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The problem is not inequality, but how we respond to it

 

The world would be a better place if there were more economic equality. Countries which have higher levels of economic equality appear more comfortable and contented, the assessments of those who have done rigorous statistical analysis prove it and none of us likes seeing people who are suffering and poor.

But economic equality is not the top priority I would strive for, and at the debate last weekend this set me and my co-speakers apart. In fact economic equality was so important to my colleagues that they were happy to subordinate their own family to that political goal. Everyone except me declared that if they could help their children to get a flat they would not do so. Yasmin Alibhai-Brown beat her breast and brow for having sent her children to private school. Lord Victor Adebowale informed his daughter in the audience that ‘she wouldn’t get jack’.

These are the sentiments of the privileged. A friend in the audience who spent a year in a caravan in the field of a kindly farmer could not imagine not wanting to help out his daughter if he were able to.

Since Marx we have kowtowed to the god of economic equality. But economic equality is an outcome, not a goal to strive for. Denmark, that paragon of egalitarianism, oriented its policies not around equality but around the family. Economic equality as a goal to strive for is a mirage.

Economic inequalities are the sum of our endowments – such as height, beauty or intelligence, as well as our choices and our luck. We do not need to rid the world of inequality. It is not being richer or poorer than someone which causes our problems. It is man’s inhumanity to man in its multitude of guises. As well as doses of very bad luck.

Suffering, hardship, physical and mental pain, illness, unhappiness, humiliation – these are the problems we should be challenging. And while pain can be dulled by economic comfort, it is problems in the family, how we conduct our relationships, lack of integrity in our business dealings and the indifference of those around us, not economic inequality, which breeds despair.

People carp about royalty. But is there anyone, anyone, who seriously would swap places with William, Harry or Charles?

For many years I lived in a council estate on a road with many mansions. But I can say quite honestly I would not have swapped my little flat for one of those residences. My son would have had no friends with whom he could play football. And my family would have fragmented into isolated individuals. Those houses were just too large.

People complain about ‘privilege’. But the inheritors of it often lead stressful, demanding lives. If it was just privilege they inherited, they would ‘chill’ and spend more time enjoying the world around them. Obligation, responsibility and expectation are the invisible burdens which our social hierarchies pass on.

All those I have known who are wealthier than me have shared their privileges with kindness and generosity. And when it is ‘advantage Belinda’ I hope I do the same.

Inequality can breed reciprocity and kindness, or selfishness. It is up to us. It is not inequality itself which causes the problems, but how we respond to it. To rail against the status quo is an easy alternative. More challenging is a personal response.

I have known people who were severely economically disadvantaged, but they invested in family and human relationships. And on that they built contentment and security. But where there is anguish, suffering and hardship, it is too easy to blame some structural inequality. At heart lies man’s selfishness to man. And none of us is absolved.

The less well-off understand the importance of friends and family and that this provides a buffer against economic concerns. In post-communist Poland I saw people ‘lend’ each other money. But the word ‘lend’ was used to ensure the pride of the recipient. To the lender it meant financial loss. When it came to house decorating, plumbing or the numerous other services required for daily living, people would sacrifice their time, energy and own immediate convenience for the wellbeing of family or friends.

Among Nigerians, if you are a decent earner there is an assumption that you will help certain members of your family. This help again involves sacrifice. It is not like British giving, where we don’t mind parting with our extra ‘fat’. And these family obligations extend not only to your children and your parents, but to your siblings and your siblings’ relatives, and no doubt other extended and fictive kin may also be involved.

Lord Adebowale, one of my co-speakers, appeared to know nothing of these Nigerian networks of giving, suggesting they are the prerogative of those who are less well-off.

Perhaps you don’t need extended family if you are embedded in the British establishment. We have devised cunning ways of being both great and good without incurring personal cost.

Traditionally, I suspect, it was networks of family which ameliorated inequality rather than caused it. And perhaps it has been our ability to shed family or exploit it which has caused some and not others to accumulate wealth.

The sickness of our own society is that the privileged, from their cosy two-parent homes, encourage the poor to shed their own families. That is what happens when one parent is missed out. And when voices like mine say ‘we must tackle single parenthood’, we are silenced.

Yet two-parent families would ease both poverty and inequality. Finding ways to facilitate this would be an obvious way out.

Liberals, socialists, anarchists and other political idealists look for new ways of redistributing wealth through co-operatives and communes. But the solution is staring them in the face. If we built up networks of friends and family, which are often wonderfully extensive with our new ‘combined families’, we would all find we had communal organisations ready-made.

 

Belinda Brown is author of ‘The Private Revolution’ and a number of well-cited academic papers. More recently, she has started writing and blogging for The Daily Mail and The Conservative Woman. She has a particular interest in men’s issues and the damage caused by feminism.

 

By            :               Belinda Brown

Date         :               June 1, 2018

Source     :               The Conservative Woman

Posted in Latest Post, Social and Economic Inequalities | Leave a comment

Study shows the impact of the 2008 financial crisis on healthcare varied between countries

 

A team of researchers from several institutions in Europe has conducted an analysis of healthcare quality levels across Europe during the 2008 financial crisis. In their paper published in Proceedings of the National Academy of Sciences, they describe the differences they found in level of care over the course of the crisis.

The financial crisis of 2008 was felt in many parts of the world, but not all countries experienced the same impact on healthcare. In some countries, those less well-off saw a decline in healthcare availability and services, while those in other countries did not. In this new effort, the researchers looked at mortality and morbidity rates (being sick or diseased) for people living in 17 countries over the years 1980 to 2014 and 2002 to 2014, respectively. Their data also included survey responses from 350,000 people regarding their levels of health and quality of healthcare they received.

The researchers report that they found major differences in numbers for people living in different countries. Some, such as the U.K. and many western European countries, actually saw a steady improvement in mortality rates for people in all income brackets—a trend that began before the crisis and continued after. Such countries also saw steady numbers for morbidity rates. In other countries, things were not as rosy. They found that while mortality rates in eastern Europe continued to improve in recent years, morbidity rates did not for those with less education and income. They also found that for those countries that felt the strongest economic impact, people of all income brackets saw reductions in availability of healthcare services.

The results by the team, they note, contrast sharply with numbers found by other researchers studying healthcare in the United States. Despite its rating as one of the top economies in the world, the country experienced an increase in both mortality and morbidity rates during the crisis, but only for those on the lower end of the economic spectrum.

The researchers conclude their findings by noting that poor people living in countries that had programs in place to provide healthcare were effectively shielded from loss of services during rough economic times. They note also that the U.S. has continued to experience rising mortality and morbidity rates even as the crisis was resolved.

Abstract

Unfavorable health trends among the lowly educated have recently been reported from the United States. We analyzed health trends by education in European countries, paying particular attention to the possibility of recent trend interruptions, including interruptions related to the impact of the 2008 financial crisis. We collected and harmonized data on mortality from ca. 1980 to ca. 2014 for 17 countries covering 9.8 million deaths and data on self-reported morbidity from ca. 2002 to ca. 2014 for 27 countries covering 350,000 survey respondents. We used interrupted time-series analyses to study changes over time and country-fixed effects analyses to study the impact of crisis-related economic conditions on health outcomes. Recent trends were more favorable than in previous decades, particularly in Eastern Europe, where mortality started to decline among lowly educated men and where the decline in less-than-good self-assessed health accelerated, resulting in some narrowing of health inequalities. In Western Europe, mortality has continued to decline among the lowly and highly educated, and although the decline of less-than-good self-assessed health slowed in countries severely hit by the financial crisis, this affected lowly and highly educated equally. Crisis-related economic conditions were not associated with widening health inequalities. Our results show that the unfavorable trends observed in the United States are not found in Europe. There has also been no discernible short-term impact of the crisis on health inequalities at the population level. Both findings suggest that European countries have been successful in avoiding an aggravation of health inequalities.

