Article by Caitlin Bradley

Photo source: https://wp.wwu.edu/alotais1/2018/11/ 

So, what is global inequality and why is it bad? Global inequality is the unequal distribution of resources, opportunities, and power that shape well-being[i], according to Oxfam America. It is becoming an increasingly important topic of discussion due to the high degree of globalisation and interconnectedness that surrounds us today. Global inequality presents a multitude of issues but one key problem is that of global health, whereby a majority of people suffer from a lower quality of life whilst a minority benefit from few or no barriers to living a fulfilled and healthy life.

How do we measure this inequality? Inequality is measurable via a variety of economic, social and environmental means, and on a global, national or local level. There are specific indicators such as the Gini coefficient (a statistical measure of income inequality which considers the entire income distribution for a country into a single number between 0 and 1) however more common indicators are the GDP[ii] or HDI[iii] of a country, all of which allow comparisons to be made and statistical conclusions drawn.

One aspect of global inequality is the correlation between health and life expectancy. Developed countries tend to have higher life expectancies compared to emerging and developing countries. For example, Monaco has an average life expectancy of 87.01 in 2023 according to the United Nations whilst Chad’s average life expectancy is just 53.68[iv]. There tends to be a consensus amongst economists that economic growth, which the West achieved through Rostow’s five stages of development model, eventually leads to investment into social institutions such as education and healthcare but also allows people to have a higher disposable income. Does this mean that richer countries benefit completely whilst poorer countries suffer? Not exactly. Moreover, national inequalities also lead to poorer health, as evidenced in the USA and the UK due to economic neoliberalism, particularly under Thatcher and Reagan. Furthermore, these highly unequal societies have problems with mental illness, life expectancy and infant mortality, children’s educational performance, obesity, teenage births, homicides, imprisonment rates and social mobility[v]. This suggests that whilst global differences in health are important, national differences are still significant and reducing inequality will improve health on both national and international levels.

A recent example of the impact of global inequality on health can be seen through the COVID-19 pandemic. This example outlines, on a global scale, differing responses to the same pandemic depending on the degree of development. This rare event exacerbated global differences in health, with healthcare services under relentless strain and consequently more severe backlogs as a result of the pandemic. In addition, the 2022 World Inequality Report estimates that between 2019 and 2021, the wealth of the top 0.001% grew by 14%, whilst average global wealth increased by just 1%[vi]. This shows how the rich got richer, while the poor got poorer during the pandemic. Therefore, it can be concluded that COVID-19 ‘revealed and compounded existing inequalities in wealth, race, gender, age, education, geographical location’[vii] and disability.

We know that inequality is a problem, but how do we tackle it? Well, there is no singular solution to this complex problem. Abject poverty is decreasing, whilst simultaneously the rich are getting exponentially wealthier, contributing towards sustained global inequality, with Piketty arguing that the main economic problem in developed countries is inequality[viii]. It is challenging to implement changes on a global scale that will positively impact global health, although there is consensus that small changes should be implemented gradually over time- revolutionary change is neither practical nor desirable. The main solutions include redistributive spending in the form of higher levels of welfare payments for those in need, and higher public investment in education, housing and healthcare, all of which are financed by higher taxation of the wealthy. An alternative way of reducing inequalities is through narrower differences in initial gross income, as evidenced in countries like Japan, so there is less need for large-scale redistribution. However, others may take the view that continued economic growth through Friedman’s Golden Straitjacket model is essential for alleviating poverty as people have more money to spend alongside greater economic freedom so they can afford to live healthier lives.

To summarise, there is no single policy to reduce inequality in health, yet it is obvious that action must be taken on a global scale. We must act now to reduce inequality if we want a more egalitarian and healthier world. As inequality disadvantages everyone, equality should be our goal because its benefits spread throughout society.

Footnote:

[i] https://www.oxfamamerica.org/explore/stories/what-is-global-inequality/

[ii] Gross Domestic Product: the total value of goods and services produced in a country in a year

[iii] Human Development Index: combines life expectancy, GDP and literacy rates

[iv] https://worldpopulationreview.com/country-rankings/life-expectancy-by-country

[v] Wilkinson and Pickett (2011) The Spirit Level: Why Equality is Better for Everyone

[vi] https://wir2022.wid.world/chapter-4/

[vii] https://theconversation.com/covid-19-how-rising-inequalities-unfolded-and-why-we-cannot-afford-to-ignore-it-161132

[viii] https://taxfoundation.org/research/all/federal/impact-piketty-s-wealth-tax-poor-rich-and-middle-class/

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