=======================Electronic Edition========================
. .
. RACHEL'S ENVIRONMENT & HEALTH WEEKLY #654 .
. ---June 10, 1999--- .
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. WEALTH AND HEALTH .
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WEALTH AND HEALTH
The environmental movement is missing the boat on the biggest
public health issue of our time. Thirty years of scientific
research have established that the most powerful predictor of
human disease is economic inequality, but the environmental
movement, for the most part, is not paying attention to economic
issues. Of course some traditional "tree huggers" have never
spent much time worrying about human health at all. But even the
environmental justice movement -- which definitely does care
about people -- is not yet fully focused on the growing gap
between rich and poor as the main predictor of human illness.
Most environmentalists still view jobs and the economy as foreign
territory, so most environmentalists are focused on something
besides the main public health problem of our time: growing
inequality of income, wealth and status.
As the NEW YORK TIMES reported June 1 in its weekly Science
Section (and we reported in REHW #497 and #584),
"Scientists have known for decades that poverty translates into
higher rates of illness and mortality. But an explosion of
research is demonstrating that social class -- as measured not
just by income but also by education and other markers of
relative status -- is one of the most powerful predictors of
health, more powerful than genetics, exposure to carcinogens,
even smoking.
"What matters is not simply whether a person is rich or poor,
college educated or not. Rather, risk for a wide variety of
illnesses, including cardiovascular disease, diabetes, arthritis,
infant mortality, many infectious diseases and some types of
cancer, varies with RELATIVE wealth or poverty: the higher the
rung on the socioeconomic ladder, the lower the risk. [Emphasis
in the original.]"[1]
It isn't the absolute level of well-being that matters so much as
the relative level. Even among the well-to-do, those higher on
the social scale are healthier. As the NEW YORK TIMES put it,
current research is showing that a mid-level executive in a
three-bedroom home in Scarsdale, N.Y. is more vulnerable to
illness than his boss who lives in a 5-bedroom home a few blocks
away.
No one is yet sure how all the components of this problem fit
together. A sense of control of one's life is a key part of it.
Stress is another. Social exclusion and residential segregation
-- especially by race but also by class -- both have important
negative impacts. A sense of opportunity, dignity, self-esteem,
the respect of others -- all these are important for health.
Social cohesion -- a sense of neighborliness -- also plays a
role: people live longer in places where they believe they can
trust their neighbors.
As Harvard economist Juliet Schor says, "The reasons may not turn
out to be so very complicated. Humans are social. We judge our
own situations very much in comparison to others around us. It is
not surprising that people experience less stress, more peace of
mind, and feel happier in an environment with more social
cohesion and more equality."[2,pg.4]
If relative standing in the community is what matters most in
protecting public health, then the modern world has been headed
in the wrong direction for at least 20 years. Inequality has been
increasing for 20 years, and not by accident. Most households in
the U.S. have lower net worth than they did in 1983, and the
wealthy few are far wealthier than they were in 1983. Between
1983 and 1995, the inflation-adjusted net worth of the top 1% of
Americans swelled by 17% while the bottom 40% of households lost
80%.[2,pg.5] In other words, the gap between the rich and the
rest of us has widened. It is this widening gap that gives rise
to disease, research shows.
This problem is not restricted to the U.S., though the U.S.
suffers from greater inequality than any other industrialized
nation. The United Nations HUMAN DEVELOPMENT REPORT 1998 points
out that in 100 countries, incomes today are lower in real terms
than they were a decade ago.[3] And in many of these countries,
inequality has grown as small elites have become fabulously
wealthy. The HUMAN DEVELOPMENT REPORT does not say so, but these
are some of the fruits of economic "liberalization" policies and
"free trade" agreements.
Within the U.S., the growing gap between rich and poor has not
occurred by accident. It is the result of public policies and
private corporate practices intended to benefit those who own
assets at the expense of those who earn wages.[2,pg.61] Here is a
short (and incomplete) list:
** Shrinking wages. Despite some growth in wages in 1996 and
1997, hourly workers in 1998 still earned 6.2% less per hour
(adjusted for inflation) than they did in 1973 when Richard Nixon
was President.[2,pg.27]
** The minimum wage has become a poverty wage. At $5.15 per hour,
the minimum wage today buys 19% less than it did in 1979, when it
was worth $6.39 per hour, adjusted for inflation.[2,pg.27]
** The median income of young families with children was 33%
lower in 1994 than it was in 1973.[2,pg.30]
** The average worker worked 148 more hours in 1996 (1868 hours)
than in 1973 (1720 hours). That's equivalent to nearly 4 weeks
additional work each year, to make ends meet.
** At a median weekly wage of $659, union jobs pay much better
than non-union (with a median of $499). But union jobs have been
destroyed by downsizing, free trade policies, and plain old union
busting. As BUSINESS WEEK summed it up in 1994, "Over the past
dozen years, in fact, U.S. industry has conducted one of the most
successful anti-union wars ever, illegally firing thousands of
workers for exercising their right to organize."[2,pg.32] Fewer
than 14% of workers are union members now, down from 35% in 1955.
** For 20 years, companies have been withholding wages from
workers and transferring that wealth to executives. In 1980, the
average CEO in BUSINESS WEEK's annual survey made 42 times as
much as a factory worker.[2,pg.32] By 1997, the average CEO was
making 326 times as much as a factory worker.
