JRF Report: Does income inequality cause health and social problems?

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Inequality grew dramatically in the 1980s and has remained at a high level ever since.

But should high levels of inequality concern us?

This study provides an independent review of the research in this field,particularly Wilkinson and Pickett’s The Spirit Level (2009), which placed income inequality firmly within public debate and argued strongly that it should be a matter of concern. It also reviews critiques of The Spirit Level since 2009, alongside the evidence and debate in the broader peer-reviewed literature.

Key points

  • The literature shows general agreement about a correlation between income inequality and health/social problems.
  • There is less agreement about whether income inequality causes health and social problems independently of other factors, but some rigorous studies have found evidence of this.
  • The independent effect of income inequality on health/social problems shown in some studies looks small in statistical terms. But these studies cover whole populations, and hence a significant number of lives.
  • Some research suggests that inequality is particularly harmful beyond a certain threshold. Britain was below this threshold in the 1960s, 1970s and early 1980s, but rose past it in 1986–7 and has settled well above it since 1998–9. If the threshold is significant it could provide a target for policy.
  • Anxiety about status might explain income inequality’s effect on health and social problems. If so, inequality is harmful because it places people in a hierarchy which increases competition for status, causing stress and leading to poor health and other negative outcomes.
  • Not all research shows an independent effect of income inequality on health/social problems. Some highlights the role of individual income (poverty/material circumstances), culture/history, ethnicity and welfare state institutions/social policies.
  • The author concludes that there is a strong case for further research on income inequality and discussion of the policy implications.

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