Mind the gap How inequality facilitates poorer social and health outcomes

Transcription

1 Mind the gap How inequality facilitates poorer social and health outcomes Sandeep Mishra

2 Inequality, risk, and health Why do inequality and risk matter? Individual-level effects of inequality Disparity, risk-taking, and deprivation Deprivation, risk, and health in a community sample Implications for policy Social mobility and inequality of opportunity Policy changes Summary

3 Inequality, risk, and health Why do inequality and risk matter? Individual-level effects of inequality Disparity, risk-taking, and deprivation Deprivation, risk, and health in a community sample Environmental-level effects of inequality Inequality and health in the workplace Summary and implications

4 Why does inequality matter?

5 Why does inequality matter? The richest 20% control 69% of wealth in Canada, 85% of wealth in the US (pre-recession) Source: Mother Jones Magazine; StatsCan; US Federal Reserve, US Bureau of Labor Statistics

6 Why does inequality matter? Source: Mother Jones Magazine; US Congressional Budget Office Data

7 Inequality has social consequences Social capital Trust Community support Women s status Foreign aid Family integrity Educational outcomes Imprisonment Wilkinson & Pickett (2009) The Spirit Level

8 Inequality has health consequences Homicide Mental health/well-being Illegal drug use Physical health Life expectancy Morbidity and mortality Teen pregnancies Obesity Wilkinson & Pickett (2009) The Spirit Level

9 Wilkinson & Pickett (2009) The Spirit Level

10 Why do relative outcomes matter? Poverty vs. inequality Absolute vs. relative outcomes Wilkinson & Pickett (2009) Individual-level effects Social comparisons Relative deprivation Stress and tension Environmental-level effects Sensitivity to the treatment of others Effects at the top and the bottom

11 Why does risk matter? Risk-taking may underlie many social and health-related outcomes Antisocial behavior Mishra & Lalumière (2009) Soc Sci Med, Mishra et al. (2011) J Gamb Stud Gambling/problem gambling Mishra et al. (2010) Pers Indiv Diff Health and well-being Byrnes et al. (1999) Psyc Bull The generality of risk and health Osgood et al. (1988) Am Sociol Rev, Hirschi & Gottfredson (1994) The Generality of Deviance, Mishra (2014) Pers Soc Psyc Rev, Mishra & Carleton (2015) Soc Sci Med Shared instigative/protective factors Stinchfield (2004)

12 Inequality, risk, and health Why do inequality and risk matter? Individual-level effects of inequality Disparity, risk-taking, and deprivation Deprivation, risk, and health in a community sample Environmental-level effects of inequality Inequality and health in the workplace Summary and implications

13 Risk-taking Risk is outcome variance

14 Risk-taking Risk-taking is typically considered irrational and reckless.. But there are circumstances where risktaking is rational and adaptive

15 Disparity and risk Disparity may facilitate risk-taking Obtaining otherwise unavailable/unattainable desirable outcomes Mishra (2014) Pers Soc Psyc Rev Imagine you have an immediate $5,000 debt: Would you rather choose a sure payout of $500, or a gamble offering a 10% chance at $5,000? Risk-sensitivity theory Gonzales, Mishra, & Camp (under review) J Behav Dec Mak, Mishra, Barclay, & Lalumière (2014) Evol Hum Behav, Mishra, Barclay & Sparks (under review) Pers Soc Psyc Rev, Mishra & Fiddick (2012) J Pers Soc Psyc, Mishra & Lalumière (2010) J Exp Soc Psyc, Mishra, Son Hing, & Lalumière (2015) Ev Psyc, Mishra & Novakowski (2016) Pers Indiv Diff, Mishra (2014) Pers Soc Psyc Rev

16 Risk-sensitivity theory Decision-makers shift from risk-aversion to risk-proneness under situations of need Need à disparity between an individual s present and desired (goal) states High need = large disparity Low need = small disparity Reviewed in Mishra (2014) Pers Soc Psyc Rev

17 Risk-sensitivity theory Desired state (Others condition) Present state (My condition) Reviewed in Mishra (2014) Pers Soc Psyc Rev