 

Johan P. Mackenbach et al. Trends in health inequalities in 27 European countries, Proceedings of the National Academy of Sciences (2018). DOI: 10.1073/pnas.1800028115

 

By            :               Bob Yirka

Date         :               June 5, 2018

Source     :               Medical Xpress

https://medicalxpress.com/news/2018-06-impact-financial-crisis-healthcare-varied.html

Posted in Health, Latest Post, Policy, Social and Economic Inequalities | Leave a comment

Number of morbidly obese will double in 20 years

 

Numbers of morbidly obese adults (BMI of 40kg/m² or over) in England, Wales, and Scotland, are expected to soar over the next 17 years, and likely to exceed four million by 2035 – more than double the 1.9 million in 2015, according to research* presented at this year’s European Congress on Obesity (ECO) in Vienna, Austria (23-26 May).

The highest prevalence of morbid obesity will be seen in Wales, with around 13% of Welsh men and 9% of Welsh women likely to be morbidly obese by 2035 if current trends continue.

For the study Laura Keaver from the CRISP research group at the Institute of Technology, Sligo, Ireland, and Dr Laura Webber from the UK Health Forum, London, used height and weight data from the Health Survey for England, Welsh Health Survey, and the Scottish Health Survey (2004-14) for adults aged 15 and older (in five year age groups) to create a model predicting BMI trends (healthy weight, overweight, obesity, and morbid obesity) over the next 17 years.

The new estimates indicate that rates of morbid obesity in adults will reach 5% in Scotland (compared to 4% in 2015), 8% in England (2.9% in 2016), and 11% in Wales (3% in 2015) by 2035.

The researchers said: “Our study reveals a worrying picture of rising morbid obesity across England, Wales, and Scotland that is likely to weigh heavily on healthcare systems and economies. Strong measures to reverse this future trend must be an important public health priority.”

In further analyses, the research team predicted future trends in social inequalities in obesity (BMI of 30kg/m² or over) by modelling BMI data from the health surveys to project trends in adult obesity prevalence (aged 16 or older) according to their sex and social group (occupation and education).

This modelling suggested that by 2035 obesity rates will be highest, and see the greatest rise, in adults working in routine and manual positions. As a result, the difference in obesity levels between those in managerial roles (29% males, 31% females) and those in routine and manual roles (39% males, 40% females) is expected to widen in England and Wales (with the exception of English females where it is expected to reduce).

In contrast, the gap in obesity levels between those with less than tertiary education (i.e., university or trade school/college) and those with tertiary education is projected to close in all countries with the exception of Welsh females where it is projected to increase.

The researchers warned that the increase in prevalence will have huge health and financial implications for health services and society. Morbid obesity entails far more serious health consequences than moderate obesity and already accounts for around a third of all obesity-related costs.

“Our findings highlight that future interventions to tackle obesity must be accessible to everyone and should be designed to impact all sectors of society to further reduce these inequalities,” they added.

 

*Keaver, L.; Xu, B.; Jaccard, A.; et al. Morbid obesity projections in the UK to 2035. Research presented at this year’s European Congress on Obesity (ECO) in Vienna, Austria (23-26 May).

 

By            :               Ingrid Torjesen

Date         :               May 30, 2018

Source     :               onmedica

https://www.onmedica.com/newsarticle.aspx?id=89ce46c1-cef2-4a03-92b3-d9ef865a31dc

Posted in Health, Latest Post, Social and Economic Inequalities | Leave a comment

Income inequality is changing how we think, live, and die

 

Why society might be more stable if we had more poverty and less inequality.

Researcher Keith Payne has found something surprising: When people flying coach are forced to walk past the pampered first-class flyers in the front of the plane, the likelihood of some sort of air rage incident rises sharply.

In his 2017 book The Broken Ladder, Payne, a social psychologist at the University of North Carolina, argues that humans are hardwired to notice relative differences. When we’re reminded that we’re poorer or less powerful than others, we become less healthy, more angry, and more politically polarized.

I reached out to Payne because his argument seems to lead to a counterintuitive conclusion: American society would be more be more stable if we had more poverty and less inequality. I reached out to him to see if that’s what he’s come to believe after writing his book.

A lightly edited transcript of our conversation follows.

Sean Illing

Tell me what you think we least understand about the social costs of inequality.

Keith Payne

One big misunderstanding is that when people start talking about inequality, their minds go straight to poverty, but poverty’s only half of the equation. Inequality is about the size of the gap between the wealthy and the poor. It’s obviously important to be concerned about poverty and to alleviate the suffering that accompanies it, but that’s still only half the problem.

Sean Illing

What’s the other half of the problem?

Keith Payne

What people underappreciate is how having extreme inequality driven by the high end of wealth also causes trouble for society and for people’s well-being. Poverty is a related but separate problem. The presence of extreme inequality destabilizes a society in ways that are hard to understand but absolutely devastating.

Sean Illing

Let’s get into that. What sorts of problems spring from these wealth gaps?

Keith Payne

For starters, it produces serious health problems, and not subjective problems but objective health problems, like chronic diseases, obesity, drug and alcohol problems, and, ultimately, shorter life expectancies. You see comparatively higher rates of these health issues in countries with the most income inequality, and that’s after controlling for average income.

Sean Illing

I know what you mean when you say “controlling for average income,” but can you make that clear for people who don’t have a background in statistics?

Keith Payne

Sure, it means that if you take two people who make the same income, but one lives in a very high-inequality place and one lives in a low-inequality place, the person in the high-inequality location is more likely to deal with these chronic diseases, more likely to deal with these drug and alcohol problems, more likely to actually die sooner than the same person living in a low-inequality environment.

he high-inequality countries also have more crime, more incarceration, more school dropouts — things that we normally associate with poverty, but in wealthy developed countries, they’re actually more closely linked to inequality than to poverty rates.

Sean Illing

It seems obvious that wealthier people with more resources and better access to medical care will be healthier than poor people. But when you compare across societies, you find that the average person in a high-inequality society like America is less healthy than the average person in a low-inequality society like Sweden or Norway. How do you explain this gap?

Keith Payne

The perception of inequality around us has a couple of different effects. One is that it makes the average person feel poorer, [in] comparison to those who have more. And the second is that it raises our expectations. It raises our standards for what we think it is to be normal. Now, that all seems very subjective, but when you perceive yourself as poor compared to other people, that sets off a chain of events that translates into physical outcomes.

Sean Illing

That’s what I’m getting at: What’s the pathway from subjective perceptions of one’s relative poverty to actual physical health problems?

Keith Payne

One pathway is stress. If you perceive yourself as relatively low on the social ladder compared to others around you, it’s stressful, and the body treats that stress in the same way it treats a physical threat. So if you get the fight-or-flight response, you get immune responses that in the short term are good, but if they go on over the long term, over weeks or months, they can cause health problems.

Another pathway is that feeling lower on the status ladder compared to other people changes the way we approach decision-making in our own minds. It makes us riskier in our decisions; we focus more on the short term as opposed to the long term. So you have more people playing the lottery, taking payday loans, making questionable choices to try to get ahead economically. The long-term effects of these choices are usually bad — economically, emotionally, and physically.

Sean Illing

You also find that high-inequality societies are more polarized, more chaotic, and more dysfunctional. What accounts for this?

Keith Payne

What you find is that people who perceive themselves as having low status in a society often search for meaning in various ways, and one form that takes is believing in conspiracy theories. People disillusioned by their status in society look for various kinds of patterns around them, ways to justify their place, and that often takes irrational forms like conspiracy theories. Other times, it takes more normative forms like enhanced religious devotion.

Feeling lower status also has the effect of leading people to feel that the system is rigged against them. And so you hear a lot in the news about lower-education white voters feeling left behind as a function of the current economy and the kind of political consequences that has.

