Inequality Is Destroying Mental Health

WRITTEN BY: OLIVIER DE SCHUTTER and KATE PICKETT

According to an Ipsos poll conducted in 2018, 27% of global respondents said mental health was one of the biggest health problems.

When the poll was repeated this year, that figure had risen to 45%, with mental health overtaking cancer and obesity as the top concern.

They are right to worry.

A 2023 study found that half the world’s population will develop a mental-health disorder in their lifetime.

But as of 2020, average government spending on mental health represented only 2.1% of health expenditures.

While policymakers should increase spending on mental health, prevention is better than treatment.

Addressing the problem at its root could mean implementing programmes aimed at reducing poverty, which, given the relentless strain of economic insecurity, is a major risk factor.

But a recent United Nations report (which one of us prepared) found that relative poverty (how an individual fares against others) fuels mental illness more than absolute poverty (being unable to afford the essentials) does.

This suggests that reducing income inequality would have a greater impact on mental-health outcomes.

STATUS ANXIETY

The UN report comes six years after one of us co-authored ‘The Inner Level’.

That book demonstrated that people living in more unequal countries, such as the United States and the United Kingdom, suffer more from chronic stress, anxiety, depression, bipolar disorder, and addiction than those in more equal societies, including Norway, Finland, and Japan.

With income inequality at alarmingly high levels, and mental health currently a bigger concern than cancer, governments – especially in wealthy countries – evidently need a reminder that the prosperity of the few is not to the benefit of all.

As the gap between rich and poor has widened, individuals increasingly value themselves and others in terms of material wealth, driving a mentally damaging race to the top.

This ever-deepening division between haves and have-nots fuels status anxiety about how one is seen or judged by others, releasing a barrage of stress hormones.

People compete to prove their worth by buying more stuff, even if it means going into debt.

All this erodes the social capital and weakens the supportive environments that help people cope with stress.

PERFORMATIVE CONSUMPTION

In this bleak landscape of inequity, performative consumption, and isolation, it is hardly surprising that people find themselves more prone to depression, anxiety, and other mental-health problems.

And while those at the bottom of the social hierarchy suffer the most, they are not alone.

The rich are also more likely to experience status anxiety, as well as worse outcomes on almost every other quality-of-life indicator, the more unequal a society is.

Over the past 40 years, high-income countries have achieved economic growth by privatising public assets, giving tax breaks to corporations and the wealthy, chipping away at workers’ rights, and implementing austerity measures.

But these efforts to boost GDP have nearly always made life worse for the poor.

Reaching a certain level of affluence has triggered spiraling inequality in many countries, canceling out the gains in wellbeing that economic growth is supposed to deliver and pushing the rungs of the social ladder farther apart.

TAXING THE RICH

Money can buy many things, but health is not one of them.

If advanced economies are serious about tackling their frighteningly high rates of psychopathology, their governments must focus on reducing inequality, not chasing GDP growth that only makes the rich richer.

Raising taxes on multinationals and the wealthy to fund universal social protection and improved public amenities would be a good place to start.

The world has become more open to conversations about mental health in recent years, but the same is not always true about taxing the rich.

Given that it could be one of the most promising ways to address the growing mental-health crisis, policymakers must not shy away from the debate.

– Olivier De Schutter is United Nations special rapporteur on extreme poverty and human rights. Kate Pickett, professor of epidemiology at the University of York, is co-founder of The Equality Trust and co-author (with Richard Wilkinson) of ‘The Spirit Level: Why Equality Is Better for Everyone’ and ‘The Inner Level: How More Equal Societies Reduce Stress, Restore Sanity, and Improve Everyone’s Well-being’.

– Copyright: Project Syndicate, 2024; www.project-syndicate.org