I’ve just been reading in a fascinating book, Behave, by neurologist Robert Sapolsky, and some of the conclusions he cites about how inequality negatively affects health struck me as critical to publicize right now, in our increasingly unequal society.
Begin with this: It’s not so much being poor that predicts poor health. It’s feeling poor. That is, how you feel, financially, when you compare yourself with other people, is the key.
Now here are some explanations for how this works. First, a psychosocial explanation: lower social capital (the collective quantity of resources such as trust, reciprocity, and cooperation available; in brief, being able to count on your society and other people for support) means higher psychological stress. That is, the less you can count on your society and other people, the more you’ll be stressed. And upping the stress response negatively affects health in a wide variety of ways. Briefly, stress causes the adrenal glands to release glucocorticoids (the ‘fight or flight’ response), which in turn quickly mobilize energy from throughout your body, increase heart rate and blood pressure to deliver energy to muscles needed for a physical challenge. The problem is that we humans often activate a mental component—an anticipatory stress response, ahead of a real challenge; which is fine if a real challenge comes. But if one is constantly convinced a challenge is coming when it isn’t, then one can become anxious, neurotic, paranoid or hostile: e.g. psychologically stressed. And such chronic psychological stress leads to serious metabolic problems: high blood pressure, diabetes, and suppression of the immune system leading to vulnerability to all kinds of ailments.
Second, what’s called a neomaterialist explanation comes from Robert Evans of the University of British Columbia and George Kaplan of the University of Michigan. This is the one that intrigues me. The idea is that “if you want to improve health and quality of life for the average person, you spend money on public goods—better public transit, safer streets, cleaner water, better public schools, universal health care”; in short, on social capital, such as they have in Denmark, say. But the more unequal a society is (which is to say, the greater the income gap between wealthy and average citizens), the less benefit the wealthy feel from policies that improve public goods. ‘What good does public transit, or childcare, or clean water, or public parks do me?’ is the idea. So then, what do the wealthy benefit from? Why from dodging or lowering taxes to keep more for themselves, and then spending their money on goods and services that benefit old number one—luxury cars with a chauffeur, private golf courses, gated communities that keep out the riffraff, bottled water that evades the public system, private schools for their kids, private luxury health plans. Evans puts it this way:
“The more unequal are incomes in a society, the more pronounced will be the disadvantages to its better-off members from public expenditure, and the more resources will those members have to mount effective political opposition” (e.g., lobbying by corporations and the wealthy to reduce public spending on social capital).
Evans actually calls this the “secession of the wealthy” (comparisons to the secession of the South to bring on the Civil War are clear), and shows how it promotes “private affluence and public squalor.” Luxury for the haves, squalor for the have-nots, in short.
But this isn’t all. Increased inequality also tends to increase crime and violence. Why? It’s related to that initial notion: it’s not how poor you are, but how poor you feel. That is, poverty amid a culture of conspicuous consumption is a big predictor of crime—as studies show all across America, and indeed throughout industrialized nations. But why? Both because of the psychosocial element: inequality means less social capital, less trust, cooperation, and people watching out for each other. And also because of the neomaterialist element: with inequality comes more secession of the wealthy from contributing to the public good (states with more income inequality spend proportionately less money on that key tool against crime, education). Both together lead to more crime.
And finally, another kicker. As has been shown with experimental animals, if you shock a rat electrically, his stress response shoots up. But if that rat can quickly bite another rat (i.e. taking his stress out on a lower-ranking rat), his stress response is far less. It’s the kick-the-dog syndrome. And it has been shown experimentally with baboons as well: one of the best ways to reduce glucocorticoid secretion is for a high-ranking baboon to displace his aggression onto a lower-ranking baboon: a male loses a fight and then chases a lower-ranking male, who promptly bites a female, who then lunges at an infant. In human societies, displaced aggression is as common as dirt: one study measuring effects with football showed that if the local football team unexpectedly lost, violence by men against their wives or partners increased by 10%, and even more (13%) when the losing team was in a playoff. This operates in poor areas even more graphically: instead of the poor rising up to attack the wealthy who cause their problems, most often they prey on their poor neighbors nearby. And crime in poor neighborhoods is one of the pervasive problems leading to anxiety, poor health, and more.
Starting to sound familiar? Starting to sound like a society you’re familiar with? It’s as if the current U.S. government, especially the Republican sector now controlling whole chunks of it, has taken this whole section and memorized it, and set out to engineer as much of the “secession” of the wealthy as they possibly can. This is why their mantra is always, cut government spending (i.e. cut those social capital programs that help the majority—good schools, healthcare, safe neighborhoods, clean water) and privatize everything from schools to roads to water to power. This is exactly what the Trump Administration is trying to do, mainly through the cabinet heads they’ve appointed to reduce and dismantle government programs and regulations. And by their upcoming push to take an axe to taxes on corporations and the wealthy. And by crippling Obamacare. And by starving schools of necessary funds so they can be privatized. And on and on.
And until the rest of us finally wake up and start to reverse the deadly slide of the United States of America into banana-republic status, we’re all (those of us who aren’t wealthy, that is) going to keep getting unhealthier by the minute.