looked down on, that kind of thing. What we found is that not just health but a huge range of social problems seem to be worse in societies with bigger income differences between rich and poor: violence, drug problems, mental illness, the proportion of the population in prison, measures of child wellbeing, involvement in community life, how much people feel they can trust others, how kids get on at school in maths and literacy scores, all these things. That’s looking at the rich, developed countries only.
And these findings are based on a review of around 200 academic papers on inequality?
There are about 200 papers on health and inequality in lots of different settings, probably 40 or 50 looking at violence in relation to inequality, and very few looking at any of the other things in relation to inequality. In a way, the new work in the book is all these other variables—teenage births, mental illness, prison populations and so on—and the major contribution is bringing all of that into a picture that had previously been just health and violence. Having all those other bits of the picture affects the kind of explanations you can give of those relationships. When it was just health, people thought maybe it’s just diet, or maybe it’s overcrowding or something like that, material factors rather than psychosocial.
Did it come as a surprise to you to find these wider connections?
It all came so slowly, and I’d spent decades wondering about health and inequality. The first time I showed those relationships was something I wrote in 1985, first published in 1986. There was quite a lot of argument about those things and I’d stuck my neck out because I found this relationship on several independent bits of data, and I felt it was sound. Then people showed the same thing among the 50 states of the US, that the more equal ones did better. I think if I’d known they were looking at that, I’d have been very worried as to what they were going to find, whether to confirm what I’d been arguing or not. In the end, there were two papers from different American research groups in the same issue of the British Medical Journal showing these relationships in the US. But it was slow before I realised that this pattern applied to most problems which, like ill health, are worse lower down the social ladder. We actually did a formal test of that. We took different death rates, some of which have social gradients and others which don’t. We took breast cancer and prostate cancer as examples which are not more common at the bottom, and then heart disease and deaths from violence and infant mortality, and things that we know have social gradients, and we found that the stronger the social gradient, the more strongly they are related to inequality. And so we’re left with a picture of inequality sort of amplifying or intensifying the effects of social status hierarchy. That’s not the same as saying in more unequal societies there are more poor people because actually what we’re finding is that everyone does worse. It isn’t just a few more at the bottom, a few more in absolute or relative poverty; it’s like a social map that affects most people.
The book has been very widely reviewed and appears to have had an extraordinary impact. Why do you think that is?
Several things. One is obviously the timing—the recession, the financial crisis, makes people more open to other ideas and they’re no longer prepared to believe that the bankers are brilliant. I think also knowing that we’ve got to deal with environmental problems, reduce carbon emissions enormously, means that people know we can’t go back to what we were doing before, to that sort of consumerism. But I think also that many people have a kind of background feeling of worry about what’s happening to our societies, why it is that among so much comfort and luxury—which is quite unprecedented—so much seems to be going wrong. Rates of self-harm among teenage girls at school are absolutely appalling. Problems of mental illness like depression and anxiety really do seem to have increased. Whether it’s drugs or violence, there is a disquiet, a worry about where we’re going.
Kate Pickett and I have done over 200 talks in the last year and I suppose usually we’re speaking to fairly well-heeled audiences, not always self-selected. Sometimes we’re speaking to the Cabinet Office or the Treasury with civil servants who presumably feel it’s their job to know some of these things. What’s most surprising is the remarkable enthusiasm shown—occasionally audiences have given standing ovations, quite unlike anything you get academically! We do present it as academic stuff—I stand up and show graph after graph and scattergrams, so we’re not doing very much tub-thumping. I think it’s because there’s been a kind of intellectual vacuum. There’s all these health and social problems that people don’t really know how to explain, and suddenly there’s an answer which fits people’s intuitions that inequality is divisive and socially corrosive. It also fits with their views about other things. There are surveys which suggest, for example, that people know that consumerism is hollow, that it’s a zero-sum game and that we’re sacrificing more important values—typically they mention family, friends, community, that kind of thing. I think also, in that we show that economic growth is no longer making an important difference to outcomes like health and happiness and measures of wellbeing, people at some intuitive level say rather romantically, weren’t we just as happy in the 1950s, or as children? It’s a kind of half-recognition that as we all get richer, as society gets richer, it doesn’t really make a lot of difference to the real human quality of life.
