inequality and child wellbeing kate e pickett, phd frsa ffph
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Inequality and child wellbeing
Kate E Pickett, PhD FRSA FFPH
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Fig 1 All cause mortality in children aged 0-14 years in European countries (three year moving average)10.
Wolfe I et al. BMJ 2011;342:bmj.d1277
©2011 by British Medical Journal Publishing Group
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The UNICEF Index of Child Well-being, 2007
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Child Well-being is Better in More Equal Rich Countries
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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Child wellbeing and income inequality in US States
Correlations and p-values Income inequality Average income
Foundation for Child Development 25-item index 0.43
(0.002)
-0.61
(<0.001)
Kids Count 10-item index (shown in graph) 0.51
(<0.001)
-0.53
(<0.001)
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Child outcomes related to income inequality
• In rich countries– Infant mortality– Low birth weight– Overweight– Educational
achievement– Peer relations– Bullying– Teenage births– Social mobility
• In US states– Infant mortality– Low birth weight– Overweight– Educational
achievement– Mental health
problems– Teenage pregnancy– Juvenile homicides
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More children are overweight in more unequal countries
Source: Wilkinson & Pickett, The Spirit Level (2009)
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Elgar FJ, Craig W, Boyce W, Morgan A, Vella-Zarb R. Income inequality and school bullying: multilevel study of adolescents in 37 countries. J Adolesc Health. Oct 2009;45(4):351-359.
Income inequality and school bullying by 11-year-olds in 37 countries (r = .62)
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www.equalitytrust.org.ukWilkinson & Pickett, The Spirit Level
Social mobility is lower in more unequal countries
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0
5
10
15
Singlemothers
Low HighFather's social class
Infa
nt
de
ath
s p
er
10
00 England & Wales Sweden
0
5
10
15
Singlemothers
Low HighFather's social class
Infa
nt
de
ath
s p
er
10
00 England & Wales Sweden
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
Infant mortality rates by social class
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Literacy Scores of 16-25 year olds by Parents' Education
-1.5
-1
-0.5
0
0.5
1
2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Parents' Education (years)
Lit
erac
y sc
ore
Sweden
Canada
United States
Source: Willms JD. 1997. Data from OECD Programme for International Student Assessment.
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Why are children so sensitive to inequality?
• Effects of relative poverty on material resources?
• Impact on family life and relationships?
• Direct experience of increased status differentiation?
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Inequality affects family life & relationships
Source: Wilkinson & Pickett, The Spirit Level (2009) www.equalitytrust.org.uk
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Inequality affects family life & relationships
Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F397–F412. 2005.
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Iacoviello M. Household Debt and Income Inequality, 1963–2003. Journal of Money, Credit and Banking 2008;40(5):929-65.
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The Effect of Caste Identity on Children's Performance
Caste Unannounced
Caste Announced
0
1
2
3
4
5
6
High Caste
Low Caste
Num
ber
of m
azes
sol
ved
Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004
Status differentiation has a direct effect on cognitive performance
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Inequalities become entrenched early in life
• Cognitive scores at 3 years of age (MCS)
• Children with the most educated parents 12 months ahead of those with the least educated parents
• Children in families with incomes below our poverty line had scores
about 8 months behind those with incomes above it
• White children about half a month ahead of the all-UK average, followed by children from a mixed ethnic background, about half a month behind
• Bangladeshi and Pakistani children lowest vocabulary scores, with averages around 35, characteristic of the lowest tenth in the population at large
http://www.cls.ioe.ac.uk
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Prenatal exposures have long-term effects
• PRENATAL STRESS– Alcohol– Nutrition– Cigarette smoke– Breastfeeding– BIRTH WEIGHT/GESTATION
Cardiovascular disease Diabetes Mental health/behaviour IQ and education Reproductive health Social status (marriage) Birth weight of next generation Health-related behaviours Birth weight of next generation
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Postnatal exposures have long-term effects
• Poor attachment• Maternal depression• Breastfeeding• Poor parenting
Failure to thrive Mental health/behaviour IQ and education Social mobility Health-related behaviours
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A two stage process: parental experiences of inequality shape child development
Parenting styles prepare children for the kind of social relations they may have to deal with in adulthood
Preparation for a society dependent on:- • trust, cooperation, reciprocity, empathy?
or:• fending for yourself, not trusting others?
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Low Income Inequality (Gini) High
Ch
ild
Wel
lbei
ng
Inequality and Child Wellbeing (UNICEF Rpt 2013)
Pickett & Wilkinson, Pediatrics. (forthcoming)
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Inequality change 2000-2010 (gini)
Ch
ild
wel
lbei
ng
Ch
ang
e 20
00-2
010
Changes in inequality and child wellbeing (UNICEF Index)
Pickett & Wilkinson, Pediatrics. (forthcoming)
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