[Pophealth] The Battle of our Time: inequality books during ThankIndians

[Stephen Bezruchka]

The following essay reviews recently published material that won't uncover 
new ground for readers on this list.  But it is one more step in creating 
awareness.

I recently came across ideas mentioned in Emanuel & Fuch's Boston Review 
Nov/Dec 2005 about US Health Care Reform which might make sense for 
strategizing about health as well.

"Dysfunctional social systems can persist for a long time. Major change 
occurs only when three developments coalesce:
   -a problem begins to attract popular and political attention
   -the major players agree upon a refined and feasible proposal
   -and a transforming political event --a major electoral realignment,
natural disaster, economic depression, or war -- takes place, creating 
what the political scientist John Kingdon has called an "open policy 
window" referring to John Kingdom "Agendas, alternatives, and public 
policies" book.

We are still working to attract popular and political attention.  Katrina 
as a natural disaster was too ephemeral, perhaps, and the major players 
are in another stadium.  STephen

****
Throw the Books at Them
A slew of new essays and studies show that fighting against inequality is 
the battle of our time
By David Moberg	November 24, 2005  In These Times
http://www.inthesetimes.com/site/main/article/2413/
In the early '80s, when researchers in Britain began studying office 
workers in Whitehall, the foreign service office, they found some 
surprising results: The death rates for the lowest-level staff were three 
times higher from all causes--and four times higher from heart 
disease--than those of the senior administrators. Differences in smoking, 
exercise, diet and other behavior that affects health explained less than 
a third of the disparity. The workers were all "middle class" and could 
take advantage of the same health care. But as their rank rose, their risk 
of dying decreased. So what was the most likely cause of their radically 
different prospects for life and health? Inequality.

We're accustomed to the notion that poverty and material deprivation can 
hurt people. But poverty is just one dimension of the larger problem of 
inequality. And the idea that inequality itself is harmful--even to people 
living in affluent societies--is rarely discussed.

A rising tide sinks many
Yet it's especially relevant for the United States, where economic 
inequality has been steadily increasing for more than three decades, 
rolling back virtually all of the progress towards a more equitable 
distribution of income made over the previous three decades. As economists 
Heather Boushey and Christian Weller note in their contribution to 
Inequality Matters: The Growing Economic Divide in America and Its 
Poisonous Consequences, a fascinating collection of essays commissioned by 
New York think tank Demos, "the average real income of the bottom 90 
percent of American taxpayers declined by 7 percent between 1973 and 2000, 
while the income of the top 1 percent went up 148 percent."Ê

Economic growth helps, but it alone is not the answer. Many Americans say 
they would find inequality tolerable if there were equality of opportunity 
and social mobility, but there is surprisingly little class mobility in 
the United States. As the title of one paper in Unequal Chances: Family 
Background and Economic Success indicates: "The Apple Falls Even Closer to 
the Tree than We Thought." More than 40 percent of children born into the 
poorest fifth of families remain in the poorest fifth as adults; less than 
10 percent make it to the top fifth. But 30 percent of children born in 
the top 10 percent remain there.ÊThere are many reasons for 
this--including race, wealth and personality--but the editors of Unequal 
Chances conclude that "genetic transmission of IQ appears to be 
surprisingly unimportant" and education and superior cognitive performance 
explain at most half of the persistence of rank between generations.

According to Sage Foundation president Eric Wanner, the new inequality is 
likely to reproduce itself as families and schools increasingly diverge in 
how they prepare each new generation. But the risk of self-perpetuating 
and hardening inequality also comes from the increasing influence of the 
wealthy and corporations over politics, the decline of broadly based 
popular organizations that link the working and middle classes, and the 
demise of the public sphere with the privatization of "the commons."

On the hedonic treadmill
But even if there were perfect mobility and educational opportunity, there 
would still be growing inequality--and that is harmful in itself. Several 
of these new books--Greed and Good: Understanding and Overcoming the 
Inequality That Limits Our Lives, Inequality Matters, Economic Apartheid 
in America: A Primer on Economic Inequality & Insecurity (an excellent 
popular introduction to the issue of equality) and The Impact of 
Inequality: How to Make Sick Societies Healthier--show how harmful 
inequality is to society as a whole and to individuals. In Greed and Good, 
a highly engaging, encyclopedic survey of arguments for and against 
equality, Sam Pizzigati, a veteran labor journalist, makes a compelling 
case that increasing inequality contributes to rising unhappiness, 
corruption of professions like law and medicine, environmental 
destruction, less innovative businesses, slower economic growth, a fraying 
social fabric and much more.

Take happiness, for starters. Surveys suggest that once people rise above 
a struggle to stay alive, rich nations are not necessarily happier than 
poorer ones, but within countries, affluent people are happier. That's 
partly because the rich--and the media--set the standard for what's 
necessary for life, a culturally relative category that expands with 
growing needs. This creates a "hedonic treadmill" or, in the words of 
economist Robert H. Frank, a "spending cascade" that puts pressure on 
consumers to buy and can even drive up prices.

As people try to "keep up with the Joneses" on less income, they are also 
tempted to shortchange the public sector, which is most important for 
those with less money. This becomes especially harmful as the rich 
increasingly retreat to private schools, gated communities and a life 
totally disconnected from average people.

Hazardous to your health
For many decades, researchers have looked at the relationship between 
inequality or poverty and health, and expected to find that material 
hardships, bad behaviors or poor medical care account for the worse health 
of those with less money. But Richard Wilkinson, a professor at the 
University of Nottingham medical school, shows in his latest book, The 
Impact of Inequality, that social inequality itself causes worse health.

