The Spirit Level: Breaking Down the Chapters

Part One: Material Success, Social Failure

Chapter 1: The end of an era

  • Asks the fundamental question of the purpose of writing this book: “How is it that we have created so much mental and emotional suffering despite levels of wealth and comfort unprecedented in human history?”
  • According to Wilkinson and Pickett (applies to affluent/capitalist/western democracies), the truth is that the luxury and extravagance of our lives is so great that it threatens the planet.
  • The quality of social relations in a society is built on material foundations. Therefore, the scale of income differences has a powerful effect on how we relate to one another. The scale of inequality affects the psychological wellbeing of us all.
  • The broken society and broken economy of the countries mentioned in this book resulted from the growth of inequality.
  • The first set of evidence presented in the book outlines how rich societies have gotten close to the end of what economic growth can do for its population. As affluent societies have gotten richer, the rates of anxiety, depression and many other social problems rise with it.
  • Predictable pattern: The more and more you get of anything, the less and less it contributes to your wellbeing. (Ex: further rises in income count for less and less)
  • As rich countries reach the end of economic growth, we need to recognize the environmental limits of growth as present levels of consumption are unsustainable.
  • We are affected very differently by the income differences within our own society as compared to the differences in average income between one rich society and another.
  • Two possibilities: what matters in a society is whether you are doing better or worse than other people and that health is determined by the effects of social mobility.

Chapter 2: Poverty or inequality?

  • First graph in chapter represents the size of income differences and how it varies from one developed country to another. Findings show that the most unequal countries are Singapore, USA, Portugal and United Kingdom, which means that these countries have income differences that are at least twice as big, including two (Singapore and USA) in which the richest 20 percent get about nine times as much as the poorest 20 percent.
  • There are lots of ways to measure income inequality and since they are all so closely related to one another, it doesn’t make that much of a difference which you use. One of the most common measures is called the Gini coefficient (most common measure used in US), where it measures inequality across the whole society rather than only comparing the extremes. The measured used in this book when comparing inequality in different countries is using the ratio of the income received by the top to the bottom 20 percent.
  • Factors that contribute to modern societies being social failures are: level of trust, mental illness (including drug and alcohol addiction), life expectancy and infant mortality, obesity, children’s educational performance, teenage births, homicides, imprisonment rates, and social mobility (not available for US states)
  • To ensure consistency, the authors tested all of these health and social problems across countries and US states.
  • The remainder of the graphs in this chapter shows the following findings:
    • Graph 2: Health and social problems are closely related to inequality among rich countries
    • Graph 3: Health and social problems are only weakly related to national average income among rich countries
    • Graph 4: Health and social problems are related to inequality in US states
    • Graph 5: Health and social problems are only weakly related to average income in US states
    • Graph 6: The UNICEF index of child wellbeing in rich countries is related to inequality
    • Graph 7: The UNICEF index of child wellbeing is not related to Gross National Income per head in rich countries
  • In regards to the first assumption presented in chapter, the evidence displayed in the graphs described above, show that the problems in rich countries are caused by the scale of material differences within each society being too big.
  • The social and health problems measured in this book are treated by policy makers as separate issues or in other words, each problem needs a separate service and remedy.
  • Two reasons for interpreting income inequality as it relates to social and health problems are: Only health and social problems which have strong social gradients are more prevalent in more unequal societies and income inequality reflects how hierarchical societies are.
  • Greater equality and improving the wellbeing of the whole population is the key to national standards of achievement and how countries perform in a lot of different fields such as the ones described in this book.
  • The authors note that although income inequality matters in developing countries, it does so for different reasons. This is due to the fact that necessities are the main part of consumption, therefore inequality issues have more to do with how many people are denied access to food, clean water and shelter rather than status.

