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The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity and Improve Everyone’s Well-Being. 2019, New York: Penguin Press

By Richard Wilkinson and Kate Pickett

Book Review by H Patricia Hynes

December 2020

“The 500 richest people in the world…gained a combined $1.2 trillion in wealth in 2019, further exacerbating inequities that have not been seen since the late 1920s…Eight of the 10 richest people in the world are from the U.S.”   

If all that you do with this book in hand is view one simple line graph on page 3 of The Inner Level, reproduced* below, you will grasp the authors’ stark and consistent findings, namely, that income inequality in developed countries is directly linked with – drives in fact – much of the health and social ills of these societies.  In essence this graph conveys that as income inequality – or the gap in income between the richest and the poorest of a country – increases, the health and social well-being of its citizens declines.

As this book both documents and generously discusses, rising income inequality leads to a plague of ills: higher rates of people in prison, higher teenage birth rates, higher rates of mental illness, more child neglect and children bullying other children, higher rates of homicide, lower educational performance and lower life expectancy, that is, the average number of years that people live.  

The United States ranks highest in income inequality, manifest in the graph, and correspondingly ranks highest in ill health and social problems, compared with other rich, developed countries.  And, conversely, the Scandinavian countries and Japan, which score lowest on income inequality, fare best in health and social well being.  Moreover, the same pattern prevails among all of the 50 US states.  

The average number of years US people live has been dropping since 2014, due in large part to the increase in suicides and drug and alcohol overdoses among midlife adults, across all racial groups.  Parallel with this tragic trend is increasing income inequality: by September 2019, income inequality in the United States had reached its highest level in 50 years. Taking a larger perspective, Wilkinson and Pickett link all of the recent global financial crises, political polarizations, nativism, growing refugee and migration trends, and rapidly worsening climate crisis in part to the global trend in inequality: “Inequality has made no small contribution to all of these…”

The arc of concern across this book is the social environment and how it is impacted by economic inequality.  Specifically how economic dominance and subordination contribute to stress, loss of community life, mental disorders, poorer physical health, abuse of alcohol and drugs, and greater violence. But the authors empathically state, “This is not a self-help book. We need to understand the receptors of social pain before we can recognize the structural causes of that pain.”

Why have young students and adults across the United States reported dramatic increases in anxiety in surveys from the 1950s through the 1990s? Mental disorders associated with anxiety parallel this trend as do the number of people disabled by mental disorders who qualify for Social Security Disability Insurance.  

The authors link these trends in anxiety and resulting mental disability to the finding that “community life is weaker in societies with bigger income differences between the rich and the poor.” Greater income differences make class differences more stark and more powerfully felt by those less equal.  Social status is more stratified in more unequal societies; and “social distances” between classes are increased.  Material wealth, conspicuously on display in more unequal societies, increasingly replaces inner well-being as the measure of one’s worth.

Not surprisingly, community life, measured by involvement in local groups, voluntary organizations and civic associations–often called social cohesion–is more prevalent in more equal societies.  This, in turn, feeds social trust and helps explain why rates of homicide are consistently lower in more equal societies.

To their credit the authors transition from how income inequality ravages the human spirit and the well being of a society to how it concomitantly weakens human motivation and activism on behalf of environmental sustainability.  While income inequality fosters status anxiety, consumerism, individualism and social dysfunction, the climate crisis requires our “acting on the basis of the common good as never before, indeed acting for the good of humanity as a whole.” Their structural recommendations for growing economic democracy to reduce income inequality include initiating progressive taxes and more generous benefits; increasing cooperative and employee-owned companies; placing employees on company boards; rebuilding the union movement; and reducing the ratio of CEO pay to the average of worker pay.  All of these proposed initiatives are reinforced by studies showing increased worker productivity, satisfaction, and innovation as well as fairer wages in more equal work places.  Wilkinson and Pickett conclude with an ominous warning: unless we reduce economic inequality, “we may have to accept that we will be defeated by climate change.”

The authors, prolific researchers and writers for many years on the theme of this book, point out that their conclusions on the effects of growing economic inequality are amplified by the findings of hundreds of other researchers. Since the 1970s when the first studies on this subject were published, hundreds of subsequent studies have consistently found that the larger the income gap between rich and poor, the higher the social dysfunction. Moreover, inequality in income drives poorer human and social well being for all in society including those at the top; but it is always the poorest who bear the worst burdens.

While The Inner Level is impressively comprehensive in its scope and latitude, it is, at the same time, single-dimensioned, when societies they study are not.  There is next to nothing regarding the statistics and effects of economic inequality between men and women and between races, and not because these more dimensioned realities of inequality have not been studied and quantified.  Put starkly in a recent Oxfam report, “the richest 22 men in the world own more wealth than all the women in Africa.”

A team of researchers, including security studies experts and statisticians, has created the largest global database on the status of women. Called WomanStats, the database enables researchers to compare the

security and level of conflict within 175 countries to the overall security of women in those countries. Their findings are profoundly illuminating for global security and world peace. The degree of equality of women (including economic equality) within countries predicts best—better than degree of democracy and better than level of wealth, income inequality or ethno-religious identity—how peaceful or conflict-ridden their countries are. Further, democracies with higher levels of violence against women are less stable and more likely to choose force rather than diplomacy to resolve conflict.

Inheritance and property laws that deprive women of resources comparable to those inherited by their brothers and husbands ultimately impoverish women, a form of economic violence. Because women’s reproduction and care for children and extended family (estimated at $10.8 trillion) are not compensated, women are cheated of savings, pensions and Social Security. Consequently, the greatest risk factor for being poor in old age is having been a mother.

Rampant discriminatory workplace policies that deny women equal pay for equal work and merited promotions are societal forms of economic violence against women. Worse for working mothers in many countries is the

persistent “motherhood penalty”—whereby they are further set back financially by lack of paid parental leave and government-funded child care.

If the authors had considered the stark fact that “nearly two-thirds of the minimum wage workers in the United States are women,” a wage that consigns them to poverty, they would have featured the “Fight for $15” campaign among their structural recommendations to reduce income inequality

Economic violence against women results in income inequality compounded throughout their lives and in old age.  And this inequality is worsened by racial inequality. Progress in closing the earnings gap between men and women has also slowed considerably, according to the Institute for Women’s Policy Research.  “If the pace of change in the annual earnings ratio were to continue at the same rate as it has since 1984, it would take until 2059 for women and men to reach earnings parity, and substantially longer for women of color. Black women’s median annual earnings would reach parity with White men’s in 2119, and Hispanic women’s in 2224.”  If progress has slowed so considerably, might it not stop altogether?  

The Inner Level would have been enriched and made more meaningful by including the documented greater inequality suffered by women and people of color and the slowing pace to re-right it. Likewise their structural recommendations for economic justice would have been more substantively grounded in the workplace misogyny and racism faced by women and people of color in their struggle for equality.

*Wilkinson, R.G. and Pickett, K., originally published in The Spirit Level: Why Equality is Better for Everyone. London: Penguin, 2010.

Pat Hynes, a retired Professor of Environmental Health, directs the Traprock Center for Peace and Justice in western Massachusetts