Wealth and Health in the United Kingdom Dr John Bone University of Aberdeen

Wealth, Health & Poverty

UK: Wealthier & Healthier? In general: As a societys wealth (Gross Domestic Product) increases so does health. But: OECD (advanced) economies: Increases in these societies wealth have less effect on health outcomes (mortality and morbidity rates) than does the promotion of income equality within the society Source: Wilkinson in Gordon Inequalities in health

Inequality in the UK: The 19 th Century Two nations between whom there is no intercourse and no sympathy; who are ignorant of each other's habits, thoughts and feelings, as if they were dwellers in different zones or inhabitants of different planets; who are formed by different breeding, are fed by different food, are ordered by different manners, and are not governed by the same laws... THE RICH AND THE POOR. (Disraeli, 1845) Two nations between whom there is no intercourse and no sympathy; who are ignorant of each other's habits, thoughts and feelings, as if they were dwellers in different zones or inhabitants of different planets; who are formed by different breeding, are fed by different food, are ordered by different manners, and are not governed by the same laws... THE RICH AND THE POOR. (Disraeli, 1845) Large proportion of the population experience long hours, hazardous and insecure work - overcrowded, squalid and (relatively) expensive housing – poor health, disease and low life expectancy. Large proportion of the population experience long hours, hazardous and insecure work - overcrowded, squalid and (relatively) expensive housing – poor health, disease and low life expectancy.

Between Factory & Landlord: Inequality in the Industrial City, Late 19 th and Early 20 th C. Social Strife: Social Strife: Trade Unionism Trade Unionism Rent Strikes (UK: 80-90% rent privately) Rent Strikes (UK: 80-90% rent privately) Reform: Reform: Workplace Legislation Workplace Legislation Housing Reform Housing Reform The Hungry Thirties & WWII The Hungry Thirties & WWII

Social Inequality: Mid 20 th Century 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 Occupied Housing Building Programme of Social and Owner Occupied Housing Youve Never Had It So Good (Harold Macmillan, British Prime Minister, 1951) Youve Never Had It So Good (Harold Macmillan, British Prime Minister, 1951)

UK Economic Development Laissez Faire (dominant until late 19 th early 20 th C.) Laissez Faire (dominant until late 19 th early 20 th C.) Collective Consumption (Castells – Late 19 th C. until 1970s) Collective Consumption (Castells – Late 19 th C. until 1970s) Embedded Liberalism (Ruggie/Harvey – from WWII until 1970s) Embedded Liberalism (Ruggie/Harvey – from WWII until 1970s) Neo-liberalism (1970s until the present?) Neo-liberalism (1970s until the present?)

An Anatomy of Economic Inequality in the UK (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 Income Inequality

Health & Wealth: UK Inequalities in Premature Mortality Source: Dorling (2010) Geographical Inequalities in premature mortality (SMR<65)

The Spirit Level (Wilkinson & Pickett, 2009) Physical Ill Health Physical Ill Health Mental Ill Health Mental Ill Health Drug Abuse Drug Abuse Educational Problems Educational Problems Imprisonment Imprisonment Violence Violence Teenage Pregnancy Teenage Pregnancy Childhood Problems Childhood 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 Social Problems

Outcomes: Scotland? Life Expectancy (Male) Life Expectancy (Male) Gaza Strip: 70 Gaza Strip: 70 Iraq: 68 Iraq: 68 United Kingdom: 75.9 United Kingdom: 75.9 Lenzie, Glasgow: 82 Lenzie, Glasgow: 82 Calton, Glasgow: 54 Calton, Glasgow: 54

Stroke and Deprivation: Scotland

Heart Disease & Deprivation; Scotland

Why Does Inequality Have These Effects? Social & Health Problems: Strain Theory (Merton) American Dream Theory (Messner & Rosenfeld) Stress

Where Do We Go From Here? Globalization & The Brazilianization of the West? (Beck) Globalization & The Brazilianization of the West? (Beck)