Chapter 3: How inequality gets under the skin

  • The best way of responding to the harm done by high levels of inequality would be to reduce inequality by itself and a society does have the capacity to reverse the sense of deterioration in social wellbeing.
  • Reviews of research conclude that people in many developed countries have experienced significant rises in anxiety and depression.
    • Graph 3.1: There is a rise in anxiety levels among US college students 1953-93
  • As anxiety has increased, there has been research done that has shown a rise in self-esteem. However this rise in self-esteem is not actually as positive as it may look at first because what we are actually seeing is a rise of insecure narcissism. Essentially we are seeing an increasing anxiety of how we are seen and what others thinks of us, which has, in turn, created a defense mechanism to boost our confidence as we experience threats to self-esteem (i.e. social evaluative threat- those which create the possibility for loss of esteem)
  • The three most powerful sources of stress that affect health are: low social status, lack of friends, and stress in early life. Studies show that these sources are seriously harmful to health and longevity.
  • In regards to pride, shame and status, the further up you are on the social ladder, the world gives you more to help repress self-doubts. Therefore the further you are on the social ladder; it is easier to feel a sense of pride, dignity and self-confidence.
  • Geographical mobility in the last half century may suggest that since we come into contact with more strangers than we ever have before, we are prone to being highly self-conscious, worried about how we appear, and are constantly trying to manage the impressions we make on others.
  • As the importance of social status increases, due to inequality, the social position becomes one of the most important features of a person’s identity.
  • As high levels of inequality produce status competition and social evaluative threat, egos have to be maintained by self-promoting and self-enhancing strategies.
  • In regards to the slogan of “liberty, equality, fraternity” from the French Revolution, high levels of inequality also weakens community life, reduces trust, and increases violence.

Part Two:

Chapter 4: Community life and social relations

  • The quality of social relations deteriorates in less equal societies. This is because inequality is a powerful social divider due to the tendency of people using differences in living standards as markers of status differences. Our position on the social ladder affects whom we consider as part of the in-group and who as a member of the out-group, which, in turn, affects our ability to identify and empathize with other people.
  • This chapter suggests inequality is divisive and even small differences seem to make an important difference.
    • Graph 4.1: The percentage of people agreeing that ‘most people can be trusted’ is higher in more equal countries.
    • Graph 4.2: In more equal states more people agree that ‘most people can be trusted’ (Data available for only forty-one US states)
    • Graph 4.3: As inequality increased, so trust declined
    • High levels of trust mean that people feel secure, they have less to worry about, and they see others as cooperative rather than competitive.
    • Studies have shown in US that health is linked to trust, which means people with high levels of trust live longer.
    • Levels of inequality also largely affect the status of women.
    • When examining measures of the percentage of women in the legislature, the male-female income gap, and the percentage of women completing higher education to make an index of women’s status, we find that more equal countries do significantly better.
    • More equal countries are more generous to poorer countries. The UN target for spending on foreign development aid is 0.7 per cent of Gross National Income.

Chapter 5: Mental health and drug use

  • People who are mentally well are able to take care of themselves, view themselves as valuable and are able to judge themselves by reasonable standards. On the contrary, people who are not mentally well are scared of rejection, keep others at a distance and tend to isolate themselves from others.
  • Strong relationship between mental illness and inequality: more people suffer from mental illnesses in more unequal countries
  • The types of mental illnesses strongly related to inequality are anxiety disorders, impulse-control disorders, and severe illness
  • Income inequality is associated with mental illness in adult women and children.
  • Why do more people in unequal places tend to have more mental health problems?
  • It is due to a set of values which increase one’s vulnerability to emotional distress such as placing a high value on obtaining money and possessions, looking good in the eyes of others and wanting to be famous. These values place us at greater risk for depression, anxiety, substance abuse and personality disorder.
  • Having a low socioeconomic status is troublesome to many people, which directly correlates to the prevalence of drug use in unequal societies.
  • The importance of social status on a person’s mental well-being is displayed in the chemical behavior of our brains.
  • Low levels of dopamine and serotonin characterize depression and other mental illnesses.

