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The Spirit Level – Why Inequality Kills

Abstract and interpretation of Wilkinson and Pickett (2010). The Spirit Level. Why Equality is Better for Everyone. London: Penguin.

Details of the research can be found at

High inequality has strong negative effects on societies, at the bottom as well as at the top. People die sooner in more unequal countries, mainly because social status has a staggering impact on health and wellbeing. Using a wealth of data and meticulous reasoning Wilkinsons and Picketts reach this conclusion: socio-economic inequality stands out as a crucial factor explaining life expectancy and many other problems like violence, drug abuse, mental illness and obesity.

More inequality increases consumption because it heightens status differences. Competitive consumption is a widely used strategy to increase status. More equality might therefore be a prerequisite for moderating consumption and creating more sustainable societies.[1]

We are the first generation to come to the end of what raising income can do for us. Raising income doesn’t make people in developed countries happier anymore. Higher income doesn’t even make us healthier. It’s predominantly increasing equality that leads to better health and more happiness.[2]


Status anxiety is the most striking socio-psychological phenomenon, leading a myriad of health problems and eventually early death. The many problems related to inequality through mainly status angst are:

  • Lack of trust (“we are less likely to emphasize with those not seen as equals”[3])
  • Mental illnesses and drug abuse
  • Physical health problems (“A sad soul can kill you quicker than a germ. – John Steinbeck”.[4])
  • Obesity (eating can provide comfort from stress and stressed people retain more fat)
  • Low educational performance (stress and perceived low status impair learning abilities)
  • Teenage pregnancies (women and men at the bottom have more children as a survival strategy)
  • Violence, homicides (violence as last resort to gain respect[5])
  • High imprisonment rates (self-reinforcing: the most effective way to turn a non-violent person into a violent one is to send him to prison[6]
  • Low social mobility (larger social distances with stronger cultural markers harder to bridge, induces stress, reinforces distances [7])

Status anxiety increases in more unequal societies because “when income differences are bigger, social distances are bigger and social stratification more important”. (p. 27) Why are human beings so sensitive to inequality?[8]

Mechanism: bad health <– stress <– low social status / lack of friends / early life stress.[9] How does it work? Psyche –> neural system –> immune system. Stress –> fight or flight response. Over short period beneficial; over prolonged periods of time leads to loss of memory, retaining fat around the waist, high blood pressure, and higher risk of infertility and miscarriage.[10]

Historic explanation: in smaller groups sense of identity was embedded in community.[11]

“To do well is … almost synonymous with moving up the social ladder.”[12] Crucial to our interaction with strangers is how they rate us; “This vulnerability is part of the modern psychological condition and feeds directly into consumerism.”[13]  Shame, “the social emotion”, is “rooted in the process through which we internalize how we imagine others see us.”[14]

Romantic love is considered less important in more unequal countries.[15]

Inequality promotes narcissism.[16] “Modesty easily becomes a casualty of inequality”.[17] In countries like the very equal Japan, modesty is valued over being self-assured. In the unequal US, it’s the opposite.

“People with high levels of trust live longer”.[18]

Women’s status is lower in unequal societies, while when women’s status is higher “both men and women have lower death rates.”[19]

Mental illnesses like depression and ADHD are related to inequality. It seems that we value ourselves in relation to others and if their standards can not be reached we become profoundly lonely and unhappy.[20] In the US, around 25 percent suffer from any mental illness, while in Japan, Germany, Spain and even Italy it’s only about 10 percent.[21]

Relationship with consumerism: “As inequality grows and the super-rich at the top spend more and more on luxury goods, the desire for such things cascades down the income scale and the rest of us struggle to compete and keep up.”[22]

Bio-Physical explanation and relationship with drugs: monkeys with low social status lack serotonine and dopamine in their brains. Status influences the occurrence of these ‘happiness hormones’ in their blood, and when given the opportunity only the low-status monkeys administer cocaine to themselves to get their dopamine levels up. Mental medicine and other drugs can be regarded as compensating for lack of low-status related hormones.[23]

“Low job status is not only related to a higher risk of heart disease: it is also related to some cancers, chronic lung disease, gastrointestinal disease, depression, suicide, sickness absence from work, back pain and self reported health.”[24] “Job stress and people’s sense of control over their work”[25] determine physical health.

