Obama's 'My Brother's Keeper' initiative, and the limits of racial uplift

This past Thursday, President Obama announced the My Brother’s Keeper initiative, a partnership between the public and private sectors aimed at bettering outcomes for some of the nation’s most at-risk young men.  I of course appreciate what New York Times columnist Charles Blow (and Obama) are emphasizing here, but the materialist part of me gets frustrated with this approach to things. 

The struggles of young black men ultimately don't come down to the lack of hugs from their fathers, though obviously we all need that. Material conditions can facilitate nurturing relationships, and they can undermine them. When one looks to the material conditions under which so many young African-American men live, one finds things that are attributable largely to poverty, and are thus shared by many poor Latino and white kids too. But one also finds conditions that have been uniquely imposed upon blacks in this country, and one must address those too.

If Obama wants to truly address the underlying issues, he would create universal preschool, change the welfare system to directly attack child poverty, desegregate suburban housing and schools along lines of race and class, pump massive resources into inner-city schools, and radically transform our predatory criminal justice system, which does more to destroy the lives of young black boys and their families than any uplift efforts can possibly counter. 

Of course, I know that if Obama had a pliant Congress he actually would do many of these things, so I don't blame him entirely. But there is a danger to having our first black president approach these issues in this way, by essentially containing the problem to the behaviors of black adults, and the institutions in black communities, thereby absolving from responsibility and reparation those public and private institutions that sustain racial inequality and white privilege. On the subject of racial inequality, when something is proposed with which everyone nods in agreement (as appears to be the case here), that probably means it isn't worth much. Bit cynical of me, I suppose.

The real American exceptionalism: our lives are stressful, unhealthy, and short

Back in October 2012, New York Times writer Scott Shane described the idea of 'American exceptionalism' as an "opiate,“ inducing a kind of hubristic national stupor that prevents us from seeing things as they truly are.

The idea that God or history has uniquely blessed the United States, justifying a proselytizing posture toward the rest of the world, is an old one.  It returned to our national discourse in the last couple of years, when conservatives accused President Obama of backsliding in his belief that Americans are the 'chosen people.'

As Shane argued, the idea that American identity is a kind of calling can have positive consequences:  “this national characteristic...may inspire some people and politicians to perform heroically, rising to the level of our self-image."  But it can also be deeply dysfunctional, as politicians of all stripes trip over one another to reassure Americans "that their country, their achievements and their values are extraordinary," while profound problems are left unaddressed.

American patriotism has always -- and uniquely -- had this 'Stuart Smalley' taint to it, but as we collectively whistle through the graveyard of apparent national decline, it seems to have over-ripened a bit.  If John Winthrop's idea of America as the 'city on a hill' drawing the "eyes of all people" was to be more than just an expression of jingoism, it demanded (and demands) a delicate balance between description and aspiration.  When it morphs into mere self-affirmation, however, we Americans become a danger to ourselves -- and to others, who increasingly keep their eyes on us for fear of what might happen if they don't.

Sadly, as a recent international health study bracingly reminds us, most of the ways in which the United States is exceptional today are negative.

The Institute of Medicine just released a study comparing American health care outcomes to other industrialized countries.  And all rhetoric about the U.S. having the 'best health care system in the world' aside, the realities are shocking.  Despite spending far more per capita on health care than any other nation, the data make it abundantly clear that the American way of life has become nasty, increasingly brutish, and comparatively short.

The optimistic takeaway here is that almost everything described below is attributable to (and capable of being ameliorated by) public policy -- in health, but in much broader areas as well.  In other words, if we can once again rediscover our aspirational identity as Americans, change is possible.

Physician Steven Woolf, a professor at Virginia Commonwealth University, chaired the panel that wrote the report.  He and his co-authors were "stunned by the findings."  Americans "have a long-standing pattern of poorer health that is strikingly consistent and pervasive" over a person's lifetime, the study found.

