Ryan_m_b said:
Relative poverty is a very important measure. There have been a wealth of studies showing that relative poverty causes health problems, even amongst people of the same socioeconomic class working in the same places doing similar jobs. It's not just imagined out of thin air due to some European liberal ideology.
I disagree with basically all of that - even the part about it being "European" - it is just liberal; it most certainly applies to American liberals.
"Important" is strictly a matter of opinion: clearly this matters to liberals. But that does not mean that there are real-world effects (or, rather, that they are correct about what those real-world effects are). I've never seen convincing evidence that there are real-world effects...so let's have a look:
It doesn't take much searching on pubmed or a similar site to find epidemiological studies into this, for example:
http://epirev.oxfordjournals.org/content/26/1/78.full.pdf
It is widely acknowledged that individual income is a
powerful determinant of individual health. It is also
acknowledged that the relation between individual income
and health status is concave, such that each additional dollar
of income raises individual health by a decreasing amount.
Agreed. But that isn't what you claimed. You claimed that inequality itself causes health problems, not that lower income causes health problems. The difference - again - is that in a poor economy, incomes go down and inequality also goes down. By your measure, a recession should
improve the health of a nation whereas the paper you cite means that a recession would
worsen the health of a nation.
Indeed, the paper even is careful to say "income poverty" (absolute poverty) in its discussion: it never cites relative poverty at all. Inequality and relative poverty are not the same thing: this paper is not discussing your point, it is discussing inequality. Inequality and relative poverty are not the same thing. Inequality has its own measure: gini coefficient. But I'll still bite:
The reason for this disconnect between what appears to be the popular liberal view and what the paper says is obvious and has been discussed before: the liberal ideology holds that there is a fixed-pie and that if someone is taking a bigger piece (fractionally), another person must take a smaller piece (by volume). But this is simply factually wrong: the pie is
not fixed in size: it grows (and occasionally shrinks), so in reality, the volume of your piece over time can still grow as the fraction you get goes down. And this is in fact exactly what happens over the long-term:
1. Incomes in all sectors rise.
2. Inequality rises.
3. Health in all sectors improves.
Now the paper does go into the issue of inequality itself:
First, in a comparison of tables 1 and 2, it is evident that
the bulk of studies that suggest an association between
income inequality and poor health have been conducted so
far within the United States (16–25). However, even within
the United States, several studies have not corroborated this
association (26–30).
Second, studies conducted outside the United States have
generally failed to find an association between income
inequality and health (31–35).
Again, the reason for the discrepancy should be obvious: European countries don't have an association between inequality and health because Europeans countries all have nationalized healthcare and Americans don't! So Americans' health is more impacted by income than Europeans.
I believe that the results of the studies into the impact of inequality itself in the US are mixed because it is very difficult to separate the different effects. But
if the hypothesis that inequality itself impacted health were correct, it should show up in European studies because the European studies remove the most obvious confounding variable: the quality of the healthcare.
The study appears to be aware of the issue and tries to explain it away:
. The absence of an association between income distribution and health in the countries listed on table 2 may therefore reflect a threshold effect of inequality on poor health.
When we turn to countries that are relatively more unequal than the United States (e.g., Chile (table 2)), we find some support for the relation (37).
So the general hypothesis that inequality impacts health failed. The alternative hypothesis is that inequality only impacts health when it is above a certain threshold. I think the lack of comment on the lack of national healthcare is a glaring omission (caveat: I haven't finished reading), but either way, the association cannot be as strong as people like to think.
This is an interesting study in that it is a meta-study listing the results of many individual studies. You said "There have been a wealth of studies showing that relative poverty causes health problems..." That's literally true, but I don't think that's what you meant because as they show, the opposite is also true: there have been a wealth of studies showing that relative poverty
does not cause health problems. I think you mean to say that the studies tend to agree and show conclusively that there is an impact. They do not:
Using the existing evidence, can we conclude that income
inequality is a public health hazard? The answer to that question is far from settled...
Ryan said:
Just because absolute poverty has been almost eradicated in the western world doesn't mean we can sit back and declare everything is fine...
Unless you believe that whether or not one is poor or rich is purely down to personal choice I can't see why anyone would be opposed to policies aimed at measuring and addressing this.
That's a strawman. I've never said that everything was fine or that we shouldn't work to fix issues with poverty - here or anywhere else. What I say is that accurate understanding of problems and useful discussion of them requires
useful and honest statistics and in my opinion, relative poverty is not a useful and honest statistic. To be clear, I think the OECD's adding of a chained threshold is an acknowledgment that the stat has failed to show what it is designed to show. But I also think - and this part is opinion - that the statistic was created for political purposes in the first place.
The fact remains that the poorer classes in society face significant bigger health problems (amongst others but health is the area I have encountered most research on) than those above.
Again, that point is not being debated - I don't know if I'm misunderstanding you or you are misunderstanding me, but it is obvious that in a country where you buy your own healthcare, having more money means having better healthcare. But that isn't what you said before: you said inequality causes health problems. That's a very much different claim. You seem to be reading a lot of things from my posts that I haven't said.