Group membership also matters; “it’s not just our individual social status that matters for health, the social connections between us matter too.”[26]

“…in rich countries, there is no relationship between the amount of health spending per person and life expectancy.”[27]

“… living in a more equal society benefits everybody; not just the poor.”[28]

“Russia has experienced dramatic decreases in life expectancy since the early 1990s, as it moved from a centrally planned to a market economy, accopanied by a rapid rise in income inequality.”[29]

Overweight amongst poor people is particularly strong related to income inequality. [31]. Stressed people eat more and differently, and build fat around the waist faster.[32]. “Recent research suggests that food stimulates the brains of chronic over-eaters in just the same ways that drugs stimulate the brains of addicts.”[33] “… lessening the burdens of inequality could make an important contribution towards resolving the epidemic of obesity.”[34]

8. Education

“…performance and behaviour in an educational task can be profoundly afffected by the way we feel we are seen and judged by others. When we expect to be viewed as inferior, our abilities seem to be diminished.”[35]. Low-caste boys performed worse in experiment after they had to publicly confirm their caste.

“New developments in neurobiology provide biological explanations for how our learning is affected by our feelings”[36] When confident dopamine releases help memory, while when threatened, helpless and stressed cortisol impairs our thinking and memory. Hence inequality influences learning abilities.

10. Violence

“If you ain’t got pride, you got nothing”[37]

Increased inequality –> status matters even more. So: inequality is structural violence. Homicides and assaults are strongly associated with inequality; “So violence is most often a response to disrespect, humiliation and loss of face, and is usually a male response to these triggers.”[38]

11. Social Mobility

“Bourdieu calls the actions by which the leite maintain their distinction symbolic violence; we might just as easily call them discrimination and snobbery. Although racial prejudice is widely condemned, class prejudice is, despite the similarities, rarely mentioned.”[39] “In more unequal societies, more people are oriented towards dominance; in more egalitarian societies, more people are oriented towards inclusiveness and empathy.”[40]

Part 3 – A Better Society

“Inequality seems to make countries socially dysfunctional across a wide range of outcomes.”[41]

The effects are not just for the least well-off, but range “across the vast majority of the population.”[42]

Solutions: “greater equality can be gained either by using taxes and benefits … or by greater equality in gross incomes before taxes.”[43]. Japan is the example of the latter; after WWII the society has been rebuilt very equally, with help from outside, which resulted in an equal society with few needs for redistribution.[44]

Causality seems to go predominantly from inequality to social problems, and not the other way around. An indication for this is the fact that children of a lower caste in experiments do worse only when their caste is publicly announced.[45]

Friendship is the opposite side of the social status coin; friendship and status are to differing modes for human beings for coming together. Economic theory of free markets is built upon the idea that material self-interest is the main governing principle of human behaviour; greed is supposed to be the “overriding human motivation”.[46] “… greater equality allows a more sociable human nature to emerge.”[47]

Like Ridley (2011) Wilkinson and Pickett conclude that “our unique capacity for specialization and division of labour means that human beings have an unrivalled potential to benefit from co-operation.”[48]

“The quality of social relations has always been crucial to well-being,” to the extent that “lack of friends and low social status are among the most important sources of chronic stress affecting the health of populations in rich countries today.”[49]

“systems of material or economic relations are systems of social relations.”[50]

Human beings have both chimp and bonobo properties; the capacity to live both violently and/or co-operatively.

“… pursuit of status is often considered a masculine characteristic” but “we should not forget how much this is likely to be a response to the female preference for high-status males… Power is the ultimate aphrodisiac” (Kissinger)[51]

“A very important source of the close social integration in an egalitarian community is the sense of self-realization we can get when we successfully meet others’ needs. This is often seen as a mysterious quality, almost as if it were above explanation. It comes of course from our need to feel valued by others.”[52]

“Though equipped with the potential to empathize very closely with others, how much we develop and use this potential is again affected by early childhood.”[53]

When people are excluded the same areas are activated “as are activated by physical pain”. ~broken heart, hurt feelings. “We appear to have a desire to exclude people who do not cooperate. … The powers of inclusion and exclusion indicate our fundamental need for social integration and are, no doubt, part of the explanation of why friendship and social involvement are so protective of health. … Social class and status differences almost certainly cause similar forms of social pain. Unfairness, inequality and the rejection of co-operation are all forms of exclusion.”[54]

“Given … how [inequality] heightens competitive consumption, it looks … that governments may be unable to make big enough cuts in carbon emissions without also reducing inequality.”[55]

Looking at countries like Sweden but also surprisingly Chile, “we can be confident that it is possible to combine sustainability with a high quality of life.”[56]

“It is often suggested that invention and innovation go with inequality and depend on the promise of individual financial incentives.” This is a myth. Evidence suggests that “more equal societies tend to be more creative.”[57]