The U.S. is at or near the bottom in virtually every health outcome:  life expectancy, obesity, diabetes, heart disease, and homicide.  We have much higher rates of death before the age of 50, accounting for most of the gap between the United States and our peer nations.

According to the report, most of these poor health outcomes are attributable to poor childhood health.

The USA has had the highest infant mortality rate of any developed country for several decades, due partly to a high rate of premature birth and low birth weight.  Dr. Woolf and his colleagues also note that the U.S. has by far the highest rate of child poverty, though they don't really touch on its role as a possible cause. 

Here is a graphic representation of the infant mortality gap:

This gap, interestingly, has a history.  

The gap between the United States and its peer nations was relatively wide in 1950s and early 1960s, and then rapidly closed.  Why did it close, and so quickly?  Policy -- the 'War on Poverty,' including Medicare/Medicaid, among other programs, which for the first time began to connect millions of Americans to the health care system (and to food) on a relatively consistent basis. 

And then, right around 1980, the gap re-emerged.  This coincided, not surprisingly, with Reagan-era cuts in public health and social programs; but it also coincided with an ongoing increase in economic inequality and insecurity.  Since 2000, the gap between the U.S. and its peers has expanded.  While infant mortality rates among African-American and Hispanics are high, this doesn't explain the gap -- white Americans have higher comparable rates as well.

In short, while we have continued to make progress over the past two decades, our peers have had much greater success:  “although U.S. infant mortality declined by 20 percent between 1990 and 2010,” the report notes, “other high-income countries experienced much steeper declines and halved their infant mortality rates over those two decades.”

The report doesn't really offer any explanations for the infant mortality gap, or for the poor health performance of the U.S. more generally, beyond behavioral factors like drug abuse, calorie consumption, not wearing seat belts, and the ubiquity of handgun violence.

I'm not a health expert, but I do think we need to consider one factor:  inequality.

While economic inequality within nations wasn't the focus of the Institute of Health report, we know from research by epidemiologists Richard Wilkinson and Kate Pickett that it strongly correlates with (and is reproduced by) health outcomes -- such as infant mortality (see above).

This is true in two senses.

First, nations with higher rates of economic inequality tend to have poorer health outcomes across the class structure -- in other words, while health outcomes are better the richer or more educated one is, they will still be lower than those of comparably placed people in more equal countries.  The Institute of Health report confirms this.

Second, economic (and educational) inequality and health outcomes are strongly correlated within societies.  In the U.S., life expectancy for white women without a high school diploma is 73.5 years, compared with 83.9 years for white women with a college degree or more.  For white men, the gap is even larger: 67.5 years for the least educated white men compared with 80.4 for those with a college degree or better.

Because the United States is drastically more unequal than any other comparable nation, the socio-economic gradient is much sharper here -- and its getting worse.  Indeed, we now have evidence that the life span of the least educated white Americans has actually contracted, falling a full four years since 1990.  The numbers are worse for women.  Some of this is attributable to changes in the labor market:  the share of working-age adults with less than a high school diploma who did not have health insurance rose to 43 percent in 2006, up from 35 percent in 1993.  While full implementation of the Affordable Care Act in the coming years may help somewhat, the deeper problems of rising inequality and economic insecurity -- and the debilitating stress and anxiety that accompany them -- remain.

Poor health outcomes, as well as inequality, are greatly exacerbated in the U.S. by our social geography, and its intersection with the nation's original sin of race.  American metropolitan areas have become increasingly segregated by income over the past two decades.  We don't yet have a full picture of the health consequences of this trend, though it certainly is both a cause and a consequence of growing inequality during the same period.

But we do know the health consequences of America's stubbornly persistent pattern of racial segregation.  African-Americans not only have poorer health outcomes than whites overall; this is true even when income and education are held constant.  More than 100 studies over the past decade confirm that racism acts as a classic chronic stressor, with serious physiological consequences: higher blood pressure, elevated heart rate, increases in the stress hormone cortisol, suppressed immunity.  Chronic stress is also known to encourage unhealthy behaviors, such as smoking and eating too much, that themselves raise the risk of disease.  Most of these investigations have been done in the United States, but a growing body of literature originates elsewhere.  "Across multiple societies, you're finding similar kinds of relationships," David Williams, a sociologist at the Harvard School of Public Health, told the Boston Globe.  "There is a phenomenon here that is quite robust."

