Abstract

Why do people in more unequal societies have worse health and shorter lives than those in less unequal ones? Why do more unequal societies tend to have more violence and weaker community life? This paper discusses the research evidence on the psychosocial pathways which suggest how and why we are affected by inequality.How big income differences are in any society seems to serve as an indicator of the scale of social differentiation and social distances within it. The evidence shows that more hierarchical societies incur a wide range of social costs reflecting the corrosive effects of inequality. But why are we so sensitive to inequality? Epidemiological research on health inequalities and the social determinants of health has demonstrated that the quality of the social environment has powerful effects on health. Particularly important are social status, friendship and early childhood experience. The indications are that poor health may share causal pathways with many other social problems associated with relative deprivation - including violence.Summarizing my recent book, The Impact of Inequality , this paper provides an account of how inequality gets under the skin to affect both health and wellbeing. Rather than making comparisons with some impractical state of complete equality, all the evidence presented shows the importance of the differences in inequality between different states of the USA or between different developed market democracies: it shows that even small increases in equality matter