This feeling of being left behind is a real thing, but it’s not necessarily traceable to the fact that factories have gone overseas and that robots are replacing jobs. That’s clearly part of it, but the resentment is far worse when it happens in a society where people with higher educations and good social connections are getting wealthier and wealthier. It’s not hard to see how that can create political problems.

Sean Illing

Is it fair to say that economic inequality produces more political tribalism?

Keith Payne

I would call it more polarization, but you can call it political tribalism. And it happens on the left and the right. Again, people look for ways to make sense of a world that seems unfair, and often they do that by retreating into tribal identities — whether it’s political or religious or ethnic or whatever.

Sean Illing

A lot of the psychological problems you point to stem from our tendency to measure ourselves in terms of our social status. But humans have done this since we started living in groups, and certainly since the emergence of private property and individual rights. We’re just hardwired to detect relative differences. Is there something unique about what we’re seeing now?

Keith Payne

There’s nothing new about this psychological tendency to measure ourselves against others; that’s no different than it was 100 years ago or 1,000 years ago. What’s different today is the scale of the inequality around us, which is about as high as we’ve seen since we started keeping records of it.

Sean Illing

Do you think we would be healthier and happier if we had more poverty and less inequality?

Keith Payne

I think there’s a case to be made that trading off some measures of wealth, like the gross domestic product, would be worth it for the benefits that come with reduced inequality. The problem now isn’t that there’s too much wealth; it’s that nearly all of the increases are going to the wealthiest members of society.

Even if by some miracle we doubled everyone’s income tomorrow, that would only increase the inequality because when you double the income of millionaires, they get a lot richer than when you double the income of somebody making $20,000.

Usually, there isn’t a trade-off between more wealth and less inequality, because if you look across countries, the countries with lower levels of inequality actually have greater levels of social mobility. It’s easier to climb up that economic ladder if you’re in a place where inequality is on a human scale, as opposed to the astronomical levels of inequality that we see in America.

Sean Illing

A free society is going to produce unequal outcomes, and that’s fine so long as those inequalities don’t explode to epic proportions. So how do we negotiate these tensions?

Keith Payne

You put it well. That’s the trade-off we face. I don’t think there’s one optimum level; each society has to sort this out for itself. What works for Norway might not be the solution for America.

But the argument isn’t that everyone should be the same, or be equally successful. The argument is that democratic societies have got to negotiate these trade-offs and find the right balance between free markets and a progressive taxation system or a safety net that helps to even out the winners and losers in a way that preserves equality of opportunity but doesn’t allow society to become destabilized by inequalities.

I’m not a policy person, so I don’t have the answers. But we have enough data to know that this is something we ought to do if we want to keep our societies stable and healthy.

 

By            :               Sean Illing

Date         :               May 24, 2018

Source     :               VOX

https://www.vox.com/2018/5/24/17368308/income-inequality-poverty-in-america

Posted in Latest Post, Social and Economic Inequalities | Leave a comment

The Big Read: Social stratification — a poison seeping into Singapore’s housing estates

 

A new phrase has entered the lexicon in the unfinished business of tackling inequality – social stratification, even as housing, education and National Service policies have encouraged social mixing over the years.

For years, policymakers in Singapore have been focusing on ways to narrow the income gap, as countries around the world seek to mitigate the side effects of globalisation.

Social inequality has become a buzz phrase among national discussions, and the issue remains a work in progress.

Of late, however, a new phrase has entered the government’s lexicon: Social stratification.

It refers to an institutionalised system of social inequality — a dire situation that Prime Minister Lee Hsien Loong warned about in February, but one which is starting to take root and risks becoming entrenched, as several Cabinet Ministers and other Members of Parliament (MPs) highlighted during the five-day debate on the President’s Address earlier this month.

“The issues of mitigating income inequality, ensuring social mobility and enhancing social integration are critical,” PM Lee had said in a written parliamentary reply. “If we fail – if widening income inequalities result in a rigid and stratified social system, with each class ignoring the others or pursuing its interests at the expense of others – our politics will turn vicious, our society will fracture and our nation will wither.”

And among the various aspects of social stratification, it is the “perceptible reduction” — in Education Minister Ong Ye Kung’s words — in social mixing in recent years that has gotten some worried.

National University of Singapore (NUS) sociologist Tan Ern Ser said: “The lack of social mixing may translate into a lack of empathy for and understanding of those who hail from disadvantaged families … leading to a reluctance to support policies aimed at improving the lots of the lower classes, and contributing towards their welfare.”

This lack of mutual understanding could also lead to the “emergence of distrust between classes, even class tension”, said Dr Tan, who co-authored the Institute of Policy Studies’ (IPS) Study On Social Capital with IPS deputy director for research Gillian Koh and NUS sociologist Vincent Chua.

For generations, social mixing has been a hallmark of Singapore society, thanks to the housing, education and National Service policies which encourage mixing across groups of different race, income and family backgrounds.

But at least two of these three policy levers, which have carefully nurtured and reinforced the culture, are not working as well as before — or as they should be.

The IPS study, which was supported by the Ministry of Culture, Community and Youth, found that while there is social mixing between classes, “there seems to be a gap along two dimensions of social stratification, that of housing and education,” Dr Tan noted.

Among other findings, the study — which was published last December — showed that on average, Singaporeans who live in public housing have fewer than one friend living in private housing. People who study in elite schools also tend to be less close to those in non-elite schools, and vice versa.

Make no mistake about it, the issue is receiving attention at the highest level: In a bid to “deliberately plan for a more equal and inclusive society”, the Housing and Development Board (HDB) has launched three Build-to-Order projects — in Woodlands, Bukit Batok and Sengkang — with rental and sold flats within the same block.

The authorities will also continually renew buildings and infrastructure to avoid ending up in a situation “where certain parts of Singapore are left to degrade and we end up with deteriorated neighbourhoods or towns, inhabited largely by lower-income or elderly residents”, National Development Minister Lawrence Wong said in Parliament during the debate on the President’s Address.

Meanwhile, PM Lee told the House last week that the Ministry of Education (MOE) will work with Raffles Institution (RI) and other popular schools so that they never become “self-perpetuating, closed circles”.

The Government has also stressed, on several occasions, the need to level the playing field from preschool in order to tackle inequality. To that end, it is doubling its annual spending on the preschool sector to S$1.7 billion in 2022.

 

HOUSING: RISK OF ENCLAVES

Moving into the Ang Mo Kio neighbourhood a decade ago after her divorce, Ms Fadillah Abdul Rahman, 45, was taken aback by the lifestyles of the “underdogs in Singapore’s society”, and was fearful her children might wind up with bad company.

She lives with two sons and a daughter in a two-room rental flat in Ang Mo Kio Avenue 6. Her eldest daughter has moved out after getting married.

True to her fears, her son, now 20, was admitted to a boys’ home for several months for disciplinary issues.

Still, the single mother wants to give her children the freedom to hang out with kids in the community. She also gives them free rein to manage their studies. Her daughter, 10, attends Ang Mo Kio Primary school, which is about a 20-minute walk or 15-minute bus ride away.

Her eldest son, Mohd Zuhairi Zakariya, 21, works as a technician at a company providing wire bonding services in Yishun. From Mondays to Thursdays, he takes night classes at the Institute of Technical Education College Central and is working towards a Higher Nitec degree in mechanical engineering.

Ms Fadillah said her daughter often plays at home or the playground in their neighbourhood. Once in a while, she would bring her to playgrounds further away, including those located near condominiums and private estates. But on such occasions, she noticed that there were hardly any children there from families living in the private homes. These children would probably play in the playgrounds located in their condominiums or be cooped up at home, she reckoned.

Within the Ang Mo Kio/Yio Chu Kang precinct, a private housing estate at Lentor Street is situated just 2.5km away from the block of rental flats where Ms Fadillah and her children are staying.