Racism also appears to have an impact on fetal and infant health, setting off a likely cascade of negative consequences.

Epidemiologists James W. Collins, Jr. and Richard J. David have uncovered a disturbing fact:  American-born black women are significantly more likely to have low birth weight babies than white women are, regardless of income level or education.  The cause, they argue, is steady and life-long exposure to racism and its consequences.  Since low birth weight correlates strongly with poor health (and educational) outcomes later in life, the relationship between race, place and health is clearly a big factor in the reproduction of racial inequality in the U.S.

This relationship has been confirmed more recently in a widely publicized study in the January 2013 issue of the Journal of the American Medical Association, on racial segregation and lung cancer.  After controlling for income and smoking rates, Dr. Awori Hayanga and his colleagues found that lung cancer mortality rates (a ratio of deaths to a population) were about 20 percent higher for blacks who lived in the most segregated American counties, than for blacks living in the least segregated counties.  The more segregated the community, the higher the mortality rate for blacks -- and, disturbingly, the lower the rates were for whites.  They surmised that differential access to health insurance and relevant and timely treatment were largely at fault.  The research of Collins and David also directs us towards the stressors of racism itself, which are in part rooted in America's unequal racial geography.

“If you want to learn about someone’s health, follow him home,” Dr. Hayanga, a heart and lung surgeon at the University of Pittsburgh Medical Center, told the New York Times.   This message -- about the relationship between place, health, and inequality -- was perhaps most powerfully conveyed for an American popular audience by the award-winning documentary Unnatural Causes.

In other words, our unequal and insecure American way of life is making us sick -- and more unequal.

While the mechanisms that connect inequality with poor health outcomes are many and hard to disentangle, it seems clear that stress and insecurity are critical.  Both affect the cardiovascular and immune systems, and both are found in abundance and in greater numbers in unequal societies -- and their effects are devastating on the young in particular.

Thomas McInerny, president of the American Academy of Pediatrics, reacted to the Institute of Health study by pointing to recent research on the long-term impact of "toxic stress" on the health and cognitive development of babies and toddlers.   "It's becoming increasingly clear that the first 1,000 days of life are critically important for children's development, and can determine the course of their life span from then on," McInerny says. "Investing in children in the first three years of life provides higher returns, for improving their productivity as adults, compared to intervening later."

Back in 2007, UNICEF put together an index of child well-being.  It measured material and educational factors, health and safety, peer and family relationships, surveys of subjective well-being, and behavioral risks.  When Wilkinson and Pickett lined this index up with rates of income inequality, they found something striking:  the more unequal a society is, the worse its rates of child well-being -- not just among poor children, but overall:

These correlations and comparisons make one thing clear:  America's poor health outcomes, particularly for our children, can be ameliorated.  Why?  Because the differences between the U.S. and its peers, ultimately, are policy differences -- and thus are amenable to collective action.  We can make America healthier (and more productive) by making it less unequal, and by investing in pre-natal care, early childhood health, and high quality and universal pre-school.  "We already know what to do," Dr. Woolf says. "It's more a matter of having the resolve and resources to actually do it."

Notwithstanding the false scarcity of our current austerity politics, we have the resources.

Notwithstanding the libertarian and narcissistic braying of the privileged, our well-being is ultimately inseparable from that of our fellow Americans.

Whether we have the resolve to see this will ultimately determine whether the term 'American exceptionalism' serves to damn or praise our national experiment.

Three-60: A few ideas about renewing opportunity

As many of you know, GOP presidential hopeful Herman Cain has proposed a reform to our tax system: the '9-9-9' plan.  Go take a look at it.  The plan calls for a 9% income tax, 9% national sales tax and 9% corporate income tax.  Cain says it would create tax equality and stabilize federal finances.  


