Cure health inequality by reducing income inequality

Cure health inequality by reducing income inequality

The relationship between health and social context includes a range of factors influencing overall well-being. Social status, class, lifestyle, education, and environment primarily shape these factors. Age, gender, race, and ethnicity are structural variables of equal importance to health outcomes. Health is being facilitated or inhibited by the socioeconomic, cultural, and political backgrounds, in which one is born and raised. The people that view these data points and makes correlations between socioeconomic status and backgrounds to health issues have an interesting career because they constantly have to adapt to the understanding of new societal groups and focus on why a certain group would make a certain decision, for example.

In the last few decades, we have seen growing income inequality between the poor and rich. Since the 1980’s, the United States of America has seen a shift in wealth from the middle class towards the wealthiest people and transnational companies. The top one-tenth of 1 percent owns as much as the bottom 90 percent. Firebaugh and Beck argued economic growth would automatically benefit the masses, which in hindsight seems questionable.

As health outcomes and life expectations closely liaise to within-country income inequality, policies should aim at finding appropriate actions to address this phenomenon. Meaning, getting basic family urgent care, in terms of medical needs cannot be compromised. Currently, in some countries, those who earn more are able to find medical treatments to treat their injuries or illnesses, whilst those who don’t have as much money are having to cope with their illness or find other treatments. For example, those who suffer from digestive problems would have to pay a significant amount to get their illness looked at, so people on lower incomes will find supplements to help them instead. The bio complete 3 supplement can deliver prominent improvements for people’s digestive systems, so people are able to treat these problems. However, not all problems can be treated with supplements. This is why changes have to be made.

Wilkinson and Pickett found health issues to be strongly correlated to income inequality within a country. To support this finding, they used two different measurement tools. The first index, applied to Western countries, was a ratio of the 20 percent top incomes in relation to the 20 percent of the bottom earners. For different states within the USA they used a second index, the Gini-index, which adopts a different methodology. Where ‘Gini = 0′ represents perfect equality (same income for everyone) and ‘Gini = 1′ is total inequality (if all income goes to one person). The outcome of these results showed that the widening income gap led to an increase of different health issues related to mental disorders, life expectancy, infant mortality, obesity and teenage births. Societal problems that correlated to income inequality included: lower levels of trust, less educational performance, more homicides, higher imprisonment rates and a lack of social mobility. Some authors found Wilkinson and Pickett’s dismissal of poverty in relation to health outcomes incorrect as they did not measure it. On the other hand, research by Beckfield and Bambra confirmed the correlation between life expectancy and health stating that the lagging welfare state in the USA led to an average loss of 3.77 quality life years in comparison to other OECD countries. The USA has an income gap of 8:1 (the average biggest earners have 8 times the wage of those at the other end of the spectrum) leading to a life expectancy of 78.7 years, which is in contrast with Japan reaching an average of 83.0 years with an income gap of 4:1. The same age dependent relation has been found in Scandinavian countries having similar income gaps as Japan.

Goda and Torres Garcia looked at the rise of global inequality and confirmed previous results by stating that within-country inequality is responsible for 70 percent of the global inequality, suggesting 30% is due to in-between country inequality.

Taking national and local figures into account for the UK, the Office for National Statistics observed a life expectancy for new-born baby boys to be 83.3 years in the Kensington and Chelsea area. Meanwhile, the life expectancy for the same cohort in Blackpool is merely 74.7 years. Nationwide, the female life expectancy is 86.6 years in Purbeck and the lowest in Glasgow City with an expectancy of 78.5 years. The authors conclude that inequality has increased over the last two decades despite improvements in these local areas.

Medical technology has improved greatly over the past two decades, with many illnesses that were fatal twenty years ago proving simple to treat now. Simple technological breakthroughs such as RFID labeling and instant messaging have meant that medical practices can be streamlined, saving time and money which can then be invested back into treating patients. With all these improvements in technology, why is there still little improvement in life expectancy in some areas? The answer lies again with income inequality, with areas that suffer from low income also suffering from lower government funding. This directly impacts the access local hospitals have to new technology, meaning they have fewer new technologies to utilise for their patients.

