The disease of inequality.

• Author: Conniff, Ruth
• Position: The Spirit Level: Why Greater Equality Makes Societies Stronger - Book review

The Spirit Level: Why Greater Equality Makes Societies Stronger

By Richard Wilkinson and Kate Pickett

Bloomsbury Press. 330 pages. $28.

I f you feel ill when you read about CEOs who pay themselves 400 times what they pay their average employees, you are not alone. Living in a society with massive income inequality makes people anxious, depressed, even physically sick, according to British health researchers Richard Wilkinson and Kate Pickett.

That is why, they argue, the wealthiest and most unequal societies lag behind countries with fewer obvious advantages in every measure of health, happiness, and well-being.

In the United States, rates of diabetes, hypertension, cancer, lung disease, and heart disease are higher than they are in more equal societies such as Greece, Finland, and Japan. Life expectancy is significantly lower here (4.5 years less than Japan). Infant mortality rates are shocking.

In their book, The Spirit Level , Wilkinson and Pickett cite copious research--their own and others'--to demonstrate that income inequality is the biggest cause of ill health in the world.

It is a dramatic thesis, and the authors argue that the bad health effects of inequality are not confined to the poor, but spread like a pollutant throughout society.

We are accustomed to thinking of public health problems as a function of poverty--particularly when you add violent crime, drug abuse, and social dysfunction to the mix, as Wilkinson and Pickett do. But the authors take pains to point out that having more poor people is not what makes more unequal societies sicker.

"The assumption is that greater equality helps those at the bottom," they write. But that's "only a minor part of the proper explanation."

This idea is so different from what social scientists expect to find that international researchers have been confounded by data showing rich people and poor people alike are less healthy in more unequal countries. The reason, the authors say, is that "everyone receives roughly proportional benefits from greater equality." In more equal societies, everyone is better off.

Furthermore, our assumption that only the poor suffer from inequality "reflects our failure to recognize very important processes affecting our lives and societies we are part of," the authors write. "The truth is that the vast majority of the population is harmed by greater inequality."

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To show how this works, Wilkinson and Pickett dig into our evolutionary...