Think of this as a descendent of Steve Forbes' 'flat tax' proposal of a few years ago, with all of the same drawbacks -- it will starve the federal government of funds, it will heavily shift the tax burden in a regressive direction, it is based on a simplistic notion of 'fairness,' and it is based on a misdiagnosis of what ails the American opportunity structure.


I'm not going to pick apart Cain's idea here.  Much.  I'm sure he figured that if 9-9-9 can sell large 1 topping pizzas,  it must signal some kind of grand universal Pythagorian harmony.  The plutocrats who dominate his party will like it, because it drastically cuts their taxes.  The Club for Growth types will favor it, because it proposes to drown the federal government in 9 inches of bathtub water.  And the religious right will be ecstatic, since it turns Satan's numbers upside-down.  It is conveniently in sync with the only tool in the conservative tool box -- shrinking government.  


It is said that if your only tool is a hammer, pretty soon every problem will begin to resemble a nail.  But of course, not every problem is a nail.  In this particular case, the 'hammer' Cain is swinging so wildly bears substantial responsibility for the current mess, and will cripple our ability to provide some measure of security and opportunity for most of our citizens now and in the future.  American conservatism seems to have become a kind of political auto-immune disease, systematically stripping us of the power and resources to address common needs and threats.  Cain et all seem to be swinging their hammer in a fit of nihilistic pique, caring little for what gets smashed.  Its an odd place for conservatives to be, isn't it?


One can, of course, understand the appeal of simple answers to seemingly complex questions.  Our politics is filled with a full metal jacket of these magic bullets -- from 'drill baby drill,' to high stakes testing of public school kids (and now, implicitly, of their teachers).   The principle of 'Occam's Razor' is too often interpreted to mean that simpler explanations and solutions are generally better than complex ones.  But there is a difference between 'simple,' and 'simplistic,' and what Occam's Razor really provides us is a heuristic for assigning the burden of proof.  


A 'simple' solution is only preferable if its explanatory power and empirical validity is equal to or greater than a solution of greater complexity.  'Creationism' is a less complex explanation for the existence of human beings than evolution is, after all.  Believers in Creation don't have to follow or understand complex causal chains, or grapple with the inevitability of randomness, or contemplate a universe that lacks a telos (a purpose) or prime mover (or has one that isn't discoverable by us).  Or worry about how Noah found room on the Ark for all those dinosaurs, and did so without sinking.  


At a certain point, don't we have a moral responsibility to be intelligent?


Anyway, my purpose here isn't to explore logical fallacies, or dissect the phenomenological flaws of the conservative mind.  Nor is it to directly critique Cain's proposal, which I believe is too simplistic to be worthy of consideration.


Rather, I wish to make a downpayment on a more empirically sound version of Cain's 9-9-9.  This is very much a first run at this.  I'll come back with more links to research, and tweak a few things.  But what follows is coherent enough to provoke conversation.


Let's try Three-60.  


I've listed three ideas below.  In each case, we generate $60 billion in additional federal revenue per year, and then aim that money at vital public investments of similar cost that will make all of us wealthier in the end, in every sense.  As an added bonus, the regressive tax shifting of the past 3 decades will be somewhat reversed, and each of the 3 ideas would stimulate the economy and create jobs, immediately.
  
None of these ideas is rooted in wishful thinking; in each case, there is ample research to demonstrate the multiplier effects.  I will fill in more details on this research as this post grows and expands.  


I'm sure we can come up with a catchy slogan -- 'complete the circle,' etc etc.  


1.  The Bush tax cuts for the wealthy go, and we get new 21st century public schools (and 0.5 million jobs):


REVENUES:  Raise $60 billion a year, by eliminating the Bush tax cuts for those with incomes above $250,000, returning the top rate to 39.6%, as it was under Clinton.  This would raise approximately $60 billion a year, while affecting less than 2% of households.  Politically this is the easiest of the 3 tax reforms I propose here, because it simply requires Congress to do nothing.  I think they can do that, don't you?