I feel that the world is full of closet egalitarians, that at some level people know this makes sense. They were pushed into the closet by Reagan and Thatcher and monetarism and neoliberal economics, but many people didn’t really stop believing that some of the old left ideas were important. We just lost confidence in them, and I think maybe we thought they just weren’t relevant to the modern world. I feel that the left entirely lost its way. In the past Marxism provided the empirical evidence that made people believe a better world was possible, and people committed themselves to that socialist project—not simply thinking that another 5 percent on top tax rates or a little bit more on child benefit would make an important difference, but committed to something that was to do with a much more fundamental change that would make the world better for all of us. And I think we need to rebuild that empirical evidence. It needs a bit of the component that we’ve done, the inequality stuff, but it also needs to combine that with how you solve the environmental problem and things to do with co-operatives, employee ownership, workplace democracy, a more leisure-based economy rather than consumerism. I think we need to map that out in a way that’s compelling, and doesn’t just make us feel that the future means making a lot of sacrifices: sacrifices to reduce carbon emissions, sacrifices for greater equality, and giving up things. We should be gaining a world.
Your work might be seen as part of a wider body of work that has emerged in the past few years, which we might call the “happiness and wellbeing literature”. There are different strands within that, however, and in contrast to the work of someone like Richard Layard, whose work has also been influential, you seem much more critical of individualistic, cognitive therapy based approaches.1
I think that’s the sad thing about his book, that he ends up saying that we all need to go to shrinks, basically.
Whereas you’re arguing for political changes?
Going back to the question of why inequality has the impact it has, could you say something about the mechanism through which it operates, which you argue is primarily psychosocial?
Yes, but at the most basic level, I think you have to dream up some evolutionary psychology to explain these things. It seems to me, though, really it’s quite obvious to anyone, that the potential for conflict between members of the same species is just huge. They can fight for territories, for nest sites, for scraps of food, for sexual partners. Of course Hobbes’s political philosophy was very much based on that idea, that this was the central political problem, that you have to have a central political power to keep the peace, otherwise life would be nasty, brutish and short because of the conflict of all against all. And he did see that we all have the same needs and require access to scarce resources. But human beings also have the opposite potential, to be the best source of comfort, support, assistance, cooperation, security, probably more than any other creature. You can be at death’s door for weeks and lots of people will look after you, or you can just live more easily through cooperation. And it seems to me that absolutely crucial for human beings has been understanding what the nature of social relations is like. Are we rivals or do we recognise each other’s needs and cooperate?
And of course the gift is the symbol of friendship because, as they say, gifts make friends and friends make gifts. It says that I recognise your need, and your sense of indebtedness means that you reciprocate the gift. I think psychologists suggest that’s a human universal; it makes a kind of social compact between us. What’s really interesting is how in the health literature, looking at the physiological effects of chronic stress, among the most powerful stressors are low social status or bad relationships or lack of friends, lack of social affiliations, lack of good relationships. It’s social relationships that are the most important stressors, and it seems to me that inequality is asking us: what game do I play in this society? Do I have to be out for what I can get, watch my back, we’re all rivals, a sort of dog eat dog society, or do I depend on reciprocity and cooperation whereby I must gain other people’s trust and my security will depend on maintaining good relationships with people? So I think at the bottom is that divide, and we know how to make friends. We also know how to be snobbish and superior, and express our status in our clothes and our choice of newspapers, choice of music, all the stuff to which Pierre Bourdieu drew our attention.