Chapter 6: Physical health and life expectancy

  • As societies become more affluent, the types of conditions/diseases that causes death and poor health change. For example, since industrialization came into play, diseases shifted from infectious diseases to chronic diseases such as cancer and heart disease.
  • Stress is a cause of chronic disease. It has been found that a lower job status creates a higher risk for heart disease, cancer, depression, suicide, back pain, chronic lung disease and gastrointestinal disease.
  • Psychological wellbeing also has a direct impact on health and we are less likely to be happy, optimistic, etc. if our social status is low. Therefore, psychosocial factors (social status, social networks, and stress in early life) determine population health.
  • Social connections have a big impact on the status of our health.
  • In rich countries there is no relationship between the amount of health spending per person and life expectancy.
  • Many studies that compare income inequality and health, that examine large countries/regions and US states, have found that, for the most part, more egalitarian societies tend to be healthier.
  • Inequality is affiliated with lower life expectancy, higher rates of infant mortality, shorter height, poor self-reported health, low birthweight, AIDS and depression.
    • For example:
    • Figure 6.3: Life expectancy is related to inequality in rich countries
    • Figure 6.4: Infant mortality is related to inequality in rich countries
    • Figure 6.5: Life expectancy is related to inequality in US states
      • Figure 6.6: Infant mortality is related to inequality in US states
      • Living in a more equal country benefits everyone; so more equal countries produced better health at any level of income
      • Stress disrupts our body’s equilibrium, also known as homeostasis, which is the state of our bodies when everything is running smoothly and all physiological processes are normal.

Chapter 7: Obesity: wider income gaps, wider waists

  • Obesity is spreading rampantly throughout developed countries.
  • Besides the severe health crisis it causes, it also affects emotional and social well-being.
  • Obesity epidemic is caused by the changes in modern societies that make us susceptible to being fat.
  • Figure 7.1: More adults are obese in more unequal countries.
  • Figure 7.2: More children are overweight in more unequal countries.
  • Figure 7.3: More adults are obese in more unequal US states
  • Figure 7.4: More children are overweight in more unequal US states
  • Besides eating and exercise habits, people with a long history of stress tend to respond to food in different ways from people who are not stressed. Chronic stress causes the body to deposit fat in the abdomen rather than on the hips and thighs. It also has the potential to change our food intake and choices, also known as stress eating.
  • People who are chronically stressed either eat too much and gain weight or eat too little and lose weight.
    • Sometimes people eat for status, but the social benefits that are derived from frequently eating do not outweigh the negative effects.
    • Socioeconomic status differences that portray the importance of body side and image also contribute to the social gradient in obesity.
    • Example: Women who move down the social ladder tend to place less emphasis on thinness and are more satisfied with their bodies.
    • Another factor to consider between levels of income inequality and obesity is the thrifty phenotype hypothesis which implies that when a pregnant woman is stressed, the development of her unborn child is modified to prepare it for life in a stressful environment. Therefore, in affluent societies, babies are prepped for an environment where food is plentiful, which makes them susceptible to obesity, diabetes and cardiovascular disease.
      • Since behavior changes are easier for people who are mentally well, decreasing the burdens of inequality has the potential to make an important contribution towards resolving the epidemic of obesity.

Chapter 8: Educational performance

  • The biggest influence on educational attainment, how well a child performs in school and later in higher education, is family background.
  • Parent involvement in education is crucial.
  • Children do better if their parents have higher incomes/have obtained higher education, if they have a place to study at home and if education is valued.
  • International educational scores are closely related to income inequality
    • Figure 8.1: Math and literacy scores of 15-year olds are lower in more unequal countries.
    • Figure 8.2: Math and literacy scores of eighth-graders are lower in more unequal US states
    • Figure 8.3: More children drop out of high school in more unequal US states
    • Figure 8.4: Implies that even if your parents are well educated/have a high social status, the country you reside in can make a difference in your educational success. However, the lower you are on the social ladder with less-educated parents; the country you live in can make a huge difference.
    • A stimulating social environment is essential for early childhood development. However, this is harder to achieve for parents/care-givers due to poverty, stress or lack of supports.
    • Societies can improve the quality of early childhood development by implementing family allowances, parental leaves from work, tax benefits, social housing, health care, programs to promote work/life balance, placing greater oversight on child support payments and most importantly, high standards of early childhood education. It is crucial for development physical, intellectual, social and emotional development.
      • A plethora of evidence supports the idea that performance and behavior in an educational task is determined by the way we feel we are viewed/judged by others. If we expect to be viewed as inferior, our abilities diminish.
      • People learn best when they are placed in stimulating environments where success is obtainable. Feeling happy and confident leads to the release of the reward chemical, dopamine; this chemical attributes to memory, attention, and problem solving.
      • Inequality directly affects educational achievement because it impacts aspirations, norms, and values for people who are lower down on the social ladder.

