2021

By: John Moeses Bauan (Unsplash)

 

Global inequality may be falling, but the gap between haves and have-nots is growing

 

In one of the most unequal countries in the world, South Africa, the poorest 40% have annual incomes of less than US$1,000 (£727) per person. The comparable incomes for the richest 10% are more than US$39,000 per person – nearly 40 times higher than those of the bottom 40%.

Those numbers, which are based on data from 2017, are actually something of an improvement on 2008, when the multiple was 50 times. But the gap in income between these groups grew by more than US$10,000 per person over this time. And more than two decades after the end of apartheid, the richest 10% are still predominantly from the white minority group, while the poorest 40% is the “exclusive” preserve of the black majority.

These extreme inequalities show that economic growth has neither been inclusive nor transformative – despite the country having implemented significant policies benefiting people with lower incomes in an effort to improve the disparity.

We’ve found similar situations in many countries – even those such as Brazil, China, India and Mexico where inequality is lower and tackling it has emerged as a fundamental development challenge.

A fair distribution of income is both a moral imperative and crucial to a socially cohesive society. Excessive income disparity also has negative implications for growth, poverty and human development.

Not a simple story

Inequality does not grow or decline everywhere at the same time and there are no constant or universal trends over time and across countries or regions. Successes are often followed by steps backwards if conditions change, and vice versa, like the recent trend in Latin American countries shows. This complexity sits at the core of the story about inequality.

As we found when collecting the different studies of our book, Inequality in the Developing World, it is fundamental to avoid oversimplifying inequality, whether at the country or global level. Instead, we must pay careful attention to how successful developing countries are trying to address these issues. This is especially important in times of deep economic adjustments and booms and busts.

The study of global income inequality also requires looking at the bigger picture, treating the world as one country. Here, forces such as globalisation or technological progress operate, with potentially asymmetric effects on inequalities within and between countries.

Global inequality has in fact been declining for several decades according to many standard measures. The figure below shows this decline as measured by the Gini index (on which 100 represents maximum inequality). But as you can see, this is driven by declining inequality between countries rather than within them.

Bigger economies such as China or India contain large shares of the world’s population – and their development has greatly influenced global inequality. The overall decline is mainly due to fast economic growth in China, which has progressively approached the global mean in income. This has narrowed inequalities between countries by significantly improving the living conditions of hundreds of millions of people.

But it’s much too early to celebrate. Although other developing countries have followed this path to some extent, the drop in global inequality is decelerating. And there is evidence that the poorest have extreme difficulties in keeping up with the rest. Differences between richer and poorer countries remain colossal.

National income inequality

The forces that have helped to narrow inequality among countries have had the opposite impact on inequalities within countries. As shown in the figure, the aggregate contribution of within-country inequality to the global measure has risen. This is true even of China and India.

These within-country trends – often of increasing inequality – are crucial to our understanding of the problem. It is this which ultimately frames people’s lives and perceptions and is the focus of policies to address inequality. The five country studies in our volume show that – at this level too – a variety of factors affect final measured inequality. There is no single general pattern applying in every period or area.

Functional and inclusive local labour markets that enable people of all backgrounds to earn a decent living matter greatly. They are the primary source of income for the majority of the population. To lower inequality in the labour market, it is essential to achieve more equal access to the sorts of skills and capital that enable workers to get quality jobs and decent earnings.

Macro factors, such as the degree of industry specialisation in a country or the existence of markets with adequate regulations and good governance, matter as well. Of particular importance is the capacity of the public sector to offset major forces that cause inequality and to provide direct access to basic goods and services.

Despite most developing countries having small welfare states compared to more developed countries, some countries have experienced varying degrees of success in addressing income inequality through active and innovative policies such as labour market reforms. Brazil and Mexico, for example, have achieved success with minimum wages and progressive tax and benefit structures.

While inequality has been rising in recent decades within numerous countries, representing the majority of the world’s population, this isn’t true everywhere. Brazil and Mexico have seen it declining even as others such as South Africa have been living with stable but extremely high inequality.

But generally, within-country inequality is highly persistent and dampens social mobility. Inequality does not fall automatically as countries develop or deploy more democratic or inclusive institutions, as was previously thought. Inequality of income is the result of a complex set of intersecting inequalities, including in education, health and the labour market.

Tackling inequality therefore requires a determined, coordinated and sustained collective effort. Our study contributes needed evidence for action in this challenging area of socio-economic development and sets out a framework for identifying effective policy measures.

 

Carlos Gradín (Research Fellow, UNU-WIDER, United Nations University)

Finn Tarp (Professor of Economics, University of Copenhagen)

Murray Leibbrandt (NRF Chair in Poverty and Inequality Research; Director of the Southern Africa Labour and Development Research Unit, University of Cape Town and UNU-WIDER Non-Resident Senior Research Fellow., University of Cape Town)

 

Date              :                  September 2, 2021

Source          :                  The Conversation 

https://theconversation.com/global-inequality-may-be-falling-but-the-gap-between-haves-and-have-nots-is-growing-159825

 

Women’s wellbeing and the burden of unpaid work

 

Soraya Seedat and Marta Rondon examine how gender inequities in the time allocated to unpaid work, exacerbated by covid-19, are affecting women’s mental health

Women spend a disproportionate amount of their time carrying out three quarters of the world’s unpaid work: 11 billion hours a day.1 Globally women undertake three times more care and domestic work than men, with women in low and middle income countries devoting more time to unpaid work than women in high income countries, although income related differences within countries also exist.2

Unpaid care work is often perceived as low value and is invisible in mainstream economics, underpinned by entrenched patriarchal institutions and national accounting systems that fail to factor in women’s total contributions. Unpaid domestic and care work is associated with greater mental health burden and negative effects on quality of life,34 although most of the evidence comes from high income countries. Internationally, during the covid-19 pandemic, time spent on care and domestic work has increased for both men and women, but the increase and intensity of this work has been far greater for women. The risk of mental illness among women engaged in unpaid work can be expected to rise during the crisis with exposure to greater and more stressful workloads. Urgent action is needed to protect women’s mental health.

 

Unpaid work, stress, and mental health

Unpaid work refers to services provided within a household for its members, including personal care and housework.5 Because of the gendered nature of domestic and reproductive roles, women and girls are often expected to assume unpaid domestic work and care.6 Unpaid care work is a major factor in determining both whether women enter and stay in paid employment and the quality of their work.7 Although evidence is limited in the context of unpaid work on the effect of individual level factors (eg, perceptions of distress, cumulative stress load, past mental health problems) and ecological factors (eg, household conditions, space constraints, noise) on stress and mental health, the contributions of drudgery and the physical demands of unpaid work need to be considered.

Women’s experience of unpaid domestic work and care, and the drudgery associated with these activities, varies a great deal not only between those in high income countries and lower income countries but also between different income groups within countries.2 Higher earning women in all countries are able to give more attention to and spend more quality time with their children by outsourcing more onerous household tasks—for example, by using care services and domestic help. By contrast, women who lack the financial means are often burdened by repetitive, time consuming, and physically demanding domestic tasks.2 This drudgery component, which makes up the largest share of poorer women’s total unpaid work burden, may cause substantial fatigue and stress, whereas the relational component of unpaid work, such as playing with children, may be stress reducing and fulfilling.2

Stress activates the release of neurohormones, including cortisol. Women who experience household tasks and childcare as highly stressful have been shown to have higher cortisol levels and slower recovery of cortisol than women who report low stress from this type of unpaid work.8 This underscores the importance of women’s subjective experience of unpaid work, as sustained high cortisol levels may partially explain some adverse mental health outcomes, including depression, in women doing unpaid care work.9 For women, higher levels of objective stress may also translate into higher levels of perceived stress (burden and role strain) compared with men.10 Moreover, the cognitive and emotional involvement and the lack of respite (eg, time for leisure, communication with partners or friends, and self-care) from unpaid work can eventually lead to physical and emotional distress, depression, and anxiety.11

The “double burden” of paid and unpaid work has differential effects, with household stress seeming to affect women more than men.12 For example, a US study13 found that inequities in the division of housework and women’s disproportionate share contributed substantially to sex differences in depression. A four wave study that mapped depression trajectories in the Swedish working population between 2008 and 2014 found that women generally worked longer hours overall and spent more time doing unpaid work than men.14 The link between more unpaid work hours and a higher depression symptom trajectory was stronger for women than men. There was also an association in women (not men) between more total work hours and a “high stable” depression trajectory. Both trajectories are associated with poorer outcomes, underscoring the need for targeted interventions to reduce women’s work hours, especially unpaid work hours.

Unpaid work also has other unfavourable deleterious effects. The Korean Longitudinal Study of Ageing (2006–18) showed that middle aged, full time homemakers had five times the risk of cognitive impairments compared with women in other occupations.15

Furthermore, providing long term or high intensity care for a sick or elderly relative has been associated with an excess of psychiatric morbidity in women (eg, depression, anxiety, and lower life satisfaction).16 Analysis of three waves of the UK Household Longitudinal Study to compare employment, earnings, and health effects in young people providing unpaid care found that young unpaid care givers for elderly, sick, and disabled people were mostly women, uneducated, living with a partner, and living in social housing.17 Compared with young people without caring responsibilities, they had worse physical and mental health, earnt less, paid fewer taxes, received more welfare, and spent more on health services.

These findings contribute to our understanding of causal associations between unpaid work and longer term individual and societal outcomes. If we consider that women and girls make up 49.5% of the global population, the direct and indirect costs are staggering.

Although evidence on the adverse mental health consequences of unpaid work in women from high income countries is growing, sex disaggregated data on the mental health effects of unpaid work in low and middle income countries are sparse. This is concerning given that the costs to physical and mental health from unpaid care giving may be even higher in these countries. A systematic review and meta-analysis comparing health outcomes of unpaid care givers and non-care givers from Africa, Asia, and South America found that unpaid care givers had higher levels of anxiety and depressive symptoms than non-care givers.18 Women comprised the majority of caregivers in 12 of the 14 included studies, and they included those caring for individuals with chronic health problems (eg, HIV, cancer, diabetes mellitus), disabled family members, or individuals without any apparent medical condition.

Unpaid work during the covid-19 crisis

The gendered nature of unpaid work has become more apparent during the covid-19 pandemic.19 A rapid assessment survey by UN Women in April 2020 found that among women surveyed in Pakistan, 49% reported spending more time on domestic chores compared with 33% of men. In Bangladesh and the Maldives, 55% and 68% of women surveyed reported spending more time on unpaid domestic work, compared with 44% and 55% of men in these countries.20 In the US and the UK, real time surveys in March and April 2020 found that more women than men had lost paid jobs.21

Gender asymmetries during the pandemic have extended to childcare, with mothers doing a greater share of childcare than fathers in response to closure of schools and day care facilities and the unavailability of home help. A UK survey of 4915 parents from two parent mixed sex households conducted early in the pandemic (April-May 2020) found that compared with 2014-15, women were spending substantially longer on childcare and housework than their male partners. Women’s paid work had also shrunk disproportionately compared with men’s, and their work productivity (measured in interrupted hours) had more steeply declined when working from home. For example, mothers and fathers doing paid work used to be interrupted during the same proportion of their work hours before the pandemic. However, the survey found mothers were being interrupted 57% more during their paid work hours than fathers.22

A nationally representative household study in the UK during the first covid-19 lockdown (April-May 2020) found that not only did women do about two thirds of the housework and childcare but they were more likely than men to reduce working hours and adapt employment schedules because of spending increased time on unpaid care.23 Increased hours spent on childcare and home schooling were associated with greater levels of psychological distress among women than men. One limitation is that the study did not assess change in unpaid care work due to lockdown and how this may have affected levels of psychological distress.

Several other studies, including from Australia, China, the UK and US, have documented a greater rise in psychological distress in women than in men during lockdown. In Australia, for example, a population based study during the first month of covid-19 restrictions to establish the population prevalence of clinically significant symptoms of depression and anxiety among adults aged 18 years and older, showed that women had a greater propensity to develop symptoms of anxiety and depression and were also more likely to be taking care of children and dependent people. These findings suggest that the disproportionate burden of unpaid care giving may be a risk factor for psychopathology.19 Other factors such as social isolation, decreased access to health and social services, and increased exposure to intimate partner violence have also been shown to disproportionately affect women’s mental health and quality of life during covid-19 restrictions.2425

Reducing the burden

Gendered social norms construct women as care givers and providers, yet unpaid work is clearly associated with poorer mental health for women. The pandemic has magnified these inequities and placed women at an even greater risk of depression, anxiety, and other common mental disorders.

Longitudinal research is needed to improve our understanding of the implications of unpaid care giving for mental health outcomes on a global level, in both pandemic and post-pandemic times. This should include in-depth exploration of the duration, type, and intensity of unpaid domestic work and care giving, the interaction with paid work, and the contribution to mental health outcomes. The interplay between individual level factors and ecological factors in shaping mental health problems also requires further examination. The pandemic has reinforced the need to generate national robust time-use survey data on the gender distribution of unpaid care and domestic work across countries as evidence for policy makers. The UN Women’s global programme, Making Every Woman and Girl Count has spearheaded such an initiative,26 and concerted efforts must be made to ensure the data are prioritised.

From a policy perspective we urgently need to drive transformative change, especially because the prolonged pandemic and recurring lockdowns in many parts of the world have entrenched gender asymmetries in unpaid work. The increase in unpaid work responsibilities during the covid-19 crisis will also make it more difficult for women who have lost their jobs to find alternative employment and income streams, as well as making it more challenging to reduce their unpaid work to the level that existed before the pandemic.

We can start to address this by prioritising the continued safe operation of childcare facilities and schools. Social protection measures, such as paid leave for workers who need to care for children or sick or elderly family members, and subsidies for people with care responsibilities must be established—or continued in countries where these measures exist. For example, a covid-19 related measure implemented in Austria grants employees three weeks of exceptional leave at full pay for childcare responsibilities for children under 14 years.27 Peru is another example where women are the default household recipients of a covid-19 stimulus cash transfer scheme that seeks to affirm women as central to families’ wellbeing.28

Providing a more extensive menu of flexible working options (eg, teleworking, staggered work hours, flexi hours) that account for women’s care responsibilities during the pandemic and beyond is another strategy to support women. Although many low and middle income countries may not have the resources to implement some of these measures, other strategies are feasible. For example, a UN Women analysis using country level data showed that if a middle income country such as South Africa made childcare services available for children under the age of 5 years, two to three million new jobs would be created and unemployment rates would go down by 10 percentage points.29 This is a compelling case for investing in free universal childcare services of high quality to reduce gender inequality in earnings and employment.30

Adopting a life cycle perspective to the more equitable distribution of unpaid care work, starting with policies that grant fathers longer paternity leave, has also consistently been associated with better infant and child health outcomes and reduced mortality.29

The covid-19 pandemic has highlighted the urgency of integrating service delivery and improved access for women to mental and physical health services, income and employee support, social welfare, and legal and justice systems. Access to legal systems needs particular strengthening to protect and support women increasingly vulnerable to intimate partner violence.

Transformative change for women requires policy that recognises, reduces, and redistributes unpaid care work. Government incentives can support this change, such as through “cash for care” subsidies to compensate parents affected by school and daycare closures and for employers that provide workers with paid leave. Ultimately, whole communities and local governments need to be involved in the provision of care. This will free up women to contribute more to the paid work economy, to engage in voluntary and leisure activities, to have more time for themselves, and to safeguard their careers with arguably less compromise to, and negative effect on, their mental health and general wellbeing.