We may assume a strong relation between income inequality and health outcomes on a global scale as Dorling in recent research concludes there are overarching arguments. Dorling (2007) confirmed a strong relation between income inequality and negative health outcomes on a global scale after an observational study performed in 126 countries.

The academic world has provided alternatives to deal with the widening gap between poor and rich. Reformed minimum wages, living wages, basic income or a global ‘fair tax’ and redistribution are only a few austerity counter-proposals to ensure overall well-being by reaching or transcending the poverty line. Minimum wages have proven insufficient and a basic income is still globally debated. An international fair tax may even prove more challenging as this requires global political support.

Minimum wages and living wages have the same aim; raising income for the least fortunate to reduce the impact of a growing income gap. A minimum wage is defined as a minimum market valued income, imposed by law and paid by employers. A living wage is a locally liaised and negotiated pay rate that a fulltime employee needs for a household of four to reach the poverty line. For the latter, societal context is important, as living in a metropolitan area is more expensive than living in the countryside. The Basic Income Earth Network defines basic income as “a periodic cash payment unconditionally delivered to all on an individual basis, without means, test or work requirement”.

A locally implemented living wage project in the UK, facilitated by the General and Municipal Boilermakers Union in 400 councils, has proven to be successful in reducing (health) inequalities as well as being beneficial for government tax income. Awareness within the community influenced policy in a way that living wages became accepted as a benchmark for society. In this regard, a living wage clearly will contribute to individual well-being and social cohesion – both factors improve health within communities.

Proposals for a Universal Basic Income (UBI) are slowly reaching the minds of global policymakers, but this process will take more time in achieving broader support. In developing a short-term response tackling inequality, a living wage appears to be a possible solution for developed countries yet remains a huge challenge for developing countries.

Emerging new technologies will demand economical strategies that are able to cope with less job certainty and keeping up with growing demands in healthcare.

A redistribution of capital, as proposed by Thomas Piketty in his book ‘Capital in the Twenty-First Century’, in combination with a UBI may prove to be the best strategy in the long-run to counter income-related health inequalities on a global scale. We must urge politicians to finally face transnational companies and the top one percent in order to obtain a globally acceptable taxation rate.

About the author:

Sam Brokken hails from Belgium and lives near the city of Leuven. He studied physiotherapy, sports physical therapy and manual therapy practicing these areas for years in private practices within local communities. He lectures in musculoskeletal disorders in relation to manual handling and ergonomics for healthcare service providers.
He is currently engaged in postgraduate work at the Robert Gordon University (Aberdeen – Scotland) within the MSc Public Health and Health Promotion course.


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“Reducing poverty and inequality through tax-benefit reform and the minimum wage: the UK as a case-study”

Inequality in the UK has been rising for some time as gaps between the lower and upper classes increase. But, there are movements such as levelling up the north east that are looking to reducing this inequality to ensure everyone gets good healthcare, education, job opportunities, etc. And now, the Institute for Social and Economic Research (ISER) at the University of Essex has released a paper titled “Reducing poverty and inequality through tax-benefit reform and the minimum wage: the UK as a case-study” as part of its EUROMOD working paper series.

The paper uses the EUROMOD microsimulation model to examine the impact on poverty and inequality of the proposals put forth in economist Anthony Atkinson’s most recent–and final–book Inequality: What Can Be Done? (2015). Atkinson, himself a co-author of the ISER study, passed away on January 1, during the final stages of preparation of the working paper.

The proposals considered include a “significantly more progressive income tax structure,” a “major increase in the minimum wage” (i.e. a “living wage”), and an increase in the amount of the nation’s universal child benefit, and two types of programs of social transfers: a strengthening of the UK’s social insurance system, and a “participation income”. A participation income–an idea developed and promoted by Atkinson–is similar to a basic income in that it guarantees all members of society a stable and secure livable income. It differs from a basic income, however, in that it is not fully unconditional: as its name suggests, a participation income is subject to a participation requirement. According to Atkinson, however, fulfilling this requirement should not require paid work or looking for paid work; it should also be able to be met through caregiving, community volunteer work, full-time education, or other unpaid but socially valuable activities.