“Greater equality makes growth much less necessary. … A great deal of what drives consumption is status competition.”[58] “.. the consumption of the rich reduces everyone else’s satisfaction with what they have… Richard Layard … treated this dissatisfaction as a cost which the rich impose on the rest of society.”[59]

Competitive consumption has had important influence in 1929 and 2008 economic crises. Inequality and debt are “intimately related”.[60]

“While inequality has been rising in the USA and Britain, there has been a long-term decline in savings and a rise in debt.”[61] Even in periods of huge economic growth, debt and bankruptcy have been found related to inequality; “bankruptcy rates rose most in parts of the USA where inequality had risen most.”[62] Competitive consumption even “became one of the main drivers of the long economic boom … which ended in crisis. … Spending on advertising varies with inequality.” Working hours increase with inequality, indicating stronger pressure to consume. “People in more unequal countries do the equivalent of two or three extra months’ extra work a year. A loss of the equivalent of an extra eight or twelve weeks’ holiday is a high price to pay for inequality. … The evidence … all concurs with the view that inequality does indeed increase the pressure to consume. If an important part of consumerism is driven by emulation, status competition or simply having to run to keep up with everyone else, and is basically about social appearances and position, this would explain why we continue to pursue economic growth despite its apparent lack of benefits. …  people’s desire for more income is really a desire for higher status…”[63] “Too often consumerism is regarded as if it reflected a fundamental human material self-interest and possessiveness. That, however, could hardly be further from the truth. Our almost neurotic need to shop and consume is instead a reflection of how deeply social we are. … Consumerism shows how powerfully we are affected by each other.”[64]

“… more equal countries … tend to recycle a higher proportion of their waste.”[65]

How to increase equality? 

Start a social movement based on insights from this research.

Myths: “It is often said that greater equality is impossible because people are not equal. But that is a confusion: equality does not mean being the same.” Nor does equality means “lowering standards or leveling to a common mediocrity. Shaw: “Only where there is pecuniary equality can the distinction of merit stand out.”[66]

Politics do play a decisive role; “historical evidence confirms the primacy of political will”. While it “was once seen as a way of improving people’s social and emotional wellbeing by changing their economic circumstances”, “people are now more likely to see psychosocial wellbeing as dependent on what can be done at the individual level. … However, it is now clear that income distribution provides policy makers with a way of improving the psychosocial wellbeing of whole populations.”[67] Problems like mental illness, obesity or drug abuse are considered separately; the poor are believed to “need to be taught to be more sensible. The glaringly obvious fact that these problems have common roots in inequality and relative deprivation” has disappeared from policy makers’ views.[68]

In the US and Britain in particular, “free-market ideology and … policies designed to create a more ‘flexible’ labour force” preceded the widening income differences of the 1980s.[69] One clear mechanism is that of trade union membership; if policies do not stimulate trade unions, like in the EU (70% of earnings covered by union membership), wages at the lower end will be under constant downwards pressure, as seen in the US (15%).

Redistributive taxes (Scandinavia) or just a more equal paying society (Japan) are both ways to improve equality, and should be employed simultaneously.[70]

So how to foster policial will? First, by changing public opinion. “Political differences are more a reflection of different beliefs about the solution to problems than of disagreements about what the problems are. … For several decades progressive politics have been seriously weakened by the loss of any concept of a better society.”[71]

Corporate power offers other solutions. “Numerous corporations are now bigger than many nation states”,[72] while “democratic control of corporate power has vanishes as corporations have become increasingly multinational. “In many top companies the chief executive is paid more each day than the average worker is in a year.”[73] The ILO found that “there is little or no evidence of a relationship between executive pay and company performance”.[74]

Are there alternatives to this excessive corporate concentrations of power and wealth? Yes, and “many … are already part of our lives and flourishing all around us.”[75]

Both the non-profit sector and employee ownership in combination with participative management methods have proven to be economically and socially beneficial. “People seem to thrive where they have more control over their work. Having control at work was the most successful single factor explaining threefold differences in death rates between senior and junior civil servants working in the same government offices in Britain.”[76] The value of companies is increasingly the value of its employees. Buying a company is buying a group of people. “… the concept of a group of people being bought and sold, and belonging to anyone but its own members, is a concept which is the very opposite of democratic.”[77]

One of the authors who recently visited a company that had been bought by its employees noticed one big difference: “People look you in the eye“.[78]