 

Key messages

• Women have historically carried a disproportionate burden of unpaid domestic and home care responsibilities

• The response to covid-19 has widened the inequality gap and highlighted women’s escalating burden of unpaid care work

• The higher risk of depressive and anxiety symptoms among women may be partially explained by this disproportionate burden

• Innovative research is needed to identify policies to reduce inequalities in the unpaid economy

 

Footnotes

Contributors and sources: SS holds the South African Research Chair in Post-Traumatic Stress Disorder and is director of the South African Medical Research Council Genomics of Brain Disorders Research Unit at Stellenbosch University. MR is a psychiatrist with a master’s degree on policy and services for mental health. She has done research on women’s mental health, violence against women and the interface between sexual and reproductive rights and health and mental health.

 

BMJ 2021; 374 doi: https://doi.org/10.1136/bmj.n1972 (Published 31 August 2021)

https://www.bmj.com/content/374/bmj.n1972

 

Book Review: The New Age of Empire: How Colonialism and Racism Still Rule the World by Kehinde Andrews

 

In The New Age of Empire: How Colonialism and Racism Still Rule the World, Kehinde Andrews explores how the intellectual, political and economic frameworks inherited from colonialism are still governing today’s world, resulting in a new age of empire that perpetuates racism, white supremacy and global economic inequalities. This compact and comprehensive book challenges the grand narratives of the Enlightenment, Western linear progress and developmentalism and offers a broader and more complete picture of the continuing problems of racism and the imperial mentality, writes Ay?e I??n Kirenci.

If you are interested in this book review, you can listen to a podcast of author Kehinde Andrews discussing The New Age of Empire at an LSE event held on 27 April 2021. 

The New Age of Empire: How Colonialism and Racism Still Rule the World. Kehinde Andrews. Penguin Books. 2021.

In The New Age of Empire: How Colonialism and Racism Still Rule the World, Kehinde Andrews explores the historical sources of present-day racism as well as the topic of underdevelopment in Africa, showing the complicated and deeply entrenched nature of these issues in their socio-historical context. By tracing back through the Enlightenment, colonialism, genocide in the Americas and the Atlantic slave trade, he reveals that the intellectual, political, economic and racial frameworks inherited from the past are still governing today’s world and generating neo-colonialist and post-racial orders. In this respect, Andrews challenges many theories in development studies that ignore the historically embedded nature of underdevelopment in Africa, instead suggesting a historical institutionalist approach with his study.

The main axis of the book is predicated on the argument that the West is always seen as a pioneer of all developments in science, industry and politics, while the global and accumulated character of these innovations, the circumstances that provided the equipment to the West to reach its goals and the effects produced are mostly neglected. Andrews emphasises that it was genocide, slavery and colonialism in the Americas and Africa that paved the way for all these revolutions, and that development also contains a contrary element in itself, underdevelopment. In other words, both development and underdevelopment are the products of the very same process. In this context, it would be beneficial to recall Andre Gunder Frank’s approach in his article ‘The Development of Underdevelopment’ (1966), which sees underdevelopment as ‘a historical product of past and continuing economic and other relations between the satellite underdeveloped and now-developed metropolitan countries’.

The New Age of Empire consists of eight chapters: the first half explains the foundations on which ‘the New Age of Empire’ has been founded, while the other half focuses on the rise of the New Age of Empire and the endurance of the imperial mentality, albeit with a new appearance, a changing balance of powers and drawing on additional actors. Thus, Andrews refers to two stages of imperialism, the second one starting after World War Two.

In Chapter One, Andrews expresses the idea that Enlightenment ideals are the intellectual base of the imperial project, which reinforces the idea of white supremacy. This leads to the denial of ‘other’ knowledges produced by non-Westerners and initiates the monopolisation of knowledge by Europeans (1-2). Additionally, it has eased the transition from the old to the new imperialism by means of its supposedly universal and humanitarian values.

Enlightened or not, this imperial discourse can be summed up by the rhetorical question formulated in Rudyard Kipling’s poem ‘The English Flag’ (1891): ‘What should they know of England who only England know?’ Kipling’s question implies the importance of having an imperial vision for England and gives it the mission of transcending its political borders. This can give us an insight into the perspectives of the time and is useful in understanding the core arguments revealed in The New Age of Empire as well. Although the poem’s question originally attributed a so-called developmental role to England in colonised areas, it also suggests a wider perspective about the nature of the relationship between the coloniser and colonised. Consequently, to what extent can country- and individual-level analyses give an account of the underdevelopment and development inherited from past colonial relations?

After the intellectual origins of modern-day imperialism are revealed, the book considers the coercive practices which cleared the ground for Enlightenment ideals and originated the first stage of imperialism (24). The second and third chapters of the book focus on how genocide and transatlantic slavery generated European development and, at the same time, African underdevelopment (57). It is precisely these same processes that set forth diverse paths for Europe and Africa.

The expansion into the Americas led to genocide, slavery and colonialism, which enabled Europe to create industrial capitalism and realise the notion of Western development (30-32). In order to eliminate the myth of Western progress grounded on the Enlightenment and the Industrial Revolution, it is necessary to grasp the actions of the West beyond its own borders, as Kipling suggested for different reasons. In addition to uncovering the interrelationship between ‘core’ and ‘periphery’ and the concepts of development and underdevelopment, this vision is also essential to understanding the foundations of today’s rooted racism and the New Age of Empire, as Andrews argues.

Therefore, it becomes relevant to ask about the system that has created systemic underdevelopment for Africa. The main concepts associated with capitalist development, the dispossession of the colonised and accumulation by the colonisers, are basic features of an age that employed genocide and slavery in order to possess lands and dispossess people. Since Andrews relates the sources of underdevelopment in Africa to these dispossessions, genocide, slavery and colonialism, studies that take the sources of underdevelopment as being the lack of proper economic institutions, capitalist relations, civil society and private sector development miss the matter at hand.

After the accumulation and dispossession phases had been completed, the West had control over the means – resources and labour – to claim colonial dominance, as outlined in detail in Chapter Four (89). As a result, racial hierarchies and economic inequalities became more systematised and institutionalised, which complicated the process. Thus, as Andrews points out, linking these problems to the quality of governance and capabilities can lead us to miss the root causes and misevaluate the current system of inequalities and racial discriminations.

As revealed in Chapter Five, Andrews evaluates the transition from the old system of imperialism to the new one as a system update and names it ‘liberal imperialism’ (111-12). The new system with its cooperative institutions embracing Enlightenment ideals, such as humanitarianism and universalism, claims to promote good governance and the liberal economic order in formerly colonised regions. However, it causes the persistence of racial hierarchies and white supremacy by accusing Africans of their own underdevelopment and relating this to the lack of good governance or their so-called tribal way of life (131).

There are many movements defending equal rights for all and the New Left campaigned for social democracy and civil and political rights over the course of the second stage of imperialism. However, realising the systemic nature of the problems of racism and social, economic and political inequalities remains most urgent, as Andrews highlights in Chapter Seven. Due to racism’s institutional and deeply rooted nature, he opts for true revolution uniting Black communities (206). Dismissing metanarratives and myths that blur our understanding of the lasting racism against Black people and the causes of underdevelopment in Africa can be the first step in combatting the anti-Black, post-colonial and post-racial world order.

Overall, The New Age of Empire provides a compact and comprehensive resource for those interested in development and colonialism studies who are looking for more critical perspectives on some of the orthodoxies in the political economy literature. Through its historical institutionalist approach, the study challenges the grand narratives of the Enlightenment, Western linear progress and developmentalism. Also, by emphasising the continuities instead of the ruptures in history, Andrews presents a broader and more complete picture of the problems of racism and the imperial mentality. Although the appearances of imperialism may have changed, the core has been preserved and continuities persist. Producing a transformation depends on us changing our approach and being critical in treating the literature before us.

 

Ay?e I??n Kirenci graduated from the department of Political Science and International Relations at Bo?aziçi University with a BA degree. During her undergraduate studies, she spent a semester at Leiden University as an exchange student, studied political science. She is currently a master student, studying Political Sociology at Istanbul University. She will continue her studies at LSE, in the MSc program of International Political Economy, in this year. Her research interests are developmental sociology, post-colonialism, international political economy and institutional economics.

 

Date             :                 September 19, 2021

Source         :                  LSE Phelan US Centre 

https://blogs.lse.ac.uk/usappblog/2021/09/19/book-review-the-new-age-of-empire-how-colonialism-and-racism-still-rule-the-world-by-kehinde-andrews/

 

Why Rising Inequality Doesn’t Stimulate Political Action

 

Economic inequality is high and rising, but Americans aren’t clamoring for government action to address it. Nathan Kelly finds that rising economic inequality, rather than making the public favor redistribution, actually helps Republicans electorally and leads to policies that further entrench it and away from policies to combat it. Meghan Condon finds that Americans react to inequality by comparing themselves with those who have less, rather than to the rich, imaging themselves better off than others who they think don’t work as hard. They both say rising inequality does not make it easier to address through political action. 

Guests: Nathan Kelly, University of Tennessee; Meghan Condon, Loyola University Chicago 
Studies: America’s Inequality Trap and The Economic Other 

Transcript

Matt Grossmann: Why rising inequality doesn’t stimulate action to address it, this week on The Science of Politics. From the Niskanen Center, I’m Matt Grossmann.

Economic inequality is high and rising, but Americans aren’t clamoring for government to do a lot more about it, and related policies are often stymied. We might expect economic inequality to lead to more efforts to address it, but instead it makes people compare themselves with others below them and helps Republicans in policy that advances inequality.

This week, I talked to Nathan Kelly of the University of Tennessee about his Chicago book, America’s Inequality Trap. He finds that rising economic inequality, rather than making the public favor redistribution, actually helps Republicans win elections, and leads to policies that further entrench it, and a way from policies to combat it.

I also talked to Meghan Condon of Loyola University, Chicago, about her Chicago book with Amber Wichowsky, The Economic Other. She finds that Americans react to inequality by comparing themselves with those who have less, rather than to the rich. Imagining themselves better off than others, who they think don’t work as hard.

They both say rising inequality does not make it easier to address through political action. Kelly finds that rising inequality makes it harder to solve both, by affecting institutions and the public.

Nathan Kelly: The core question of the book surrounds how it is that rising economic inequality has changed American politics in a variety of ways, and I looked at several different pathways through which rising inequality might feed back into the political system. A couple of those pathways related to the policy making process in American political institutions, and a couple of pathways related more to sort of traditional political behavior with even some connections to political psychology.

So the two more institutional pathways had to do with how rising inequality has affected the ability of Congress to pass new laws. And one of the core findings there is that as inequality rises, it does make it harder to pass new legislation. And importantly, the effect of new legislation is very different depending on the existing level of inequality. So when inequality is low, there’s really no effect. There’s no linkage between legislative productivity and distributional outcomes. But if inequality is already high, then Congress failing to get things done actually further exacerbates economic inequality. So there’s a situation there where high inequality feeds back on itself through the political system, through the pathway of basically legislative gridlock.

Another part of the policy-making process that I looked at was the extent to which legislators are able to make bipartisan policy changes. I mean, because we know that even in context of very high polarization over the last couple of decades, Congress does still get things done. They do still come together in bipartisan ways to make policy. But what I focused on was the types of policy that get made when polarization is high and when gridlock is prevalent. And what I found is that the places where it’s most likely for the parties to come together and make policy in the context of high inequality are in policy domains where it’s likely that the policy outcome will further exacerbate inequality. So when inequality is high, bipartisan policy-making is more likely to exacerbate economic inequality. So that’s a second way in which we sort of have what I refer to as an inequality trap, where rising inequality changes American politics in ways that further reinforce inequality.

And then there are the more behavioral pathways. And there, I looked at public opinion and voting behavior. And with regard to public opinion, what I essentially found is the public opinion is not a super central part of this story, this feedback loop. There’s not very strong evidence that the public responds very consistently in one way or another to rising inequality, so it’s not as if rising inequality makes people fundamentally more conservative or fundamentally more progressive. There’s not much of a response, except for among a small portion of people actually at the lower end of the income distribution. And so for poor people, there does seem to be some evidence that they actually become less supportive of redistribution as inequality increases. So that’s not the kind of response that would, that would produce a sort of cyclical self-correcting pattern. It’s one that would be self-reinforcing, at least in that segment of the population.

And then with regard to election outcomes, I’ve found that in general, Republicans are benefited by rising inequality. They tend to perform better in congressional elections and presidential elections when inequality is high, and there are obviously a lot of other factors that go into collection outcomes, but everything else sort of held constant, Republicans perform better when inequality is high, and Republicans enact policies that tend to exacerbate economic inequality further. So there’s a potential there for a feedback loop that leads to the title of the book, America’s Inequality Trap, where as inequality rises, it leads to changes in the political system that sort of trap us in inequality and potentially even exacerbate inequality further.

Matt Grossmann: Condon and Wichowsky find biased comparisons inhibit responses to inequality.

Meghan Condon: Our book asks how Americans think about the rich, the poor, and inequality, in an era of rapidly growing economic divides. And it asks why we don’t see more robust, broad-based support for government action to decrease economic inequality in the US. Our focus is on people’s social experience with class, how contact in comparison across class divides is changing, and how it affects our politics.

So as humans, we compare ourselves to others all the time. And I think one of the best ways for anyone who’s listening to get the intuition for the book, and think through just how important social comparison is to how we see ourselves and our society, is just to think for a second about all the social comparisons you have made already today with people at work, on the street, in the media. Think through how those made you feel, whether the comparisons you made between yourself and others brought you up or brought you down, made you feel big or small, made you feel empowered, envious, covetous, less than.

And then what we do, what Amber Wichowsky and I do is we take a step forward and we ask how those comparisons affect our politics, how we see ourselves in the social hierarchy, and what we want government to do about the differences between us. The book shows how people understand inequality through interpersonal status-based thinking, and demonstrates that opportunities for cross-class interaction and comparison have declined over the last half century in ways that insulate American politics from growing inequality. So we find that when it comes to inequality, focusing on different comparisons with the rich, the poor, or the middle class changes what people want government to do, and whether they feel empowered to make those demands.

In several experiments and observational studies, we find when Americans compare upward with the rich, they perceive their own status as lower. And that, for middle, and working class, and poor Americans means that they’re perceiving their status more accurately. People comparing upward with the rich like that also want government to strengthen the safety net and redistribute resources. Support for food assistance, education, unemployment insurance, they all go up with upward comparison. But at the same time, in some cases, looking upward can make people feel less efficacious. So while they may want more from government, they feel less empowered to make those demands.

Downward comparison with the poor boosts status perceptions. It makes people feel that their own status is higher, but it doesn’t change policy opinions or advocacy. People comparing with the poor feel better about themselves, but not much differently about the role of government or their own political power.

And then the next thing that we investigate is where those comparisons come from. And we find that these comparisons are structured by our communities, the media, political messages, and even psychological cravings to look up or down. Americans as individuals are actually deeply sensitive to inequality, but the American response to inequality is muted by countervailing forces. And I can talk more about these as we go, but the big lens are growing economic segregation, which has made the rich increasingly invisible for most Americans, in particular depressing opportunity for upper comparison. And then second, misleading class images in the media fill that gap left blank by personal lived experiences, allowing class stereotypes to increasingly structure the comparisons we imagine. These images and stereotypes are really persistently racialized and gendered in the US. And then third, economic anxiety and precarity, which are absolutely exploding in the US, make people crave downward comparison to feel better about themselves in uncertain times. And again, this decreases the upper comparison. It makes people more accurate about status and supportive of the safety net.

