The King’s fund think tank states that ‘people living in the poorest areas are dying from coronavirus at twice the rate of those in the richest areas’ in the UK. At first, it seems incredible that a virus can discriminate based on economics or wealth, but that appears to be what is happening across the globe. Initial fears were that the virus would attack the elderly, but as the virus has progressed we have seen other demographics hit just as hard by the virus. So what is going on?
A book written over 10 years ago, asserts the link between inequality in society and health and social problems. ‘The Spirit Level – Why Equality is Better for Everyone’, written by Richard Wilkinson (economist and epidemiologist) and Kate Pickett (epidemiologist) in 2009 with over 50 years of research behind them, eerily looks to be forecasting the impact of the coronavirus by country.
Effectively the research is stating that living in poverty increases an individuals susceptibility to illness through a number of related factors. This is now being played out on a country by country basis, as we see those countries with low levels of poverty being able to manage the pandemic with no lockdown or a short lockdown, and limited deaths. When looking at a country, what matters is not the average wealth of a country, but how that wealth is distributed within the country and how much poverty is within that country.
Countries such as the US where the top 10% of Americans own 70% of the wealth, have a high wealth gap.
This leads to high levels of poverty as defined by ‘The Spirit Level’. The US went into this crisis with the biggest divide between rich and ‘the rest’ for over a century. Today’s billionaires are as extreme in their wealth as the age of oil baron John D Rockefeller.
The book asserts that first world poverty is displayed through the following factors: mental health, drug use, physical health, life expectancy, obesity, educational performance, teenage births, violence, imprisonment and social mobility.
Extensive poverty increases the risk of transmission through: dense housing, poor social conditions, poor healthcare, obesity, low trust issues with government, poor investment in the healthcare system and other health issues which increase susceptibility to the virus.
These factors have also be outlined by Economists Sir Angus Deaton and Anne Case which found that poor young Americans were dying from what they called the ‘diseases of despair’.
Applying ‘The Spirit Level’ on a country basis, we see Japan at one end of the spectrum with a small wealth gap and predicted low susceptibility to health issues. Japan has had no lock down and very few coronavirus related deaths, less than 1,000 to date. How can a country such as Japan that has an ageing population manage to survive the coronavirus with such few fatalities?
Japan has rejected a lockdown, because they say the virus will resurge and elimination of the virus is impossible.
They believe that it is important to limit the damage to the economy and it is not possible to bring the total cases down to zero particularly with new waves of the virus. Social distancing remains voluntary, but with good hygiene, effective contact tracing the outbreak has grown slowly. The low wealth distribution means little poverty in society and its associated social problems. The Japanese can effectively distance themselves despite dense cities. This has helped the Japanese stay safe and the economy stay alive.
Other countries that also have low wealth inequality include Scandinavian countries and Northern European countries. The Scandinavian and Northern European countries have the lowest wealth gap and according to ‘Spirit Level’, and the lowest health and social problems and are faring better with the coronavirus outbreak.
At the other end of the wealth gap spectrum is the US and the UK, who have been experiencing both lockdowns and high death tolls. Can we relate the outcomes of the coronavirus to income inequality in first world countries? Not without detailed and thorough research to confirm it, but country by country the results are echoing the distribution seen in the ‘Spirit Level’.
Looking at the national outcomes we can clearly see how well the Northern European countries and Japan are faring compared to countries with a wide wealth distribution such as the US and the UK.
A wealth gap such as that seen in the US is not acceptable in today’s world. The virus is showing that the poor living standards experienced by those living in poverty increases susceptibility to devastation by epidemics. The deaths in the US are growing fast and following their own trajectory, different to Asian and European countries. The country is in lock down but the huge wealth gap in the US will allow the virus to penetrate deeper than other countries.
Listening to the news, stories that relate poverty to the spread of the virus are prolific. In Singapore, 80% of all Singaporean coronavirus cases are in the migrant workforce where some live in dormitories with up to 20 bunk beds in a room making self isolation impossible. We are learning about poverty in first world countries and it does not make for comfortable listening.