Homemaker Jacqueline Aw, 39, her husband and two daughters — aged 2 and 6 — are among the families living in the Lentor Street estate.

Her elder daughter is enrolled in a NAFA Arts Preschool, the first arts-theme preschool in Singapore. The child also attends various enrichment classes in abacus, gymnastics, athletics, piano, dancing, as well as English and the Chinese language.

Her girls do not play in the neighbourhood park, but instead enjoy going to the indoor playground at SAFRA in Toa Payoh and Punggol.

Ms Aw, who grew up in a rental flat and knows of friends and family who have lived or are living in such units, said she is happy to visit them if they invite her family. Nevertheless, the former flight stewardess noted that her family does not know anyone living at the rental flats at Ang Mo Kio Avenue 6.

Acknowledging her children’s privileged background, she added that she tries to inculcate the right values in them, such as being grateful for what life has given them.

However, some families in Ang Mo Kio whom TODAY interviewed said they would steer clear of the rental flats. One resident, who only gave her name as Madam Tan, said she and her twins, both 7 years old, will avoid going near the rental flats as the people there may be “less educated”, and the environment looks a bit “scary”. Madam Tan works in a bank and her family lives in a five-room flat in Yio Chu Kang.

The situation and prevailing sentiments among residents in Ang Mo Kio are mirrored across the island in various housing estates.

Rental flat residents, for example, said they have few opportunities to interact with Singaporeans from different family backgrounds because their day-to-day activities are often confined within their neighbourhoods.

The IPS study found that even though the vast majority of Singaporeans

reside in public housing, private-home dwellers had more ties with others who live in private homes than with those who lived in public flats.

In 1989, the Government implemented the Ethnic Integration Policy to prevent racial enclaves, by ensuring that each HDB block and estate broadly reflect the Republic’s racial proportion.

While the measure has largely met its aim, enclaves are now potentially forming along socioeconomic lines, experts said.

Prior to the Government’s recent announcement, there were no HDB blocks designed to house both rental and sold units.

Flats under the public rental scheme are heavily subsidised to cater to needy households, whose total household income falls below S$1,500 per month and have no other housing options.

According to the latest General Household Survey in 2015, 1- and 2-room flats are congregated in the Bukit Merah, Kallang and Ang Mo Kio planning areas, while a larger proportion of private houses are found in Bukit Timah, Bedok and Hougang.

Figures from the Department of Statistics also show that while the proportion of Singaporeans living in condominiums has surged from 6.5 per cent to 15.6 per cent from 2000 to last year, the proportion living in 1- and 2-roomers has inched up from 5 to 5.8 per cent over the same period.

Noting the aspirations of homeowners who desire more privacy for example, Singapore Management University sociologist Paulin Straughan said the growing proportion of gated communities could result in “unintended consequences”, such as fewer chances for social mixing to take place.

LIMITS OF ‘FORCED MIXING’

With a general decline of neighbourliness, more resources should be dedicated to organising community-based events such as block and street parties, in order “to bring people out of their sanctuary and mix in common spaces”, Prof Straughan suggested.

Such community activities go some way in bridging social divides between the rich and the poor, residents and MPs said.

Over in the Jalan Kukoh neighbourhood in Bukit Merah, for instance, ground-up initiatives such as ReadAble and Catch Plus (Children and Teen Community Hub Plus) — which are targeted at students from low-income families — are often run by volunteers from more privileged backgrounds.

Ms Lyn Razali, who lives in a two-room unit along Jalan Minyak, said Catch Plus has helped her two daughters and herself widen their social networks. The after-school care programme is targeted at students aged seven to 16 from low-income families in the neighbourhood. It focuses on the academic and socio-emotional aspects of their development.

“Through these activities, we have befriended Singaporeans who live in condominiums, and they invite us over to their homes. But ultimately, we are brought together through the community (regardless of) financial status,” said Ms Razali, 38, whose husband works as a driver.

The Catch Plus programme was the brainchild of Jalan Besar GRC MP Lily Neo, who looks after some lower income households in the Jalan Kukoh area.

Dr Neo noted that “forced mixing” is helpful only if the individuals themselves continue to foster their relationships beyond instituted activities. She added:

I feel some people may be more comfortable and at ease sticking with their own groups… We can try out different programmes, but when I leave it to them, would they hang out together? They may or they may not.

Some Singaporeans had mixed views on the extent to which social mixing and integration could be instituted.

Public relations consultant Oo Gin Lee, 49, reiterated that it is “only natural” for people to interact with others with whom they share similar preferences and lifestyles — and these would likely still boil down to their spending powers, added Mr Oo, whose family lives in a condominium in Bukit Timah.

Ms Lim Shaw Hui, 45, believes that schools are society’s best shot at promoting social mixing from young. The mother of two sons aged 7 and 9 said she made a deliberate decision to enrol her children in a neighbourhood primary school. She added:

It is too simplistic to think that hawker centres and playgrounds are sufficient to encourage mixing.

SCHOOLS: THE GREAT SOCIAL LEVELLER BEING THREATENED?

While Singapore’s schools are seen as the most effective social levellers, there is growing concern that so-called elite primary and secondary schools coveted for their academic rigour could be disproportionately attracting students from affluent families.

There is a need to relook some of the admission policies, some parents and experts said.

Mr Oo pointed out that affiliation schemes which prioritise certain students for admission because their parents are alumni, or because they themselves graduated from primary schools within the same family of schools, widen the divide between institutions.

Children whose families are living within a 1 to 2km radius are also given priority under existing policies. With some primary schools such as Henry Park Primary School, Singapore Chinese Girls’ School and Methodist Girls’ School located in or near a private estate, these schools tend to be “homogenised”, said Prof Straughan.

Such a policy has also created an unintended vicious circle: The high demand for places at prestigious schools drive up prices of nearby homes, with well to do families snapping up these flats.

Speaking in Parliament last week, PM Lee cited his recent conversation with

Mr Ong, where he was told that RI — which has a strong tradition of accepting students from diverse backgrounds, so long as they make the cut — has become “less diverse” over the years.

To address this, the new RI principal, Mr Frederick Yeo, has been speaking to parents of potential students in primary schools across Singapore, to encourage them to apply to RI.

To the principal’s surprise, some of the parents told him they did not want to send their child there, because they feared he would not be able to fit in with other more well-off students, PM Lee said. But PM Lee stressed that the parents’ fear was unfounded — in reality, RI students still come from varied backgrounds, with 53 per cent of its students living in public housing, and all the students “get along confidently and comfortably”.

In response to queries, MOE cited co-curricular activities (CCAs), inter-school camps and national school games as examples of opportunities that “provide common spaces for students from diverse backgrounds to forge friendships”.

Eight in 10 schools today have a “relatively balanced mix” of students, with at least 5 per cent of students from both the top and bottom socio-economic quintiles.

“MOE is committed to an inclusive education system which ensures that all students regardless of their background and abilities are given opportunities and support to realise their potential,” said a ministry spokesperson.

Several popular schools, including RI, Hwa Chong Institution and Methodist Girls’ School, also cited inter-school projects as platforms for students to interact with peers from various backgrounds.

However, most of these initiatives involve only a small group of students from each school.

Parents who have kids in both an elite school and a neighbourhood school said they have observed a stark difference in their children’s social networks.

Mr Oo’s eldest daughter goes to a popular girls’ school in Bukit Timah, while her sister studies at a less well-known school in Telok Blangah. “Their friends are so different. My second goes to an average school, and you can see that there is greater diversity,” he said. “When you look at (my eldest’s peers), they are all rich. In the morning, the roads to her school are often congested because a larger majority of the parents drive their kids to this school.”

At the same time, examples abound of children from less affluent families who were able to get into the elite schools — but the feeling among observers is that the odds could be increasingly stacked against those from less privileged backgrounds, and the onus is on school leaders to ensure the pathways remain open to all.

