The concentration of global wealth in the hands and bank accounts of relatively few people is behind more than just 2011's Occupy Wall Street movement. Social epidemiologist Roman Pabayo says it's also affecting our health.
"When the Occupy Wall Street movement made headlines, it also made income inequality a topic of conversation," he says. "It brought to light the unfair advantages the rich have over the poor, and research in this area picked up steam."
Oxfam reports that in 2017, 82 per cent of the wealth generated that year went to the richest one per cent of the global population. Pabayo says that inequality will always exist, but the gap is widening. "The result is health inequities-the disadvantaged can't afford the same access to resources and opportunities for health."
Pabayo's research has made an important connection between income inequality and the mental health of adolescents, and what he found is that girls in particular are being affected.
Depression amongst teens is a growing public health concern in the U.S., where Pabayo's study took place, and in Canada. "Depression is the leading risk factor for suicide, which is the ninth leading cause of mortality in Canada."
"And, while depression itself is an obvious health issue, it has other serious implications-the ability to work, maintain relationships and social interactions, and participate in healthy behaviours such as obtaining sufficient sleep and physical activity. Mental health is a determinant for overall health and well-being."
The study asked boys and girls in grades 9 through 12 in public secondary schools in Boston to report how often they experienced certain symptoms in the previous month. Symptoms include feeling very sad; feeling grouchy, irritable or in a bad mood; feeling hopeless about the future; sleeping a lot more or less than usual; and having difficulty concentrating on school work.
The results showed that girls living in neighbourhoods with higher inequality had significantly higher depression scores than girls living in more equal areas. The same was not true for boys, though.
According to Pabayo, this was not surprising as boys and girls tend to cope differently. "Generally speaking, boys externalize their stress through aggression. Girls, on the other hand, will internalize their problems."
Pabayo's study also highlights the mechanisms at work connecting income inequality to depression.
For one, living in a neighbourhood with a high level of income inequality leads to comparisons with others and, ultimately, a sense of deprivation. "Social comparisons trigger feelings of inadequacy and unfairness and it can enhance our frustration with lack of status-something adolescents are becoming aware of at that age."
Income inequality erodes social cohesion-a factor Pabayo also examined. "Social cohesion is essentially a feeling of community. It means people feel connected and that they can trust one another. They feel like they belong," he explains.
"The erosion of social cohesion and trust lead to fear and insecurity which are associated with depression and can affect all people of all income levels."
Pabayo's study measured students' perception of social cohesion in their neighbourhood by asking their level of agreement with statements that describe a cohesive community. The statements included:
- I live in a neighbourhood where people know and like each other.
- People in my neighbourhood are willing to help their neighbours.
- People in my neighbourhood generally get along with each other.
- People in my neighbourhood generally share the same beliefs about what is right and wrong.
- People in my neighbourhood can be trusted.
The results showed that student-reported social cohesion didn't explain a connection between the income inequality in a neighbourhood and depression amongst its youth. At an individual level, however, youth who had reported their neighbourhood was highly cohesive reported lower depressive symptom scores.
Pabayo says his research findings can be used to address the problem.
"Knowing that girls who live in neighbourhoods with certain economic conditions are at a greater risk, means interventions can be developed specific to their needs." He suggests in-school programs and supportive counselling could target girls in need.
Pabayo also says government investment over the long term would improve health for all members of a society-the most privileged and the most disadvantaged.
"Things like basic health coverage, funding for education and community and recreational programming level the playing field for members of a society," Pabayo says. "Not only does that encourage more positive feelings in a community, it also means we have more equal access to opportunities to be healthy."