The Spirit Level authors said that in the course of their research they became aware that almost all problems common at the bottom of the social ladder are more prevalent in unequal societies.
This high level of poverty is causing the entire economy of those countries to enter a shut down showing that a high wealth gap is bad for all.
Post coronavirus it is likely that the US and other countries with a high wealth gap will see their extreme wealth gap narrow and society move towards a more socially responsible way of living. An extensive healthcare system, more social housing, better environmental standards and a move away from GDP centric economics in favour of ‘Living Standards’ for measuring success will be the logical response to this coronavirus pandemic.
Rebel Economics 
Hi Jenny, thank you. Spot on and informed. Loads of love Angus x
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There is of course a link between health and poverty on a statistical scale, but a causal link does not necessarily follow on the individual level. Not every poor person has poor health and not every healthy person is wealthy. The Japanese owe much of their good health in old age to their diets, not their low wealth gap. A healthy diet and lifestyle is by and large a matter of choice rather than circumstance. If wealth redistribution were the answer to health inequalities, then communism should have sorted that out by now, but that is patently not the case. Much food for thought in your article Jenny, thank you
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You have to read the spirit level !! I don’t think I can explain as well as them … chart on page 20 incredible to see … obviously I’ve got my links to the steel industry and looking at those old steel towns … my heart goes out …
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Thank you Jenny – I am reading The Spirit Level as you suggested. But I am also reading a major critique of it which you can find at this link
Click to access beware-false-prophets-jul-10.pdf
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Thanks Daniel – I will look at this too – ultimately the spirit level findings are bearing out in real life with the coronavirus. I’m looking at where the U.K. is hit in terms of geography too. It’s pretty compelling the link between poverty and coronavirus and I’m sure belatedly a lot of research will be done on this. Countries with a more proportionate wealth distribution such as Japan and Scandi and Northern European countries have navigated the pandemic much more successfully and we have a lot to learn.
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There is little doubt that disease hits the least healthy hardest and that poverty and ill-health are more common in post-industrial towns. However, to draw generalisations about causation in relation to income or wealth inequality is a very different matter. There are serious statistical flaws throughout The Spirit Level which are detailed in the critique and which render its findings false.
I wholeheartedly agree with your desire Jenny to lift whole communities out of poverty and improve their life chances. There are no easy answers, as successive governments have found, but flawed social science can’t form the basis of socio-economic policy.
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Thank you for your comments. Obviously I believe that it is the government’s job to lift communities out of poverty, and certainly not to put them into poverty. Poverty is clearly a huge determiner of morbidity with the coronavirus. Societies with less poverty, have less lock down and ultimately a better economy. Given many epidemiologists are predicting a mutation of the virus, we should learn all we can to beat it. Getting a vaccine is a long process. Changing our exposure through reduction in poverty is a permanent and lasting improvement.
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Indeed, enabling people to lift themselves out of poverty and encouraging and facilitating good health for all is what we expect governments to use our taxes to achieve. Their success ultimately depends on correctly understanding the true underlying causes of existing problems and devising and implementing policies to remedy them. A focus on any one measure of the health of a socio-economic model, be it GDP growth, income inequality, happiness etc. will inevitably lead to poor policy decisions. Even exploring a full range of measures, correctly and rigorously applied, can at best, identify where we need to dig deeper using more direct and specific tools to identify the real causes of a problem and devise workable solutions.
I always enjoy reading your thought provoking articles Jenny and look forward to your next piece!!
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I know, its so fascinating, to see social economic theory playing out in the face of a pandemic. Looking at those countries that have successfully negotiated through this crisis gives the UK a lot to learn. The Spirit Level may not have all the answers, but the graph on page 20 suggests that the link to poverty and health is a huge part of the spread of this pandemic. Obviously governments that recognise these issues will fare better. I think we have a lot to learn in the UK from countries such as Japan, Northern Europe and Germany. Hopefully those lessons will be learnt and implemented before any mutation of a virus that many are predicting.
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