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In 2009, when the world was still absorbing the shock of the previous year's financial crisis, a book called The Spirit Level was published. Written by a couple of social epidemiologists, it argued that a whole raft of data conclusively showed that societies with greater inequality also had a range of more pronounced social problems, including higher rates of violence, murder, drug abuse, imprisonment, obesity and teenage pregnancies.
Given that naked profit motive had just taken the world to the brink of economic collapse, it was a good moment to take stock and reflect on where rising inequality was leading us. For the previous 30 years a broad consensus had operated in politics, particularly in the US and Britain, that as long as those at the bottom were being lifted by the rising tide of wealth, then it did not much matter that those at the top were rising much faster.
But then the crash came, it turned out that the boom and bust years were not over, and ordinary taxpayers found themselves in the unjust position of bailing out the banks that had been guilty of the greatest excesses of greed and social irresponsibility. As a result, austerity followed and those who suffered most from its effects were the poorest members of society.
Meanwhile, the bonus culture continued, the banking industry has changed little (in America, the Trump administration is now loosening the limited financial regulations put in place after the crash), and income inequality remains strikingly high in many countries.
Now Richard Wilkinson and Kate Pickett, the authors of The Spirit Level, have returned with a new book, The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity and Improve Everyone's Wellbeing. I meet the pair, who are a couple, at a bar in St Pancras station, London, where we talked about their work while they waited for a train back north: Wilkinson is emeritus professor of social epidemiology at the University of Nottingham, and Pickett is professor of epidemiology at the University of York.
Wilkinson is in his mid-70s, but aside from a slight hearing problem and a pair of impressively wintry eyebrows, he is a picture of youthful energy, not to mention scathing opinions. If anything it's Pickett, 22 years his junior, who is the moderating voice.
The new book, as the subtitle suggests, focuses on the psychological or mental costs of inequality, which, they argue, are many and varied. The basic premise is that inequality creates greater social competition and divisions, which in turn foster increased social anxiety and higher stress, and thus greater incidence of mental illness, dissatisfaction and resentment. And that leads to coping strategies - drugs, alcohol, and addictive behaviours such as shopping and gambling - which themselves generate further stress and anxiety.
It's a bleak portrait, but one that Wilkinson and Pickett insist could be quickly and effectively improved.
The Spirit Level sold more than 150,000 copies and was translated into numerous languages around the world. But I wondered if - given that the situation has not greatly changed - they felt governments had taken notice.
Wilkinson mentions being consulted by senior Labour MPs; though during the Conservatives' time in power. He does not make it sound like the revolution is imminent.
Pickett takes the opportunity to interrupt her partner.
"To answer more systematically,'' she says, perhaps with the faintest of admonishments, "we've been consulted at international, national and local level. We've done a fair amount with various UN organisations, we've done EU things. I'm on the commission for sustainable equality.''
Christine Lagarde, head of the IMF, made a statement on equality that they recognised as coming directly from their book. And President Obama also said some things that, as Wilkinson puts it, "sounded a bit like it might have come from us''. But perhaps the biggest impact was among fellow academics, who have since started to look at the effects of inequality in many other disciplines.
There were also critics - dismissed by Wilkinson and Pickett as "ideological'' - who questioned either the validity of their statistics or the conclusions they drew from them. What struck me, reading the book, was that if the homicide rate was a major sign of inequality then it was noticeable that since 1980, the year that inequality really started to grow in the US after 50 years of flatlining, murders also began to fall. There is now a lower murder rate in America than there was in 1950. What accounted for that apparent anomaly?
"It means there must be other things involved,'' says Wilkinson confidently. "But we can say that if those same changes, whatever they are, had happened without the increase in inequality, homicides would have fallen even more.''
This seems a remarkably bold prediction, but then Wilkinson has been working in the area of inequality for decades, and he is as convinced of his case as only someone who has spent so long studying one subject could be.
There certainly seems little doubt that reports of anxiety, particularly among young people, are much more widespread now than they have been in living memory. A recent US study found that 20% of Americans reported being highly stressed, and an older study suggested that the average American child in the 1980s "reported more anxiety than child psychiatric patients in the 1950s''. Yet the 1980s, as a King's College London study has shown, was, by comparison to recent years, much less stressful for teenagers in Britain.
"Given that economic growth has brought us unprecedented luxury and comfort,'' Wilkinson and Pickett write, "it seems paradoxical that levels of anxiety have tended to increase rather than decrease over time.''
To many lay observers, the answer is that today's young people, the so-called "snowflake'' generation, are less hardy than their predecessors, less willing to accept difficulties and more likely to voice anxiety or distress about adverse circumstances they may encounter.
Wilkinson and Pickett posit a very different explanation. They believe that the growing anxiety stems in larger part from increasing social pressures brought about by material inequalities; in effect greater status anxiety. A recent meta-analysis of studies published in The Lancet Psychiatry concluded that rates of mental illness are higher in societies with larger income differences. The UK and the US are at the top of the graph on both mental illness and income inequality.
