if the Robin Hood index were reduced from 30% to 25% (about where it is in England), deaths from coronary heart disease would be reduced by 25%

Steve's note: The following article describes two important studies (from Harvard and Berkeley) that impressively link income inequality to many various social problems, like higher mortality rates, crime, welfare, substance abuse and educational problems. It explains why the growing inequality of the Reagan Years, described in detail on this web site, played such a critical role in worsening our nation's social problems. An extremely important read!

ECONOMIC INEQUALITY AND HEALTH | By Peter Montague
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What is not so obvious is that the health of the poor is harmed in proportion to the size of the gap between rich and poor. It isn't the absolute level of poverty that matters so much as the size of the gap between rich and poor. In other words, "...what matters in determining mortality and health in a society is less the overall wealth of that society and more how evenly wealth is distributed. The more equally wealth is distributed the better the health of that society," according to an editorial in the BRITISH MEDICAL JOURNAL April 20th.[5] Two recent studies of the U.S. indicate that this is so,[6,7] and they are not the first to make the case.[8,9]

The two recent studies, published in April in the BRITISH MEDICAL JOURNAL, examine all 50 states within the U.S. Each study defines a measure of income inequality and compares it to various rates of disease and other social problems. Both the studies -- one from Harvard and one from University of California at Berkeley -- conclude that the greater the gap between rich and poor, the greater the chances that people will be sick and die young. It isn't the absolute level of wealth in a society that determines health; it is the size of the gap between rich and poor. Let's look at some of the details:

George Kaplan and his colleagues at Berkeley measured inequality in the 50 states as the percentage of total household income received by the less well off 50% of households.[6] It ranged from about 17% in Louisiana and Mississippi to about 23% in Utah and New Hampshire. In other words, by this measure, Utah and New Hampshire have the most EQUAL distribution of income, while Louisiana and Mississippi have the most UNEQUAL distribution of income.

This measure of income inequality was also tested against other social conditions besides health. States with greater inequality in the distribution of income also had higher rates of unemployment, higher rates of incarceration, a higher percentage of people receiving income assistance and food stamps, and a greater percentage of people without medical insurance. Again, the gap between rich and poor was the best predictor, not the average income in the state.

Interestingly, states with greater inequality of income distribution also spent less per person on education, had fewer books per person in the schools, and had poorer educational performance, including worse reading skills, worse math skills, and lower rates of completion of high school.

States with greater inequality of income also had a greater proportion of babies born with low birth weight; higher rates of homicide; higher rates of violent crime; a greater proportion of the population unable to work because of disabilities; a higher proportion of the population using tobacco; and a higher proportion of the population being sedentary (inactive).

Lastly, states with greater inequality of income had higher costs per-person for medical care, and higher costs per person for police protection.

The Harvard researchers used a slightly different measure of inequality, called the Robin Hood index.[10] The higher the Robin Hood index, the greater the inequality in the distribution of income. The researchers calculated the Robin Hood index for all 50 states and then examined its relationship to various measures of health and well being.

They found that the Robin Hood index correlated with the overall age-adjusted death rate. Each percentage point increase in the Robin Hood index was associated with an increase in total mortality of 21.7 deaths per 100,000 population.
The Robin Hood index was also strongly associated with the infant mortality (death) rate; with deaths from heart disease; with deaths from cancer; and with deaths by homicide among both blacks and whites.

The Harvard team concludes that reducing inequality would bring important health benefits. For example, if the Robin Hood index were reduced from 30% to 25% (about where it is in England), deaths from coronary heart disease would be reduced by 25%.

These studies are important because they confirm work that has previously found a relationship between income inequality and health, using data of good quality from all 50 states.[11] Inequality in the distribution of income and wealth[12] has been increasing in the U.S. for about 20 years.[13,14,15,16] In 1977 the wealthiest 5% of Americans captured 16.8% of the nation's entire income; by 1989 that same 5% was capturing 18.9%. During the 4-year Clinton presidency the wealthiest 5% have increased their take of the total to over 21%, "an unprecedented rate of increase," according to the British ECONOMIST magazine.[17]
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The growing gap between rich and poor has not been ordained by extraterrestrial beings. It has been created by the policies of governments: taxation, training, investment in children and their education, modernization of businesses, transfer payments, minimum wages and health benefits, capital availability, support for green industries, encouragement of labor unions, attention to infrastructuire and technical assistance to entrepreneurs, among others. In the U.S., government policies of the past 20 years have promoted, encouraged and celebrated inequality. These are choices that we, as a society, have made. Now one half of our society is afraid of the other half, and the gap between us is expanding. Our health is not the only thing in danger. They that sow the wind shall reap the whirlwind.