Chapter 9: Teenage births: recycling deprivation

  • Teenage motherhood is bad for the mother, baby and society.
  • The concept of weathering means that postponing pregnancy for poor and disadvantaged women does not mean they will have healthier babies.
    • Some studies have ruled that children of teenage mothers have a greater chance of being excluded from mainstream society, coupled with worse physical and emotional health, and deprivation.
    • Teenage birth rate is strongly related to relative deprivation and to inequality.
      • High rates of teenage motherhood are seen in communities where there are also high rates of divorce, low levels of trust/social cohesion, high unemployment, poverty, and high crime rates.
      • Not only poor young women becoming teenage mothers; inequality in teenage birth rates runs across the board in society.
      • Figure 9.1: There is a gradient in teenage birth rates by household income, from poorest to richest.
      • Figure 9.2: Teenage birth rates are higher in more unequal countries.
      • Figure 9.3: Teenage pregnancy rates are higher in more unequal US states
        • There is a widening gap between people who take the slow and fast lane to adulthood. This means that people taking the slow lane are young people born into families in higher socio-economic classes, who spend a lot of time completing their education/career training, and putting off marriage/having children until they are established as sustainable adults. The fast track means young people don’t always complete the amount of education necessary to be successful, experience many patterns of unemployment, and low-paid jobs.
        • The impact of inequality on family relationships and stress in early life can produce a few things:
          • Individuals, who grow up with a lack of trust for others, along with a struggle to maintain resources, are more likely to become sexually active earlier, have more short-term relationships and place less emphasis on parenting.
          • Individuals, who grow up with trust for others, mature later, have more long-term relationships, put off sexual activity, and invest more time on parenting/child development.
          • Father absence from a family may have a negative affect on the likelihood of teenage pregnancy within a family.
            • It was found in both New Zealand and USA that the longer a father was absent from a family, the more likely his daughter would have sex at an earlier age and become a teenage mother.
            • Teenage mothers may have difficulty maintaining a relationship with the father, if he comes from an area of high employment and low wages.

Chapter 10: Violence: gaining respect

  • Patterns of violence remain very consistent across time and space. For the most part, young men typically engage in violent acts. Moreover, it is young men from low-income areas that are victims and perpetrators of violence.
  • High levels of inequality increase the stakes in the competition for status, in other words, status matters more. It’s important to note that the impact of inequality on violence is strongly correlated more so than other effects of inequality presented in this book.
  • Shame and humiliation among young men are psychological factor that can perpetuate violent acts.
  • Figure 10.2: Homicides are more common in unequal countries.
  • Figure 10.3: Homicides are more common in mow unequal US states
  • Figure 10.4: There is more conflict between children in more unequal countries (based on percentages reporting fighting, bullying and finding peers not kind and helpful)
  • Figure 10.5: In less equal US states more people think they would do better than average in a fistfight.
    • In societies with high-income inequality, more people lack protections and buffers (i.e. family, friends, associates who promote high self-esteem, education, and skills). Therefore this causes shame and humiliation to become very sensitive issues, status becomes increasingly important, status competition increases and more people experience lack of access to opportunities of status and social success.
    • There is a close correlation between ups and downs in inequality and violence, in which studies show that if inequality decreases, so does violence, and vice versa.

