Comments on: Inequality as a Political Phenomenon

By: Patrick S. O'Donnell

Patrick S. O'Donnell — Wed, 25 Jun 2008 16:38:13 +0000

Orin (and anyone else interested in this discussion):

I’ve put together a short (hence manageable) list of books that should help persuade one of Daniel’s claims made here and filled out in his post at the Medical Humanities Blog (i.e., of the salience of equality/inequality issues when it comes to achieving public health goals):

Anand, Sudhir, Fabienne Peter, and Amartya Sen, eds. Public Health, Ethics, and Equity (New York: Oxford University Press, 2004).

Daniels, Norman. Just Health: Meeting Health Needs Fairly (Cambridge, UK: Cambridge University Press, 2008).

Davis, Marion, Carolyn Clancy and Larry R. Churchill, eds. Ethical Dimensions of Health Policy (New York: Oxford University Press, 2002).

Farmer, Paul. Infections and Inequalities: The Modern Plagues (Berkeley, CA: University of California Press, 1999).

Farmer, Paul. Pathologies of Power: Health, Human Rights, and the New War on the Poor (Berkeley, CA: University of California Press, 2003).

Henderson, Gail E., et al., eds. The Social Medicine Reader, 3 Vols. (Durham, NC: Duke University Press, 2005).

Marmot, Michael and Richard G. Wilkinson, eds. Social Determinants of Health (New York: Oxford University Press, 2006 ed.).

Smith, Richard, et al., eds. Global Public Goods for Health (New York: Oxford University Press, 2003).

By: Daniel S. Goldberg

Daniel S. Goldberg — Wed, 25 Jun 2008 08:42:18 +0000

Orin, your questions got me started on a lengthy and somewhat desultory response, so I moved it to my own blog here:

http://www.medhumanities.org/2008/06/on-income-inequ.html

By: Orin Kerr

Orin Kerr — Wed, 25 Jun 2008 05:04:46 +0000

Thanks, Daniel. Just to be clear, when you refer to the correlation between income inequality and health, you mean that societies with low inequality tend to have better physical health than societies with high inequality, right? If so, is the idea that they correlate with something else, or that inequality determines physical health? (And if the latter, how?)

By: Daniel S. Goldberg

Daniel S. Goldberg — Tue, 24 Jun 2008 23:22:50 +0000

While most people can agree that not all inequalities are inherently unjust, there is a sizeable body of data showing a non-artifactual and robust correlation between the overall income inequalities of a society and its health. The details of this relationship remain quite cloudy in many areas, which is in part why the correlation itself remains an intensely-studied phenomenon, which it has been for over 20 years.

But the existence of the correlation is robust, persistent, and is almost certainly not an artifact. The bottom line is that there is very good reason for doubting on the population level that significant income inequalities are good for “everyone” in the pareto optimal sense Orin suggests. Societies with larger socioeconomic disparities generally fare worse in the vast majority of health indicia one chooses to use.

There are a number of good sources for this argument, though I’m particularly partial to Ichiro Kawachi’s book, “The Wealth of Nations.” Some of Sen’s work is also excellent on this.

By: Orin Kerr

Orin Kerr — Tue, 24 Jun 2008 21:09:07 +0000

Is income inequality good or bad?

If Frank and I make the same salary, and Frank gets a big raise and I get only a medium-sized raise, both Frank and I are richer. And yet the raises have created income inequality. In that case, aren’t we both better off with inequality, though?