The Tragic Health Effects of Income Inequality Show the Need for a Basic Income Guarantee

by Richard Cook

From the April 30, 2009, edition of Nature comes a fascinating review of a book that shows a striking correlation among nations between large income disparities and poor health. The book is The Spirit Level: Why More Equal Societies Almost Always Do Better by Richard Wilkinson and Kate Pickett (Allen Lane 2009).
The title of the review is “Why Inequality is Fatal.” The review states:

“Why are our chances of reaching a great age so affected by wealth and status? The obvious answer is that more income buys better health. But it is a lot more subtle than that, as shown three decades ago by the Whitehall Study, in which epidemiologist Michael Marmot examined the death rates of British civil servants. To the surprise of many, he found that his subjects — all in continuous paid employment and with equal access to health care — were more likely to die in any given year if they were in a lower- grade job than a higher one. Marmot concluded that the employment hierarchy itself created status-dependent stress that affected the workers’ health.

“In their new book, epidemiologists Richard Wilkinson and Kate Pickett extend this idea with a far-reaching analysis of the social consequences of income inequality. Using statistics from reputable independent sources, they compare indices of health and social development in 23 of the world’s richest nations and in the individual U.S. states. Their striking conclusion is that the societies that do best for their citizens are those with the narrowest income differentials — such as Japan and the Nordic countries and the U.S. state of New Hampshire. The most unequal — the United States as a whole, the United Kingdom and Portugal — do worst.

“Many measures of the quality of life, including life expectancy, are correlated with the degree of economic equality in each country. A variety of problems such as mental illness, obesity, cardiovascular disease, unwillingness to engage with education, misuse of illegal and prescription drugs, teenage pregnancy, lack of social mobility and neglect of child welfare increase with greater inequality. Violence, from murder to the bullying of children at school, follows the same pattern.”

The key word in all this is “stress.” We see everywhere around us a dramatic increase in stress during the current economic recession. Loss of jobs, foreclosure of homes, increased debt, absence of health insurance, families under pressure to meet rising costs for food and other necessities—all are taking their toll.

The review points out that stress “triggers the release of the hormone cortisol, which raises blood pressure and blood sugar levels, from which myriad health and social problems unfold. This seemingly hard-wired response has been well studied in social hierarchies of monkeys; low-status animals become predisposed to atherosclerosis and cardiovascular disease. Humans experiencing chronic stress exhibit similar symptoms, accumulating abdominal fat under the influence of a part of the brain associated with addiction.

“Cortisol overrides ‘feel-good hormones’ such as oxytocin, involved in establishing trust, and dopamine, the reward signal that reinforces memory, attention and problem-solving ability. Cortisol-induced stress predisposes some individuals to mental illness or violent behavior. It can hasten the arrival of puberty, which may prompt premature sexual adventures, providing a plausible explanation of the high prevalence of teenage pregnancies in the most unequal societies. Cortisol also transmits stress to a fetus, with lasting consequences for physical and emotional development.”

Within the United States, income disparities have become worse during the last generation, since the “Reagan Revolution” of the 1980s unleashed the predators of Wall Street and put the lords of high finance in charge of our society. Today, even life expectancy in the U.S. is declining.

Of course there are many things individuals can do to reduce their levels of stress, including exercise, dietary improvements, and meditation. But society also has an obligation to step in. We know many of the reasons the incomes of working and middle-class people have stagnated or declined, including the shipping so many of our good manufacturing jobs overseas and the payment of outrageously high salaries, including bonuses, to CEOs and financiers. We also know that the minimum wage is much too low and housing too expensive, even with the bursting of the housing bubble.

But books like The Spirit Level should also make it clear the benefits that could be realized from a basic income guarantee such as I have advocated through my “Cook Plan” and as groups like the U.S. Basic Income Guarantee Network promote. I explain the rationale in my book, We Hold These Truths: The Hope of Monetary Reform. Another example of a solid income guarantee program is Stephen Shafarman’s citizens’ dividend proposal in his book Peaceful, Positive Revolution. (Both published by Tendril Press: www.tendrilpress.com.)

A basic income guarantee would break the killer stress cycle even while more systematic remedies to income disparities are sought. A huge weight would be lifted off peoples’ shoulders if they knew that no matter what economic hardships they had to endure, the basic needs of themselves and their families would be met.