“An important ideological cost of the Cold War was that America gave up its historical commitment to equality.”[79] “The scale of economic inequality which exists today is less an expression of freedom and democracy as of their denial. Who, apart from the super-rich, would vote for multi-million dollar bonuses for the corporate and financial elite while denying adequate incomes to people who undertake so many essential and sometimes unpleasant tasks – such as caring for the elderly, collecting the trash, or working in emergency services? The truth is that modern inequality exists because democracy is excluded from the economic sphere. It needs therefore be dealt with by and extension of democracy into the workplace. We need to experiment with every form of economic democracy – employee ownership, producer and consumer co-operatives, employee representatives on company boards and so on.”[80]

It pays greatly to improve equality; if in the US income inequality was brought to the level of Sweden, trust levels might rise by 75 per cent, mental illness and obesity might be cut by two thirds, teenage birth rates halved and “prison populations might be reduced by 75 per cent, and people could live longer while working the equivalent of two months less per year.”[81]

“Political will is dependent on the development of a vision of a better society which is both achievable and inspiring. … a more equal society in which people are less divided by status and hierarchy; in which we regain a sense of community, in which we overcome the threat of global warming, in which we own and control our work democratically as part of a community of colleagues, and share in the benefits of a growing non-monetized sector of the economy.”[82]

“We know that greater equality will help us rein in consumerism … We have seen that the rich countries have got to the end of the really important contributions which economic growth can make to the quality of life and also that our future lies in improving the quality of the social environment in our societies”.[83]


Side notes:

“The evidence shows that reducing inequality is the best way of improving the quality of the social environment, and so the real quality of life, for us all.” (p. 29)

Zygmunt Bauman (2011) asserts that governments focus increasingly on security while people long for safety. The preference for security, in the form of gated communities and so on, is rooted in (perceived) inequality.[84]

Link Bateson: inequality is quality of relationship; a typical difference that makes a difference.

The hidden importance of status differences I recognize from the practice of theatre. Status games, strategies to render an on stage character higher or lower than other characters, are one of the best ways of making the audience believe in a scene. Keith Johnstone’s work on improvisation shows this in a very clear way.[85]

  1. [1]p. 217-
  2. [2]p. 77. The Big Idea, p. 81
  3. [3]p. 56, attributed to De Toqueville
  4. [4]p. 73
  5. [5]p. 140
  6. [6]p. 154
  7. [7]p. 163
  8. [8]p. 31
  9. [9]p. 39
  10. [10]p. 85-86
  11. [11]p. 42
  12. [12]p. 40
  13. [13]p. 42-43
  14. [14]p. 41
  15. [15]p. 44
  16. [16]p. 42
  17. [17]p. 45
  18. [18]p. 57, referencing to Barefoot, Maynard, Beckham, Brummet, Hooker, Siegler (1998), Trust, health and Longevity. In: Journal of behavioral medicine 21 (6): 517-26.
  19. [19]p. 60
  20. [20]p. 65
  21. [21]p. 67
  22. [22]p. 70
  23. [23]p. 71-72
  24. [24]p. 75
  25. [25]p. 75
  26. [26]p. 79
  27. [27]p. 81, my emphasis (SJ)
  28. [28]p. 84
  29. [30]
  30. [29]p. 87,

    7. Obesity

    “Food is the most primitive form of comfort. – Sheila Graham”[30]p. 89

  31. [31]p. 93
  32. [32]p. 95
  33. [33]p. 96
  34. [34]p. 103
  35. [35]p. 113
  36. [36]p. 115
  37. [37]p. 133
  38. [38]p. 140
  39. [39]p. 164
  40. [40]p. 168
  41. [41]p. 174
  42. [42]p. 174
  43. [43]p. 184
  44. [44]p. 242
  45. [45]p. 194
  46. [46]p. 199
  47. [47]p. 199
  48. [48]p. 201
  49. [49]p. 201
  50. [50]p. 202
  51. [51]p. 207
  52. [52]p. 209
  53. [53]p. 213
  54. [54]p. 215
  55. [55]p. 217
  56. [56]p. 221
  57. [57]p. 225
  58. [58]p. 226
  59. [59]p. 227
  60. [60]p. 296
  61. [61]p. 227
  62. [62]p. 228
  63. [63]p. 228-229
  64. [64]p. 230
  65. [65]p. 232
  66. [66]p. 237
  67. [67]p. 238
  68. [68]p. 239
  69. [69]p. 244
  70. [70]p. 247
  71. [71]p. 248
  72. [72]p. 251
  73. [73]p. 250
  74. [74]p. 250
  75. [75]p. 252
  76. [76]p. 256, my emphasis
  77. [77]p. 257
  78. [78]p. 259
  79. [79]p. 263
  80. [80]p. 264
  81. [81]p. 268
  82. [82]p. 271
  83. [83]p. 272
  84. [84]p. 58
  85. [85]See Johnstone (1979).
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