It’s really important to know which game to play, and your social environment tells you how other people are doing this and you see that at the bottom sharing means equality. Hunting and gathering societies appear to have been highly egalitarian, based on gift exchange and food sharing, and I think these things go deep in human societies. Eating together is still an important symbol, and then religious life, the communion; it’s a recognition of the importance of not fighting over basic necessities. The most important thing we should not dispute is access to food, because then society’s gone—it’s everyone for themselves. But you see it’s social hierarchy which, in a sense, is everyone for themselves, but in a kind of routinised way—we know who is most powerful. If you think about monkey hierarchies, it’s the strongest at the top, and where you are is sorted out usually by physical conflict or some kind of face-off, and recognising the hierarchy is simply recognising that so and so is stronger than you.
Your view of human nature seems to be quite an optimistic one in that you’re arguing that people have the potential for behaving in different ways, for sharing or not sharing, and although you don’t mention him, your description in The Spirit Level of hunter-gatherer societies seemed to me not that different from the description provided by Engels in The Origin of the Family, Private Property and the State. What is also interesting in the book is your use of arguments from evolutionary psychology which you seem to view quite positively, whereas the left in general has been very critical of it, mainly because it’s often been used in quite reactionary ways.
That’s because the left didn’t get into it. I remember in the 1960s empirical work was dismissed as naive empiricism—you needed “theory”. And that meant we left the empirical work to the right. And it was then that they started building up all the stuff that led to neoliberalism a couple of decades later, which was strengthened by sociobiology. But sociobiology was so right wing because the left would not touch the field. Like any other field, it can be used by people of any political persuasion. It has rich pickings for the left as well as anyone else.
In the book you talk about the Whitehall studies of civil servants in the 1970s which showed that, contrary to the widespread belief at that time that heart disease and other stress–related diseases primarily affected senior managers and executives, in fact the lower down the civil service hierarchy you were, the more likely you were to experience those health conditions. One reason for that which you discuss at length is the impact of low social status but another factor you mention is lack of control over the work process, which recalls Marx’s notion of alienation. How important do you think that is?
Yes, I think there’s quite a widespread literature on the importance of a sense of control, and the Whitehall studies showed its importance to health—and not just the Whitehall studies. Interestingly, you might think that the more hierarchical the society, the less control the people at the bottom would have—and I think that’s probably true—but interestingly an American psychologist, Jean Twenge, looks at studies done over the past 50 years of levels of anxiety and finds a gradual upward drift in anxiety levels. But she also did the same with studies of the external locus of control which has been increasing gradually for a long time, and I wonder if that is also partly exacerbated by greater inequality. One of the remarkable differences between Japanese and American society seems to be that Americans are much more likely to have what psychologists call an external locus of control and the Japanese an internal locus of control. Japanese people blame themselves when they don’t do well and things go badly, Americans will say they we unfairly marked, or it was a stupid exam, or they weren’t taught properly. At another level though, I don’t know if control only matters if there are unpleasant things that happen to you if you have low control. It might only happen in the presence of a threat and maybe if you just had a lot of capital in the bank, you’d have control. At a level of truism, what do you use control for? To avoid nasty things happening to you.
More recent research into the impact of managerialism in public services also suggests that the loss of control or discretion over the work process is a major source of stress and discontent among workers, such as teachers, nurses and even academics. They’re governed by targets and performance indicators and there’s a sense of real unhappiness that they can’t work in the way they want to work.
Yes, and people in Sweden have suggested that the need for control at work implies greater levels of workplace democracy because you can’t have control in a completely individualistic, autonomous way—we have to work together. Some of the psychological experiments on sense of control have involved giving people what appear to be not very difficult arithmetical problems to solve, though naturally they’re made to be insoluble in some way—is that a test of the importance of control, or just a test of the sense of failure? I don’t feel very confident that I know how to separate these things. If your washing machine breaks down, if you have a good income, it doesn’t matter; you just get it repaired, even if it costs £100. Low sense of control means you’re going to be without a washing machine till you’ve saved up enough money, and that’s a real menace.
One of the points that you and Kate make in the book is that in more unequal societies more of the problems are concentrated at the bottom. However, you seem to take the position that while problems of material poverty are a real issue for people in the developing world, they are much less of an issue in developed countries like the UK, where the real issue is inequality. Given that we now have more than two and a half million people unemployed, given that child poverty in the UK is still among the highest in the OECD countries, aren’t you in danger of underestimating the material impact of poverty, as opposed to the psychosocial impact of low social status?