Human beings are fundamentally social animals, and during most of their 
evolutionary history lived in small groups that valued--and zealously 
protected--egalitarianism. Humans have the capacity for both cooperative, 
egalitarian solutions and hierarchical, competitive strategies, and most 
complex societies rely on both. When there's an imbalance, Wilkinson 
argues, it's not just the society that gets sick; the individuals within 
it become literally ill.

The evidence that greater inequality in rich countries leads to higher 
death rates and shorter lives--by as much as 15 years for those with low 
incomes and status--comes from a large number of comparative studies. 
Wilkinson argues that inequality creates chronic stress. That's partly 
because as societies grow less equal, there's less trust, greater 
conflict, more crime, less "social capital" and more racism.ÊAlso, in 
highly unequal societies, more individuals suffer from stresses associated 
with low status, weak social ties (such as limited links with others as 
kin or friends), and emotional difficulties early in life. While stresses 
normally lead to hormonal responses that help individuals survive, the 
chronic stress of unequal societies is much different in its cumulative 
effect. These social stresses leads to bodily changes that reduce 
immunity, raise the risk of heart disease and other illnesses, and lead to 
dangerous behaviors, such as heavy drinking, that increase the chance of 
disease and death.

While the impact on health may be surprising, inequality more obviously 
exerts a pernicious influence on democracy. Early observers of America, 
including Alexander de Tocqueville, linked the democratic republicanism to 
"the equality of conditions" of Americans.ÊNow, democracy is threatened by 
inequality of conditions--both through the undue influence of the monied 
and through the withdrawal (and exclusion) of low-income voters who see 
politics as irrelevant to their lives.

Sociologist Christopher Jencks and journalist Robert Kuttner argue in 
Inequality Matters that the United States has uniquely high and growing 
levels of inequality not for the usual reasons offered--such as increased 
use of computers or a skills gap--but because of the erosion of political 
forces that promote equality, such as labor unions, government income 
supports or working class parties. Why has there been such a growth of 
low-wage jobs? "It's politics, stupid," says Jencks.

An ideology of greed
How did this political sea-change come about? David Harvey, author of The 
Condition of Post-Modernity, offers an elegant explanation in A Brief 
History of Neoliberalism. Harvey argues that ruling elites in the United 
States promoted neoliberalism--or free market fundamentalism--for both 
this country and the world as "a project to achieve the restoration of 
class power," which was threatened economically and politically in the 
late '60s and early '70s. As a central part of that strategy, corporations 
and the rich, supported by allies in think tanks and conservative 
organizations, used globalization not only to produce new markets and 
cheap labor, but as a political battering ram to attack policies that 
restricted capital or protected workers.

Harvey argues that neoliberalism serves to legitimize what the powerful 
want to do, which includes dismantling all the institutions and political 
forces that had increased economic equality. It does so by cloaking 
policies in the garb of "freedom." But the freedom is mainly for private 
property, and then, to a lesser degree, for individuals as consumers. 
Individuals aren't free to choose solidarity or equality.

The neoliberal strategy, however, contains internal contradictions. For 
example, although growing inequality favors the wealthy in the short run, 
it is also associated with slower economic growth. And Harvey argues that 
neoliberalism faces difficulties resolving how to enforce a dictatorship 
of the market while advocating individual freedom, how to create citizen 
loyalty in a state that offers only protection of property and national 
security, and how to preach competition at a time of growing economic 
concentration.

Americans seem at best ambivalent about restraining great wealth. But 
Pizzigati shreds the rationales for inequality--as an incentive, as a 
justifiable reward, as the price paid for charitable benevolence--and 
argues that a just society must not only "level up" the poor but also 
"level down" the rich, capping their incomes at ten times the minimum 
wage. (The average CEO last year made 431 times the average worker's 
earnings). That would create a real incentive for the elite to raise the 
wages of most workers in order for them to increase their own incomes, and 
it could have a wide range of benefits--from slowing the hedonic treadmill 
to improving health and giving free reign to motivations other than greed.

It's a utopian proposal--but so was the estate tax when it was first 
proposed two centuries ago (and which, if the Republicans have their way, 
may soon become utopian again). Inequality Matters includes some more 
modest proposals--such as major political reform, national health 
insurance, stronger labor laws and new global trade deals--but even these 
seem pretty utopian in Bush World.

It was only in the late 18th century that people--other than the utopian 
Levellers--started thinking that poverty might be abolished.ÊIn An End to 
Poverty? A Historical Debate, historian Gareth Stedman Jones writes about 
how the global revolutionary-pamphleteer Thomas Paine and the French 
philosophe Marquis de Condorcet were inspired by the American and French 
revolutions to propose social insurance systems, a radically novel 
proposition.ÊThey were attacked by reactionaries in terms that are 
all-too-familiar two centuries later.

Progressives need both to fight the diverse immediate battles against 
neoliberalism and to develop a long-term goal of redistributing income, 
wealth and power from the contemporary ruling class to the working and 
middle class majority. To do so requires unity. But too often working and 
middle class constituencies, while sharing a common interest in creating 
an alternative to inequality and neoliberalism, are divided by differences 
in experience and culture. In Class Matters: Cross-Class Alliance Building 
for Middle-Class Activists, United for a Fair Economy organizer Betsy 
Leondar-Wright explores the impact of those differences, for example, in 
degrees of security, and offers a how-to guide on bridging the class 
divide.

Few projects are more important than developing that common commitment to 
realize one of the central political principles of a just 
society--equality, the foundation of both liberty and fraternity.
------------------------------------------------------------------------


David Moberg, a senior editor of In These Times, has been on the staff of 
the magazine since it began publishing. Before joining In These Times, he 
completed his work for a Ph.D. in anthropology at the University of 
Chicago and worked for Newsweek. Recently he has received fellowships from 
the John D. and Catherine T. MacArthur Foundation and the Nation Institute 
for research on the new global economy.