In the simulation study, the authors note that “this participation condition cannot be imposed in our simulation exercise due to lack of data” and thus carry out the study “on the basis that everyone is entitled.” In other words, for the purposes of the working paper, they have chosen to simulate what is effectively an unconditional basic income.

The authors simulate a basic income at the level of £75 per week (or £3,902 per year), which replaces many means-tested programs.

One conclusion of the study is that, in comparison to strengthened social insurance (SI), the set of reforms introducing a participation income (PI) “produces a larger immediate impact on both inequality and poverty”. As the authors summarize, “[i]n achieving this greater impact the PI-focused package affects considerably more households, both positively and negatively: 43% of all households see a substantial gain and 21% a substantial loss, compared to 34% and 10% respectively with the SI-focused alternative.”

Other researchers have also recently used the EUROMOD microsimulation method to model the effects of basic income policies–including Malcolm Torry of the Citizen’s Income Trust (“A variety of indicators evaluated for two implementation methods for a Citizen’s Basic Income“) and, to more skeptical conclusions, the OECD (“Basic Income as a Policy Option: Can it add up?“).


The full working paper is free to download from ISER’s website:

Anthony B. Atkinson, Chrysa Leventi, Brian Nolan, Holly Sutherland and Iva Tasseva (June 2017) “Reducing poverty and inequality through tax-benefit reform and the minimum wage: the UK as a case-study,” EUROMOD Working Paper Series.

Reviewed by Caroline Pearce.

Photo: “The Poverty Trap…” CC BY-NC-ND 2.0 Neil Moralee (taken in Taunton, England)


Scott Santens: “Is the solution to extreme wealth inequality really – Alaska?”

Scott Santens: “Is the solution to extreme wealth inequality really – Alaska?”

Scott Santens. Credit to: Singularity Bros.


Scott Santens, writer and long time UBI advocate, speaking at the Davos World Economic Forum 2017, views the Alaska Permanent Fund as a foundational aspect for the funding for a Universal Basic Income – a UBI.  Santens, and a growing number of people all over this planet are coming to the conclusion that something like a UBI is required in order to provide an effective counterbalance to the inequality of wealth distribution that currently plagues the world’s populations and the human ramifications of automation, robotization of the workplace.

Santens points out that, in a democracy, all citizens are deemed equal under the law and the Alaskan fund offers an excellent example of how the wealth being extracted from a communities resources must first and foremost benefit the people that comprise that community. The Alaskan fund extracts a percentage of the wealth being extracted from its resources and that money is then used to fund Alaska’s social programs as well as annually depositing as much as a thousand dollars or more into the pockets of every Alaskan citizen. A sort of pay to dig policy. That Alaskan Fund is now worth some fifty billion dollars. Conversely, in a similar but more aggressive manner, some years ago Finland was adamant that its offshore oil resources must benefit all of the Finnish people.  Finland took money off the top of the oil profits and put it into what is now a trillion dollar fund that is currently benefiting everyone in Finland.

But for Santens, resource funding is only one of a nation’s assets from which a UBI can produce a revenue flow that can both enrich and empower the populations it will serve.

Santens points out that a related resource, land itself, needs to be re-evaluated.  Land is not just where we build our homes, grow our crops and where our businesses and factories operate from.  Land is where wealth is invested and from which wealth is extracted. People can hide their money and their wealth, but they can’t hide their land.  Therefore a Land-Value Tax  would provide “… an extremely progressive tax on both corporations and individuals because land is so unequally distributed towards the top.”  Instead of the value of the land being decided by the owner, the land would be valued for the wealth it represents. A vacant downtown lot would then be as valued as the next door highrise and further motivate the owner to develop the land.

