7/31/2017 Market Myths and Social Facts by Kate Pickett and Richard Wilkinson - Project Syndicate

GLOBAL HEALTH & DEVELOPMENT

KATE PICKETT
Kate Pickett is Professor of Epidemiology at the University of York.

RICHARD WILKINSON
Richard Wilkinson is Honorary Visiting Professor at the University of York.

SEP 21, 2016

Market Myths and Social Facts

YORK Many of us remember the 1970s for its music and fashion, but we should also take a
lesson from its mistaken beliefs. Without easy access to data or analyses of social trends,
some ideas about the workings of nature and society were completely backward. Today, we
know things that were simply unknowable back then.

If you asked doctors in the 1970s who was most likely to suffer a heart attack, they would
share an intuition about executive stress. People in senior leadership positions, it was
believed, face higher risks of coronary disease because of the demands of their jobs.

It turns out that there is no such thing as executive stress, and heart disease is far more
common and deadlier in people further down the socioeconomic ladder. Politicians and
policymakers (and of course physicians) now know about health inequalities and the link
between social status and morbidity, even if they do not always act effectively to address it.

In the United Kingdom, this discovery dates back to 1980, when the Department of Health
and Social Security published its Report of the Working Group on Inequalities in Health.

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7/31/2017 Market Myths and Social Facts by Kate Pickett and Richard Wilkinson - Project Syndicate

The Black Report, as it became known (after its chairman, Sir Douglas Black of the Royal
College of Physicians), systematically collated all the available data on socioeconomic status
and health outcomes. Men in the lowest socioeconomic group, it turned out, were dying at a
rate twice that of men in the highest, and the gap was growing, despite the establishment of
the National Health Service.

Prime Minister James Callaghans Labour government commissioned the Black Report in
1977, but by the time it was published, Prime Minister Margaret Thatchers new
Conservative government was in power. According to the British Medical Journal, in its 2002
obituary for Black, The Black report was not to Mrs. Thatchers liking and was never
printed; instead, 260 photocopies were distributed in a half-hearted fashion on Bank
Holiday Monday. And, although the report had a huge impact on political thought in the
United Kingdom and overseas leading the OECD and the World Health Organization to
assess 13 countries unequal health outcomes this did not extend to UK government
policy.

Just as Thatchers government was burying the Black Report and pretending that health
inequalities didnt exist (and, indeed, that society didnt exist), it was also pursuing
neoliberal economic policies without any evidence to support them. These measures
included reduced public spending and the privatization of public goods, lower taxes,
inancial deregulation, and free-trade agreements.

In the late 1970s and early 1980s, neoliberalisms defenders promised that embracing
market-based solutions would unleash economic growth, generating the proverbial rising
tide that lifts all boats. But, like executive stress, this phenomenon was a phantom. That
didnt stop Thatcher and US President Ronald Reagan from pursuing an agenda that
disrupted the health and wellbeing of millions of people. In the face of growing inequality,
they saw the gap between rich and poor as just a side effect, and possibly even a spur for
innovation, aspiration, and creativity for those lower down the ladder.

They were wrong about that, too. Even before the 2008 global inancial crisis, neoliberalism
was causing what the University of Durhams Ted Schrecker and Clare Bambra have called
neoliberal epidemics. As Schrecker and Bambra and many others have shown, income
inequality has profoundly damaging and far-reaching effects on everything from trust and
social cohesion to rates of violent crime and imprisonment, educational achievement, and
social mobility. Inequality seems to worsen health outcomes, reduce life expectancy, boost
rates of mental illness and obesity, and even increase the prevalence of HIV.

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7/31/2017 Market Myths and Social Facts by Kate Pickett and Richard Wilkinson - Project Syndicate

Deep income inequality means that society is organized as a wealth-based hierarchy. Such a
system confers economic as well as political power to those at the top and contributes to a
sense of powerlessness for the rest of the population. Ultimately, this causes problems not
only for the poor, but for the af luent as well.

One problem in the past was that income inequality and its link to social and health
problems was overlooked in comparison to measures of national wealth, such as average
income (GDP per capita). But, as leading economists and institutions such as the
International Monetary Fund and the World Economic Forum are coming to realize, income
inequality is a serious problem for economic stability and growth, too.

Careful analysis of statistical data debunked the idea that stressed executives are at a higher
risk for heart attacks. Now, it has debunked the 1980s myth that greed is good, and has
revealed the extensive damage inequality causes. It was one thing to believe these myths
decades ago, but when experience and all the available evidence show them to be mistaken,
it is time to make a change.

Any man can make mistakes, but only an idiot persists in his error, said the Roman
philosopher Cicero. Now that we know how inequality harms the health of societies,
individuals, and economies, reducing it should be our top priority. Anyone advocating
policies that increase inequality and threaten the wellbeing of our societies is taking us for
fools.

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