Yes, but I think even when you are in relative poverty, it’s the psychosocial effects that get you. I’ve talked to homeless people on the streets, and I remember a man saying, “What I want most is someone to talk to.” If you take something like homelessness, what feed into it are things that are created or made more common by inequality—domestic conflict, people coming out of prison, drug and alcohol problems, people coming out of the army too. These are psychosocial things that are mostly strongly related to inequality. I remember a Rowntree study which showed that poorer families are likely to give their kids more pocket money than better-off families, presumably because they don’t want their kids to suffer that sense of inferiority and not participate, and so on. They feel that is the most important thing and, okay, you’ll save on something else. I suspect that many of the signs of absolute poverty reflect the importance of participation—I’d rather save on food and look decent when I go out.
There are effects of absolute poverty—I think they apply to a very small percentage of the population—and we are looking at very big effects over the whole population. The less than 1 percent who are homeless, that’s not going to affect national death rates or life expectancy. But if you look at the Americans who come below the federal poverty line, I think that just over half of them have more than one vehicle, 80 percent apparently have some kind of air conditioning and over a third of them have computers. So it’s clear that there’s the desire to be part of the culture and I think that some of the signs of absolute poverty come out of relativities, and in a way are an indication of how highly social we are. Like debt, in a way—you spend because you want to look good, trying to keep up. It’s not materialism that makes people chalk up these huge credit card debts; consumerism is driven by something that shows how highly social we are. It’s about wanting to be something, to create a better impression, to look better and feel better in all sorts of ways in relation to other people.
It’s true, though, isn’t it, that for many people debt has been a way of surviving, rather than a way of competing or looking good?
Once you’ve got into it, it’s very difficult to get out of it.
At one point in the book you argue that “for several decades, progressive politics have been seriously weakened by the loss of any concept of a better society”. For many on the left, the collapse of Communism in Eastern Europe means that some variant of market capitalism is now the best we can hope for. Given the current crisis of global capitalism of the past two years, to what extent do you think this is true or can we still aspire to a more egalitarian, even socialist, alternative?
I think we can take some things out of the market, like healthcare, education, maybe some transport. But I don’t believe that in the foreseeable future we cannot have the market as a really important element in our lives. I think it has damaging effects but I don’t think there are other ways of allocating and rationing goods. But I do think that a lot of the harm that the market does comes from inequality, that some people’s purchasing power is so much more than others.
We discuss the effects of digitisation. I do think there are huge possibilities for massively extending the range of public goods, in that if we can find a different way of paying the people who produce the music, the films, the computer games, the computer programmes, all the written word—we don’t have to pay any more than we’re paying now maybe—but it wouldn’t cost us anything extra to make it free to everyone, worldwide probably. In a way, I think, that has to come. Obviously, industry will fight it, will try and maintain monopolistic controls, some people who create the stuff will too, but the technology just means that costs will get lower because it can be produced for so little. That would make a major difference to what citizenship felt like. I think if we had more democratic employee-owned companies that would also make a difference: people say that employee buyouts turn a company from being a piece of property into a community.
We always talk about social capital and cohesion and so on in residential communities but it’s at work that we have most to do with each other, and it’s at work that we’re most subject to status differentiation and hierarchy. It’s where inequality is first created, with some people getting so much more than others. Most capital is now institutional capital and it would be possible to have a world in which all capital was institutional, being pushed around by people who are just paid professionals. Everyone could be paid what is nominally a salary or a wage, rather than profits, everyone might be an employee. That’s very different from 19th century capitalism, but I do think there’s scope for much greater equality, moving away from a consumer society towards a leisure society, a more locally-based economy in which people talk in terms of sustainability, a greater sense of community at work, a huge increase in the range of public goods, and so on. There’s really a possibility of moving towards a world which does feel a lot better for all of us. But I think we need that picture mapped out, written about, covered in films, in a way that is inspiring and exciting.