However, New Zealand has three times as much mental illness as Italy, and the same levels of income inequality, and France has double the rates of mental illness as its neighbour Spain, and yet its income inequality is roughly the same. Clearly there are many factors at play, but I wondered if material wellbeing itself might be the cause of anxiety, which is to say that the further we get from existential struggle, the more anxiety we feel about other challenges and stresses.
"If that were true,'' says Wilkinson, "anxiety would be related to GNP per head, which it is not. It also suggests not merely a free-floating amount of anxiety which then becomes attached to something, but that the decline of a main source of anxiety - subsistence - would actually increase overall anxiety. Is that really plausible? We have not come across it before.''
He notes that the Italian anomaly is usually attributed to the close family relationships in Italy. In any case, he maintains that it's the general consistency of the data showing the relationship between inequality and mental health, rather than the anomalies, that is most notable. And it's Wilkinson and Pickett's contention that we are mentally in a dysfunctional relationship with hierarchy, constantly seeking to establish a higher foothold on the social ladder, and it's a struggle that negatively affects all classes and income brackets.
Anyone who has looked at Instagram recently would be hard pressed to deny the degree of social anxiety on display. Never have we been so adept at flaunting both our wealth and our insecurities.
So let's agree, for the sake of argument, that inequalities breed anxieties which in turn damage mental health. But could this be a price worth paying for society at large?
THERE'S a scene in The Third Man in which Orson Welles compares the 30 years of brutality and bloodshed under the Borgias, which produced "Michelangelo, Leonardo da Vinci and the Renaissance'', with the 500 years of peace and democracy of the Swiss, which gave us the "cuckoo clock''. Is there a sense that more equal societies are less creative, less dynamic?
"No, absolutely not,'' says Pickett. "That argument is one of the arguments that people make to say perhaps we need a certain amount of inequality because it drives aspiration and innovation and creativity, but the evidence doesn't support that. The evidence suggests that there are more patents [for inventions] awarded per head of population in more equal societies.''
"Marginally more,'' cautions Wilkinson.
"Uneven societies waste a huge amount of talent. Lower social mobility, lower educational attainment, they're not optimising capital development,'' says Pickett.
The same principle applies to organisations too, she says. "There is evidence showing that companies with a bigger pay ratio are less efficient, less productive, produce less shareholder value, so they're not driving the kind of benefits that the apologists for inequality suggest.''
The encouraging evidence for the benefits of equality the pair tend to point to is from Scandinavia and Japan, which shows significantly reduced signs of social tension, status anxiety and poor mental health, and a higher tendency towards trust and reciprocity or what's known among sociologists as "social capital''.
The US political scientist Robert Putnam found that more ethnically and culturally diverse communities - particularly in America - were likely to possess less social capital. And with reduced trust and sense of reciprocity, people are less willing to contribute to others' wellbeing. Could Japan's and Scandinavia's high level of social capital and lower levels of anxiety be attributed to their greater ethnic and cultural homogeneity?
"I'm not so sure Putnam's right about that,'' says Pickett. "If you think about Japan - which is perhaps the most homogenous of all those countries we're looking at - they don't achieve their equality through taxes and benefits [Japan has a lower income range rather than a higher tax range]. So I don't think homogeneity is required for equality.''
In a sense, all politicians believe in equality, the equality of opportunity; or at least they all pay lip service to it. But reading Wilkinson and Pickett's book, I get the impression that they would like to see more focus on the equality of outcome.
"Yes!'' they both chorus.
"I think you can't have one without the other,'' says Pickett. "There is this consensus across the political spectrum that equality of opportunity is a good thing, but when you really start to unpick that, you can't have that without greater equality of outcomes.''
Without addressing outcomes, they say, the opportunities will always be heavily loaded in favour of the privileged. This seems a reasonable point. The problem, of course, comes in rebalancing those outcomes. One way, Pickett suggests, might be a re-evaluation of how we reward different skill sets.
For example, numeracy and computer literacy are premium skills that often command high salaries. Whereas those with an ability to look after the old and infirm or an empathetic outlook required in social work are frequently much less highly valued by society and the market. However, as artificial intelligence makes increasing inroads into the computerised world, that imbalance could conceivably be smoothed out.
Wilkinson sees automation as a straightforward equalising measure.
"It's about taking rises in productivity out in terms of leisure rather than increased income,'' he says like a true social scientist.
But as Pickett acknowledges, increased leisure, like increased equality, will necessitate a huge cultural shift and require an ambitious approach to education of both adults and children alike.
Where, then, to start on narrowing the distance between rich and poor? If they could impose one piece of legislation tomorrow what would it be?
"I would want companies to have to put some of their profits each year into an employee-controlled trust which would then have voting rights on the board,'' says Wilkinson.
"I'd go for a Finland-style educational system, completely comprehensive,'' says Pickett.
Whatever one makes of Wilkinson and Pickett's thesis, it seems obvious that high levels of inequality do diminish trust and belief in reciprocity. Just how much these effects account for mental ill-health or, indeed, how mental ill-health is defined and measured, are subjects worthy of informed debate. If nothing else, it surely warrants our attention that countries such as Germany, Sweden and Japan manage to thrive with much lower levels of inequality.
- Guardian News and Media