The world was more equal 200 years ago than it is now. Data from the World Bank and the United Nations shows that the world GINI coefficient was just over 0.4 in 1820 and is nearer 0.7 now. The GINI coefficient measures income inequality. In an area that was perfectly equal the score would be 0 and in an area that is perfectly unequal the score would be 1. So we are in a world that is approaching being twice as unequal now as it was in 1820.
But we have not been on a steady march towards being more unequal over the last two centuries. Robert Putnam (Policy Academic and Clinton Advisor) has suggested that patterns of inequality may be cyclical. He has been monitoring inequality in the USA. In a recent talk to the Environics Institute and the Munk School of the University of Toronto he reported that the USA was about as equal in 1910 as it is now. But it was more equal from 1910 to the mid 1960s before regressing to where we are now.
There is some evidence that Canada’s trajectory may be the same, though reliable data from 100 years is hard to find. What we do know from reports at the World Bank and UN is that like the USA, Canada is becoming more unequal. Despite the fact that we have been doing well financially, with our GDP per capita increasing 20 fold since 1961, our GINI has been slowly creeping up. It now sits at about 0.44. Or, in other words, income inequality in Canada is worse than it was across the world in 1820. In our defence, our tax system does lead to some re-distribution but it still leaves Canada a long way behind most of Europe including France, Germany and the Scandinavian countries with regards to income equality.
And our trajectory is concerning. The share of our country’s income that goes to the top 10 percent of earners has increased over the last 30 years while the share for the lowest 20 percent of earners has decreased. Our investment in the future has also decreased; the percentage of our GDP the Government spends on education has decreased from nearly 8 percent in 1971 and was just over 5 percent in 2011. Our collective efforts are going the same way. Union membership is down. The percentage of workers in Unions has decreased from 37 percent in 1981 to 30 percent in 2011. We seem to be spending less money on society while some individuals are getting richer. As we vote for lower taxes, less investment in people and fewer controls on business it seems there is a move from a “we” society to a “me” economy.
The academic literature and organizations like the World Health Association, World Banks and Harvard School of Public Health all agree that increasing income inequality and lower investment in people is bad for the health of the population.
Toronto has seen this. Despite the fact that the city has boomed and is richer than it has ever been, income inequality has increased and this is having an impact on health. Toronto public health produce a report called The Unequal City. It uses 34 indicators such as life expectancy and other health metrics to produce a picture of the City. Twenty-one of these indicators show a clear pattern where low income groups have worse health than high income groups. Over the last decade there has been a decrease in health inequalities in only one of these 21 areas. Inequalities have stayed the same in 16 areas but health inequalities have become worse in the remaining four.
Quoting from the Unequal City report:
“When compared to the highest income groups Men in the lowest income group are 50% more likely to die before age 75. The relationship between income and premature mortality has not changed over time and inequities have persisted.
- Women in the lowest income group are 85% more likely to have diabetes. The relationship between income and diabetes was significantly stronger in 2012 than it had been in 2003.
- Young women aged 15 to 24 in the lowest income group are twice as likely to be reported with chlamydia infection. The relationship between income and chlamydia incidence has not changed over time and inequities have persisted.
- Babies in the lowest income group are 40% more likely to be born with a low birth weight. The relationship between income and the rate of low birth weight births has not changed over time and inequities have persisted.”
Toronto Public Health call for better services and population based planning to try to decrease health inequities. However, it would seem that there needs to be a cultural change if we are going to be able to deal with the problem of income and health inequity. We need to look at progressive taxation to decrease our GINI score. We need to work out if we have the right level of investment in education and other social determinants of health such as housing. If union membership is decreasing we need to think about protection for the increasing numbers of people in precarious jobs. In general we need to think about whether as a rich country we want a “me” economy or we prefer a “we” society where we invest in offering the best life to the most people.
Despite our wealth and our amazing scientific progress it looks like Canada was looking after society better 50 years ago than we are now. But that simply shows that we can do it if we want to.