Taken together, the evidence in the book explains that the American response to inequality has been anemic, because at the same time that economic inequality has grown, most Americans have had fewer of the specific types of social comparative experiences that make that inequality salient and mobilize support for redistribution and empower public action.

Matt Grossmann: In part, due to these social comparisons, Kelly finds no self-correcting patterns for inequality.

Nathan Kelly: There are some different theoretical models that might lead us to expect what you might call a thermostatic response to rising inequality. So there’s lots of parts of the political system, right? Where if something moves toward the left, then the input that produces that leftward movement is likely to shift in the other direction over time. And so there’s a lot of self-correction that happens in American politics. There’s a lot of back and forth where things don’t move too far in one direction or the other before a correction happens.

So part of the expectation is just that, that we see these sort of self-correcting patterns all over the place in American politics. So if that’s the kind of pattern that we would see with inequality, what would we expect to see? Well, we would expect to see rising inequality helping Democrats do better at the polls, perhaps pushing public opinion in a more progressive direction in order to sort of arrest rising inequality of things that are sort of out of equilibrium in some way.

And of course there are also sort of more rigid economic theories that expect public opinion and election outcomes to move in a self-correcting way in response to inequality. There’s the famous Meltzer and Richard model of the size of government, where they talk about how basically the median voter is going to shift to the left as inequality rises. And if that happens, then in the American context, Democrats should do better. People should be shifting in a progressive direction. Now, that theory has had … Probably the best way to say it is the evidence has been mixed on that theory over time. And then I think this book is just one more piece of evidence that’s like, “Well, that theory doesn’t really work.”

But there are actually some really good reasons to expect what I found in the book, which is either a non-response to rising inequality in the public, or if there is a response, that it actually moves things in a conservative direction and helps Republicans. To some extent, there’s this idea of status bias in public opinion, and in the sense that people sort of become used to whatever the current context is. And so if that current context involves inequality, they just become used to inequality being higher, and then they don’t request a response, because they just adjust to the new situation.

And then there’s also the book that I think is paired with this one, the Condon and Wichowksy book, that looks at where people make comparisons, and they tend to make comparisons in a downward direction rather than an upward direction. And if they do make comparisons in an upward direction, it actually makes them feel less efficacious and less like they can actually achieve things in politics. And those patterns are precisely in line with the results that I find in this book.

Matt Grossmann: He says bipartisan actions, like financial deregulation, even increase inequality.

Nathan Kelly: Part of the story of the book is that Democrats and Republicans actually joined together in a bipartisan fashion to deregulate the financial industry. Historically, Democrats had been the party that was most supportive of financial regulation, and Republicans tried for quite a while to chip away at financial regulation and deregulate that sector. And by the 1990s, there was actually sufficient support among Democrats. Not the entire party, but a sufficient portion of the Democratic Party actually joined with Republicans to repeal Glass-Steagall.

And so one of the things I look at in the book is why and how that happened, and it gives rise to the question of whether this is really a permanent thing, or whether the Democrats joining with Republicans was kind of a temporary blip that happened in the 1990s, kind of the Bill Clinton era of the Democratic Party. And so I think the jury is still out on that question, but part of what seems to have driven some Democrats toward financial deregulation was actually the amount of inequality that exists. If you go back into the congressional record and listen, and look at some of the speeches, you see Democratic members who are typically pretty progressive members of Congress, talking about how their constituents are falling further and further behind, that they need access to credit and part of the reason that they need to deregulate the financial industry is to open up credit access to their lower income constituents that are falling further and further behind in terms of inequality. And so, I don’t think the evidence on this is totally airtight, but it’s certainly suggestive that rising inequality made it possible for Democrats to shift toward financial deregulation. Since then, of course there’s been some reregulation has happened, but the reregulation that’s happened has been pretty mild in comparison to the old Glass-Steagall framework. And Democrats have not completely gone all in on fully reregulating the finance sector. So I think it’s actually likely that we’re not going to see Democrats completely reverse on this over a long period of time, as long as inequality remains as high as it is.

Matt Grossmann: Trying to understand dynamics over time is hard, but Kelly uses several techniques.

Nathan Kelly: When we’re doing these time series models, they’re looking at these long-term trends in how variables relate to each other. One of the key things that we’re always doing is anytime we’re looking at an outcome, we’re always controlling for previous values of that outcome. So we’re essentially making sure that we’re looking at change in an outcome while we’re looking at change in an input. So by controlling for a long series of previous values, in some cases on an outcome variable, that helps to guard against this whole… Have you missed something? Is there something else going on because we’ve controlled for previous dynamics so if there are other things pushing an outcome variable in a particular direction, we essentially will have accounted for that already by controlling for previous values of the outcome. But there are these long-term trends that we have to account for as well, and this doesn’t completely get rid of that problem.

And so one of the things that we want to also be sure to do is if there were really big, exogenous macro level factors that we haven’t accounted for in these time series models that we do at least statistically account for. And so throughout the book, one of the things that you’ll see is footnotes pointing to more detailed methods decisions. And one of the things that was done repeatedly was including a variety of time trends in these models to make sure that we weren’t just seeing journalistic trends driving the results, and almost without exception, when you include those longterm trends, doesn’t fundamentally alter what we see in terms of the results. So that does provide some reassurance, at least that we’re capturing what we think we’re capturing when we estimate these models.

Matt Grossmann: In the economic other Condon and [Wakoski 00:16:55] look at the micro level, asking people to imagine interactions with richer or poorer people.

Meghan Condon:We joined several research methods to understand American perception of class and inequality and the drivers of support for government action. We use a combination of survey data and large-scale experiments, but also qualitative research. And so we ask the thousands of people in our studies who are imagining conversations and interactions with the rich and the poor to write a little bit about what they imagined, to write about who that rich or poor person is in their imagination, what they think and might talk about, how they feel. And what comes to light and when it comes to the poor is that Americans really hold a dominant public image of the poor as lazy, undeserving. This image is racialized and gendered. We show experimentally that people are imagining a poor person in their minds as a black woman, disproportionately. And they tell us this in their qualitative answers. So people talk about imagining… They give pretty detailed descriptions.

They talk about imagining woman who is overweight with many children, someone who has a cell phone, use the language, “Has the luxury of a cell phone, but still won’t work or doesn’t have a job.” They talk about imagining interactions where they offer assistance to the poor person, where they are generous and magnanimous and the other person refuses to take advantage of the help that’s offered. One particularly detailed description came from one of our respondents who talked about imagining a conversation with a person who was unemployed because of substance abuse problems, and imagine telling that person about a job that was possible. And that the person, who keep in mind, is completely imagined and fictitious, doesn’t show up for the job interview. So the image that comes out of the poor in our qualitative data really does reflect what social scientists and political observers have been talking about for a long time. I mean, certainly since welfare reform in the 1990s, but even well before that, that Americans have this dominant, shared public image of racialized poverty and the undeserving path [inaudible 00:19:37]

Matt Grossmann: Condon says economic anxiety and segregation push Americans from upward comparisons.

Meghan Condon: Economic segregation, which in communities, in the workplace, even in families and marriages, is growing right along with inequality, but it’s not growing evenly. It’s the rich who are segregating more and more, disappearing into wealthy enclaves and zip codes and neighborhoods, social circles. And so the segregation of wealth means that the great majority of people in the nation who aren’t wealthy themselves are having fewer and fewer opportunities for upward comparison. And then psychologically, when people feel uncertain, insecure, or anxious, we want to compare downward to feel better. We want to say, “Well, at least I’m not her. At least I’m not him.” And so economic anxiety, which is also rising with inequality, makes people try to avoid upper comparison and focusing downward comparisons. So taken together, these countervailing forces are pushing Americans away from upper comparison, away from the comparisons that increase support for redistribution. And it isn’t that we never make these upward comparisons. We always make downward comparisons. That’s not the case. But the conditions in an increasingly unequal society make upward comparison less likely.

Matt Grossmann: Views of class differences come more from nonpolitical sources and they’re distorting.

Meghan Condon: The messages that we receive about inequality from political groups and elites and the images of wealth and poverty in popular culture both matter, especially when people’s daily lives aren’t providing experiences for comparison. So especially in the context of growing income segregation. These other sources of class images are becoming even more important. So I want to say two things here. First, when it comes to political messages, it can be consequential, but despite how it feels sometimes to political scientists or people who are heavily engaged in politics, for most people, this political messaging from interest groups and parties and leaders is really only a tiny slice of their lived experience with class differences and social comparison across economic divides. That’s the reason that we focused in this book on the political consequences of social comparison, coming from other nonpolitical sources, from neighbors and coworkers, entertainment, media, and the like.

So we’re writing actually a followup book now that gives more attention to political rhetoric about inequality. But we wanted to start off meeting people where they are, which for many people isn’t glued to political media. Now people in the United States are drinking from a fire hose of class messages from popular culture and entertainment media. And so we do investigate those in the economic other. In particular, we’re really curious about images of wealth when it comes to celebrity culture, social media and reality television. We watched reality television and some of it’s content systematically and analyzed the data for this [inaudible 00:22:56]. And what we found was that though there are many images of the economic elite in celebrity culture, in social media, in reality television, from Undercover Boss to The Real Housewives to Kim Kardashian, when we watched it systematically, we found that these messages are about class, are highly synthetic and they’re engineered to make people feel good, to be entertained and to feel pleasure and to keep watching.

That’s not how upward comparison feels in the real world. In real life upward comparison, doesn’t feel very good. It’s not pleasurable. It can make you feel worse about yourself. So entertainment media manages to craft upward comparison that feels pleasurable in ways that interrupt that connection with less people’s opinions about inequality. So we call these three ways, the fool, the friend, and the fairy godparent. So reality television, for example, casts the rich as either objects of derision, the fool, so to speak as people who can’t get along with their families and make bad decisions, don’t work hard. We can think about the original example of this as Paris Hilton in The Simple Life who couldn’t do basic working class labor. And so people can watch wealth, but feel superior. The second way is the friend the Us Weekly, the rich, they’re just like us celebrities.

They’re just like us. Many, many celebrities and reality television stars have mastered the art of making it seem as though they have a real social relationship with their fan base. And so people engage in upward comparison with the rich that feels similar rather than distant from those upper-class others. And then finally, the fairy godparent draws on the ideas about the American dream. We can think about shows like Shark Tank or Undercover Boss, where the rich is cast as a fairy godparent of sorts as not this distant other living in a very different life, but as the person who has made it and will help everybody else climb up and reach well. And so taking together all of these images of wealth in entertainment media, don’t work much at all, like real-world cross class experiences. They don’t make people feel resentful. They don’t make people feel distant or more aware of divides. They make people feel good. And so they don’t really fill the gap that’s left blank by lived experience.

Matt Grossmann: Americans are polarized, but partisans on each side are responsive to similar mechanism.

Meghan Condon: Self-identified Democrats and Republicans do differ in their attitudes about inequality and redistribution. We find that as well. Democrats are generally more concerned about inequality, more supportive of redistributive policies in our studies and across the work of others. In our qualitative data, we find that Republicans are more likely to emphasize personal responsibility when thinking about the poor and more likely to hold favorable views of the very rich, seeing them as hardworking and deserving of their great wealth. But at the same time, Republican voters are not as far right on economics as Republican political elites. And we see anger and resentment directed at the top of the distribution among Republicans and Democrats alike. And in fact, in our experiments, Republicans and Democrats reacted in the same way to upward social comparison. Their sense of status found they became more supportive of public policies that help level the playing field.

Meghan Condon:

So their starting points were different, but they moved in the same direction. But there are ways that Republican elites can keep voters in line with their more conservative economic position. And it’s not just by deflecting attention on two entirely different issues. One is to bring in race, ethnicity, and immigration into the picture. Remember, in our experiment where we varied the names of the economic other, white respondents who saw that Latino name got a bigger boost to their perceived status. This is a really important tactic that we see actors on the right using, that employee’s social comparison. Second, remember that because the wealthy elite are so socially invisible in real life for most people, there’s substantial difference in terms of who Americans think the elite are. People think of corporate executives, Wall Street bankers, hedge fund managers. They come to mind for some, but we also find in our qualitative data that when people think of the rich and the elite, for some they’re thinking of public employees and government workers, people with a great deal of security rather than [inaudible 00:28:04].

So for these people, it’s not income that defines those at the top of whether they have protection against economic catastrophe. The response may be a politics that seeks to remove some of the privileges that public sector employees hold, and that might be the result of upward comparison. Elites have a great deal of flexibility when it comes to framing the rich. We have a pretty unified image of the poor in our minds, but a lot of flexibility and a lot of ambivalence about what we think of the wealthy.

So focusing attention on social mobility instead of the gap between the very rich and the rest is also a strategy that political elites can use. Remember Jeb Bush called his failed 2016 bed right to rise and it’s true. American beliefs about social mobility do help temper demands for economic redistribution, but it’s interesting that a figure like Trump emerges in a time when Americans’ faith in the American dream had faltered a bit following the great recession and the long sluggish recovery.

Trump’s rhetoric fits the broader pattern in right-wing populous discourse. He often gives a one-two punch of an upward contrast that can spark resentment pointing to the elite, the rich, then joined in quick succession with a downward contrast that boosts subjective status and deflects anger onto the non elite. It’s a message that takes advantage of the anger inducing upward contrast, but pairs it with a message of downward comparison that serves to counter the potentially demobilizing impact of upward comparison.

Matt Grossmann: Kelly also finds that inequality and polarization go together.

Nathan Kelly: My story certainly overlaps a lot with the polarization story that polarization, status quo bias, all of those things go hand in hand, and those are connected to inequality and interesting ways. The thing that I think I do in the book, that’s maybe more explicit than a lot of the previous research on polarization and inequality is that I actually analyzed legislative productivity explicitly and trace the extent to which polarization leads to gridlock, which then interacts in interesting ways with economic inequality.

I think my book is really filling out the polarization inequality story more than explicitly contradicting it. That said, it seems like if you looked at polarization and gridlock and their relationship to inequality, it’s clear that the more proximate variable to inequality is, is gridlock rather than polarization. So they’re all tied up together and it’s hard to disentangle them completely. But the story I tell in the book is totally with a polarization story, but with just a more of an emphasis on legislative action and inaction rather than polarization.

With regard to the social issue emphasis, I think this is a question that probably is going to require some follow-up research. I see the possibility that part of the reason we have the shift towards social issues is because of rising inequality. I think to some extent, Democrats probably understand the strategic situation, understand that rising inequality isn’t really helpful to them in an electoral sense. And so they have gone along with the shift toward cultural issues that Republicans have also been happy to do.

So, I think that the story of my book is related to the story of a shift to culture war issues. I think the question is whether the culture war issue shift happened and then we had the rise in inequality, whether the rise in inequality really proceeded and precipitated the shift toward cultural wars issues. I think if you look at the timing, it seems to be the case that rise in inequality happened before the major shift to cultural wars issues, but these things were happening in tandem with each other. So teasing out the causal ordering there, I think is a really important question to follow up on actually.

Matt Grossmann: And he agrees that downward comparisons might help explain these dynamics.