A parent, Ms Anne Soh, felt that students’ socioeconomic backgrounds have a definite bearing on how well they do in schools. For example, those who are better off are exposed to enrichment classes from a young age, she noted.

Both Ms Soh, 47, and her husband work in a church, earning a total of about S$4,000 each month. They live in a four-room flat at Ghim Moh with two sons and a daughter.

Their eldest son, who is now 19, graduated from one of the top secondary schools and junior colleges here. Declining to be named, the son, who is a full-time national serviceman, said his friends from school came from “fairly similar” socioeconomic backgrounds, in contrast to his peers in the military. He said:

In our society, it’s hard to ensure mixing in schools when everything is based on academics … Because the richer you are, the more you can afford stuff like tuition.

Ms Soh noted that at her second son’s school, quite a number of students also come from well-to-do families.

However, school leaders have placed a strong focus on taking in students with special needs and learning abilities, she said. They have instilled a culture of service to the community, and students are encouraged to share the values with their family members, she added. For example, the students organise annual community service trips which their fathers are also invited to participate in.

Ms Lim suggested that schools conduct CCAs in clusters, based on their geographical locations, so that students with common interests can come together, despite their different backgrounds.

Pasir Ris-Punggol GRC MP Zainal Sapari mooted the idea of “community schools”, which do away with cut-off points and affiliation priorities for admission. These schools could offer both primary and secondary education, he suggested. He said:

We need to let our children interact with people not only from different backgrounds, but of various academic aptitudes. Instead, now, we are encouraging social stratification at a young age by streaming them, labelling some as ‘gifted’.
IT ALL STARTS AT HOME

On her decision to enrol both her sons in a neighbourhood school, Ms Lim said she and her husband “wanted them in an environment where they would get to mix around and widen their social circles”.

“We also did not want to put them in an ‘elite’ school because of the academic pressure,” said Ms Lim, a part-time assistant director at Beyond Social Services.

Having come from a privileged background herself, Ms Lim said this was why she wanted to ensure her children are exposed to people from all walks of life.

Since young, her children would accompany their parents at fundraising events. They also visit and support a family living in a rental flat within their estate in Pasir Ris, said Ms Lim. These monthly visits over the last two years have helped her children forge a strong friendship with the other family’s son, she added.

Associate Professor Chua pointed out that volunteerism is “an effective means to narrowing the inequality gap”. “Networks are conduits for the flow of resources. Mentoring relationships (for instance, free tuition) are one example, they facilitate the sharing of resources, possibilities and synergies,” he added.

Some Singaporeans from lower-income households reiterated that there are sufficient opportunities for people like them to rise from the lower rungs of society, as well as mix with people from different socioeconomic groups. It is up to the individual, they said.

Mr Mohd Zuhairi said: “We are what we are … It is about how you want to change your life. You got to be hardworking and have a positive mindset. There are opportunities, but you must know what you want your life to be.”

Dr Tan stressed that family upbringing is critical: In a situation where a child is raised in a family which has “socialised him or her to have low aspirations, to not take education seriously, to feel incapable of doing better and to see himself as a victim of circumstances”, the child is less likely to break out of his class background.

A SOCIETAL EFFORT

In his parliamentary speech, Mr Ong described tackling inequality as an “unfinished business”.

He noted that Singapore, like other nations, had wrestled with the problem of inequality in its early days. But its journey from Third World to First had created new forms of inequalities, said Mr Ong, who also cautioned that social stratification could “poison” the society over time.

Overall, experts say the situation in Singapore is far from dire, but there are signs of social stratification taking root — and these need to be nipped in the bud.

While Singaporeans have enjoyed “a fairly upward mobility” in the past, Prof Straughan cautioned against a growing discontent and unhappiness among the younger generation who may feel that it is “almost impossible for them to reach for the stars”.

Agreeing, Dr Tan said that if the “class boundaries are not permeable” and the chances of moving up are slim, the lower classes may feel “a sense of hopelessness, discontentment, and envy”.

Given the absence of longitudinal data on the topic, “it is hard to say whether things are getting worse”, said Dr Tan.

Nevertheless, the critical question is whether inequalities are “systematically entrenched”, Prof Straughan reiterated.

Addressing the issue publicly, several national leaders have noted that social stratification is a risk for developed societies. PM Lee, for example, pointed out that “any society which has been stable for a long time tends to stratify”, citing the entrenched notions of class and caste in the United Kingdom and India.

Assoc Prof Chua noted that “an all-out meritocracy in the latter stages will produce the kinds of divides we are seeing”.

To bridge these gaps, government policies are one thing. But the public at large has a role to play as well, in terms of attitudes and mindsets.

Ultimately, “friendships are a combination of context and choice”, Assoc Prof Chua said. “The important thing would be to complement one’s social circles with bridges to others. The best networks are those that are rich in variety,” he added.

 

By            :               Kelly Ng and Toh Ee Ming

Date         :               May 29, 2018

Source     :               Channel News Asia

https://www.channelnewsasia.com/news/singapore/the-big-read-social-stratification-a-poison-seeping-into-10283526

Posted in Latest Post, Policy, Social and Economic Inequalities | Leave a comment

Racism impacts your health

 

Outside in public: Smiling, dressed real fine, manners on point. I am well schooled on how to be respectful, how to take up space, how to use silence when necessary. Travelling home on transit listening to music to drown out my day — filled with injustices from the minute I left my “sanctuary” ten hours earlier. Fumbling for keys, nearly pushing the door down to my home. All I experienced outside threatens to crash down my door and engulf my insides and swallow me whole. My breath struggles to calm itself. Grief shadows me through the hallway. I self-talk my way into the kitchen, slipping my armour off; my thick silver bangle hits the floor, the sound awakening me to reality. I am home. I sit still for a minute and contemplate how I will go out again to face the monster of anti-Black racism. I drink my tea quickly, and begin to make dinner. – Feb 9, 2018, author’s journal

Witnessing and hearing stories about racism can impact your health. The feelings evoked can make you ill if not processed.

The recent news of Tina Fontaine’s trial

and the acquittal of Gerald Stanley, a white farmer accused of killing a young Indigenous man, Colten Boushie, of the Red Pheasant First Nation are examples of the Canadian legal system’s commitment to the Indian Act and colonial dominance.

This ongoing colonial dominance has a transgenerational trauma impact on the health of Indigenous and colonized peoples.

Two recent examples that indicate the kind of violence that Black people experience: A school that allowed police to shackle a Black six-year old girl’s wrists and ankles; a children’s aid system that put a child refugee from Somalia into foster care yet never applied for his Canadian citizenship, so years later he received deportation orders to a country where he does not speak the language.

The impact of this colonialism and anti-Black racism on the health of Black and Indigenous peoples is elongated and insidious. We navigate systems, structures and communities that perpetuate abhorrence towards us in all aspects of our lives.

Experiencing and fighting such systems for justice for our children, ourselves and our community members has devastating effects on our health.

As a health and human rights researcher, therapist and professor who has explored the deep implications of racism, I would like to share some insights into the impacts of racism on our health.

My hope is that by doing so I create dialogue and encourage communities to continue to voice their experiences of violence and racism — in order to demand changes and ultimately create more supports.

Violence is a continuum

Health indicator statistics of Indigenous communities report increasing disparities between Indigenous and settler populations. Systemic racism affects Indigenous population’s health in various ways, this includes limited healthy food choices, inadequate living conditions and substandard health care. The infant mortality rate within Indigenous communities is almost 12 times that of settler communities.

The statistics, usually presented by state authorities, come without context or consideration to the broad range of causes — one of which is the continued exposure to state violence on a daily basis.

We have anecdotal evidence: We see loved ones, friends, ourselves and respected community leaders struggle with the emotional and physiological impacts of racism on a daily basis. While anti-Black racism’s effect on the health of Black communities is documented, studies from the U.S. are more illustrative.

