Inequality and child wellbeing Kate E Pickett Ph

Inequality and child wellbeing Kate E Pickett, Ph. D FRSA FFPH

Fig 1 All cause mortality in children aged 0 -14 years in European countries

The UNICEF Index of Child Well-being, 2007

Child Well-being is Better in More Equal Rich Countries Source: Wilkinson & Pickett, The Spirit Level (2009) www. equalitytrust. org. uk

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)

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

More children are overweight in more unequal countries Source: Wilkinson & Pickett, The Spirit Level (2009)

Income inequality and school bullying by 11 year-olds in 37 countries (r =. 62) 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.

Social mobility is lower in more unequal countries Wilkinson & Pickett, The Spirit Level www. equalitytrust. org. uk

Infant mortality rates by social class Source: Wilkinson & Pickett, The Spirit Level (2009) www. equalitytrust. org. uk

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?

Inequality affects family life & relationships Source: Wilkinson & Pickett, The Spirit Level (2009) www. equalitytrust. org. uk

Inequality affects family life & relationships Source: Bowles S, Park Y. Economic Journal 2005; 115 (507): F 397–F 412. 2005.

Iacoviello M. Household Debt and Income Inequality, 1963– 2003. Journal of Money, Credit and Banking 2008; 40(5): 929 -65.

Status differentiation has a direct effect on cognitive performance Number of mazes solved The Effect of Caste Identity on Children's Performance Caste Unannounced Caste Announced Source: Hoff K, Pandey P, World Bank Policy Research Working Paper 3351, June 2004

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

Prenatal exposures have long-term effects • PRENATAL STRESS – – – Alcohol Nutrition Cigarette smoke Breastfeeding BIRTH WEIGHT/GESTATION Ø Ø Ø Ø Ø 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

Postnatal exposures have long-term effects • • Poor attachment Maternal depression Breastfeeding Poor parenting Ø Ø Ø Failure to thrive Mental health/behaviour IQ and education Social mobility Health-related behaviours

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?

Child Wellbeing Inequality and Child Wellbeing (UNICEF Rpt 2013) Low Income Inequality (Gini) Pickett & Wilkinson, Pediatrics. (forthcoming) High

Child wellbeing Change 2000 -2010 Changes in inequality and child wellbeing (UNICEF Index) Inequality change 2000 -2010 (gini) Pickett & Wilkinson, Pediatrics. (forthcoming)