Chapter 11: Imprisonment and punishment

  • The rate of people being locked up in prison is determined by three things:
  • The rate at which crimes are actually committed
  • The tendency to send convicted criminals to prison for particular crimes
  • The lengths of prison sentences
    • Changes in any of these three factors determine the degree of change in the proportion of the population imprisoned at any point in time.
    • Figure 11.1: More people are imprisoned in more unequal countries
    • Figure 11.2: More people are imprisoned in more unequal US states
      • People of lower class, income, and education are more likely to become imprisoned as compared to people higher up the social scale.
      • Prison data shows us that societies with high levels of income inequality subject their prisoners to more punitive sentencing and capital punishment.
        • A harsher prison system and a high rate of imprisonment do not counteract crime and protect the public as much as it would like you to believe. Sometimes these measures can actually increase crime.
        • More unequal societies tend to experience higher rates of re-offending. (US & UK= 60-65%, Sweden and Japan=35-40%)
        • More unequal societies create a tougher, harsher environment as public and policy makers are inclined to imprison more people and execute punitive attitudes.
        • The more a country imprisons people; less of their wealth is spent on welfare programs for citizens.

Chapter 12: Social mobility: unequal opportunities

  • Social mobility is referring to the equality of opportunity within a society, which is valued across a political spectrum.
    • Easiest way to measure social mobility is to examine income mobility, which is how much people’s incomes change over their lifetime or how much they earn when compared to their parents.
    • Rich parents are more likely to have rich children, and poor parents are more likely to have children who stay poor.
    • Figure 12.1: Social mobility is lower in more unequal countries,
    • Figure 12.2: Social mobility in the USA increased to 1980 and then decreased.
      • Government spending on education is strongly correlated to the level of income inequality.
      • Increased inequality is also due to the segregation of rich and poor communities.
      • Taste and class keep people in their place as discrimination and prejudice is used to keep people from improving their social status.
      • Social status is maintained by exhibiting one’s superiority over another. When this occurs, the person who seeks to regain status will take their ill emotions out on those who are even more vulnerable.
      • This is known as displaced aggression and is defined as, when a person reacts to a provocation from someone with higher status by taking his or her aggression out on someone of lower status.
        • A group density effect is when the health of ethnic minority groups is maintained by living in areas with people like them as compared to living in areas where more of the dominant ethnic group is present.
        • In regards to ethnically isolated families/individuals, psychological effects of stigma/discrimination can be strong enough to overcome the health benefits that are associated with material wealth.

Part Three:

Chapter 13: Dysfunctional societies

  • There is a tendency in this type of research that some countries do well on almost everything, while others do badly. Therefore, you can predict a country’s performance on one outcome just by knowing the outcomes of others.
  • Japan and Scandinavian countries have the lowest rates of suffering in the context of health and social problems, while the USA, Portugal and the UK have the highest suffering rates.
  • It is more important to consider how a society becomes more equal rather than whether or not it actually does so.
  • The prevalence of certain ethnicities in a society and historical factors, which could have led a society to become more or less equal, gives explanations that are typically suggested for income inequality. However, it really comes down to economic growth and social status as being the biggest determinants of income inequality in a country.
  • A common response to research in the social science field is that people think the outcomes/results are obvious. However, it is important to keep in mind that the vast majority of the population of a country is negatively affected by income inequality.
  • Figure 13.2: Rates of illness are lower at both low and high educational levels in England compared to the USA.
  • Figure 13.3: Death rates among working-age men are lower in all occupational classes in Sweden compared to England and Wales.
  • Figure 13.4: Infant mortality rates are lower in all occupational classes in Sweden than in England and Wales.
  • Figure 13.5: The relation between county median income and county deaths according to whether the counties are in the twenty-five more equal states or the twenty-five less equal states.
    • It is difficult to determine the reason for the level of problems that is linked to low social status from one country to another without accepting that inequality is a huge denominator and a damaging force.