One of the great things about your book is that it’s opened up that whole debate, and after more than two decades of neoliberalism it begins to point some ways out. That said, we now, of course, have a new government in the UK. After the initially very positive reception of your book, do you remain hopeful that the ideas will continue to have an impact, or do you feel that the door has now been closed?
In a sense, I’m less interested in political parties than in where the majority of the population is. I do think it was impressive that the BNP didn’t make the gains they expected but actually made losses. But more important than that is the fact that to gain the possibility of election David Cameron had to move so far from Thatcherism, and that reflects how the population has moved. I think that since the financial crash inequality has been moving up the agenda very fast. All the three main parties said that inequality was too great and should be reduced. Cameron quoted our book as showing that by every measure the quality of life is damaged by inequality, while Michael Gove, in a radio programme where we were meant to be having an argument, said: “Richard’s right”! And I think the Labour Party will have to go through some pretty fundamental rethinking.
You’re quite clear in your book that one of the major factors contributing to the growth of inequality was the reduction of the power of the unions in the 1980s and the 1990s on the one hand and the growth of corporate power during that period on the other. I guess that raises the question of what, despite his warm words about inequality, Cameron would do to curb that power.
I think it’s fairly easy to do things that help the employee-owned sector, such as co-operatives. You can give tax incentives; you can give funds to help firms through employee buyouts. You can also make sure that where there are employee-owned firms, they have constitutions that mean that people are not tempted to sell off to other industries. And we can create consumer movements that favour moving our custom to mutual mortgage companies, using the Co-operative Bank and so on, as a way of making people aware that these are ethically preferable forms of organisation. I think we have to make the people who get their bonuses feel that we regard them simply as greedy, not as brilliant. I was interested to read what Jeremy Clarkson was saying about these supercars, that you can’t park them on the street—they get scratched—which is an indication of the mood.
Trade union power is a difficult issue because it’s clear that strong trade union movements are an important part of more equal societies—there are several papers that say that. Indeed in New Hampshire, where we find that incomes are more equal before taxes than most other states, one of the more egalitarian states, I found recently it is illegal to try and get people to sign a contract in which they are not allowed to join a trade union. They’re not allowed to ban trade unions and it’s illegal to organise strikebreakers. It seems to me that may be one of the reasons that the income differences before taxes are smaller there. But I think we’re still a long way away from having a public opinion that would support giving the unions back their power. There are many near-monopolies—the Post Office or the railways—that there are no alternatives to if a workforce goes on strike and where the damage is to the public and not so much is lost by the company itself—because its customers don’t have anywhere to go. I think it was very different striking when there were lots of competitive providers but it seems to me that maybe we need to rethink the strike weapon. Are there ways you can do it by not collecting fares or something that would make strikes less unpopular?
The recent legal situation with British Airways employees before the appeal looked almost as if the legislation removed the right to strike. I suppose I do feel that there’s a very long process of re-education that has to be done—rather like the early socialists, setting up the Workers’ Educational Association, going and producing pamphlets and giving talks everywhere, that has to be done. But in order to do it, we need the well mapped out empirical basis of the kind of society that should be replacing this one. But I do think we should be able to grow the new society within the old, from co-operatives, employee-owned firms, being a growing sector within the economy. I think their benefits would increase as the conventional sector became smaller. The usual hierarchy and pay differentials set by the private sector would be less influential and I think, as you diminish hierarchy at work, as you make the managers and directors answerable to the body of employees, you almost certainly begin to change values. So I think one could map out an institutional basis for changing attitudes and levels of inequality, and making work a less unpleasant, alienating experience. But normally when I’m asked the question about how we get there, I say we’ve got to do it in every way—taxes and benefits, minimum wages, education policies, levels of unemployment that are tolerated, all forms of economic democracy and so on.
You’ve set up the Equality Trust and you say several times in the book that what we need is a social movement that would bring about some of these changes. How do you see that developing, and what form might that movement take?