** Pensions are slowly disappearing, and the quality of pension
programs is rapidly declining. Only 47% of workers are covered by
pension plans (down from 51% in 1979). Furthermore, there has
been a shift away from "defined benefits" pensions to "defined
contribution" plans. Under the old-style plans, a worker received
a lifetime pension of a certain amount based on years worked and
wages earned. The new-style plan takes a chunk of a worker's pay
check (which may or may not be supplemented by a contribution
from the employer) and invests it. If the investment does well,
the worker has money for retirement; if not, tough luck. Defined
contribution plans accounted for 42% of all pension plans in
1997, up from 13% in 1975. In addition, only 16% of low-wage
workers are covered by pensions, vs. 73% among workers in the top
fifth wage bracket, so pensions themselves contribute to
inequality.
** The federal government subsidizes home ownership through a tax
deduction for interest paid on mortgages for owner-occupied first
and second homes. Unfortunately, this amounts to a subsidy for
the well-off: the more you have to spend, the more your
government subsidizes you. Tax subsidies for affluent homeowners
have remained steady for 20 years while federal funding for
low-income housing has been slashed 80%.[2,pg.38]
** Savings are a thing of the past. The U.S. personal savings
rate has fallen from 8.6% in 1984 to 2.1% in 1997 and 0.5% in
1998. People are spending a larger portion of their incomes on
health care, child care, housing, and college tuition. Even the
cost of saving has risen as banks have steeply increased their
service charges, especially on small accounts that don't meet the
high minimums needed to avoid fees.
** The U.S. Conference of Mayors reports that requests for
emergency food increased an average of 14% during the period
1997-1998. One out of five requests for food assistance went
unmet. The AMERICAN JOURNAL OF PUBLIC HEALTH in 1998 reported
that 10 million Americans -- including more than four million
children -- do not have enough to eat;[4] a majority are members
of families with at least one member working.
** All members of Congress enjoy publicly financed health care,
but they refuse to extend these same benefits to their
constituents. And the private sector is walking away: in 1985
nearly two thirds of all businesses with 100 or more employees
paid the full cost of health care coverage. Today fewer than
one-third still do.[2,pg.43]
** Increasingly a college education is the key to decent wages,
but since 1989 tuition and fees have increased 94% -- three times
as fast as inflation.[2,pg.47]
** Racism is a key factor in income inequality. It is hard for
blacks to find work and when they do, they are paid less than
whites for equal performance. The NEW YORK TIMES May 23 said
"Booming Job Market Draws Young Black Men Into Fold," reporting
that the "booming" economy has created a tight labor market,
resulting in blacks getting good jobs. But deep in the story, you
learn that unemployment among black youth has dropped from its
high of 20% in the 1980s to 17% today -- still twice as high as
among white youths.[5]
** The income gap between blacks and whites is reflected in a
serious "wealth gap" as well. In 1995, the median black household
had a net worth of $7,400 -- about 12% of the median wealth of
white households ($61,000). Median black financial wealth (net
worth minus home equity) was just $200 -- a mere 1% of the
$18,000 median financial wealth of whites.
Hispanic households have even less than blacks. The median
Hispanic household had a net worth of $5,000 in 1995, just 8% of
the median net worth of white households. The median financial
wealth of Hispanics in 1995 was zero.
** Housing discrimination explains a good deal of this
inequality. According to a 1991 report on fair housing audits in
25 U.S. cities, published by the Department of Housing and Urban
development, blacks encountered discrimination more than half of
the time.[2,pg.56]
In the past 5 years, 193 studies have been published on various
aspects of socioeconomic status and health, according to the NEW
YORK TIMES.[1] The National Institutes of Health last year
declared the relationship between social status, race and health
to be one of its top priorities. The John T. and Catherine D.
MacArthur Foundation has established a Network on Socioeconomic
Status and Health.
But to most environmentalists, the idea of pressing for a
high-wage, "high road" economy -- to counter the present "low
road" rush toward low-paying, part-time jobs without benefits --
still seems like a suggestion from another planet. (See REHW
#618, #619, and #620.)
Luckily a coalition (called Sustainable America) has formed to
advocate for all of the pieces we now know we need: a high-wage
economy, clean production of needed goods and services, and a
political democracy in which people can participate in the
decisions that affect their lives. In sum, Sustainable America
is taking on the whole ball of wax.[6] It's about time someone
did.
--Peter Montague
(National Writers Union, UAW Local 1981/AFL-CIO)
==========
[1] Erica Goode, "For Good Health, It Helps to be Rich and
Important," NEW YORK TIMES June 1, 1999, pgs. D1, D9.
[2] Chuck Collins, Betsy Leondar-Wright and Holly Sklar,
SHIFTING FORTUNES; THE PERILS OF THE GROWING WEALTH GAP (Boston,
Mass.: United for a Fair Economy, 1999). Available from: United
for a Fair Economy, 37 Temple Place, Boston, MA 02111. Or:
www.stw.org. Highly recommended.
[3] HUMAN DEVELOPMENT REPORT 1998 (New York: Oxford University
Press, 1998). See http://www.undp.org/hdro.
[4] Katherine Alaimo and others, "Food Insufficiency Exists in
the United States: Results from the Third National Health and
Nutrition Examination Survey (NHANES III)," AMERICAN JOURNAL OF
PUBLIC HEALTH Vol. 88, No. 3 (March 1998), pgs. 419-426.
[5] Sylvia Nasar and Kirsten B. Mitchell, "Booming Job Market
Draws Young Black Men Into Fold," NEW YORK TIMES May 23, 1999,
pg. A1.
[6] See www.sanetwork.org.
Descriptor terms: economy; wealth and health; race; racism;
inequality;
################################################################
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****************************************************
Dennis Raphael, Ph.D.
Associate Professor and Associate Director,
Masters of Health Science Program in Health Promotion
Department of Public Health Sciences
Graduate Department of Community Health
University of Toronto
McMurrich Building, Room 101
Toronto, Ontario, CANADA M5S 1A8
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