Chapter 14: Our social inheritance 

  • The implications of the author’s findings are closely related to the institutional structures of market democracy.
  • However, people may be cautious to take this evidence at face value. A market democracy is efficient when the main human motivation is greed and avarice.
  • Friendship and social status are complete opposites but they are linked in regards to how much they vary across a society.
  • They hold such high importance because they mirror the different ways humans deal with social organization and political life.
  • Systems of material or economic relations are systems of social relations.
  • Economic game:
    • Ultimatum game: participants are randomly paired but remain unknown to one another because they do not meet. A known sum of the money is given to the proposer who then divides it as he or she leases with the responder. All the responders do is merely accept or reject the offer. If rejected, neither partner gets anything, but if it is accepted, they each keep the shares of money offered.
    • This game shows how equally or unequally people choose to divide money between themselves and someone else.
    • The quality of our social relations is so crucial to our wellbeing, survival, and reproductive success, that it makes social interaction to most powerful influence driving the evolution of the human brain.
    • Humans have social strategies to deal with different kind of social organization.
    • Dominant hierarchies are characterized by self-advancement and sautés competitions.
    • Non-dominant hierarchies are characterized by cooperation and mutual interdependence
    • The nature of a child’s early life has a huge affect on the development of their personality and the type of people they grow up to be in adult life.
    • Mirror neurons: when we watch someone do something, mirror neurons in our brains are activated to produce the same actions.
    • Oxytocin: this chemical makes more people likely to trust and is also released when one feels as though they are being trusted
      • A sense of cooperation activates the reward centers in the brain, which serve to encourage reciprocity and mutuality while resisting the urge to act selfishly.
      • The influence of inclusion and exclusion relate to our fundamental need for social integration and explain why friendship and social involvement promote good health.

Chapter 15: Equality and sustainability

  • Social and environmental sustainability go hand in hand.
    • The environment can no longer handle further increases in emissions; economic growth in developed societies does not increase measures of wellbeing.
    • Figure 15.1: Low infant mortality rates can be achieved without high carbon emissions
    • Equality can improve the real quality of life at lower levels of consumption.
      • If policies are to be introduced that will ultimately reduce emissions, they must applied fairly in order to gain public acceptance.
      • New technology is not enough to reduce emissions as more efficient technology has been introduced and emissions continue to rise.
      • A steady-state economy is putting caps on the extraction of minerals and the use of the world’s resources
      • Greater equality makes growth not as important. This is what would make a steady-state economy successful.
        • As inequality increase status competition, we struggle more and more to keep up with the trends. Furthermore, the rich reduce everyone else’s satisfaction with what they do have.
        • Figure 15.3: People work longer in more unequal societies.
          • People in more unequal countries work two to three extra months a year.
          • Figure 15.4: More equal countries recycle a higher proportion of their waste.
          • Consumerism, individualism, and materialism are characteristics of rich market democracies, not fixed expressions of human nature.
          • Greater equality will allow us all to work together to solve the environmental problems that threaten us all.

Chapter 16: Building the future

  • In order to make change or to achieve equality, we need a continuous stream of small changes in a consistent direction.
  • This can be done by increasing people’s sense of security and to reduce fear; to make everyone feel that a more equal society has room for everyone and that a more fulfilling life is possible without a society based on hierarchy and inequality.
  • Income distribution provides policy makers an outlet to improve the psychosocial wellbeing of whole populations.
  • Many policies for health and social problems have a tendency to be based on the belief that the poor need to be taught to be more sensible.
  • Two paths to greater equality that should be used simultaneously; use taxes and benefits to redistribute income and decreasing income different in gross market incomes before any redistribution.
    • Need the political will to pursue these solutions
    • Unions can make a difference to an extent in regards to political will but for the most part, high levels of inequality in a society reflect where the power sits in our economic institutions.
    • What can be done?
      • First approach: tackle loopholes in the tax system, limit ‘business expenses’, increase top tax rates, and legislate to limit maximum pay in a company to some multiple of the average or lowest paid employees.
      • Second approach: Democratic employee-ownership; redirects power out of the hands of the state, but also holds great economic and social benefits over organizations owned and managed by outside investors in whose interests they act.
        • Example: tax concessions
        • In order to make a considerable difference in this approach, participative management methods need to be implemented.
        • Has the potential to increase equality by expanding liberty and democracy.
        • Technology contributes to rapidly reducing variable costs however there are many institutional structures in place that seeks to minimize this new breakthrough.
        • Work towards a society where income does not decide which goods you have access to, and in turn, our possessions don’t place as much of an emphasis on social status.
        • Need to create a sustained movement committed to a better society (political will)
        • Need a broad conception of where we are going; creating the political will to make society more equal is more important than implementing a set of policies to reduce inequality.

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