In one U.S. study, researchers studied 1,574 Baltimore residents of which 20 per cent reported that they had been racially discriminated against “a lot.” This same group had higher systolic blood pressure than those who perceived they had been discriminated against very little. Additionally, over a five-year period the group that felt they had been discriminated against “a lot” had higher declines in kidney function.

In a 1997 to 2003 study on racial discrimination and breast cancer in U.S. Black women, researchers found that perceived experiences of racism resulted in increased incidents of breast cancer, especially among young Black women. In 2011, a pivotal study on the impact of racism on health scholars linked lifetime experiences of discrimination to higher prevalence of hypertension in African Americans.

Biases in research

These are just a few examples of some studies being done on the impact of racism on health. However, most studies have been conducted in the U.S., the U.K., New Zealand and Australia. Canada does not yet collect race-based health or experiences of racism on health data through any formal mechanism. This poses a problem when scholars are asked to produce “scientific data” to prove that racism impacts health inequities and disparities. How do you provide “statistically significant evidence” on the impact of anti-Black racism when systemic issues limits your access to collecting this same data? My future research proposes to support the collection of increased health data on the impact of anti-Black racism in Canada and globally.

In Black communities no one is immune from racism — from our unborn to our school age children to our elderly. Consciously and unconsciously our health becomes obstructed.

The impact on health intensifies for those in Black communities who are women, working class, lesbian, gay, bisexual or trans (LGBT), dis(abled), refugees or newcomers. Here, the combination of oppressions creates additional stress on mental and physical health and well-being. I call this intersectional violence.

For example, the massacre of Muslims in a Québec mosque and anti-Islam policies continue to further impact the health of marginalized, often surveilled communities. Two victims of the Québec massacre were Black. This fact is hardly mentioned. This is an example of anti-Black racism within communities of colour.

Health impacts from anti-Black racism and anti-Indigeneity are often dismissed or kept silent by health scholars and health-care workers. The findings challenge the illegitimacy of systems of dominance and question the humaneness and accountability of colonial power. As such, research on the health impact of anti-Black racism is underfunded and under researched.

The “realness” of health impacts related to racism interrupts narratives of the “disadvantaged,” the “poor,” the “lazy” and the “needy.” Such stereotypes re-victimize and further aggregate health inequities. Yet understanding racism as a determinant of health is important to understanding economic and social barriers to success.

When we fail to address the real impact of racism on Black communities’ health, we not only lose our community members to often preventable disease, illness, institutionalization and ultimately death, we also lose our opportunity for redress and to energetically participate in transnational anti-oppression movements.

Health impacts

Experiencing racism throughout our lifespan can overwhelm our health functionality. Repetitive acts of untreated trauma and violence lead to debilitating health issues.

The impact of anti-Black racism within our educational system is well documented by our lived experiences and “unexplained” drop-out rates. The effect of prolonged injustice from junior kindergarten through to post-secondary education, can lead to exacerbated health conditions.

The under-recruiting and under-hiring of African/Black and Indigenous peoples in medicine, psychology, education, health and in academia directly affects the impact of racism on these same communities.

Adversely, the over-hiring of African/Black community members as personal support workers, health aids and child care workers with little opportunity to move into positions of power in these fields directly establishes a division between the “helper” and “the helped,” resembling enslavement roles where Africans served whites while living in conditions that gravely impacted their own health.

The impact of the over-representation of our children in state care on the health of Black families due to separation and transgenerational trauma is never measured.

As our children and elders endure acts of violence during vulnerable times in their lives, without protection or support, their grief response becomes hidden or dissociated. This leads to challenges in seeking and receiving health care which increases despairing health results.

The myth that Black people do not seek mental health therapy comes from a falsified notion of “super resiliency” instead of the reality of under-funded and purposely delayed services that prevent health and wellness in our communities. This leads to many community members suffering and seeking services in silence and isolation.

The burden on Black and colonized folks’ bodies, minds, spirits, health and wellness is all-encompassing.

Possibilities for change

Having a provincial anti-racism directorate and local Toronto anti-Black racism action plan indicates a way forward. Much activism over many years resulted in these strategies getting put into action.

The directorate’s effectiveness will be measured in its implementation, the diversity of its members and its power to eliminate health disparities and address the health impacts of racism and violence on the daily lives of Black, Indigenous and racialized peoples.

Research funding needs to be increased. Universities need to hire scholars from communities who are directly impacted by racism and whose work address these health inequities — to support communities impacted by these same injustices.

What if the Afrocentric Alternative school, the only one in Canada, was well resourced and supported as a health strategy to combat the early stigmatization and violence experienced by school-aged Black children?

What if, in the case of the killing of the late Colten Boushie, the jury was not all white?

What if we looked to Black Live Matters as a public health racial justice movement trying to prevent further health atrocities?

What if we collected health data on the impact of racism – using both informal and formal research methods – empowered, developed and implemented by Black and colonized communities to create health equity programs and strategies to address our health disparities?

 

By            :               Roberta K. Timothy (Assistant Lecturer Global Health, Ethics and Human Rights School of Health, York University, Canada)

Date         :               March 1, 2018

Source     :               The Conversation

https://theconversation.com/racism-impacts-your-health-84112

Posted in Latest Post, Social and Economic Inequalities | Leave a comment

Economic Equality Is Key to Solving Climate Change, Report Shows

 

Economies need to reduce inequality and promote sustainable development for the world to avert the perils of runaway global warming, according to new research.

The risk of missing emissions targets increased dramatically under economic scenarios that emphasizes high inequality and growth powered by fossil fuels, according to research published Monday by a team of scientists in the peer-reviewed Nature Climate Change journal.

“Climate change is far from the only issue we as a society are concerned about” said Joeri Rogelj, the paper’s lead author and a research scholar at the International Institute for Applied Systems Analysis outside of Vienna. “We have to understand how these many goals can be achieved simultaneously. With this study, we show the enormous value of pursuing sustainable development for ambitious climate goals in line with the Paris Agreement,” he said.

The paper bridges two of the most intractable challenges facing policy makers across the globe. Scientists predict higher frequencies of floods, famines and superstormsunless the world keeps temperature rises well below 2 degrees Celsius (3.6 degrees Fahrenheit) this century. At the same time, growing income inequality has been robbing advanced economies of dynamism needed to boost their resilience to change.

The IIASA researchers modeled six different scenarios in order to determine conditions that would limit warming to 1.5 degrees Celsius, according to the paper.

“Our assessment shows particularly the enormous value of pursuing sustainable development for reaching extreme low climate change targets,” said Keywan Riahi, a coauthor of the paper. “On the other hand, fragmentation and pronounced inequalities will likely come hand-in-hand with low levels of innovation and productivity, and thus may push the 1.5 degrees Celsius target out of reach.”

Greenhouse gas emissions should peak before 2030 after which they’ll “decline rapidly” with a combination of phasing out of industry and energy related CO2 combined with an “upscaling” carbon capture and carbon dioxide removal, according to the report. An estimated 37 billion metric tons of carbon dioxide was released last year, 2 percent more than 2016, according to researchers in the Global Carbon Project.

“Bioenergy and other renewable energy technologies, such as wind, solar, and hydro, scale up drastically over the coming decades in successful scenarios, making up at least 60 percent of electricity generation by the middle of the century,” according to the researchers. “Traditional coal use falls to less than 20% of its current levels by 2040 and oil is phased out by 2060.”

— With assistance by Eric Roston

 

By            :               Jeremy Hodges

Date         :               March 6, 2018

Source     :               Bloomberg

https://www.bloomberg.com/news/articles/2018-03-05/economic-equality-is-key-to-solving-climate-change-report-shows

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The Cancer Threat to Africa’s Future

 

While significant progress has been made in halting the spread of communicable diseases in Africa, rates of non-communicable illnesses, especially cancers, are rising. With just 5% of global funding for cancer prevention spent in Africa, a new global strategy is needed to help manage a looming health crisis.

