Wealth and Health in Wealth and Health in the United Kingdom the United Kingdom

Dr John BoneDr John Bone

University of AberdeenUniversity of Aberdeen

Wealth, Health & PovertyWealth, Health & Poverty

UK: Wealthier & Healthier?

In general: As a society’s wealth In general: As a society’s wealth (Gross (Gross Domestic Product)Domestic Product) increases so does health. increases so does health.

But:But:

OECD (advanced) economies: ‘Increases in OECD (advanced) economies: ‘Increases in these societies wealth have less effect on these societies wealth have less effect on health outcomes health outcomes (mortality and morbidity (mortality and morbidity rates)rates) than does the promotion of income than does the promotion of income equality within the society’ equality within the society’

Source:Source: Wilkinson in Gordon Wilkinson in Gordon ‘Inequalities in health’‘Inequalities in health’

Inequality in the UK: The 19Inequality in the UK: The 19thth CenturyCentury

Two nations between whom there is no Two nations between whom there is no intercourse and no sympathy; who are ignorant intercourse and no sympathy; who are ignorant of each other's habits, thoughts and feelings, as of each other's habits, thoughts and feelings, as if they were dwellers in different zones or if they were dwellers in different zones or inhabitants of different planets; who are formed inhabitants of different planets; who are formed by different breeding, are fed by different food, by different breeding, are fed by different food, are ordered by different manners, and are not are ordered by different manners, and are not governed by the same laws ... THE RICH AND governed by the same laws ... THE RICH AND THE POOR. (Disraeli, 1845)THE POOR. (Disraeli, 1845)

Large proportion of the population experience Large proportion of the population experience long hours, hazardous and insecure work - long hours, hazardous and insecure work - overcrowded, squalid and (relatively) expensive overcrowded, squalid and (relatively) expensive housing – poor health, disease and low life housing – poor health, disease and low life expectancy.expectancy.

Between Factory & Landlord:Between Factory & Landlord:Inequality in the Industrial City, Late Inequality in the Industrial City, Late

1919thth and Early 20 and Early 20thth C. C.

Social Strife: Social Strife: Trade UnionismTrade Unionism Rent Strikes (UK: 80-90% rent privately)Rent Strikes (UK: 80-90% rent privately)

Reform:Reform: Workplace LegislationWorkplace Legislation Housing ReformHousing Reform

The ‘Hungry Thirties’ & WWIIThe ‘Hungry Thirties’ & WWII

Social Inequality: Mid 20Social Inequality: Mid 20thth CenturyCentury

The ‘Post War Settlement’:The ‘Post War Settlement’: The ‘Job for Life’The ‘Job for Life’ The Welfare State (NHS)The Welfare State (NHS) Building Programme of Social and Owner Building Programme of Social and Owner

Occupied HousingOccupied Housing ‘‘You’ve Never Had It So Good’ You’ve Never Had It So Good’ (Harold (Harold

Macmillan, British Prime Minister, 1951)Macmillan, British Prime Minister, 1951)

UK Economic DevelopmentUK Economic Development

Laissez Faire Laissez Faire (dominant until late 19(dominant until late 19thth early 20 early 20thth C.) C.)

Collective Consumption Collective Consumption (Castells – Late 19(Castells – Late 19thth C. C. until 1970’s)until 1970’s)

Embedded Liberalism Embedded Liberalism (Ruggie/Harvey – from (Ruggie/Harvey – from WWII until 1970’s)WWII until 1970’s)

Neo-liberalism Neo-liberalism (1970’s until the present?)(1970’s until the present?)

An Anatomy of Economic An Anatomy of Economic Inequality in the UK Inequality in the UK

(NIP/Hills,2010)(NIP/Hills,2010) ‘Britain is an

unequal country,

more so than many other

industrialised countries and more so than

it was a generation

ago’.

UK Wealth Inequality UK Wealth Inequality

UK Income Inequality 1960 - UK Income Inequality 1960 - 20052005

Health & Wealth: UK Inequalities in Premature Mortality Source: Dorling (2010)

Geographical Inequalities in premature mortality (SMR<65) 1921-2006

The Spirit Level (Wilkinson & The Spirit Level (Wilkinson & Pickett, 2009)Pickett, 2009)

Physical Ill HealthPhysical Ill Health Mental Ill HealthMental Ill Health Drug AbuseDrug Abuse Educational Educational

ProblemsProblems ImprisonmentImprisonment ViolenceViolence Teenage PregnancyTeenage Pregnancy Childhood ProblemsChildhood Problems Trust & Community Trust & Community Social Mobility*Social Mobility*

‘The evidence shows that almost all the problems that occur most often in the poorest neighbourhoods – including those that make us a broken society – are systematically more common in more unequal societies. Rates are not just a little higher, but between two and eight times higher. Wider income gaps make societies socially dysfunctional across the board (Wilkinson and Pickett, 2009).

Income Inequality, Health and Income Inequality, Health and Social ProblemsSocial Problems

Outcomes: Scotland?Outcomes: Scotland? Life Expectancy (Male)Life Expectancy (Male)

Gaza Strip: 70Gaza Strip: 70 Iraq: 68Iraq: 68

United Kingdom: 75.9United Kingdom: 75.9

Lenzie, Glasgow: 82Lenzie, Glasgow: 82

Calton, Glasgow: Calton, Glasgow: 5454

Stroke and Deprivation: Scotland Stroke and Deprivation: Scotland

Heart Disease & Deprivation; Heart Disease & Deprivation; ScotlandScotland

Why Does Inequality Have These Effects?

Social & Health Problems: Strain Theory (Merton)

American Dream Theory (Messner & Rosenfeld)

Stress

Where Do We Go From Here?Where Do We Go From Here?

GlobalizatioGlobalizationn & The & The

‘Brazilianizati‘Brazilianization of the on of the

West’? (Beck)West’? (Beck)