Nathan Kelly: The economic other book is really, really useful and I think it provides a whole lot of information about one of the possible mechanisms for the aggregate patterns that I’ve seen, not just in this book, but repeatedly and other work that I’ve done as well. Exactly quantifying how much of the aggregate pattern is due to the downward comparison bias. In a sense, I think is really hard to say. I couldn’t even really guess at a quantification of that and I think it would be interesting maybe to talk about if there’s a way to sort that through and try to figure out how to piece together what proportion of the response to inequality is due to this downward comparison bias.

I mean, I haven’t thought of how to do that and maybe an obvious way that some listener is like, “Oh yeah, that would actually be very easy to do. You should just do this and they can do that, and that would be wonderful.”

Matt Grossmann: Condon points out that both projects also show economic anxiety and racial politics going together.

Meghan Condon: Nathan Kelly shows for example, that racism is associated with less support for redistribution. That this relationship has magnified when inequality is high. He hypothesizes that high inequality activates a scarcity mindset among the less of where there’s greater tendency toward out group bias and greater unwillingness to provide resources to others. We observed similar dynamics in our research. So for example, in one of our experiments, we randomly assign subjects to an economic anxiety condition where they’re first asked to write about their economic worries and financial situation before continuing on with the study.

Everyone in the study was then asked to select a news article about a person at either the top or the bottom of the income ladder to read about and compare themselves to. So they got to select their comparison target up or down. Our central finding in this study is that Americans may prefer not to make any cross class comparison if given that option, but when they must, the more economically anxious they feel, the more they prefer to compare with the poor, rather than the rich. These downward comparisons protect against ego threat.

They give us a status boost, but remember that for many white Americans, poverty is deeply racialized and thus these downward comparisons also activate racial biases among white Americans that damp and support for egalitarian policies. In another experiment, we show that white Americans, particularly white Americans without a college degree, get a particularly large boost in status when they engage in downward comparison with an ethnic racial other.

So I think that our results are broadly very consistent with anything Kelly’s work and examine more than micro foundations of some of these patterns and the social roots of some of the experiences Americans are having that are guiding their thinking.

Matt Grossmann: Americans perceive the poor more as black women and the rich more as white men.

Meghan Condon: Race is a central part of our story. If you think about economic inequality through the lens of social comparison, class politics is identity politics because we imagine the economic other as a person with race and with gender. And when we think about class and economic divides in the United States, we are thinking about race and gender, even if we don’t admit it, or sometimes even if we don’t fully recognize it.

So we’re social scientists and if we try to explain economic difference in some sort of statistical representation, we’re likely to pick one indicator. Maybe income, maybe wealth, and show you how it varies across people all on its own. Maybe we’ll bring in race or gender into the story by showing gaps or different distributions, but the economic indicator is its own separate thing. When it comes to social comparative thinking about class, economic difference is absolutely never scrubbed of race, gender, or other social categories. It’s animated by them.

Economic difference is almost literally fleshed out by social groups and identities in our minds, and this is very true, consistently true in the United States and across all of our studies. We have experiments and surveys in the book that consistently document the fact that Americans across identity groups are again, likely to imagine the poor as a black woman and the rich as a white man. That is deeply ingrained in our mind and we aren’t seeing that change.

Along with many other scholars, Amber and I believe that this welding together of race and gender and class in our public images is definitely one of the primary reasons we don’t see thinking of the poor bringing about more support for assistance. And we’re able to test this idea directly. So we ran one experiment in which we varied the identity of the person at the bottom of the ladder.

Half of the people in the study saw a name that was designed to make them assume the person was white Jake or Catherine Kowalski. The other random half saw a Hispanic name Consuela or Jose Hernandez. White subjects in this study without a college degree, which are growing part of the Republican base were much more sensitive to this treatment. And in this case, contrasting with an ethnic racial other boosted their sense of status, even above the class comparison.

Others have similarly shown that racial attitudes affect support for redistribution, and Amber and I really believe that attention to social comparison reveals the absolute impassability of solving mysteries about class in American politics without investigating race or gender.

Matt Grossmann: Kelly says the US might not stand out for inequality stimulating the impact of racial resentment.

Nathan Kelly: The question about whether the US is an outlier here, or whether the US is somehow special or has a particular problem with an inequality draft is a good one. I think that it’s highly likely that the United States is not the only country experiencing these sorts of patterns. I think it may be the case that the United States has this problem on a grander scale than other countries in part, because of the policy-making institutions that are more unique to the United States and that there is more of a status quo bias in terms of policymaking in the United States system.

But a lot of the other factors that contribute to the inequality trap in the United States are very likely to be present in other countries as well. There is comparative evidence that as inequality rises, attitudes toward immigrants and anti ethnic minority attitudes do increase. And so one of the patterns that I saw in the book was that really racial resentment, racial animosity was one of the key drivers and how people respond to rise in inequality.

So people who have more racist attitudes are much more likely to respond in a conservative direction when inequality rises. And that’s if you control for the more general ideological orientation. I mean, I think that kind of pattern it’s not specific to the United States, just because we have this particular racial history in our country. It does seem to exist in other countries as well, based on the comparative evidence.

I actually think that increasingly the United States can be seen very much as just another example of things that are happening around the world. I’ve done some work in Latin American politics and see very similar patterns in South America and central America as we see in the United States. The United States is maybe not as special as we Americans sometimes think it is.

Matt Grossmann: But Condon says Americans aren’t alone, but do have some particularities.

Meghan Condon: We do know from others’ cross national research, that the US is an outlier when it comes to support for redistribution and the public response to economic inequality. So we can add to that, that the US also has a particularly deeply ingrained public image of the poor as black and female and our empirical studies, they don’t extend to other countries. So I can’t say for sure whether Americans respond differently to social comparisons across class divides.

But what I think we provide is a framework for thinking through the forces, in any national context that drive people to make different comparisons. Forces like class segregation, economic anxiety, media exposure to class images, and the connections between social groups like race and gender and economic circumstances. All of these forces are going to govern broad patterns in social comparison across any national context. And all of those factors vary across countries. So I think investigating the politics of social comparison globally is a fascinating question.

Matt Grossmann: Is it really the public that’s the problem here? American support redistributed policies, but Condon says it’s not in a way that matters politically.

Meghan Condon: Americans do support a variety of redistributive policies, education, social safety net programs, financial reform, taxing the wealthy, and that’s true, but support isn’t as high as we might predict based on America’s levels of inequality and how inequality matters cross nationally. Further, we don’t see mass mobilization…

And further, we don’t see mass mobilization of support for policies that might reduce economic inequality in the U.S. We don’t see opinion moving further to the left as inequality rises, opinion is pretty flat, even though inequality is changing rapidly, and inequality is just not a top priority for most Americans. So while we might see majority support for some of these programs, it’s not placed at the top of their priority list. We also don’t have robust counter movements. Labor in the U.S. is weak. We see some bursts of social movement activism, like the Fight For 15 movement, but these moments consistently struggle to broaden coalitions. And the legislative victories are really piecemeal.

So we have intense opinion minorities that are pushing for redistributive action in the United States, but we do lack broad diffuse support. And this opens up space for economic elites to mobilize against any policy that threatens their position. And, of course, they benefit from polarization and gridlock and political institutions that produce status quo bias. Voters have become cynical about government capacity to address these issues and reduce trust to dampen support for redistribution. So broadly, mass support for government action to reduce economic inequality is present, but it isn’t as strong as we expect and it isn’t strong enough to counter these other forces that are driving policy.

Matt Grossmann: And Kelly adds that policy responds more to changes in views than the stable support for redistribution.

Nathan Kelly: If you look at the cross sectional time series data, there is a lot of support for redistribution. And so the question is, well, why doesn’t this happen? And so there’s this whole literature on unequal representation, and to the extent that that literature is focused on cross sections, they find a lot of bias toward upper class interests. But there’s also a lot of evidence that suggests that when the system responds to public opinion, it doesn’t respond to static public opinion, like a measurement of public opinion at a particular point in time. It responds to changes in public opinion, so you don’t need a lot of people to want something. What you need is a lot of people that want something and then they maybe even become more supportive or more people become supportive of a particular policy over time, and that sends the signal to politicians to actually do something.

And so we’ve got a lot of supporting cross sections for redistribution, but it seems like the problem is to the extent that, that opinion shifts over time, it may be being eroded, and how much of that is due to this downward comparison bias and how much of it is due to upward comparisons and a real sense of lack of efficacy as the rich just pull further and further away from everyone else? I think it is very much an open question.

Matt Grossmann: They’re both now looking at political messaging. Kelly finds that the upper class drives the issue agenda away from redistribution.

Nathan Kelly: So the new book is called Hijacking The Agenda, and I think that comparing this book to that book is a lesson in why you should get really smart co-authors to work with, because it makes the work better. I think that book is a really interesting book that brings together different skill sets to the four authors have. What we do in that book is we are focused on the agenda and the legislative process and what it is that Congress pays attention to and what they don’t pay attention to, perhaps more importantly. We looked very specifically at how campaign donations affect what members of Congress talk about. We find that there’s a fairly direct relationship to where the money comes from and what issues members of Congress talk about. We utilize some 500 million words from the Congressional record in order to figure out what members of Congress are talking about.

And we focus on upper class issues or issues that are things that the upper classes tend to care more about, and then on the other hand, issues that the middle and lower classes tend to care more about, and then we look at where the money comes from. And so part of the analysis is a quantitative analysis that looks at data from 1996 to 2007 or so, later than that, actually, we updated into the current decade, and we find the quantitative evidence that there’s a very clear correlation between money coming from business interests and members of Congress talking about the issues that business cares most about. Then we also do a series of very detailed and careful case studies of policymaking and really show how both money and just the positionality of business in the American economy, what we call and what other scholars have called structural business power, really shapes the agenda.

Nathan Kelly: And then we also show that when members of Congress are talking about things in Congress, it’s not just a bunch of hot air. What they talk about actually does translate into action eventually. So the agenda setting stage is super important, and this is really the stage where we can see money mattering perhaps most in the legislative process. So it’s a book that I’m excited about and I hope that people find it interesting as well.

Matt Grossmann: Condon and Wichoswky are looking at whether political messaging might help stimulate action.

Meghan Condon: Amber and I are working on a second book that addresses questions raised in The Economic Other. We’re investigating which political messages dominate contemporary discourse about inequality and which of those messages foster high political engagement and support for aid to the poor. We’re especially interested in how groups and candidates and leaders use race and gender in political rhetoric about economic inequality and how that affects people who hear their messages. We’ve collected a great deal of textual and visual data from candidate ads and social media debates, speeches, organizing group messages, and we’re analyzing them using some of the same techniques we used for the rhetoric of everyday Americans in The Economic Other.

And then in this new book, in a series of experiments, we’re manipulating components of inequality related messages and experiments varying the race and the gender of the comparison target, combining inequality rhetoric with mobilization messages that highlight in-group and intergroup solidarity or descriptive representation. And so our first book, the one we’ve talked about today, paints a pretty disturbing picture of national politics. And we’re in the early stages of the second book, which we’re hoping to contribute ideas about how American democratic life can be more participatory and generous even in an age of rapidly growing inequality.

Matt Grossmann: Condon says liberal politicians are trying to raise the salience of upward comparison, but they’re up against a divisive Trump strategy.

Meghan Condon: I’m not sure that Sanders and Warren are acting on our advice, but their rhetoric is definitely consistent with it. So their messaging is consistent and it’s focused on upward comparison. Others on the left, even Biden toward the end of the campaign, even the actors at the state and local level are sometimes even perhaps more effective in pairing upward comparison creatively with power building messages. And we did see this across the campaign. This is one of the things that Amber and I are investigating right now for our next book project. Trump was another story. His rhetoric is absolutely filled with cross class comparison, but not in a straight forward or unidirectional way. So we might say Sanders and Warren were constantly asking people to look up, to think about the rich, to think about the difference between the billionaire and themselves, to think about their distance from the centers of power and how the deck is stacked against them.

Donald Trump, on other hand, would use a combination of an upward and downward cross class comparison throughout his rhetoric. And one of the things he did, again, was offer this one, two punch of social comparison. So his populous messages of upper comparison, telling people they were being forgotten, underestimated, left behind, talking about the moneyed elite, the media, other advantaged parties who were looking down on them that was consistent. But then in a few different ways, often in the very next sentence or the same sentence, Trump would pivot, I mean, almost in the breath to downward comparison. So sometimes the downward comparison would be really vague saying directly, “You are the elite. You’re smarter. You’re better,” boosting that image. But often, most often, he relied on race and ethnicity to induce downward comparison immediately following that upward comparison.

He’s talking to a largely White audience and he’s inducing them to compare themselves with immigrants, Muslims, and people that he would talk about in crime ridden urban centers, which is often code for Black people. And so what his rhetoric did for his largely White audience was create a dissatisfaction and a desire for change with often a very broad brush, vague, upward comparison, and then having created that craving, given immediate boost to self-concept and status by getting people to think of people in groups that they perceive as less than or as lower status.

Matt Grossmann: There’s a lot more to learn. The Science of Politics is available biweekly from the Niskanen Center and part of the Democracy Group Network. I’m your host, Matt Grossman. If you liked this discussion, you should check out our previous episodes, including Labor Unions and Inequality, Inequality and Polarization, How Views of Inequality Change with Television, Who Speaks for the Poor in Congress, and How Local Politicians Respond to Richer and White Constituents. Thanks to Nathan Kelly and Meghan Condon for joining me. Please check out America’s Inequality Trap and The Economic Other, and then listen in next time.

 

Date                    :                     July 14, 2021

Source                :                     Niskanen Center

https://www.niskanencenter.org/why-rising-inequality-doesnt-stimulate-political-action/

 

 

Photo by: Clay Banks (Unsplash)

 

Global herd immunity remains out of reach because of inequitable vaccine distribution – 99% of people in poor countries are unvaccinated

 

In the race between infection and injection, injection has lost.

Public health experts estimate that approximately 70% of the world’s 7.9 billion people must be fully vaccinated to end the COVID-19 pandemic. As of June 21, 2021, 10.04% of the global population had been fully vaccinated, nearly all of them in rich countries.

Only 0.9% of people in low-income countries have received at least one dose.

I am a scholar of global health who specializes in health care inequities. Using a data set on vaccine distribution compiled by the Global Health Innovation Center’s Launch and Scale Speedometer at Duke University in the United States, I analyzed what the global vaccine access gap means for the world.

A global health crisis

Supply is not the main reason some countries are able to vaccinate their populations while others experience severe disease outbreaks – distribution is.

Many rich countries pursued a strategy of overbuying COVID-19 vaccine doses in advance. My analyses demonstrate that the U.S., for example, has procured 1.2 billion COVID-19 vaccine doses, or 3.7 doses per person. Canada has ordered 381 million doses; every Canadian could be vaccinated five times over with the two doses needed.

Overall, countries representing just one-seventh of the world’s population had reserved more than half of all vaccines available by June 2021. That has made it very difficult for the remaining countries to procure doses, either directly or through COVAX, the global initiative created to enable low- to middle-income countries equitable access to COVID-19 vaccines.

Benin, for example, has obtained about 203,000 doses of China’s Sinovac vaccine – enough to fully vaccinate 1% of its population. Honduras, relying mainly on AstraZeneca, has procured approximately 1.4 million doses. That will fully vaccinate 7% of its population. In these “vaccine deserts,” even front-line health workers aren’t yet inoculated.

