Article by Madeleine James 

It is clear that in the 21^st century a great deal of the world’s richest nations suffer with social and health issues, which are more common in less developed poorer countries. Therefore, I pose the question that does being a wealthy nation always necessarily mean you are a healthier one? When discussing this issue, it is important to consider the argument that inequality can commonly be the root of wellbeing in a society. And so, how can we consider whether a rich country is a healthier one without investigating its inequality.

Measuring inequality is not straightforward. Inequality consists of many layers such as economic, social and political, all of which need different tools in order to be measured. The Gini coefficient is a statistical measure us to assess inequality[1] many argue that it is the most commonly used measure of inequality[2] (1 = complete inequality and 0 = perfect equality). It is important to consider other measures of inequality when investigating a country’s ‘health’ as it is multidimensional, thus another measure such as the Robin Hood Index offers more insight into the complex relationship between a country’s health and inequality. Both measures considered sophisticated are used by various organisations such as UNICEF and US Census Bureau.

Kate Pickett’s and Richard G. Wilkson’s book The Spirit Level: Why Equality is Better for Everyone in an insightful piece of work which brings together many pieces of evidence to emphasise the idea that income inequality is not good for any of us, not the poor, not the rich and certainly not society as a whole[3]. In chapter 2 ‘Poverty or Inequality’ they introduce different indexes when looking at data such as an Index of Health and Social Problems whilst looking at income inequality and the United Nations Children’s Fund’s (UNICEF) Index of Child Wellbeing when arguing that this index is independent of a nation’s income per person. The Index of Child Wellbeing was compiled by UNICEF combining forty unique indicators which all cover some aspect of a child’s wellbeing. This chapter presents many theories and ideas about whether firstly there is a correlation between wealthy countries and them being considered ‘healthy’, and secondly if truly there is any connection between wellbeing and average income levels. By using both of these indexes the findings showed that a country’s wealth holds little relevance in the debate in that it is the distribution of wealth in a country that undoubtedly determines how healthy a country candidly is both socially and economically.

Inequality has negative effects in many areas of life for instance higher levels of crime, obesity, teenage pregnancies, life expectancy, infant mortality and mental illness, all of which can all be classified as components of wellbeing. Focusing on well-being supports the tracking of the equitable distribution of resources[4], a skill many wealthy nations lack Chapter 2 of The Spirit Level: Why Equality Is Better For Everyone explores the idea people lower down the social ladder face more challenges both material and psychological than those higher up the ladder. People lower down the ladder seem to suffer more as a result of two factors one being the circumstances of their living conditions and the other being that people end up at the bottom of social ladder because they are more prone to problems which then drag them down. The main issue here is deprivation. The gap between social groups is persistently growing, which is causing majority of its problems. Societies are constantly comparing themselves to each other and in doing so experience higher levels of stress and struggle to keep up to what is seen as the ‘norm’. The chapter highlights the example of that in US 12.6% of Americans living below the federal poverty line chose to have air-conditioning, a truck, computer, dishwater or a second car[5] over food, further reflecting the idea people feel a strong way about maintaining an appearance of prevailing standards and the inequalities that social pressure can create.

What this all shows is that regardless of a nations wealth it cannot be considered healthy if the gap between the social ladder continues to grow. The takeaway is clear equality drives wellbeing instead of wealth. Ultimately, for a nation to succeed the focus needs to shift from affluence to wealth distribution

[1] https://www.datacamp.com/blog/gini-coefficient?dc_referrer=https%3A%2F%2Fwww.google.com%2F

[2] https://ourworldindata.org/what-is-the-gini-coefficient

[3] https://citizen-network.org/library/the-spirit-level.html

[4] https://www.who.int/activities/promoting-well-being

[5] https://contentstore.cla.co.uk/EReader/Index?guid=62f9e3ee-b9d8-e611-80c9-005056af4099&pcid=3445029&t=eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJqdGkiOiI3MzRjMzRjNC0zNTg1LTRmM2QtYjAzYi1hNjliYmUxY2E2MmQiLCJuYmYiOjE3NjI3NzU2OTcsImV4cCI6MTc2Mjc3NTk5NywiaWF0IjoxNzYyNzc1Njk3LCJpc3MiOiJEQ1MiLCJhdWQiOiJSZWFkZXIifQ.2ou7iLc5zv6DsGIQ_oKgIaqeMAgOMhOpy3Ja5pWWCLY&b=False

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