CHICAGO – One of the most pressing public-health challenges in Africa today is also one of the least reported: cancer, a leading cause of death worldwide. Every year, some 650,000 Africans are diagnosed with cancer, and more than a half-million die from the disease. Within the next five years, there could be more than one million cancer deaths annually in Africa, a surge in mortality that would make cancer one of the continent’s top killers.

Throughout Sub-Saharan Africa, tremendous progress has been made in combating deadly infectious diseases. In recent decades, international and local cooperation have reduced Africa’s malaria deaths by 60% , pushed polio to the brink of eradication, and extended the lives of millions of Africans infected with HIV/AIDS.

Unfortunately, similar gains have not been made in the fight against non-communicable diseases (NCDs), including cancer. Today, cancer kills more people in developing countries than AIDS, malaria, and tuberculosis combined. But, with Africa receiving only 5% of global funding for cancer prevention and control, the disease is outpacing efforts to contain it. Just as the world united to help Africa beat infectious disease outbreaks, a similar collaborative approach is needed to halt the cancer crisis.

Surviving cancer requires many things, but timely access to specialists, laboratories, and second opinions are among the most basic. Yet, in much of Africa, a lack of affordable medications, and a dearth of trained doctors and nurses, means that patients rarely receive the care they need. On average, African countries have fewer than one trained pathologist for every million people, meaning that most diagnoses come too late for treatment. According to University of Chicago oncologist Olufunmilayo Olopade, a diagnosis of cancer in Africa is “nearly always fatal.”

Building health-care systems that are capable of managing infectious diseases, while also providing quality cancer care, requires a significant investment in time, money, and expertise. Fortunately, Africa already has a head start. Past initiatives – like the Global Fund to Fight AIDS, Tuberculosis, and Malaria, the US President’s Emergency Plan for AIDS Relief, and the World Bank’s East Africa Public Health Laboratory Networking Project – have greatly expanded the continent’s medical infrastructure. National efforts are also strengthening pharmaceutical supply chains, improving medical training, and increasing the quality of diagnostic networks.

Still, Africans cannot face down this threat alone. That is why the American Society for Clinical Pathology, where I work, is cooperating with other global health-care innovators to attack the region’s growing cancer crisis. We have teamed up with the American Cancer Society (ACS) and the pharmaceutical company Novartis to support cancer treatment and testing efforts in four countries: Ethiopia, Rwanda, Tanzania, and Uganda. Together, we have brought immunohistochemistry, a key diagnostic tool, to seven regional laboratories, an effort we hope lead to more timely cancer diagnoses and greatly improve the quality of care.

To complement these technical efforts, the ACS is also training African health-care professionals how to carry out biopsies and deliver chemotherapy. That initiative, funded by Novartis, is viewed as a pilot program that could expand to other regional countries.

Finally, our organizations are advocating for enhanced cancer-treatment guidelines in national health-care planning efforts, protocols that we believe are essential to improving health outcomes. These initiatives are in conjunction with other undertakings, such as a joint ACS-Clinton Health Access Initiative program to broaden access to cancer medications.

When the world took notice that infectious diseases like HIV/AIDS, polio, and malaria were ravaging Africa, action plans were drawn up and solutions were delivered. Today, a similar global effort is needed to ensure that every African with a cancer diagnosis can get the treatment they need. Now, as then, success depends on coordination among African governments, health-service providers, drug makers, and non-governmental organizations.

There is no place on Earth that is immune from the dread of a cancer diagnosis; wherever the news is delivered, it is often devastating to recipients and their families. But geography should never be the deciding factor in patients’ fight to survive the disease. Cancer has been Africa’s silent killer for far too long, and the global health community must no longer remain quiet in the face of this crisis.

 

Danny A. Milner, Jr., is Chief Medical Officer of the American Society for Clinical Pathology.

 

By            :               Danny A. Milner

Date         :               March 2, 2018

Source     :               Project Syndicate

https://www.project-syndicate.org/commentary/african-cancer-health-care-crisis-by-danny-a-milner-2018-03?a_la=english&a_d=5a995c5078b6c709384d6b44&a_m=&a_a=click&a_s=&a_p=homepage&a_li=african-cancer-health-care-crisis-by-danny-a-milner-2018-03&a_pa=opinionthatmoves&a_ps=secondary-articles

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Its poverty, not individual choice, that is driving extraordinary obesity levels

 

The statistics point remorselessly towards obesity being a symptom with an underlying social cause. That should completely change the approach to dealing with it.

The “obesity epidemic” deserves much more serious attention than it is getting. It is, after all, thought to be killing nearly three million people a year worldwide. It is putting huge pressure on health services, yet the public policy response in developed countries such as the US and UK is pitiful, largely confined to finger-wagging at children’s sugary treats.

The story that has not been getting out is that there is a clear and extraordinary correlation between obesity and social inequality.

Obesity is invariably presented as a diet issue for nutritionists, whereas social inequality is deemed the domain of sociologists and economists. Put another way, even as the inequality gap becomes more and more obvious there’s been a medicalisation of a social problem. Yet obesity is not just a matter for nutritionists: rather, it is a product of social inequality and requires a collective social response.

This failure to face up to the underlying causes of obesity is all the more striking as issues of social inequality and justice are dominating the news agenda. Despite vast increases in total wealth in the world today, the health issue remains a marker for a general political problem about inequality in society, even in the most affluent societies.

The tragedy is that obesity is usually treated as a problem and responsibility of individuals or families – not as a social problem like, say, low-educational achievement or delinquency. And so the solutions are pitched at that individual or family level.

And yet the statistics point remorselessly towards obesity being a symptom with an underlying social cause. That should completely change the approach to dealing with it. But so far, it hasn’t.

Vital statistics

Take the US. There, the most “obese” state, Arkansas, is also the fourth poorest state overall, whereas the poorest state, Mississippi, is also the third most overweight.

The picture in the nation’s second poorest state, New Mexico, is less clear because there it is complicated by another factor: ethnicity. New Mexico has “only” the 33rd highest adult obesity rate – apparently bucking the trend. Yet even in “The Land of Enchantment”, the correlation of wealth and health still leaves its unmistakable fingerprint. There, the adult obesity rate is 34.4 per cent among black adults, 31.3 per cent among Latino adults and a comparatively sprightly 23.9 per cent among white adults, again reflecting wealth distribution.

Recall that in terms of relative income, a study last year found that it would take 228 years for the average black family to reach the same level of wealth that white families have today, while for Latino families, it would take 84 years. Meanwhile, colour correlates to poor health and reduced life expectancy.

Recent studies in England also illustrate this link between obesity and income. Of the 10 worst areas in terms of overweight or obese children, half are also in the worst 10 for child poverty. England’s most obese council, Brent, is also its ninth poorest, whereas England’s wealthiest council, Richmond, despite being a neighbouring council in London, is one of the sprightliest, with a relatively low rate of obesity. And England’s poorest council? Another London borough, Newham, is also the eighth most affected by childhood obesity.

In its way, these figures are as disgraceful an indictment of social priorities and inequality as the 19th century mortality levels due to epidemics of rickets or typhoid. And the solutions needed are every bit as collective rather than individual.

Victorian parallels

Imagine that the Victorians had tried to tackle typhoid by advising everyone to live in the countryside near clean wells, rather than by building sewers and water treatment plants. Today’s response to an epidemic that kills so many people around the world that it has become the fifth leading cause of early death, is just as unrealistic.