Haiti has received about 461,500 COVID-19 vaccine doses by donations and is grappling with a serious outbreak.

Even COVAX’s goal – for lower-income countries to “receive enough doses to vaccinate up to 20% of their population” – would not get COVID-19 transmission under control in those places.

The cost of not cooperating

Last year, researchers at Northeastern University modeled two vaccine rollout strategies. Their numerical simulations found that 61% of deaths worldwide would have been averted if countries cooperated to implement an equitable global vaccine distribution plan, compared with only 33% if high-income countries got the vaccines first.

Put briefly, when countries cooperate, COVID-19 deaths drop by approximately in half.

Vaccine access is inequitable within countries, too – especially in countries where severe inequality already exists.

In Latin America, for example, a disproportionate number of the tiny minority of people who’ve been vaccinated are elites: political leaders, business tycoons and those with the means to travel abroad to get vaccinated. This entrenches wider health and social inequities.

The result, for now, is two separate and unequal societies in which only the wealthy are protected from a devastating disease that continues to ravage those who are not able to access the vaccine.

A repeat of AIDS missteps?

This is a familiar story from the HIV era.

In the 1990s, the development of effective antiretroviral drugs for HIV/AIDS saved millions of lives in high-income countries. However, about 90% of the global poor who were living with HIV had no access to these lifesaving drugs.

Concerned about undercutting their markets in high-income countries, the pharmaceutical companies that produced antiretrovirals, such as Burroughs Wellcome, adopted internationally consistent prices. Azidothymidine, the first drug to fight HIV, cost about US$8,000 a year – over $19,000 in today’s dollars.

That effectively placed effective HIV/AIDS drugs out of reach for people in poor nations – including countries in sub-Saharan Africa, the epidemic’s epicenter. By the year 2000, 22 million people in sub-Saharan Africa were living with HIV, and AIDS was the region’s leading cause of death.

The crisis over inequitable access to AIDS treatment began dominating international news headlines, and the rich world’s obligation to respond became too great to ignore.

“History will surely judge us harshly if we do not respond with all the energy and resources that we can bring to bear in the fight against HIV/AIDS,” said South African President Nelson Mandela in 2004.

Pharmaceutical companies began donating antiretrovirals to countries in need and allowing local businesses to manufacture generic versions, providing bulk, low-cost access for highly affected poor countries. New global institutions like the Global Fund to Fight AIDS, Tuberculosis, and Malaria were created to finance health programs in poor countries.

Pressured by grassroots activism, the United States and other high-income countries also spent billions of dollars to research, develop and distribute affordable HIV treatments worldwide.

A dose of global cooperation

It took over a decade after the development of antiretrovirals, and millions of unnecessary deaths, for rich countries to make those lifesaving medicines universally available.

Fifteen months into the current pandemic, wealthy, highly vaccinated countries are starting to assume some responsibility for boosting global vaccination rates.

Leaders of the United States, Canada, United Kingdom, European Union and Japan recently pledged to donate a total of 1 billion COVID-19 vaccine doses to poorer countries.

It is not yet clear how their plan to “vaccinate the world” by the end of 2022 will be implemented and whether recipient countries will receive enough doses to fully vaccinate enough people to control viral spread. And the late 2022 goal will not save people in the developing world who are dying of COVID-19 in record numbers now, from Brazil to India.

The HIV/AIDS epidemic shows that ending the coronavirus pandemic will require, first, prioritizing access to COVID-19 vaccines on the global political agenda. Then wealthy nations will need to work with other countries to build their vaccine manufacturing infrastructure, scaling up production worldwide.

Finally, poorer countries need more money to fund their public health systems and purchase vaccines. Wealthy countries and groups like the G-7 can provide that funding.

These actions benefit rich countries, too. As long as the world has unvaccinated populations, COVID-19 will continue to spread and mutate. Additional variants will emerge.

As a May 2021 UNICEF statement put it: “In our interdependent world no one is safe until everyone is safe.”

 

 

By               :          Maria De Jesus (Associate Professor and Research Fellow at the Center on Health,                                                                      Risk, and Society, American University School of International Service)

Date            :         June 22, 2021

Source        :          The Conversation

https://theconversation.com/global-herd-immunity-remains-out-of-reach-because-of-inequitable-vaccine-distribution-99-of-people-in-poor-countries-are-unvaccinated-162040

 

Inequalities Are Shaping How We’re Fighting the Pandemic — And How We’ll Remember It

 

Covid-19 infections in most countries have been hugely underestimated — not least because rich countries bought almost all the tests.

The first wave of the 1918-19 influenza pandemic did not have much impact in India; it was the second wave that was the most devastating.

It is now thought that 12 million people died in India during the flu pandemic, the equivalent of 4 percent of the population at that time. Most of these deaths were concentrated in a few short months from September to December 1918. This quote is from Punjab’s sanitary commissioner at the time:

“The hospitals were choked so it was impossible to remove the dead quickly enough to make room for the dying….; the burning ghats (cremation site) were literally swamped with corpses; the depleted medical service, was incapable of dealing with more than a minute fraction of the sickness requiring attention.”

Yet amazingly this incredible event was barely recorded. While photographic images are widely available for the 1918-19 flu pandemic in Europe, the United States, and the UK, there are virtually no such images for India.

A century later, another deadly pandemic is sweeping India, and watching our screens it feels like the only thing that has changed from a century ago is that the impact of coronavirus in India is not hidden; it is on 24-hour news across the world. The Covid-19 pandemic is many terrible things, but unlike the 1918 flu, it at least seems to be being clearly recorded and understood across the world.

Yet in fact I think this is far from the case. Instead, brutal historical and existing inequalities are not just shaping how we fight this pandemic but how we are recording it and how we will remember it too.

Twenty years before influenza hit India, there was an outbreak of bubonic plague. While it did not take nearly as many lives, it was still very serious. Unlike the influenza epidemic, there is a relatively strong photographic and written record of this outbreak. So why no pictures of the influenza pandemic?

One of the obvious differences was that, unlike the flu, other countries were not impacted by India’s bubonic plague. I think part of the reason events in India today are getting so much coverage in the Western press is probably because widespread vaccination in rich nations has meant Covid deaths at home have collapsed to very low levels.

Perhaps events in India are so terrible that they would have broken through even during the height of the coronavirus pandemic in the United States and Europe. Yet the pandemic has been as bad in Latin America from the beginning as it has been India, but this has barely registered. Queues for oxygen, overwhelmed graveyards, deaths on the street, privatized health systems leaving the poor to die — all have been pretty much a constant in Latin America for the last year.

This also says a lot about our colonial ties and historic connections. That news from Latin America barely registers time and again is partly because of a linguistic and cultural gap that itself is a product of colonialism.

The other main similarity with the influenza pandemic is something that is perhaps the ultimate inequality: lives and deaths that are not even recorded at all. The official numbers of those testing positive for Covid-19 in most countries have been hugely underestimated — not least because rich countries bought almost all the tests. In Kenya, the government is still testing about 3,000 people a day, and tests cost as much as $100. The UK is testing a million people a day.

The Economist magazine estimates that the true death toll from Covid-19 so far is more like 10 million people, not 3 million, and that two thirds of these deaths have not been in rich nations but in poor and middle-income countries. In Egypt, the level of excess deaths (the difference in the total number of deaths in a crisis compared to those expected under normal conditions) is 13 times the number of official deaths from Covid-19. Yet the story of the last year has been dominated by deaths in rich nations, and the history of the first year of this pandemic is likely to be so too.

This inequality in reporting and measuring, leading to the sense that this pandemic was not very serious in the developing world over the last year, has in turn had a major impact on the response. The drive to get vaccines to the developing world has been criminally inadequate and continues to be so.

The scenes in India, in contrast to a rich world now rapidly heading towards full vaccination, are only now finally making the issue of global vaccine apartheid and the suffering in developing countries bigger news.

Part of the reason the dramatic scenes in India are getting more coverage is in turn a result of inequality. It is because they are happening in Delhi, where global media outlets have their correspondents, and the middle classes are being impacted so tragically. The huge suffering of the poorest and of those in the countryside where there is literally no hope of any medical care of any substance is once again being barely recorded — just as it was in 1918. Independent epidemiologists believe India could be seeing not the official 4,000 deaths a day but in fact as many as 32,000.

Without hard facts, the void is filled by anecdotes and personal stories. It seems likely to me, for instance, that coronavirus is also raging across Kenya as we speak and is probably more serious now than at any point in the last year — not because the official numbers show this, but simply by the number of people I know who have lost loved ones or been sick themselves in recent weeks and months.

When my friend Doreen died suddenly and tragically from Covid-19 earlier this year, I found out by WhatsApp. I woke up one morning and sent a message to her husband Stuart to see how she was doing. Only the day before her oxygen levels had been stable and things were looking positive. Stuart’s reply was short and devastating: “Max she is no longer with us.”

I was reminded of this this week when I heard from colleagues and friends in India. They said every morning they dread switching on their phone for fear of seeing messages about friends who have died in the night. It made me reflect on the many thousands of heart-breaking messages being sent each day, each one bringing with it sadness, loss, rage, and disbelief. Beyond the selective headlines, maybe it is this most personal and intimate communication that is in some ways the more accurate record of this terrible moment in our history.

There is no doubt that Covid-19 is a huge global trauma, operating on a personal, family, community, national, and global scale all at once. Its ramifications and implications will be felt for decades to come. In her book on the 1918 influenza pandemic, Pale Rider, the author Laura Spinney asks how we can have forgotten the most lethal episode of the 20th century. I don’t think there is the same danger of humanity forgetting Covid-19.

But I do think that inequalities in the way we measure and record this pandemic have direct implications for how it is understood at the time, how it is responded to, and how it will be remembered.

And it is frightening to think that after all the world has been through in the last year, that unless something dramatic changes, most deaths from Covid-19 are yet to come. A year ago, the main barrier to beating this cruel disease was science. Today it is inequality.

 

Max Lawson is Head of Inequality Policy at Oxfam International.

 

By                   :                      Max Lawson 

Date               :                      June 7, 2021

Source           :                      Inequality.org 

https://inequality.org/research/inequality-pandemic-developing-countries/

 

There a lack of female home ownership in Latin America – here’s how can we change this

 

• Female home ownership in the developing world is a critical issue, writes the International Finance Corporation VP Georgina Baker.
• It affects both living conditions and women’s ability to build and grow their own businesses.
• In Central America, less than 40% of women have access to a bank account, and only 6% have taken out a mortgage.
• Baker explains why that's a problem and what needs to be done to change it.

For people in the developed world, a mortgage is a step toward owning a home. In developing countries, that dream is often elusive—especially for women.

Female home ownership in the developing world is a critical issue: it not only has ramifications on living conditions, but in women’s ability to build and grow their own businesses. Accessing formal credit relies heavily on collateral, namely large assets—a house or an apartment—that women often lack but which are essential to building their credit history. In many cases, women also use their homes as the base for their business.

Central America presents a clear example of this challenge. Less than 40% of women in this region have access to a bank account, and only 6% have taken out a mortgage . In comparison, 16% of women in Colombia and 13% of women in India used formal loans to purchase housing, according to a recent IFC study, Her Home—Housing Finance for Women.

These gender disparities limit women’s financial capacity and business growth opportunities. Women demonstrate greater educational performance and positive traits (such as lower default rates on their bank loans) as banking clients, but they remain woefully underserved by the financial sector. Women-owned businesses have less access to commercial loans because they tend to be part of the informal sector and therefore lack the proper documentation—for example, proof of income or real estate collateral—required to access financial services. Central America needs to break down this barrier to make its growth more inclusive and to continue reducing inequality.

With this in mind, IFC (the private sector arm of the World Bank Group), recently pioneered a new partnership with Global Bank in Panama to launch the first ever mortgage product targeted specifically toward women . The aim is to create opportunities that will tackle the two interconnected issues of housing finance for women and supporting women-owned businesses. The initiative will address the fact that women-owned businesses in Panama currently have less access to loans because they lack the real estate collateral that financial institutions require.

With one of the largest and most stable financial sectors in the region, this initiative in Panama will show the commercial viability of promoting financial products and services for women to become homeowners and use this as a gateway to receive loans to finance their businesses. This could potentially be a solution that developing economies in Latin America and other regions could replicate to expand access to capital for women entrepreneurs.

The financial sector could also stand to benefit as female homeownership is an untapped business opportunity. Despite the hurdles that women face, there is a large unmet demand for housing finance for women-headed households, particularly in developing countries . IFC’s latest study on women’s access to home ownership—covering Colombia, India, and Kenya— confirms that the women’s housing finance market is more than $70 billion in these three countries alone.

In the one of Panama’s neighboring countries, Colombia, the estimated market size for women’s housing loans is $23 billion, and 49% of women who participated in a survey planned to purchase a home or make home improvements in the next five years. While women make up half of the population, only a small fraction of them are property owners. In fact, only 8% of female-headed households in Colombia applied for a housing loan in the last five years.

Colombia is trying to address this challenge. The country started putting in place initiatives to offer subsidized interest rates for a lower income segment of the population, which includes female-headed households. In another example, India’s “Housing for All,” a Credit Link Subsidy program, provides a subsidy if a woman is on the registered title.

Latin America is also well positioned to start adopting innovative housing finance products and services geared toward women . This way, the banking sector can tap into a large underserved market and add value to their bottom line while contributing to the growth of the housing sector. The positive impacts could be widespread: for the banks, these initiatives help to attract and retain women as retail customers, while also supports women-owned businesses and thus promoting and inclusive economic growth. It’s time for women to own a home and turn their dream into a reality.

 

By                            :                        Georgina Baker (Vicepresidente, IFC para Latinoamérica)

Date                        :                         May 4, 2021

Source                    :                         World Economic Forum 

https://www.weforum.org/agenda/2021/05/women-latin-central-america-housing-houses-poverty-change-gender/

           

Photo by :  Steve Knutson (Unsplash)

 

What ancient Greek handwashing can teach us about socio-economic inequality

COVID-19 poses massive challenges nationally and globally when it comes to socio-economic inequality. It has hit the vaccine rollout especially hard, threatening new and potentially more lethal variants, while low-risk people are being vaccinated in rich countries well ahead of high-risk people in poorer countries.

Even before the pandemic was officially declared on March 11, 2020, socio-economic inequality was flagged as one of the greatest threats to the global economy.

The pandemic has only accelerated socio-economic inequality, impacting women and racialized people especially hard.

But why is socio-economic inequality so threatening to human societies and how can archeology inform public policies for mitigating it?

As an archeologist who has spent the past 13 years excavating and studying material culture at the site of Eleon, an ancient town in central Greece, I study the effects of a socio-economic collapse that took place over 3,000 years ago. By excavating and interpreting the human past, I believe that we can avoid past mistakes and build a more inclusive future.

Inequality in Mycenaean Greece

Long before Athens and Sparta were major players, Greece was home to the Mycenaeans, a Late Bronze Age culture comprising small city-states each ruled by a wanax (king).

The wanakes (kings) established their authority at feasts, where the wanax and other elites performed sacrifices to the gods. These feasts manifested and reinforced social inequalities within Mycenaean society. Inequalities between participants were emphasized by the rooms they could access within the palaces, the clothes they wore, the food they ate and even what they drank from.

