This is an extract from an interview with Richard Wilkinson and Kate Pickett, conducted shortly after the publication of their latest book, The Inner Level. The interview was conducted by Jonathan Gadsby, of the Critical Mental Health Nurses’ Network.
Kate and Richard’s book, The Spirit Level, published in 2009, was a significant addition to research about inequality, and is undoubtedly known by many readers of Asylum. It provided evidence that inequality (rather than just poverty) is strongly correlated with many problems in society, including health problems. Their new book, The Inner Level, updates that work and provides a new and more interpersonal focus. Jonathan caught up with them both at their office in York University.
Jonathan: Who do you most want to read The Inner Level?
Kate: When we wrote The Spirit Level, what we were showing was the effects on whole populations of inequality. The prevalence of different things in a population. That is quite an abstract idea. It has policy implications, but it is not always easy for people to see what it means for them in their lives. But it is actually affecting individual people’s feelings and thoughts and behaviours, so we wanted to tease that out and help people see how what is most important to them in their lives and relationships – that intimate world – is affected by structural things.
We wanted to write it for an audience who wouldn’t necessarily think they were interested in politics, sociology, economics, policy but are interested in their own life and well-being and that of their family and friends.
Jonathan: Do you think that your first book changed the debate about the importance of poverty versus the importance of inequality?
Richard: It is hard to tell whether we were just the beneficiaries of the rising interest in inequality post- financial crash, with Occupy… or whether we helped create that interest in inequality. For me, Tony Blair thought that inequality didn’t matter – perhaps it mattered in the 1930s when so many people were living in awful squalor, but now the bottom 20% of people in society had accommodation, flat screen televisions etc.… But we are drawing attention to the social effects of inequality. We often say that there is a naive view of inequality, that it only matters if it creates poverty, but we are trying to show that it affects us in all kinds of ways much more deeply – psychologically – I sometimes say that inequality is a social relationship between superiority and inferiority.
Kate: Put alongside things like Thomas Piketty’s analysis of the causes of inequality, the crisis, and other things that were going on – I think it was a key part in opening up that conversation leading to a wide acceptance that inequality itself is damaging. However, the book has been much more influential in some spheres than in others. The role of inequality is much more accepted at international level
– by the UN, the World Bank, the International Monetary Fund and by the World Economic Forum, who last year said it was the number one problem facing sustainable development in the world this decade… The arena in which we have had the least effect has been national level politics, because of the government we have had since 2010.
Jonathan: Would you say The Inner level is a hopeful book?
Richard: I think anything that gives you more understanding of a problem increases grounds for optimism. If it is giving understanding at the societal level on individual problems I think that is very strong grounds for optimism.
Kate: We do spend some time towards the end of the book talking about possible solutions, and that is hopeful. We feel that the zeitgeist is right for this book – the timing. It was right for The Spirit Level because of the global financial crisis. The timing is right for this one because of an epidemic of mental health problems, distress, discomfort and psychological distress being exceptionally high in this country.
Richard: I think there is also a growing recognition of the inadequacies of many forms of treatment of mental illness. There are books coming out all the time about the inadequacies of drug therapy treatment. Inevitably, very high rates of mental health issues leads people to want to think about context and not just about them as individual failings.
Kate: Danny Dorling has recently published a book called Peak Inequality and he thinks that in the UK we have reached peak income inequality and that things can only get better. I’m not so sure… but I think there are a huge number of people around the world, from different perspectives, who are now convinced that we have to have system change. A growing movement including people from all walks of life and academic disciplines – I think we will look back on this period of history as when the neoliberal journey came to an end.
We should also say that young people give us hope. In the ways that they seem to be thinking and voting and acting, compared to our generation, the younger generation are progressive in their thinking, they are less racist, less homophobic, and less misogynistic, less for Brexit. So that’s hope the future.
Jonathan: It was striking in the book that the main thing you ask for is more democracy – ‘democratisation of the economy’. Is this an anti-capitalist book?
Richard: It depends what you mean by capitalism. I don’t think we would suggest that there is no role for the market… It is a question of how much one modifies the market… we think that capitalism needs very major modifications particularly in the antisocial incentives it gives to business. I do think that to deal with the environmental problems that we are facing business has to change fundamentally. While you have shareholders who are demanding high profits and maximisation of profits I don’t think you can reach sustainability.
Kate: I would say this is an anti-business as usual book…. ‘Business as usual’ starts to look stupid, actually…
Jonathan: What would the economic democracy you describe look like within a mental health service? For staff and for service-users?
Richard: The staff as a whole would be choosing the people at the top and they would be answerable. Within companies with more democratic structures more information flows and this is part of the reason for their success.
Kate: When the National Health Service was founded it was a radical idea, with radical aims and values. Yet it was staffed with an incredible hierarchy. The hierarchy of employment within the NHS has always been staggeringly steep, with doctors at the top and cleaners at the bottom, and everybody treating each other rather horribly in-between. But… when we think about team care for anybody with a complex health condition, whether it’s physical or mental, the number of people that are involved – the number of skills that need to be brought to bear – why on earth should we value any one of those skills more than another? In terms of pay and prestige? I think we need a radical rethinking of contributions in teams.
Richard: Endless structures alienate people from what are the real social purposes of their roles. That means they don’t get feelings of purpose and self-worth.
Jonathan: Is there a danger that what you describe as a ‘correlation’ (between inequality and various outcomes for individual health and societal problems) could be interpreted as saying that the stratification occurs because of people’s ill-health, because of their lack of confidence, their psychological make-up or lack of social skills… that what we see is a sorting of society based on the very things that you’re noticing.
Richard: In order to counter that I say, okay, the common view is that the hierarchy is simply a sorting of people available, the less able go down and the resilient go up. But we could do this with hair colour. All the grey hairs in this room, all the light haired, all the dark haired on that side… But that sorting won’t change the hair colour of anyone in the room! And yet, in The Spirit Level, we showed that some of these problems were 10 times as common in more unequal societies, so it can’t be just a sorting process. And on that basis we argue that it is substantially a response to social differentiation, to inequality itself.
The Inner Level (Penguin Books, 2018) is available to buy in high street bookshops, or why not try hive.co.uk, a tax-paying UK online bookstore that also supports a tax-paying local bookshop of your choice.