INVESTMENTS:   Use the $60 billion above to address the backlog of repairs and deferred maintenance at the nation's 100,000 public schools...and create 0.5 million construction jobs in the process.  The 21st Century School Fund, the Economic Policy Institute and the Center on Budget and Policy Priorities have recently proposed the Fix America’s Schools Today (FAST) program, which is what I'm advocating here.  Hammered by the recession, local governments are unable to do this themselves; indeed, many of them have been laying off teachers and deferring maintenance, both of which are expensive to all of us in the long run.  Even if states and localities do attempt to pay for such things, they will mostly do so by increasing property and sales taxes, which land much more heavily on ordinary American families and small businesses than the federal ones I'm tweaking here.  Senator Sherrod Brown (D-OH) introduced a variation on the FAST program back in September, for only $30 billion.  Let's double it, and consistently devote the revenues raised each year by my proposal above to a kind of educational infrastructure bank.  This shouldn't be a one-shot stimulus, but rather an ongoing effort to maintain and improve our entire public school infrastructure -- and expand it, as I argue in #2 below.  This will create jobs, improve public education, and relieve states and localities of financial burdens.  What's not to like?


2.  Reform the estate tax, and we get a world class system of universal and public early education.



REVENUES:  The United States now has the greatest concentration of wealth in the hands of  the rich in nearly a century. As billionaire Warren Buffett reminds us, “Without the estate tax, you in effect will have an aristocracy of wealth, which means you pass down the ability to command the resources of the nation based on heredity rather  than merit.”


The estate tax is a tax on the transfer of assets at death -- a tax on inherited wealth, in other words.  We could eliminate it for those with estates under $2 million ($4 million for a couple), and use graduated rates for estates above that size (let's say 45% on the taxable portion below $10 million, with an additional 10% tax on the amount above that).  This would raise between $40 billion and $60 billion a year.  It would affect no more than 1 of every 200 estates, and would have a variety of positive effects beyond the revenue it would raise (and beyond the useful things we might purchase with that money -- see below).



INVESTMENTS:  According to Jane Waldfogel of Columbia University, approximately $60 billion a year would pay for universal preschool for all 3-and-4-year-olds, with relatively small class sizes.  Spending on early childhood development and education is perhaps one of the best examples of positive public investment.  Indeed, I would argue, it is the single most important social policy of the 21st century -- a moral and economic imperative on a par with addressing global warming.  James Heckman, a Nobel laureate at the University of Chicago, has written extensively about the economic benefits of high-quality early education.  David Kirp usefully synthesized some of this research in his readable 2009 work, The Sandbox Investment.  


Extensive economic and cognitive research has demonstrated that investments in early childhood development (particularly before the age of five) have very high (and long-lived) returns at very low levels of risk.  An individual’s success in the labor market and quality of life is strongly influenced by their first years in childhood. The long-term benefits of early investment in child development, particularly in disadvantaged youth, include lower spending on remedial and special education, lower spending on health interventions, increased school completion and higher academic achievement, higher incomes (and therefore tax payments), lower spending on means-tested income assistance, and lower criminal justice costs.  The returns (the 'multiplier effects') are estimated to be between $13 and $17 per dollar spent on early education.


Aside from the obvious long-term benefits above, I can think of 2 other more immediate advantages of this.


First, it is stimulative.  Because many states presently lack a public early education infrastructure, expenditures over the first few years would be heavily weighted toward construction and the hiring of teachers...thus boosting employment.  Also, by providing free child care, universal public early education would relieve an enormous economic burden for young working families, thus increasing demand in the economy.  


