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Institute of Health and Wellbeing Early Career Researchers' Blog

IHAWKES election special part II: Professor Andy Gumley

  • May 06 / 2015
  • 1
Current Affairs

IHAWKES election special part II: Professor Andy Gumley

£1 doesn’t mean the same thing to all:

One remarkable moment in the electoral campaign was David Cameron’s reassurance to the UK public that the proposed Conservative budget cuts amounted to a £1 reduction for every £100 – something that every family or business could cope with. I guess in a society where the principle of equality is cherished and where policies are geared towards improving equality and minimizing inequality then such reassurances are well grounded.

Equality is related to better physical health, greater feelings of trust and lower levels of violence. Inequality measured by how much richer the top 20 percent than the bottom 20 percent is in each country, is related to increased rates of mental illness (r=0.73) and drug problems (r=0.63).

Psychosocial factors are key in understanding the associations between income inequality and health where social hierarchical organisation favours those ranked highly and disfavours those ranked at the bottom. Internal threats arising from the experience and perception of inequality increase stress through feelings of shame, threat and distrust, which acts on psycho-neuro-endocrine mechanisms. External threats acting on the person include exposure to antisocial behaviour, reduced civic participation, less social capital and reduced social cohesion increase feelings of disconnectedness, loneliness and paranoia.

Not just perception of rank but the availability of resources within systems are key to understanding the health effects of social hierarchies. Lynch and colleagues (2000) argued “the effect of income inequality on health reflects a combination of negative exposures and lack of resources held by individuals, along with systematic underinvestment across a wide range of human, physical, health, and social infrastructure” reflecting the manifestation of the sum of historical, cultural and political-economic processes.

In the past 30 years alcohol and drug-related deaths, violent deaths and suicide have increased to a greater extent in Scotland compared to the rest of the UK and Europe. Physical health inequalities have increased in Scotland relative to the rest of the UK evidenced by premature death due to cardiovascular disease, cancer and stroke. McCartney and colleagues have shown that these increasing inequalities are associated with the Index of Economic Freedom (or in other words the extent to which neoliberal or monetarist economic policies predominate).

So £1 isn’t the same to every individual and neither is £1 the same to every community or every nation within the UK. Problems of inequality and its terrible consequences cannot solved by austerity. Austerity can only further hit the more vulnerable groups in our society who already experience greater risks of disconnection, alienation and hopelessness. What’s happened in Scotland during the last 30-years in terms of inequality and what is happening in Scotland during this election provides an important opportunity for UK based parties to start to seriously rethink the impact of policies that increase inequality, and the associated costs to us all. Maybe adopting a principle of Equality in the UK would be a good start.

References:

Lynch, JW., Davey Smith, G., Kaplan, GA. & House, JS. Income inequality and mortality: importance of health of individual income, psychosocial environment or living conditions. BMJ. 2000 April 29; 320(7243): 1200–1204.

McCartney, G, Walsh, D., Whyte, B., & Collins, C. (2011) has Scotland always been the ‘sick man of Europe’? An observational study from 1855 to 2006. European Journal of Public Health, Vol. 22, No. 6, 756–760

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