Palace-sponsored feasting required contributions from individuals and communities. This had an effect on agricultural strategies, which favoured short-term intensification in production over long-term resilience.

This increased the Mycenaean elites’ vulnerability to climate change, disease and warfare. Ultimately, the Mycenaean city-states collapsed around 1200 BCE. The palaces burned and the wanakes disappeared from Greece for good.

While we are unable to identify a singular cause for the collapse of the Mycenaean Greek palatial culture, it is clear that the one per cent paid the highest price when the system went bust. A growing number of archeological studies across the globe question the economic and social impact of collapse on the 99 per cent.

The degree to which collapse disproportionately impacted elites has even led to the hypothesis that class warfare played a role in the fall of the Mycenaean palaces.

Handwashing and the performance of inequality

In a recent paper fellow archeologist Bart?omiej Lis and I examined one element of palace-sponsored feasting: handwashing.

Our research identifies handwashing equipment archeologically for the first time through a detailed study of abrasion patterns on clay vessels. We trace the origins of this equipment to Egypt, where similar metal handwashing vessels appear during the third millennium BCE.

Mycenaean elites maintained a monopoly over the earliest bronze handwashing equipment. Vessels were used for a form of purification that required both metal vessels and ritual knowledge to properly perform, preventing the custom from spreading outside the palatial elite.

Other forms of daily handwashing likely took place that did not require this equipment. Local elites performed handwashing with metal vessels to highlight their own privileged socio-economic status. Think of this showboating like gathering a few of your close friends and flying them to a tropical island for your birthday in the middle of a pandemic.

Our research found that post-collapse, Greek handwashing equipment became widely available, now manufactured in cheap clay versions. This demonstrates that some elites with knowledge of this handwashing custom survived the collapse. It also shows that the custom was no longer restricted to a specific social class. This shows how collapse functions not only to redistribute wealth and political authority, but also technology and information monopolized by elites.

While these may seem like positives, we should not forget the economic devastation brought by the collapse. Most Mycenaean infrastructure fell into disuse, settlements were abandoned and population levels plummeted. These impacts were felt for centuries.

Back to the future

The Mycenaean collapse serves as a warning: unchecked growth of socio-economic inequality increases the vulnerability of complex societies to collapse. However, the same data argues that reducing inequality can make economies more resilient to future climate challenges.

Geoffrey Kron, an expert in Greek and Roman economics, has shown how both in ancient Greece and the United States increasing economic inequality can be linked with authoritarian governments and the erosion of democracy. Governments should heed the growing socio-economic inequalities laid bare by COVID-19. Those that fail to address growing inequalities do so at their own peril.

It is easy to think that handwashing is accessible to all today, but COVID-19 calls attention to communities both within Canada and around the globe where clean water is not a given. In these communities, even the most basic defence against the novel coronavirus is a daily challenge.

While there are positive signs that socio-economic inequality is being recognized nationally in Canada and the U.S., more can be done by all governments to mitigate socio-economic inequality starting with investing in remote and traditionally disadvantaged communities.

In doing so, we can truly build back better.

 

By                  :                      Trevor Van Damme  (Postdoctoral Fellow in Greek and Roman Studies, University of Victoria)

Date              :                      April 20, 2021

Source          :                      The Conversation 

https://theconversation.com/what-ancient-greek-handwashing-can-teach-us-about-socio-economic-inequality-158405

 

Bridging the health inequality gap: an examination of South Africa’s social innovation in health landscape

 

Abstract

Background

Despite the end of apartheid in the early 1990s, South Africa remains racially and economically segregated. The country is beset by persistent social inequality, poverty, unemployment, a heavy burden of disease and the inequitable quality of healthcare service provision. The South African health system is currently engaged in the complex project of establishing universal health coverage that ensures the system’s ability to deliver comprehensive care that is accessible, affordable and acceptable to patients and families, while acknowledging the significant pressures to which the system is subject. Within this framework, the Bertha Centre for Social Innovation & Entrepreneurship works to pursue social impact towards social justice in Africa with a systems lens on social innovation within innovative finance, health, education and youth development. The aim of this study is to demonstrate the capacity for social innovation in health with respect for South Africa, and to highlight some current innovations that respond to issues of health equity such as accessibility, affordability, and acceptability.

Methods

Different data types were collected to gain a rich understanding of the current context of social innovation in health within South Africa, supported by mini-case studies and examples from across the African continent, including: primary interviews, literature reviews, and organisational documentation reviews. Key stakeholders were identified, to provide the authors with an understanding of the context in which the innovations have been developed and implemented as well as the enablers and constraints. Stakeholders includes senior level managers, frontline health workers, Ministry of Health officials, and beneficiaries. A descriptive analysis strategy was adopted.

Results

South Africa’s health care system may be viewed, to a large extent, as a reflection of the issues facing other Southern African countries with a similar disease burden, lack of systemic infrastructure and cohesiveness, and societal inequalities. The evolving health landscape in South Africa and the reforms being undertaken to prepare for a National Healthcare Insurance presents the opportunity to understand effective models of care provision as developed in other African contexts, and to translate these models as appropriate to the South African environment.

Conclusions

After examining the cases of heath innovation, it is clear that no one actor, no matter how innovative, can change the system alone. The interaction and collaboration between the government and non-state actors is critical for an integrated and effective delivery system for both health and social care.

 

By                  :                     Katusha de Villiers 

Published      :                      01 March 2021

Source          :                       Infectious Diseases of Poverty

                                             https://doi.org/10.1186/s40249-021-00804-9

                                             https://idpjournal.biomedcentral.com/articles/10.1186/s40249-021-00804-9#citeas

de Villiers, K. Bridging the health inequality gap: an examination of South Africa’s social innovation in health landscape. Infect Dis Poverty 10, 19 (2021).

 

Socioeconomic status determines COVID-19 incidence and related mortality in Santiago, Chile

Abstract

The COVID-19 pandemic has affected cities particularly hard. Here, we provide an in-depth characterization of disease incidence and mortality and their dependence on demographic and socioeconomic strata in Santiago, a highly segregated city and the capital of Chile. Our analyses show a strong association between socioeconomic status and both COVID-19 outcomes and public health capacity. People living in municipalities with low socioeconomic status did not reduce their mobility during lockdowns as much as those in more affluent municipalities. Testing volumes may have been insufficient early in the pandemic in those places, and both test positivity rates and testing delays were much higher. We find a strong association between socioeconomic status and mortality, measured by either COVID-19–attributed deaths or excess deaths. Finally, we show that infection fatality rates in young people are higher in low-income municipalities. Together, these results highlight the critical consequences of socioeconomic inequalities on health outcomes.

INTRODUCTION

The COVID-19 crisis has exposed major inequalities between communities. Understanding the societal risk factors that make some groups particularly vulnerable is essential to ensure more effective interventions for this and future pandemics. Here, we focus on socioeconomic status as a risk factor. Although it is broadly understood that social and economic inequality has a negative impact on health outcomes, the mechanisms by which socioeconomic status affects disease outcomes remain unclear. These mechanisms can be mediated by a range of systemic structural factors, such as access to health care and economic safety nets. We address this gap by providing an in-depth characterization of disease incidence and mortality and their dependence on demographic and socioeconomic strata in Santiago, a highly segregated city and the capital of Chile.

RATIONALE

Combining publicly available data sources, we conducted a comprehensive analysis of case incidence and mortality during the first wave of the pandemic. We correlated COVID-19 outcomes with behavioral and health care system factors while studying their interaction with age and socioeconomic status. To overcome the intrinsic biases of incomplete case count data, we used detailed mortality data. We developed a parsimonious Gaussian process model to study excess deaths and their uncertainty and reconstructed true incidence from the time series of deaths with a new regularized maximum likelihood deconvolution method. To estimate infection fatality rates by age and socioeconomic status, we implemented a hierarchical Bayesian model that adjusts for reporting biases while accounting for incompleteness in case information.

RESULTS

We find robust associations between COVID-19 outcomes and socioeconomic status, based on health and behavioral indicators. Specifically, we show in lower–socioeconomic status municipalities that testing was almost absent early in the pandemic and that human mobility was not reduced by lockdowns as much as it was in more affluent locations. Test positivity and testing delays were much higher in these locations, indicating an impaired capacity of the health care system to contain the spread of the epidemic. We also find that 73% more deaths than in a normal year were observed between May and July 2020, and municipalities at the lower end of the socioeconomic spectrum were hit the hardest, both in relation to COVID-19–attributed deaths and excess deaths. Finally, the socioeconomic gradient of the infection fatality rate appeared particularly steep for younger age groups, reflecting worse baseline health status and limited access to health care in municipalities with low socioeconomic status.

CONCLUSION

Together, these findings highlight the substantial consequences of socioeconomic and health care disparities in a highly segregated city and provide practical methodological approaches useful for characterizing the COVID-19 burden and mortality in other urban centers based on public data, even if reports are incomplete and biased.

 

By                :                        Gonzalo E. Mena, Pamela P. Martinez, Ayesha S. Mahmud, Pablo A. Marquet,

                                             Caroline O. Buckee, Mauricio Santillana

 

Date            :                         May 28, 2021

Source        :                         Science

                                             Science  28 May 2021:
                                             Vol. 372, Issue 6545, eabg5298
                                             DOI: 10.1126/science.abg5298

                                             https://science.sciencemag.org/content/372/6545/eabg5298.full

 

Book Review: Unsustainable Inequalities: Social Justice and the Environment by Lucas Chancel

In Unsustainable Inequalities: Social Justice and the Environment, Lucas Chancel demonstrates the role that economic inequality plays in maintaining social injustice and environmental unsustainability, exploring ways to better balance the reduction of socio-economic inequality and the strengthening of environmental protections. This is an accessible, relevant and thought-provoking analysis that uses well-presented facts and figure to unpack the intricate relationship between social injustice and environmental harm, finds Gayathri D. Naik. 

 

Unsustainable Inequalities: Social Justice and the Environment. Lucas Chancel. Harvard University Press. 2020.

‘Inequality’, ‘social justice’ and ‘the environment’ are embedded in our discussions of climate change. These three terms are always interlinked, each reverberating with the others, and this interlinkage forms the premise of the new book by Lucas Chancel, Unsustainable Inequalities. Offering an economist’s perspective, this book will surpass the expectations of all non-economics readers through its accessible analysis and inclusion of a detailed examination of social injustice and environmental unsustainability.

Chancel argues that social injustice and environmental unsustainability are connected by one common element – economic inequality. Economic inequality remains the root cause of all other inequalities across the globe. From societal interactions to international diplomacy, the possession or lack of income and wealth brings either attention or discrimination. The terminology ‘developed and developing’ itself points to economic inequalities between nations. While developed countries try to sustain their income, developing countries focus on economic development to combat poverty and inequality. Often choices of development have resulted in unsustainable environmental policies.

Spanning seven chapters, the book demarcates Chancel’s arguments in three parts. Part One discusses the sources of unsustainable development; Part Two deals with the interactions of environmental and social inequities; and Part Three outlines the implications of political, social and economic policy for reducing inequality and raising environmental protections. The trajectory of the book’s analysis is essentially twofold. Firstly, it unfolds the basic cause of all inequalities as economic inequality, which is the result of less prudent public policy choices: a fact that is now attracting more attention from international agencies than ever before. Secondly, Chancel examines the link between this inequality and environmental inequities. The book focuses attention on the principles of the 2030 Agenda for Sustainable Development and its seventeen Sustainable Development Goals (SDGs) where equality meets sustainability. The SDGs are a United Nations-led collaborative approach uniting all countries in ensuring economic development, socially equitable public policy and actions against climate change.

Throughout Unsustainable Inequalities, Chancel discusses the need and ways to balance the reduction of socio-economic inequality against environmental protection. Unless economic inequalities are addressed, the SDGs would remain incomplete. Chancel highlights the fact that environmental harm is caused by, and itself a cause of, social inequalities among present generations as well as between generations. Thus, both inter-generational and intra-generational equity are threatened.

The book underscores Chancel’s argument that while reducing economic inequality leads to improvements in the environment and ecosystems, this is not an automatic guarantee. But why can’t inequality be addressed? What are its causes that have such a devastating impact on social equality and the ecosystem? Chancel presents his findings here. Inequalities vary among nations and they have increased within nations in the twentieth century. According to him, the decrease in public wealth and the exponential increase in private wealth are key factors in the widening of wealth inequality, leading to the confinement of wealth with a few, while others live in poverty or below poverty lines without any welfare measures from the state. Additionally, technological innovation, trade and financial globalisation as well as the adoption of neoliberal trade policies have contributed to the slow death of the social state.

Sharing the benefits and burdens in natural resources has always been inequitable – be it in access to natural resources, exposure to hazards, burden-sharing in responsibility and unequal participation in policymaking as well as inequalities in enjoying the benefits of environmental policies. A parallel could be drawn here to the unequal distribution of wealth among a small number of individuals who are also highly influential in politics. The super-rich influence not only tax policies, but also policies on natural resources. A contradiction arises here as countries argue for cleaner energies to address climate change, but vehemently support the rich and powerful in the perpetuation of environmental harm.

Chancel stresses the role of natural resources energy in inequality to substantiate this point. Energy is crucial in the economic and social development of a nation, improving its economy, strengthening its health, employment facilities and improving socialisation. Access to and use of energy are unequal across the globe with developed countries like the United States leading the world’s energy consumption; in many developing countries, electricity is a dream for millions. This is true in the case of other resources like clean drinking water, healthy food and territorial resources.

Income inequality also causes unequal exposure to risk. Poor people are vulnerable to both natural hazards and human-caused environmental accidents, risking their health, life and property. Chancel highlights this through the example of discrepancies in the health impacts caused by air pollution in cities like New Delhi. These cities are not only the victims of hazards but also of unequal and untargeted policies. A vicious cycle formed by economic, environmental and political inequalities is thus highlighted by Chancel.

The book argues for the need to reduce economic inequality without compromising environmental needs. For this, substantial amounts of public investment are required in energy, water, health and transport. This needs to be supplemented by efforts to change social choices regarding energy and transport. Chancel suggests that progressive ecological taxation can be introduced where every polluter is held responsible for paying based on the legal principle of ‘the polluter pays’. The benefits of such taxation should be spent to ensure inclusiveness among the poor to enable them to switch to greener choices. For all these efforts, a coherent and collaborative approach in policymaking is required, with the participation of all stakeholders at local, regional, national and international levels.

Many point out that the poor are simultaneously significant polluters at the local (although not the global) level due to their inability to switch to unaffordable greener choices and the victims of that same pollution. Chancel shows this to be true. But why? Unsustainable Inequalities provides an answer – economic inequality. Through a simple and well-organised presentation of facts and figures, this book has unpacked the intricate relationship between social injustice and environmental harm and argues for delinking the complex nexus they form with economic inequality. This book is a highly relevant and thought-provoking read during the COVID-19 pandemic when millions are affected socially and economically by lockdowns and restrictions. Our changed circumstances have nonetheless raised hopes for a better, eco-friendly future if we have the determination to regulate our consumption and emissions.

Gayathri D Naik is a Doctoral Candidate at the School of Law, SOAS, University of London. She holds BAL.LLB (Government Law College, Ernakulam), MPA (Indira Gandhi Open University, New Delhi) and LLM (South Asian University, New Delhi). She is a Commonwealth Scholar from India. Her doctoral research looks into equity and groundwater issues in India.