Second, the American opportunity structure is fundamentally broken, and this proposal would move us toward a repair.  American children can go to public school from kindergarten through high school, at no cost to their parents.  While there are many ways in which public schooling has historically reproduced social and economic inequalities, rather than erasing them (race is the most obvious example), for much of the century after the end of the Civil War it served the dual purposes of social mobility and economic growth reasonably well, at least for white Americans.  


Over the past 30 years, however, it has become increasingly necessary for American parents to extend the education of their children both backwards and forwards in time -- for 2 or 3 years before kindergarten, and 4 (or more) years after high school.  While k-12 is free, the burden of paying for these additional years falls almost entirely on individual families.  Since early childhood education and college education are so incredibly important for (in the first case) cognitive and social development, and for human capital and earning capacity (in the second case), AND because their costs have increased far faster than incomes have, we have essentially privatized the link between education and opportunity in the US.  And because we have privatized it, we have mainlined inequality straight into the heart of our opportunity structure.  We can already see its effects, and there is nothing in place at present to check it.  I cannot stress this point enough, and one must take a long historical view to see it.  The fault lines of racial inequality have always permeated our educational system, even as we moved away from the formal apartheid set-up under which we lived for so long.   They are still there, embedded within our social geography (housing and school segregation), and we have done very little to reverse it since the Milliken decision in the mid-70s.  These racial inequalities have now been joined (and reinforced) by class inequalities.


My father and I originally proposed something like this back in our 2005 book, in part because the politics of it are just so elegant.  As Warren Buffett and Elizabeth Warren have both argued recently, the wealthy have attained their elevated status in part because of the social wealth and public investments of their fellow citizens.  A recognition of that inter-dependence fits nicely with the idea of 'paying it forward.'  The wealthy not only pass on the overwhelming majority of their privilege to their children -- they pass it on to all American children, and thus to the society which enabled them to live so well.  Hard to argue with, no?


3.  A new tax bracket for income over $2 million, and make college free for about 80% of full-time students.


REVENUES:  Raise $60 billion a year, by creating a new top tax bracket (let's say, 50%), which would be levied on income over $2 million.  This would also raise approximately $60 billion a year.


INVESTMENT:  Around 80% of full-time college students in the U.S. attend either four-year public universities, or two-year schools.  Approximately 2.5 million students are enrolled full-time at two-year colleges, paying around $18 billion in tuition, fees, room and board (minus financial aid).  4.7 million are enrolled at public four-year colleges, paying in the neighborhood of $47 billion each year.    


Thus, creating a new tax bracket for income above $2 million would enable four out of every five full-time college students to go to school for free, at present costs.  


I'm a little less excited about this one, because there are some complications.  Three leap to mind.  


For one, the cost of higher education has risen faster than inflation for decades now.  There is a danger that this proposal would effectively subsidize universities unnecessarily, and even create incentives for further price increases.  Or, to put it more mildly, it accepts the present cost structure, instead of seeking to change it.  Of course, massive federal participation would presumably create leverage for serious change, particularly if (as I propose here) the funding is aimed at students attending public universities, not private ones.  And if the money goes to students and their families -- not the universities themselves -- then perhaps they can put the power of choice and competition to work.  


Second, the federal subsidies I'm proposing here would presumably go to every student, including those who come from families that can afford to pay for school themselves.  One imagines that the subsidies could be scaled in some way to address this, or taxed back, perhaps.


Third, by advocating this idea, I don't want any readers to think that I believe that sending every American to college is the answer to the inequality and economic stagnation of the past 3 or 4 decades.  I don't.  Our economy doesn't generate enough living wage jobs; our public and private social safety net has become increasingly frayed, leaving a growing percentage of Americans vulnerable to economic insecurity; class inequalities are not only increasing, but are being reinforced and exacerbated by our educational and health care systems, as well as our tax system.  Sending more kids to college won't solve this.  Or, to put it differently, the problem with the American economy isn't its workers.


