For many people today, poverty takes a terrible toll on health. Although there are more millionaires than ever today, there are also far more people who are having difficulty meeting even the most basic human needs.
We need to talk about the fact that we have created an economy where the accumulated financial wealth of the top one percent of households exceeds the combined wealth of the bottom 95 percent. Where in the very midst of prodigious wealth, one in every four preschoolers live in poverty. Where it’s easier for a Bill Gates to make another billion dollars than for a single mother to keep a roof over the head of her children.
The problem is not that Bill Gates and others like him are incredibly rich. The problem is that the amount of Microsoft stock Bill Gates owned in 1999 was worth twelve times the total amount of all the securities owned by all the 33 million African-Americans combined. The problem is not that Disney CEO Michael Eisner makes a lot of money. The problem is that in 1998 he made more than 25,000 times as much as the average Disney worker.
We are witnessing a level of inequality in wealth distribution that makes the extremes of medieval feudalism pale in comparison. We’ve created, in the words of Jeff Gates, “a sumptuous heaven for some, an ungodly struggle for most, and a living hell for many.” Newspapers give us daily reports of stock prices, rejoicing when the stock exchanges rise, but rarely mention when consumer debt-loads become unbearably high. In 1998, at the height of the boom of the 1990s, more people filed for bankruptcy in the United States than went to college. In 1999, three men — Bill Gates, Paul Allen, and Warren Buffet — had a net worth greater than the combined GDP of the 41 poorest nations and their 550 million people.
We need to talk about this because, in this sea of inequality, the rising tide isn’t lifting all the boats. It’s sinking a lot of them. Working people are experiencing increasing insecurity. They are no longer sure that they or their children will find decent work paying a living wage, or that anyone will help them out if they lose their jobs, get sick, or grow old. As the richer get richer and the poor get poorer and more numerous, increasing numbers of people experience feelings of powerlessness, social exclusion, chronic anxiety, low self esteem, social isolation, and the sense that life is out of control. This contributes substantially to heart disease, depression, and other debilitating and deadly ailments. A large and growing body of medical literature says that wealth inequality and the resultant insecurity are among the leading causes of disease, disability and death.
Some say there’s no cause for concern if wealth is concentrating among the few, as long as total wealth is increasing. But there’s a problem with that. Look at California. What’s taken place there in recent years exemplifies what happens when wealth becomes increasingly concentrated in the hands of the few.
In the 1990s, no state in the nation generated more wealth than California. Silicon Valley, the epicenter of the computer industry, and Hollywood, the center stage of the world’s entertainment industry, were generating new millionaires by the minute. But the distribution of this growing wealth was becoming increasingly unequal. In the United States as a whole, the richest 1 percent now earn more per year than the bottom 40 percent combined. In California, the richest 1 percent now earn more per year than the bottom 60 percent.
Wealthy households, of course, wield vastly disproportionate political power. But they have tended to be less interested in public services that support the general welfare and more interested in isolating themselves from social problems. Walled off behind gated communities and windows with iron bars, they have been more inclined to spend public funds to build prisons than to improve social conditions. In an eerie mirror image, the two hottest areas in California’s construction industry today are the building of gated residential communities and the building of gated prisons.
As money gets concentrated in the hands of fewer people, so does political power, and public policies tend increasingly to reflect the desires of the wealthy few. According to the California Budget Project, in the 1950s one dollar of every hundred dollars in state personal income went to building schools, roads, and water systems. By 1997, however, that public investment was down to a barely visible seven cents.
Studies have shown that failure in school is stastically more closely linked to criminal violence than smoking is to cancer. But in the 1990s, California became the first state in the country to spend more on prisons than on education. In the last 25 years, as economic power has becoming increasingly concentrated in the hands of ever fewer people, California’s spending on education has dropped dramatically while the state’s prison budget has multiplied by a factor of fifty.
There are now five times as many African-American men in California prisons as there are in California state universities. And the state now has the highest youth incarceration rate in the country.
The consequences to public health have been equally tragic. California, which used to rank at the top of the nation in health statistics, now ranks near the bottom. The state now has the nation’s highest percentage of families without health insurance.
Unfortunately, California is not an aberration. It is an example. Wherever inequality of wealth distribution becomes extreme, societies tend to spend less on public education and social safety nets. This takes a toll on the health of everyone, not just the poor.
There are few things worse for human health than for a society to become increasingly polarized between the have-nots and the have-everythings.