 

Note: This article gives the views of the authors, and not the position of USAPP– American Politics and Policy, nor of the London School of Economics. 

 

By                     :                       Gayathri D Naik

Date                  :                       April 25, 2021

Source              :                       LSE Blogs Phelan US Centre

https://blogs.lse.ac.uk/usappblog/2021/04/25/book-review-unsustainable-inequalities-social-justice-and-the-environment-by-lucas-chancel/

 

 

 

 

Photo by :  Karthikeyan K (Unsplash)

 

Inequality and the Care Economy

 

Care work has long been considered the work that makes all other work possible.

The term “care work” encompasses both paid and unpaid work. The International Labor Organization includes two overlapping activities in their definition of care work: direct, personal and relational activities, like caring for children or nursing someone who is ill, as well as indirect care, like cooking and cleaning.

Most of the care work done around the world is unpaid and done by women and girls, often from marginalized groups. The amount of time women spend doing unpaid caregiving in comparison to men has profound impacts on economic inequality across gender.

The undervalued nature of care work also has ramifications for paid care workers. Care work has already been one of the fastest-growing sectors of the American economy, the Institute for Women’s Policy Research finds. The number of these jobs, which tend to pay less than the median annual wage across all sectors, is expected to expand further as the elderly population in the United States grows.

Domestic workers are one particular category of care workers. Domestic workers, whether they are hired by an individual or through an agency, do a wide range of work, from cleaning to personal care. The common denominator is that they work in private homes. Like all care work, the demographics of domestic workers is very gendered, analysis from the Economic Policy Institute shows.

Domestic work is also heavily racialized. Domestic workers are more likely than all other workers to be immigrants, and undocumented workers in the sector face additional vulnerabilities.

In the United States, domestic work is deeply entwined with the legacy of slavery. This legacy is why domestic workers, along with agricultural workers, were left out of the labor protections granted in the 1930s, including the collective bargaining protections of the National Labor Relations Act. This exclusion continued in various subsequent labor protections.

Domestic work is also borne out of the history of settler colonialism in the United States. Indigenous people worked during the colonial period as domestic servants, both as enslaved or waged laborers. Policies created by the Bureau of Indian Affairs institutionalized the practice. This was a part of the U.S. policy of assimilation – Indigenous girls were placed in boarding schools to learn about maintaining a household, and then placed in the homes of white settler colonial families as domestic workers.

The current realities of domestic workers reflect these racist histories. Domestic workers continue to be excluded from a variety of labor protections to this day. Working in private residences leaves domestic workers particularly vulnerable. Surveys done by the Institute for Policy Studies and National Domestic Workers Alliance have highlighted the lack of worker protections and potential for sexual harassment and abuse. This lack of protection goes hand in hand with the devaluation of domestic work. As the Economic Policy Institute shows, domestic workers face high poverty rates.

Groups like the National Domestic Worker Alliance have long organized and advocated to enshrine rights and benefits tailored to the unique challenges domestic workers face. Several cities and states have passed domestic worker bills of rights, and Rep. Pramila Jayapal and Sen. Kamala Harris have introduced a National Domestic Worker Bill of Rights in Congress.

Implementing worker protections and benefits is one crucial aspect of reducing inequalities in the care economy. So too is investment in care. A first of its kind study from the UCLA Labor Center sheds light on the California households that employ domestic workers, which total as many as 2 million,  44 percent of which are low-income.

Poor pay is also prevalent in California, UCLA found.  Four in ten employees are paid a low wage, defined as less than two-thirds the full-time median wage, which at the time of the study was $13.83 an hour. Seventeen percent were paid below the minimum wage. One in five moderate and high-income households paid a low wage despite being able to pay more, while a third of low-income households paid higher wages.

Some states have implemented programs to begin to offset the costs of providing care. In Hawaii, the Kupuna Caregivers Program provides financial assistance to employed caregivers to offset the cost of care so they can remain in the workforce. Washington has created a social insurance program to help cover the costs of elder care. The National Academy of Social Insurance has laid out a menu of options for states building towards universal family care. Modeling from the International Trade Union Confederation also shows that investments in the care economy is a more gender equitable way to stimulate employment and economic growth.

Care work is critical to the functioning of our society at any time. During the Covid-19 pandemic, this workforce, which is overwhelmingly female and disproportionately people of color, has become even more essential. The term “care work” encompasses both paid and unpaid work and encompasses both direct activities, like caring for children or nursing someone who is ill, as well as indirect care, like cooking and cleaning.

Domestic workers are one particular category of care workers. Whether hired by an individual or through an agency, this workforce performs a wide range of tasks, from cleaning to personal care, in private homes. Already a vulnerable category of workers, domestic workers are under immense stress as they serve on the frontlines of the Covid-19 pandemic. According to an April 2020 survey by the National Domestic Workers Alliance, 84 percent of domestic workers reported experiencing food insecurity, 77 percent were the primary breadwinners for their families, 72 percent reported having lost their livelihoods, and half reported lacking access to medical care during the pandemic.

As a joint survey from the Institute for Policy Studies and the National Domestic Workers Alliance shows, Black immigrant domestic workers are even more vulnerable during this crisis. More than 800 respondents in three communities — New York, Boston, and Miami-Dade County in Florida — show the scale of this crisis. As of June 2020, 65 percent reported being at risk of eviction or utility shut off in the next three months, 49 percent were fearful of seeking out government aid due to their immigration status, 45 percent had lost their jobs, and a quarter reported having their hours reduced.

 

Source                :         Inequality.org

https://inequality.org/facts/inequality-care-economy/

 

Economic inequality can help predict COVID-19 deaths in the US

 

COVID-19 has not affected everywhere in the US equally, there are significant disparities in Covid-related illnesses between the states. In new research which analyses the relationship between COVID-19 and economic, social and demographic factors, Harold Clarke and Paul Whiteley find that those states with greater income inequality are more likely to see coronavirus cases and related deaths.  

The United States has more reported cases of COVID-19 and more deaths from the virus than any other country in the world. So far, over one million Americans have contracted the disease and nearly 70,000 have died.  The incidence of Covid-related illness varies widely across the states with the number of people infected ranging from over 100,000 in New York to less than 400 in Alaska.  Differences in economic inequality are important for explaining these highly divergent health outcomes.

In 2014 the French economist Thomas Piketty published a widely cited book, Capital, which showed that economic inequality has increased markedly since the early 1970s in the US and many other countries.  Reacting to Piketty’s findings researchers have shown that inequality has many undesirable effects including significant negative impacts on public health, and the COVID-19 crisis is a case in point.

We gathered data on the number of Covid cases and fatalities in each state and developed a statistical model of the impact of economic inequality and other possibly influential factors on the pandemic.  We assess economic inequality with the Gini Index, a standard measure which varies from 0 (total inequality) to 1 (total equality).  Although economic inequality is considerably greater in the US than in other major Western democracies such as Great Britain, France and Germany, the extent of inequality also differs significantly across states within the US. For example, in 2018 the Gini varied from a low of .43 in Alaska and Utah to a high of .52 in the District of Columbia and New York.

Investigating the impact of inequality on the incidence of Covid in various states needs to take into account other potentially influential factors.  Most obvious is population size – other things equal, large states can be expected to report more cases and fatalities than small states.  Population density matters as well since inter-personal transmission of the virus will be higher in densely populated areas.  Also, older people, especially those over 65, are more vulnerable to the disease.

The size of minority populations (African-American, Hispanic) is relevant too.  People in these groups frequently are employed in blue-collar and service occupations that involve close contact with others which increases their exposure to the virus.  In addition, ethnic minorities are more likely to suffer from co-morbidities such as asthma, diabetes, obesity and cardiovascular disease that make the impact of the disease particularly debilitating and possibly fatal.

The overall health and well-being of a state’s population also is important.  We measure this using the Human Development Index (HDI) which combines information on educational attainment, annual income and longevity.  The quality of a state’s health care system is relevant as well and so we control for that.

Our analyses show that several factors affect the number of Covid cases and also deaths.  Although the percentages of African Americans and Hispanics and the over 65s do not have significant direct effects, states with larger and more dense populations have more Covid cases. Figure 1 shows that this is true for deaths as well where the coefficients measure the size of the impact of different variables on fatalities. In contrast, states with superior health care systems and higher levels of human development have experienced fewer cases and fatalities.

All these factors aside, states with greater income inequality are more likely to report more COVID-19 cases and fatalities. The effect of inequality is large – it is tied with the Human Development Index as the second strongest predictor of Covid deaths in various states.    Figure 2 shows that the predicted number of cases in a state grows nearly seven-fold, from 2368 to 14,618, if the level of economic inequality increases from its lowest to its highest observed level.  Similarly, the number of deaths climbs from 65 to fully 723 as economic inequality increases.

These large predicted effects of inequality are statistically robust. Including other possible predictors such as whether a state has a Democratic or Republican governor does not change effects.  In addition, the results remain strong if we exclude states like New York or New Jersey that have experienced very high levels of cases and fatalities.

The fact that minority populations do not directly affect the number of cases or fatalities can be understood by noting that African American and Hispanic populations tend to be concentrated in states with higher levels of economic inequality.  Members of these groups are more likely to experience negative health effects associated with greater inequality and these effects drive the incidence and seriousness of the illness.

Minorities are not alone – economic inequality works to increase the incidence and impact of COVID-19 among all segments of the US public.  Although the future course of the Covid crisis is uncertain, state-level differences in inequality are working to define how the pandemic will unfold across America in the months ahead.

 

Harold Clarke – University of Texas at Dallas

Harold D. Clarke, Ph.D. Duke University is Ashbel Smith Professor, School of Economic, Political and Policy Sciences, University of Texas at Dallas, and Adjunct Professor, Department of Government, University of Essex.

 

Paul Whiteley – University of Essex

Paul Whiteley is a Professor in the Department of Government at the University of Essex. His research interests are in electoral behaviour, public opinion, political economy and political methodology.

 

Date            :            May 6, 2020

Source        :            LSE USCentre

https://blogs.lse.ac.uk/usappblog/2020/05/06/economic-inequality-can-help-predict-covid-19-deaths-in-the-us/

 

Challenging disability stigma across sub-Saharan Africa

 

The IPC and Loughborough University have collaborated on a project – Para Sport against Stigma – to develop the reach and impact of Paralympic sport across sub-Saharan Africa.

The Paralympic Games have been a powerful vehicle in stimulating progressive social change toward greater inclusion of disabled people within sport and wider cultural life. The Paralympic movement has established itself as a forerunner in the pursuit of a more inclusive world. Its impact has raised awareness of disability rights, advocated for equal opportunity, promoted the use of assistive technologies (AT) and challenged ableist assumptions that have contributed to the cultural stigma around disability.

However, Paralympic sport has yet to reach many low to middle income countries across the Global South, where stigma associated with disability continues to reinforce social exclusion, marginalisation, and a lack of investment in infrastructure for disability sport. Indeed, there is somewhat of a global divide when it comes to equal access of Para sport.

Despite over 160 countries competing in the Paralympic Games, only around 60 countries have Paralympic sport embedded in their sports systems. This global disparity in equality and access has been recognised by intergovernmental organisations, disability rights groups, and scholars and practitioners working within the field. It also presents the single biggest challenge for the International Paralympic Committee (IPC), who aim to bring the Paralympic Games – starting with Tokyo 2020 - to Sub-Saharan Africa.

It is this challenge that has led to a partnership between Loughborough University, IPC and the University of Malawi, Chancellor College on a project entitled, ‘Para Sport against Stigma’. The project aims to develop the reach and impact of Paralympic sport across sub-Saharan Africa by harnessing the communicative and socially transformative power of Paralympic sport as a vehicle for challenging disability stigma.

It is part of  AT2030, a programme funded by UK Aid and led by the Global Disability Innovation Hub (GDIH) that aims to test ‘what works’ to improve access to Assistive Technology. Over the next four years (2020-24), the project will coordinate interdisciplinary action research within Gambia, Malawi and Zambia, working closely with local community groups, stakeholders, Universities, media organisations and National Paralympic Committees (NPC). It is a research approach that has collaboration with local communities and organisations at its core, to enable better understanding and perspective on how Paralympic sport can be localised and have effective, relevant and sustainable impact.

The research is built upon 3 pillars of activity that connect Paralympic broadcasting and media with community engagement and the development of Paralympic sport pathways. Some key activities include, for example: working with national broadcasters and the IPC to localise and adapt highlights of the Tokyo Paralympic Games to suit community radio –  an important, accessible and trusted media source that spans social class and urban/rural divides – and the inclusion of Paralympic stories from national athletes. Community education and theatre, as important sites of knowledge reproduction, will bring these stories to life and help challenge dominant disability narratives. In addition, the IPC will work to support NPC’s with development toolkits, designed to establish and maintain effective pathways towards international competition for grassroots athletes and coaches.

The project is an important platform for the growth of para sport in parts of the Global South. It is, however, not without its challenges. Disability concerns differences in ability, and we must recognise the varying perspectives and reservations held by those that live with these differences as we work to combat the stigma that has been identified.

The provision and quality of AT fluctuates across the urban and rural landscape and this must be addressed effectively through the adaption of Paralympic media content. In particular, stigma at the intersection of gender and disability requires consideration, and this project offers an important opportunity to better understand the complex socio-economic inequalities and relations that underpin the lives of many disabled women in Sub-Saharan Africa. Using the power of para sport, this project hopes to establish yet more foundations, upon which we can build a fairer and more prosperous world for those with a disability.

 

 

Dr Emma Pullen is a lecturer in the School of Sport, Exercise and Health Sciences at Loughborough University. Her main research interests include disability, gender, culture, and media.

Sam Ruddock is a two-time Paralympian that debuted for Great Britain in track and field athletics at the London 2012 Paralympic Games. After Rio 2016, he is now focusing on track cycling for Tokyo 2020. Alongside his preparations for Japan, he is a physical education and school sport coordinator in primary/elementary education.

Jennie Wong is a sport practitioner with expertise designing and managing inclusive sport programmes on a global scale.  She is currently the project manager for Para Sport Against Stigma at Loughborough University London.

 

Date                     :                   November 27, 2020

Source                 :                   Sportanddev.org

https://www.sportanddev.org/en/article/news/challenging-disability-stigma-across-sub-saharan-africa

 

 

Tackling Social Determinants Of Health Around The Globe

 

A global health equity movement relies on research showing how social factors affect health.

Social determinants of health—factors such as housing, education, neighborhood, and income—have increasingly entered health policy conversations as a growing body of research reveals the direct relationship between these so-called social determinants and health outcomes. Professor Sir Michael Marmot was an early proponent of shifting from the traditional model that focused on how health affects economic status to a new view that economic status affects health.

A renowned thinker, leader, author, and researcher on health equity in England and across the world, Marmot has led research groups on health inequalities for more than forty years. His work at the World Health Organization as chair of the Commission on Social Determinants of Health and on the report Closing the Gap in a Generation (2008) led health officials in England to ask him to apply these findings to their own country. The result was Fair Society, Healthy Lives (2010), also known as the Marmot Review.

The Marmot Review concluded with six policy objectives where action was needed to achieve health equity. Cities and regions around the world have followed this blueprint, with some, such as Manchester, England, adopting the moniker of a Marmot City. Marmot recently completed a retrospective review of progress in England toward the Marmot Review’s policy objectives. That report, Health Equity in England: The Marmot Review 10 Years On (2020), reveals areas of progress but shows that much work remains.

