The Health of Nations: Why Inequality Is Harmful to Your Health

by Ichiro Kawachi, Bruce P. Kennedy

Overview

Praised by The Lancet, which called it a "lucid account that . . . deserves to be read by everybody interested in the politics of health," and the New England Journal of Medicine, The Health of Nations provides powerful evidence that growing inequality is undermining health, welfare, and community life in America. The book's prizewinning authors also make an urgent argument for social justice as a necessary vehicle for the betterment of society.

The Health of Nations is the synthesis of years of groundbreaking research on the connections between social structures and health and welfare, and one which Nobel Prize winner Amartya Sen says "has much to offer in reshaping the agenda of the debate on health care." Now in a revised edition which includes a new afterword, it dramatically demonstrates that growing inequalities, far from being a benign by-product of capitalism, threaten the very freedoms that economic development is thought to bring about.

Product Details

ISBN-13:	9781565848962
Publisher:	New Press, The
Publication date:	07/26/2006
Edition description:	Revised
Pages:	263
Product dimensions:	5.40(w) x 8.20(h) x (d)

About the Author

Ichiro Kawachi is an associate professor at the Harvard School of Public Health and a recipient of Robert Wood Johnson Investigator Awards in Health Policy Research.

Bruce P. Kennedy was a social epidemiologist, formerly at the Harvard School of Public Health.

Table of Contents

	Acknowledgments	vii
	Introduction	1
1.	Economic Goals and "The Permanent Problem of the Human Race"	9
	Living in the Material World	9
	Unbalanced Consumption: The Case of World Hunger	15
	"The Permanent Problem of the Human Race"	18
	Judging the Great American Growth Machine	20
2.	Prosperity and Happiness	29
	Does Money Buy Happiness?	29
	Why Happiness Is Not Enough	38
3.	Prosperity and Health	43
	The Health of Nations	43
	The Relative Income Hypothesis	50
	Poverty as a Relative Concept	54
	What Explains Socioeconomic Differences in Health?	59
4.	Keeping up with the [Dow] Joneses	65
	Prosperity and the Rise of Consumer Society	65
	Critiques of the Consumer Culture	74
	Consumer Culture and Consumer Debt	77
	Consumer Debt and the Charity Crunch	82
5.	Inequality: The Private and Public Price We Pay	85
	Is Inequality Good for Productivity?	85
	Winner-Take-All Markets	92
	The Dysfunctions of Inequality: A Rebuttal to Davis and Moore	100
	Inequality and Death Revisited	101
6.	Stepping on the Hedonic Treadmill	109
	Working Harder, Feeling Worse	111
	The Time Squeeze	116
	Spending Time with Your Loved Ones Can Improve Your Health	120
	Failing to Achieve the American Dream: The Costs of Social Exclusion	129
7.	The Social Costs of Consumption	137
	Material Goods and Positional Goods	137
	Positional Competition	141
	Suburban Sprawl	143
	The Rise of Gated Communities	148
	The Roseto Effect	155
	Recapitulation	158
8.	Politics and Health	161
	The Politics of Rich and Poor	161
	Political Ideology and Health	168
	Inequalities in Political Participation	170
	Social Capital and Political Participation	173
	Social Capital and Health	180
	Income Inequality and Social Capital	185
9.	Conclusion	191
	References	203
	Index	221

Editorial Reviews

Following up on studies like The Loss of Happiness in Market Democracies, The Health of Nations: Why Inequality Is Harmful to Your Health is a timely summation of recent economic research that shows how extreme prosperity always comes at the expense of others' poverty and perhaps of one's own well-being. Ichiro Kawachi, director of the Harvard Center for Society and Health, and Harvard School of Public Health professor Bruce P. Kennedy focus on how (as any Buddhist will tell you) "merely wishing for more money seems to lead to unhappiness" and, looking internationally, ask "are we happier and healthier [as Americans] as a result of all our consumption and accumulation?" Their counterintuitive answer is a resounding "no."

Publishers Weekly

Two Harvard School of Public Health professors will irk conservatives with their argument that US capitalism generates disparities that compromise its citizens' health. They chart the correlation between national wealth and life expectancy, and the "Robin Hood index" of proportion of income that would need to be redistributed to achieve equal income distribution; and discuss attitudes in the US, Japan, and Sweden toward government measures to reduce inequality. Annotation c. Book News, Inc., Portland, OR

The First World is fat but not happy, and its consumerist ways are spreading like an epidemic to the farthest reaches of the globe. Poverty is a reality even in America, write Harvard School of Public Health researchers Kawachi and Kennedy. But, they maintain, "in an affluent society such as the United States, there are diminishingly few things that the poor cannot afford that would make a difference between life and death." In other words, the economic challenge most Americans face today is not having the wherewithal to get things that they need, but instead having the means to get the things they want: a second television, perhaps, or a boat, or a house in the Hamptons. However, this unprecedented success comes at a cost in terms of social equity and the distribution of goods and services around the world: 200 years ago, the difference in per-capita income between the richest nation, the United Kingdom, and the poorest, China, was a mere $1,200 (in dollars adjusted to 1990), whereas today the difference between the richest nation, the US, and the poorest, Sierra Leone, is more than 25 times that. Inequality is also on the rise within the First World, with wealth concentrated in fewer and fewer hands: in the US, "the incomes of the bottom 60 percent of households have stagnated in real terms during the last twenty-five years, whereas the rich have continued to pull ahead." This inequality, the authors suggest, is something of a disease and in all events has not made the rich any happier, for all their shiny toys; rather, the uneven distribution of wealth yields isolation in the form of gated communities, social angst in the fear of falling behind, and bigger and bigger waistlines asAmericans of all social classes become more and more indolent. More diagnosis than prescription, but the epidemiological view of swollen-wallet sickness makes for highly interesting reading.

Kirkus Reviews

"An extremely important and timely study." —Amartya Sen, Winner of the Nobel Prize in Economics

"Why should this book be important for clinicians and biomedical researchers? To improve health in the United States or elsewhere in the world, we must address factors that affect the health of populations but have only indirect relevance for patient care." —The New England Journal of Medicine

"A timely summation of recent economic research that shows how extreme prosperity always comes at the expense of others' poverty—and perhaps of one's own well-being." —Publishers Weekly

From the Publisher