These caveats aside, I do think the benefits of doing this would be huge.  Let's list just a few:
*  Perhaps this is the most obvious benefit, but it would clearly increase the knowledge and critical thinking skills of millions of young adults, with all the likely social, political and economic gains this will bring
*  In a labor market which increasingly uses higher education as the gatekeeper -- the obstacle that must be leapt in order to gain access to economic security and the primary social goods we need to be truly free -- this proposal will help to reverse the stunning class inequalities of American higher education.
*  Most college students graduate today with between $20,000 and $30,000 worth of debt, not including credit card debt.  This has a series of cascading effects, shaping decisions about career choice, family formation, entrance into the housing market, the purchase of health care, etc.  Relatedly, many parents spend down their home equity and their retirement funds to send their children to college and keep them there.  If college is fully funded, this releases demand into the economy.  In 1979, Pell Grants covered 75% of the cost of a four-year public university education; today, they cover less than a third.  This proposal reverses the trend.
*  Free college would enable students willing and able to do so to pursue graduate and professional education, because they won't have to immediately get to work to pay off debt.  It will also enable many graduates to go into professions that are less profitable, but of great social value -- like teaching, for example.


Let me know what you think!

how inequality reproduces itself, and why policy matters

Nancy Folbre, economist at UMass-Amherst, has a thought-provoking piece on yesterday's NY Times Economix Blog, "Born to Lose: Health Inequality at Birth."

In the post, she summarizes some of the work by Princeton's Janet Currie and others, on the relationship between health disadvantages at birth, and future economic well-being and educational achievement.  


One of the most fascinating and important interdisciplinary research agendas of the last decade has been the effort by economists, sociologists and epidemiologists to understand how inequality is reproduced in the developed world, and how/why inequality matters.  To the extent that I have any optimism left about the possibility of a more just America, it is based on my reading of this literature.  Of course, as a theoretical and empirical matter this question (inequality) is hardly new; the reproduction of capitalist class relations has generated some of the most insightful intellectual work of the past 150 years, starting with Marx.


But this work -- typified for me by the vital work of Richard Wilkinson and Kate Pickett in Great Britain, and James Heckman, Thomas Shapiro/Melvin Oliver, and Annette Lareau in the US -- is different.  It isn't theoretical, at least not primarily.  Rather, it seeks to understand how inequality is partly rooted in such things as pre-natal and and infant health, the environmental factors shaping cognitive development, social capital, nutrition, exposure to violence, the correlation of all of these things with place, and the overall income and wealth inequality in the society in which children are raised.  It acknowledges the vital importance of resources, of course (family income and wealth), and the power that shapes their distribution.  But it also attempts to show us why and how a lack of wealth and income matters -- how it shapes places, families, bodies, minds, and ways of seeing the world.  In the context of the US, as I have argued elsewhere (and will argue further here in the future), the ubiquity of racial and economic segregation also appears to profoundly shape all of these things, and thus the distribution of primary social goods.  It is (and will be) my contention that untying the knot of metropolitan segregation is likely to unravel many more things.  But more on that later.


I see 3 absolutely vital (and interrelated) insights coming from this stuff:
1.    International comparisons (see Wilkinson's work with Kate Pickett) reveal that income inequality within  developed societies tends to have enormous impacts on health, culture and quality of life for all citizens, not just the least privileged.  In other words, citizens living in societies with great inequalities of income tend to have worse outcomes in terms of mental health, obesity, social trust, exposure to violence, life expectancy, and social mobility.  The statistical correlations are simply too strong and consistent not to be at least in part causative.  The graph below comes from Wilkinson and Pickett, and can be found on their website.  Note the strong relationship between income inequality and infant mortality, which appears to be recursive -- in other words, inequality leads to high infant mortality rates, which tends to reproduce inequality, etc.





2.  Policy matters, because those developed nations with less inequality (and the improved quality of life that seems to stem from it) are more equal because they have chosen it -- its not culture that matters here, or economic growth.  And just as the circle of inequality is vicious, the circle of equality is virtuous:  in so far as a society chooses to be more equal, it tends to be more willing to make decisions (even sacrifices) that will benefit the collective good.