The negative effects of income inequality on mental health
“The world’s richest large country, the city on a hill, seems to be coming apart.”
—The Economist (6/14/18)
In 2011 British epidemiologists Richard Wilkinson and Kate Pickett released the second edition of their book “The Spirit Level: Why Greater Equality Makes Societies Stronger.” It contained new evidence and a response to their critics.
The authors studied levels of trust, mental illness, life expectancy, infant mortality, educational achievement, teen births, homicides, and incarceration rates.
Among selected industrialized countries the authors found that the U.S. performed the worst on all nine indicators, and that the most consistent predictor was economic inequality. Significantly, the more equal American states had better results on these issues.
A common measure of economic inequality is the Gini scale where 0=complete equality and 100=complete inequality. All the countries in the authors’ study (except Israel, Portugal, and Singapore) are 9 to 14 points below the U.S. score of 41. They all did significantly better than the U.S. on the nine issues above.
In their new book The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity, and Improve Everyone’s Wellbeing, Wilkinson and Pickett have gathered more data about inequality’s negative effect on mental health. They submit that “inequality eats into the heart of our immediate, personal world, and the vast majority of the population are affected by the ways in which inequality becomes the enemy between us.”
In a 2010 paper Wilkinson and Pickett found that only 10 percent of Japanese and Germans suffered from some form of mental illness, while 20 percent of those in the United Kingdom and 25 percent of Americans did so. The Gini scores of Japan (32), Germany (31), the U.K. (34), and the U.S. (41) show, except for the UK, a significant correlation.
Our authors cite research that showed that “in 1980, 4 percent of Americans suffered a mental disorder associated with anxiety, today half do.” Between 2007 and 2017 the number of Americans receiving Social Security Disability benefits due to a mental disorder increased 2.5 times.
A survey by the World Health Organization revealed that “the life-time prevalence of any mental disorder was 55 percent in the U.S., 49 percent in New Zealand, 43 percent in the Netherlands, 33 percent in Germany, but only 20 percent in Nigeria and 18 percent in China.” The criterion here was wealth and not necessarily income inequality.
The most alarming statistic is increased mortality rates for American men without a college degree ages 45-54. They are dying because of drug and alcohol abuse, and their suicide rate is eight times the national average. As Princeton economist Anne Case states: “These people kill themselves slowly with alcohol or drugs, or quickly with a gun.” From 2000 to 2016, 183,000 Americans died from opioid overdoses.
Young people are also suffering. In Britain, since 2011, there has been a 68 percent rise in rates of self-harm among girls aged 13 to 16, and 58 percent of British teachers believe that there is a mental health crisis in their schools. From 2010 to 2015 there was a 36 percent increase in depressive episodes among American adolescents. School bullying is also much more prevalent in unequal countries.
Research has shown that status anxiety is much higher in unequal countries, and one study revealed that “people of lower status in hierarchies have higher levels in their blood of a clotting factor called fibrinogen, implying that their bodies are constantly on high alert to heal potential wounds.” Levels of self-worth are, as would be expected this study, are lower in unequal countries.
Anxiety has been found to cause depression, drug addiction, and increases in suicidal thoughts, narcissism, and schizophrenia. Excessive drug use correlates tightly with economic inequality all over the world.
Most people do not realize that narcissism is categorized as a mental illness in psychiatry’s Diagnostic and Statistics Manual. From 1982 to 2006, psychologists administered the Narcissistic Personality Inventory to thousands of American college students, and they found that there was a 30 percent increase in the display of narcissistic symptoms. Two questions especially caught my eye: “If I ruled the world, it would be a better place,” and “I can live my life any way I want to.”
Wilkinson and Pickett report an ever increasing “defensive, narcissistic presentation of self” in unequal societies, and a reviewer from The Guardian newspaper remarks that “we risk creating a society of mini-Trumps all clawing at one another’s hairpieces.”
Trump certainly epitomizes this description of narcissistic people: “They tend to lack empathy, react aggressively to criticism and favor self-promotion over helping others.” Narcissists undermine the social fabric of those around them, but the one in the White House has upset economic and diplomatic relations throughout the world.
Critics will say that correlations, even those that are very strong and even those that change in tandem over time, do not prove causation, but Wilkinson and Pickett have answered them with good arguments. There are a number of controlled primate and human studies involving social status, a major way in which income disparity expresses itself, that prove causality.
People are most familiar with the class experiment in which students were told that blue-eyed people did better on tests than others, and the result was that the blue-eyed students did indeed perform better. Another test in India demonstrated that students do equally well on solving puzzles until the caste status of each student is announced.
Those who say that inequality is natural and preferable, because it induces people to try their best to move up the ladder, have been proved wrong. Most European countries have higher social mobility rates than the U.S. does. While only 25 percent of Americans born in the lowest economic 20 percent move out of the bottom, a full 40 percent of Danes do. There are fewer and fewer Andrew Carnegies: only 7 percent of Americans now make it from the bottom to the top 20 percent.
The “American” dream is being fulfilled in other countries where higher taxes fund programs that produce lower abortion rates, lower infant and maternal mortality, lower teen births, higher high school and college graduation rates, fewer homicides, and far lower incarceration rates.
The U.S. sexually transmitted disease rate in 2017 was the highest ever and public health experts tie it to reduction of funding (40 percent since 2002) for prevention programs.
Nick Gier of Moscow taught philosophy at the University of Idaho for 31 years. For more on inequality see www.nickgier.com/InequalityPage.pdf. Also check out his website on the middle way between communism and capitalism at www.nickgier.com/MiddleWay.pdf. Email him at firstname.lastname@example.org.