In the early years of the 19th century, the industrial towns of the West were characterised by overcrowding, poor housing, bad water and disease. Epidemics, even in the modern cities of New York and London, were – it was assumed – a part of life. The fact that they caused significantly greater suffering in the poorer, slum neighbourhoods only contributed to the blase responses of city leaders. Epidemics were interpreted as punishments for moral turpitude – in much the same way that today’s illnesses linked to being overweight are. It was only very slowly that such attitudes – deeply rooted in religious notions of individual guilt – gave way to public health measures.

But then this was an era before the mechanisms for the transmission of diseases was understood, indeed in an era before even the idea of germs as tiny, invisible life-forms was fully accepted. And so it seemed only reasonable to middle-class New Yorkers that diseases like cholera would hit working-class neighbourhoods the hardest. It was seen as proof of their moral depravity.

Meanwhile, businesses fought against public sanitation proposals fearing increased costs – in much the same way that the food industry resists or subverts public health initiatives as the investigative journalist, Michael Moss, in particular has detailed. And like today, the business interest was often backed by politicians. The hazards back then were not ambiguous things such as sugary fizzy drinks or ready meals, but rotting animal carcasses and mountains of refuse. Yet the opposition to change was similar – every improvement had to be fought for.

So what are the factors that push poorer people towards unhealthy eating? Food and health policy expert Martin Caraher explains that food choices are massively influenced by factors such as income, knowledge and skills. Others have highlighted the fact that eating well invariably involves more food preparation time. Yet such explanations don’t fit many cases, indeed seem dangerously retrospective. What is sure is that you cannot deal with the obesity epidemic by taxing popular snacks, anymore than you could deal with rocketing suicide rates by taxing sales of rope.

The point is that we need to collectively tackle the places where obesity germs breed – in stressed communities characterised by insecure and erratic employment, inadequate education, stress, depression and a lack of social cohesion. That this requires an enormous shift in public priorities is only to be expected – but the consequences of not acting are far worse.

 

Martin Cohen is a visiting research fellow in philosophy at the University of Hertfordshire. This article first appeared on The Conversation (theconversation.com).

 

By            :               Martin Cohen

Date         :               February 27, 2018

Source     :               The Independent

http://www.independent.co.uk/life-style/health-and-families/poverty-individual-choice-driving-obesity-health-a8219831.html

Posted in Health, Latest Post, Social and Economic Inequalities | Leave a comment

Why Amartya Sen remains the century’s great critic of capitalism

 

Critiques of capitalism come in two varieties. First, there is the moral or spiritual critique. This critique rejects Homo economicus as the organising heuristic of human affairs. Human beings, it says, need more than material things to prosper. Calculating power is only a small part of what makes us who we are. Moral and spiritual relationships are first-order concerns. Material fixes such as a universal basic income will make no difference to societies in which the basic relationships are felt to be unjust.

Then there is the material critique of capitalism. The economists who lead discussions of inequality now are its leading exponents. Homo economicus is the right starting point for social thought. We are poor calculators and single-minded, failing to see our advantage in the rational distribution of prosperity across societies. Hence inequality, the wages of ungoverned growth. But we are calculators all the same, and what we need above all is material plenty, thus the focus on the redress of material inequality. From good material outcomes, the rest follows.

The first kind of argument for capitalism’s reform seems recessive now. The material critique predominates. Ideas emerge in numbers and figures. Talk of non-material values in political economy is muted. The Christians and Marxists who once made the moral critique of capitalism their own are marginal. Utilitarianism grows ubiquitous and compulsory.

But then there is Amartya Sen.

Every major work on material inequality in the 21st century owes a debt to Sen. But his own writings treat material inequality as though the moral frameworks and social relationships that mediate economic exchanges matter. Famine is the nadir of material deprivation. But it seldom occurs – Sen argues – for lack of food. To understand why a people goes hungry, look not for catastrophic crop failure; look rather for malfunctions of the moral economy that moderates competing demands upon a scarce commodity. Material inequality of the most egregious kind is the problem here. But piecemeal modifications to the machinery of production and distribution will not solve it. The relationships between different members of the economy must be put right. Only then will there be enough to go around.

In Sen’s work, the two critiques of capitalism cooperate. We move from moral concerns to material outcomes and back again with no sense of a threshold separating the two. Sen disentangles moral and material issues without favouring one or the other, keeping both in focus. The separation between the two critiques of capitalism is real, but transcending the divide is possible, and not only at some esoteric remove. Sen’s is a singular mind, but his work has a widespread following, not least in provinces of modern life where the predominance of utilitarian thinking is most pronounced. In economics curricula and in the schools of public policy, in internationalist secretariats and in humanitarian NGOs, there too Sen has created a niche for thinking that crosses boundaries otherwise rigidly observed.

This was no feat of lonely genius or freakish charisma. It was an effort of ordinary human innovation, putting old ideas together in new combinations to tackle emerging problems. Formal training in economics, mathematics and moral philosophy supplied the tools Sen has used to construct his critical system. But the influence of Rabindranath Tagore sensitised Sen to the subtle interrelation between our moral lives and our material needs. And a profound historical sensibility has enabled him to see the sharp separation of the two domains as transient.

Tagore’s school at Santiniketan in West Bengal was Sen’s birthplace. Tagore’s pedagogy emphasised articulate relations between a person’s material and spiritual existences. Both were essential – biological necessity, self-creating freedom – but modern societies tended to confuse the proper relation between them. In Santiniketan, pupils played at unstructured exploration of the natural world between brief forays into the arts, learning to understand their sensory and spiritual selves as at once distinct and unified.

Sen left Santiniketan in the late 1940s as a young adult to study economics in Calcutta and Cambridge. The major contemporary controversy in economics was the theory of welfare, and debate was affected by Cold War contention between market- and state-based models of economic order. Sen’s sympathies were social democratic but anti-authoritarian. Welfare economists of the 1930s and 1940s sought to split the difference, insisting that states could legitimate programmes of redistribution by appeal to rigid utilitarian principles: a pound in a poor man’s pocket adds more to overall utility than the same pound in the rich man’s pile. Here was the material critique of capitalism in its infancy, and here is Sen’s response: maximising utility is not everyone’s abiding concern – saying so and then making policy accordingly is a form of tyranny – and in any case using government to move money around in pursuit of some notional optimum is a flawed means to that end.

Economic rationality harbours a hidden politics whose implementation damaged the moral economies that groups of people built up to govern their own lives, frustrating the achievement of its stated aims. In commercial societies, individuals pursue economic ends within agreed social and moral frameworks. The social and moral frameworks are neither superfluous nor inhibiting. They are the coefficients of durable growth.

Moral economies are not neutral, given, unvarying or universal. They are contested and evolving. Each person is more than a cold calculator of rational utility. Societies aren’t just engines of prosperity. The challenge is to make non-economic norms affecting market conduct legible, to bring the moral economies amid which market economies and administrative states function into focus. Thinking that bifurcates moral on the one hand and material on the other is inhibiting. But such thinking is not natural and inevitable, it is mutable and contingent – learned and apt to be unlearned.

Sen was not alone in seeing this. The American economist Kenneth Arrow was his most important interlocutor, connecting Sen in turn with the tradition of moral critique associated with R H Tawney and Karl Polanyi. Each was determined to re-integrate economics into frameworks of moral relationship and social choice. But Sen saw more clearly than any of them how this could be achieved. He realised that at earlier moments in modern political economy this separation of our moral lives from our material concerns had been inconceivable. Utilitarianism had blown in like a weather front around 1800, trailing extremes of moral fervour and calculating zeal in its wake. Sen sensed this climate of opinion changing, and set about cultivating ameliorative ideas and approaches eradicated by its onset once again.

There have been two critiques of capitalism, but there should be only one. Amartya Sen is the new century’s first great critic of capitalism because he has made that clear.

 

By            :               Tim Rogan

Source     :               Aeon

https://aeon.co/ideas/why-amartya-sen-remains-the-centurys-great-critic-of-capitalism

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