In 2019 Marmot brought his framework to the Americas in the report Just Societies: Health Equity and Dignified Lives—Report of the Commission of the Pan American Health Organization on Equity and Health Inequalities in the Americas. This more recent effort includes perspectives on indigenous populations, gender and sexual identity, and migrant populations while also exploring emerging environmental threats such as climate change.

Spanning the globe while also reaching into cities and neighborhoods, Marmot’s contributions to the field of health equity have changed lives, policies, and the outlook for people around the world. Alan Weil, Health Affairs Editor-In-Chief, sat down with Marmot on April 28, 2020, to discuss his work and recent events. What follows is an edited transcript. The full interview can be heard at http://www.healthaffairs.org/podcasts.

 

Alan Weil:

Let me start by having you take us back to 2010, to the original Marmot Review [Fair Society, Healthy Lives]. Your charge was to focus on health inequality in England. You took on social inequality more broadly as the dominant determinant of health. That was a bold choice. I wonder if you could say a little about what led you to take a social determinants approach when your charge was to focus on health inequality?

Sir Michael Marmot:

Well, I had chaired the WHO [World Health Organization] Commission on Social Determinants of Health. And so you might say that the bold decision was there, going to the WHO, and suggesting to the director general that he should set up a commission on social determinants of health.

At the time, and in some quarters still, the discussion about economics and health was that the direction went from health to economics. In other words, it was your health that determined your income or the health of nations that determined the economic performance of nations. I was convinced from my own research that there was an important pathway that went the other way, and we should say that. I went to J. W. Lee, who was the newly elected director general of the WHO, and suggested we set up a Commission on Social Determinants of Health to say that there is a causal pathway from social and economic conditions to health.

My view was that health was a better goal than economic performance: Even though the pathway may go in both directions, which was the more important goal? Well, I had no doubt at all! I’m a doctor. I didn’t study medicine so that I could help contribute to a bigger economy. I studied medicine because I wanted to help people be healthy, and I went into public health because I wanted to help populations be healthy. So that was, in my view, a far more important goal.

Then the British government said, “You produced this global report; how could we apply the conclusions and recommendations of your global commission to one country, England? Could you do a commission for us?” I accepted that challenge, and we set up a high-level panel of commissioners. We set up nine task groups to review the evidence tailored to a rich country, and a specific rich country: England.

The charge was to look at, as we called it in the UK, health inequalities. That meant much more than inequalities in the health care system, it meant the conditions that made people sick, which means the social determinants of health. How could we use the evidence to make the case for what needed to happen on the social determinants of health in order to improve health and reduce inequalities?

We had six domains of recommendations: early child development; education and lifelong learning; employment and working conditions; having enough money to live on, to lead a healthy life; healthy and sustainable places in which to live and work; and taking a social determinants approach to prevention—so-called lifestyle.

None of the six domains had to do with the health care system—not because I thought that the health care system was unimportant, but because everybody was looking at the health care system. That’s what people do when you say health: everyone immediately jumps to the health care system.

 

SOCIAL GRADIENT

Weil:

One element of the original Marmot Review is this notion of a gradient. Equity isn’t just about lifting up the poorest or the bottom, but it’s the entire spectrum of disadvantage. Could you talk a little more about the evidence base for that and what the implications are?

 

Marmot:

Well, there aren’t many people who could say this, but the British Civil Service changed my life. Civil servants exclude the poorest people in society, and they exclude the richest. But they certainly know about hierarchies, and [in the Whitehall Study of the British Civil Service] we saw this amazing hierarchy in health and in mortality rates by grade of employment. By definition, everyone was employed; they were largely white, we had very few immigrants, and no women. It excluded a lot of the kind of normal variations, and yet we had this remarkable social gradient.

Of course, this phenomenon was not confined to civil servants. When we were then able to look at national figures, there it was, this remarkable gradient for the country for local areas and neighborhoods, classified by the index of multiple deprivation. Life expectancy runs in a graded way all the way from top to bottom, and there’s an even steeper gradient for disability-free life expectancy.

In my 2010 Marmot Review, I coined the rather unfortunate term “proportionate universalism,” a classic British compromise. The default position of social policy in Britain, as in the United States, is to target, to means-test. You don’t get certain benefits unless you’re below some threshold. Well, the problem with that is it misses the gradient. It seems to me that we want universalist policies that apply to everybody. Rather than say: “We’ll have this service for problem families,” say: “We’ll have this service for everybody, but with effort proportionate to need.” That was the idea of proportionate universalism. It was trying to combine the commonsense benefits of targeting with the universalist approach that would deal with the gradient.

 

AUSTERITY AND INEQUALITY

Weil:

So, here you have a vision, proportionate universalism, that’s designed to be progressive. But one of the findings in the 2020 Marmot Review ten years later [Health Equity in England: The Marmot Review 10 Years On] is that Britain went through a period of retrenchment, and government investments actually became more regressive.

 

Marmot:

If you classify local authorities into quintiles by deprivation, policies over the past ten years were neatly regressive. The more deprived the area in which the local authority is located, the steeper the reduction in spending by local government. In the poorest 20 percent, there was a 32 percent reduction in per capita spending, and in the richest, the least deprived 20 percent, it was 16 percent.

Two characteristics of austerity were implemented in 2010: one, rolling back of the state, and two, having regressive social and economic policies. You can’t get away with it and think you’re not causing damage. You may have had the aim of reducing the national debt and the annual deficit. But you can’t do it and think there are no ill effects.

My 10 Years On review showed a very clear change in the curve of improvement of life expectancy. The rate of increase of life expectancy slowed dramatically and, in fact, just about ground to a halt. The inequalities in life expectancy increased by deprivation and by region. And life expectancy of the poorest women, particularly outside London, went down. So, we have at least three phenomena: stalling life expectancy, increasing inequalities, and actually a decline in life expectancy for the poorest women outside London.

I’ve shown that most social and economic policies became more constrained and more regressive over the ten years, and health inequalities got worse. I can’t say the one caused the other. It is not an experiment. But it’s highly likely that austerity and erosion of these social and economic conditions contributed to the health picture that we see.

 

ROLE OF GEOGRAPHY

Weil:

In your work you focus on the role of geography and the geographic unit. Could you expand on the role of geography and community and neighborhood and how your thinking about that role has evolved?

 

Marmot:

It’s a very interesting question. I think about geography in different ways. One is, it’s a proxy for individual characteristics. We can get data on deprivation by area much more quickly than we can by characteristics of individuals. So, on one level I think of geography as a proxy for the individual.

Then there is the second way to think about it. My colleague, Peter Goldblatt, when he was at the Office of National Statistics, showed years ago in the UK—and Raj Chetty a few years later published similar data for the US—this very interesting interaction. If you look at people of the highest socioeconomic level, there’s no regional difference within the UK in life expectancy or mortality. If you’re at the top level, it doesn’t matter where you live. You can live in depressed Newcastle-upon-Tyne or you can live in opulent London, and it doesn’t make any difference. The lower you are in the social hierarchy, the more the region matters. And that’s really interesting.

Now you could say region is a proxy for the individual, but it’s capturing something that the national socioeconomic classification based on occupation is not capturing. So, being a shop worker or a deliveryman and living in the North East, life is harder than being a shop worker or deliveryman and living in the South East of the country. And you could translate it into individual characteristics.

Or you could ask, What is it about the North East that’s different from the South East? It may relate to economic opportunities. It may relate to social conditions. It could be historical geography. I mean, it could relate to the decline of manufacturing in the North, whereas there was decline in manufacturing in the South East, but there was also the rise of the service sector, the very vibrant City of London and financial sector, in a race with New York to be the financial capital of the world, with all of the trickle-down in industry and employment that there is. So, one could think about geography as telling us something more about the lives of individuals, but also telling us something about place.

And then the third way I think about place is it’s a locus for action. We’ve talked about the fact that things went pretty poorly in terms of national action between 2010 and 2019. The only locus where there was encouragement was at the city level. So, the city of Coventry became a Marmot City. We’re working with Greater Manchester. They declared themselves a Marmot Region. We’re working with Gateshead, which is the city just across the river from Newcastle, on the Chester-le-Street side, so they’ve taken a Marmot approach to doing things at the city level.

If I ask myself, Which is more important, the national or the city level, the answer is, They’re both important. The national level sets fiscal policy, for example. Child poverty is very much affected by national policy. But there’s good reason for applauding action at the city level, not just because, well, if we can’t get national action, let’s get city action. But that is where people live and work. It is an appropriate locus of action.

 

CROSS-NATIONAL PERSPECTIVE

Weil:

You recently completed the Pan American Health Organization (PAHO) commission report [Just Societies: Health Equity and Dignified Lives]. Could you reflect on the additional challenges associated with analyzing these issues from a cross-national perspective?

 

Marmot:

Unlike the answer I gave you at the beginning of our conversation, we included health systems in the PAHO commission report because it’s important. In the UK, we have the National Health Service, which lots of people study. We have a high degree of equity of access. That’s not true when you go to the countries of the Americas. They have huge inequalities between countries and within countries. So, they are twin challenges.

In some of the South American, Latin American countries, there’s a strong tradition of social medicine that was active in the fight against military dictatorship. We needed to try and learn from that strong tradition in Argentina and Brazil and other countries, such as Chile, where they’ve been very active. They’d fought and died for their beliefs. There was a very good tradition on which we could draw, and also huge inequalities.

And there were also some particular challenges that we focused on. The health of indigenous versus nonindigenous peoples throughout the Americas united our commissioners from Canada, the United States, and the rest of the region.

Related to that, for people of African descent throughout the Americas—again, a huge issue of disadvantage. We talked about structural racism quite overtly. And we also were more explicit about gender. We certainly talked about sexual orientation and people with and without disability. So, we drew attention to several of these issues.

One thing that we did more explicitly than I’d done in my previous three reports (the global commission, the English one, and the European Review), we were much more explicit about human rights both as a value and as a mechanism—the value of respecting human rights, but also a mechanism for taking action.

We also wanted evidence from the region of what you could do, because it might be that you could adapt what was going on in the Italian city of Trieste to La Paz or Guayaquil or Rio de Janeiro. But it might be that you couldn’t very well. What’s going on in Trieste is very impressive, but it’s got this Austro-Hungarian tradition mixed with Italian. We wanted examples of what you could do in the [American] region.

 

COVID-19

Weil:

I do want to reserve a few minutes to talk about the current COVID-19 pandemic. I’m curious how your reaction to the pandemic is shaped by your work. And I’m also curious about how the pandemic shapes your views of your own work.

 

Marmot:

My view is that the COVID-19 pandemic and the societal response to the pandemic expose and amplify preexisting problems. I know the figures from Britain better, but I’m reading pieces in the New York Times that are more or less saying word for word what I’ve been saying about Britain.

Look at working from home: If you look at deciles of income, the lower your income, the less likely you are to be employed in an occupation where working from home is a possibility. So, professors can work from home, but workers in the hospitality industry can’t. Hotels have closed, restaurants and cafes and pubs and bars have closed. Those workers are either unemployed or, if they’re furloughed with 80 percent of their salary [as is the case in the UK], their income has dropped.

Something like a third of household income is spent on entertainment, dining out, and things of that nature. Well, of course, the richer the household, the more likely they are to dine out and go to restaurants and opera and even football. I mean, football tickets are so expensive, and it’s become something for the rich to enjoy. The poor people who worked in those industries are either unemployed or had a drop in income, and the people who are spending money in those industries are spending less, so they actually have more money.

Look at shelter. The same people who can work from home, probably, if they have an aging grandparent, can say, “Well, you use a separate bathroom.” I was talking to a journalist, and we were talking about a nurse living in a one-bedroom flat with two children and a husband. She comes home from a day in the wards and she’s trying somehow to get her clothes off and have a shower before she hugs her children so she can be clean. But that’s hard to do when you’re in a one-bedroom flat with a tiny bathroom.

So child poverty, education, work, income, and living conditions will all be made worse by the pandemic and the societal response to the pandemic.

Then the question is, What happens next? In 2009, the year after the global financial crisis, the global economy shrank by 0.1 percent, according to the International Monetary Fund. Now the IMF estimates that the effect of COVID-19 on the global economy is thirty times bigger than the global financial crisis of 2008. And I think they’ve underestimated.

Do you remember the Grenfell Tower fire, the high-rise housing block in London that went up in flames three years ago, and seventy-two people died? It was terrible, huge, terrible. You could think about that fire in two ways: One is it exposed the underlying problems in society, and the second is it told us that we need to do things differently. The underlying problem that it exposed was that if you look at the electoral ward adjacent to Grenfell Tower and the rich bit of the borough where Harrods is, the life expectancy gap for men is twenty-two years. Yes, the Grenfell Tower fire was a terrible tragedy, but what about the slow-burning injustice of that twenty-two-year gap in life expectancy between the poor area and the rich area within the same London borough?

Faced with the catastrophe, the conflagration, everybody—politicians of all stripes—said, “Oh, gosh, we’ve got to do something.” But what did they do about the underlying inequalities? They imposed austerity, made them worse, and fanned the flames of injustice.

So, coming back to COVID-19. We’ve got this pandemic, that’s a conflagration. What did the government do in Britain? They said, “We’ll spend whatever it takes.” The same political party that in 2010 presented debt reduction as a moral imperative, something where there was no alternative, now they’re saying, “Debt, forget it, whatever it takes.” Well, if they can do that for the conflagration, they should do that for the slow-burning injustice of persisting health inequalities. And the message of my 10 Years On report is: Whatever you do, don’t come out of this pandemic saying, “Ah, now we’ve got to impose austerity.” We have to do things differently as we emerge from the pandemic.

 

EVIDENCE OF PROGRESS

Weil:

I was hoping we could end with some positives. What do you see that encourages you?

 

Marmot:

If I showed you my diary (before COVID-19 hit), you would see that these ideas are taking off—people are concerned about it. We set up an Institute of Health Equity in Hong Kong. I was planning to go to Hong Kong, Japan, and South Korea to work on a network that we want to develop on social determinants and health equity. We were planning a meeting in Canada to promote uptake of the PAHO commission report. I was planning to go to Argentina and Brazil, and I’ve been invited to Colombia. I’m chairing a commission on the social determinants of health for the Eastern Mediterranean region of the WHO, the largely Muslim countries of that part of the world. And we’ve got lots of European activity. I can’t get to Australia as often as they invite me.

These ideas are taking off. And I’m delighted by that. There’s progress. We said at the beginning of the WHO Commission on Social Determinants of Health we wanted to create a social movement for health equity and social determinants. And I think we’ve been doing that. That’s what my diary is telling us, in every region of the world.

What’s behind it is two things. One is an increase in knowledge. We know a lot more than we did. And that comes from people working hard all over the world to produce the evidence. The second is a commitment to social justice and health. It’s both of those—it’s the evidence that people are compiling that we can make a difference and the wanting to make a difference because it’s the right thing to do, that is hugely encouraging.

We have to recapture that as we emerge from the pandemic.

Weil:

It’s been a wonderful conversation. I am grateful to you for taking the time to talk to me.

 

By                   :                 Alan R. Weil

Date               :                 July 2020

Source           :                  Health Affairs

HEALTH AFFAIRSVOL. 39, NO. 7: FOOD, INCOME, WORK & MORE   https://doi.org/10.1377/hlthaff.2020.00691

https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00691