Secondly, for Santens a strong, social motivator for a UBI is the ever shrinking workplace where employees are increasingly being undervalued and then victimized by the threat of automation and robotization these days. Santens provides graphic representations of how the decline of collective bargaining, worker’s rights and our wages – which not too long ago had almost balanced out income distribution – have been declining proportionate to the increase in income inequality for years now. Santens understands that a UBI is not just an income supplement whereby workers canweather technological changes in the workplace, but a means whereby we finally achieve the freedom to refuse to take work that is unsafe or underpaid and, instead, achieve an equality of empowerment when bargaining with prospective employers. An equality of needs as it were.

Thirdly, Santens offers that a “annually rising intellectual property fee could be added to any intellectual property wishing to be monopolistically excluded from the public domain, with the revenue returned to citizens universally for their co-ownership of the government granting such protection.” Santens uses the example of data miners like Google and Facebook that extract information from their hundreds of millions of users for free, and then they sell that information to third party profiteers, as the reason why that information must come with a price to the data miners. When you profit from us you pay us for the privilege.

Then there is the creation of money itself. Not that long ago only the state could create new money but corporate and financial lobbyists were able to convince many governments that the commercial banks could be trusted with this responsibility. Santens wants governments to take back this responsibility and thereby put themselves back in charge of first determining the value of the money and secondly setting the value of the money significantly above the cost of producing it so as to ensure adequate funding for that nation’s UBI.

For Santens these three pillars, resource and land value funding, worker empowered bargaining and intellectual property/data mining are all keys to diminishing and, hopefully, continuing to bring greater balance to the economic inequality we see today. But Santens cautions that none of these changes will ever occur, or if they do they will not survive the reactive response of the wealthy set. For without real, effective democratic reform none of these progressive ideas will survive for long. Santens points out that “barriers to voting must be torn down, and the franchise must be expanded” if we wish to implement such radical but much needed changes to the inequality that is plaguing this planet’s populations.

Ben Mangan, “Will universal basic income end inequality? Maybe.”

Ben Mangan, “Will universal basic income end inequality? Maybe.”

Ben Mangan is the executive director of the Center for Social Leadership (CSSL) at UC Berkeley-Haas business school, as well as a lecturer there. He is also a senior fellow at the Aspen Institute.

In a January 2017 article for TED, Mangan notes that universal basic income (UBI) has been seen by many as a solution to a wide range of issues such as financial insecurity of workers, a widening wealth gap in developed nations and the impact of technology on work. Even though he observes there would be huge upsides to a UBI (e.g. elimination of poverty), Mangan thinks the barriers to implementation are considerable. He therefore proposes three alternatives that could provide a more sustainable solution to the underlying issues.

  1. Match savings of lower-income workers when they invest in assets.
  2. Increase bargaining power of workers.
  3. Build a new post-secondary education and training system.

Read more: Ben Mangan, “Will universal basic income end inequality? Maybe.”, January 13, 2017.


Reviewed by Kate McFarland

Photo: CC BY 2.0

Anthony Painter, “A universal basic income: the answer to poverty, insecurity, and health inequality?”

Anthony Painter (credit to: RSA)

Anthony Painter (credit to: RSA)

Anthony Painter, Director of the Action and Research Center at the RSA, in an editorial article described an experiment in the middle of the 1970s in the small town of Dauphin, Manitoba, Canada. As Painter describes, there were “statistically significant benefits” to the physical and mental health of the participants in the experiment, which was in the British Medical Journal.

The experiment involved the provision of “a basic income—a regular, unconditional payment made to each and every citizen” of Dauphin. A complete statistical analysis was not provided for several decades because of a loss of political interest.

Painter claims inequality and poor health outcomes is a well-established finding with the mechanism is less known.

Read the full article here:

Anthony Painter, “A universal basic income: the answer to poverty, insecurity, and health inequality?“, The British Medical Journal, December 12th, 2016