I think that there are probably different stages. I suspect that the easiest part is to get these ideas into the middle class, particularly middle class people working in the public sector, but also the media, and I think that must be the first stage. But I’ve been feeling for some time that we need to make better links with the trade union movement and we are now getting invitations from the unions. I’m doing a talk at the Unison annual conference and this week I did a talk at the Public and Commercial Services union annual conference in Brighton. Kate and I have also spoken at TUC events. It is very different—people don’t ask you about your data, or things about causality. They say, “What does it mean for us?” or, “What can we do about it?” But it’s not just trade unions. We talk to Quaker groups, academics and health service people who think that we’re telling them that what they’re doing is useless, that we’re saying it’s just a sticking plaster. And I say that sticking plasters are very important. I also hope that it will all catch on so that soon my contribution will be entirely irrelevant.
I think that’s one of the things about how to get there that is important, particularly when you look at Greece, with the possibility of similar things happening in Portugal and Spain, and apparently in Greece they’re having to formulate policies to restrict incomes at the top to make the other cuts acceptable. We have tried to get the parties to sign up to what we call an equality test, which is basically that they will not try and cut the deficit in ways which will increase inequality. The Liberal Democrats during the election campaign signed up to it very forcibly—we had a two-page letter from Nick Clegg, signed by him, saying that they would do that. The other parties replied saying that “fairness is at the heart of our agenda” and all that, but not more. We’re following up now to Clegg and Cameron, saying this is how you answered us, so what about now? But I think if there has got to be a really nasty squeeze, with the poorer people in the public sector paying for the problems of the rich and the private sector, it shouldn’t be accepted unless the rich and the private sector are having to pay quite heavily themselves.
If you look at trends in income distribution during the 20th century, the economist Paul Krugman in his book The Conscience of a Liberal has shown that basically inequality is high until about 1930 and the crash.2 With the New Deal, inequality goes on down through the Second World War, through the 1950s and 1960s and goes on decreasing until it peters out in the 1970s. Then, of course, you get the rise in inequality during the 1980s. It seems to me that decline is probably driven by a fear of communism—the 1930s being seen as the collapse of capitalism that Marx predicted, fear of the power of unions, fear of the rise of European Communist Parties, and in the 1960s we thought of Communist countries as more efficient than us—they had faster growth rates; we thought they would outgrow us. It was only in the 1980s that we knew these economies weren’t working so well and Thatcher could say there is no alternative. I think it’s when they ceased to be an economic and political threat that income differences began to widen. Paul Krugman doesn’t quite make that link but he says it’s driven by politics.
Yet I remember a World Bank report which looked at what they used to call the Asian Tigers. They all became much more equal in the 1960s and 1970s and they said it was because in each case these countries had Communist rivals—Taiwan had mainland China to worry about, South Korea had North Korea and the Philippines had guerrilla forces operating. And of course Britain in the war reduced the hierarchies. Richard Titmuss says that was because they wanted people to feel that the burden of war was equally shared to gain popular participation in the war effort. I think it’s those kind of threats which lead to the long-term change and make people feel they can’t get away with the bonus culture kind of stuff.
And today we have the anger over bankers’ bonuses and we’ve also seen the example of Greece.
Yes, with the example of Greece and whether governments are going to make really stringent cuts stick, and what they will have to do to make people see it as fair. But the same problems arise when you think about reducing carbon emissions dramatically, as we’ve got to: if the rich are able to go ahead living the same lives unscathed, then the rest of society won’t like it. And so I think that in a way we must use that. What this needs is a widespread awareness of the issues. I think there’s just a huge educational task to be done but it needs a bit more research to feed into it. The New Economics Foundation is doing some useful stuff—we need more of that sort of thing. The easiest way of communicating the politics is to paint an idea of the future society.
1: Layard, 2005.
2: Krugman, 2008.
Krugman, Paul, 2008, The Conscience of a Liberal: Reclaiming America from the Right (Allen Lane).
Layard, Richard, 2005, Happiness: Lessons from a New Science (Allen Lane).