18 Risk-sensitivity theory Desired state Present state Reviewed in Mishra (2014) Pers Soc Psyc Rev

19 Risk-sensitivity theory Desired state Present state Reviewed in Mishra (2014) Pers Soc Psyc Rev

20 Risk-sensitivity theory Desired state Present state Reviewed in Mishra (2014) Pers Soc Psyc Rev

21 Risk-sensitivity theory Desired state Present state Reviewed in Mishra (2014) Pers Soc Psyc Rev

22 Risk-sensitivity theory LOW DISPARITY Desired state Present state Reviewed in Mishra (2014) Pers Soc Psyc Rev

23 Risk-sensitivity theory Desired state HIGH DISPARITY Present state Reviewed in Mishra (2014) Pers Soc Psyc Rev

24 Does risk-sensitivity theory predict risky decision-making in people?

25 Disparity and risk Descriptive decision-making Rode et al. (1999) Cognition 20 decisions: low-risk vs. high-risk Each decision made under a condition of either high disparity or low disparity

26 Disparity and risk You need to draw one black bead out of ten. You will earn $1 if you meet your target. Which option would you like to draw from? (a) A cup containing 5 white and 5 black beads. (b) A cup containing a random combination of 10 black and white beads.

27 Disparity and risk You need to draw one black bead out of ten. You will earn $1 if you meet your target. Which option would you like to draw from? (a) A cup containing 5 white and 5 black beads. (b) A cup containing a random combination of 10 black and white beads.

28 Disparity and risk You need to draw nine black beads out of ten. You will earn $1 if you meet your target. Which option would you like to draw from? (a) A cup containing 5 white and 5 black beads. (b) A cup containing a random combination of 10 black and white beads.

29 Disparity and risk You need to draw nine black beads out of ten. You will earn $1 if you meet your target. Which option would you like to draw from? (a) A cup containing 5 white and 5 black beads. (b) A cup containing a random combination of 10 black and white beads.

30 Disparity and risk 0.5 Decision Tendency Risk Preference Risk Avoidance Risk Preference Best Risk Avoidance Best Probability of Meeting Need Mishra & Lalumière (2010) J Exp Soc Psyc

31 Disparity and risk 0.5 Decision Tendency Risk Preference Risk Avoidance r =.88, p < Risk Preference Best Risk Avoidance Best Probability of Meeting Need Mishra & Lalumière (2010) J Exp Soc Psyc

32 Risk-sensitivity theory Growing research shows risk-sensitivity theory predicts risk-taking in various domains Status Mishra et al. (2014) Evol Hum Behav; Ermer et al. (2008) Evol Hum Behav Monetary Mishra et al. (2015) Ev Psyc; Mishra et al. (2012) Brit J Psyc Finance/Investment Mishra et al. (2012) Brit J Psyc Social Mishra & Fiddick (2012) J Pers Soc Psyc Ecological Mishra & Lalumière (2010) J Exp Soc Psyc and using different measures Descriptive/explicit Mishra & Fiddick (2012); Mishra et al. (2012, under review) Experiential/implicit Mishra & Lalumière (2010), Mishra et al. (2012)

33 Pay inequality and risk Inequality is a condition of disparity Comparison of one s own situation to situations of (often privileged) others Pay inequality should motivate risk-taking Risk-sensitivity theory Epidemiological evidence

34 Does inequality affect risk-taking at the individual level?

35 Dependent measure Choice task Mishra & Lalumière (2010) J Exp Soc Psyc 6 choices between low-risk and high-risk options Would you rather choose: [1] $3 guaranteed, or [2] 10% chance of $30? Participants received $$ from one of their choices

36 Income inequality and risk 94 participants Run in same-sex pairs No-inequality (control) conditions Pair members given $0 each Pair members given $10 each Inequality (experimental) condition One member of pair given $10, the other, $0 Mishra, Son Hing, & Lalumière (2015) Ev Psyc

37 Income inequality and risk Risky Choices (CT) Victim Beneficiary Equal ($0) Equal ($10) Mishra, Son Hing, & Lalumière (2015) Ev Psyc

38 Income inequality and risk Risky Choices (CT) Victim Beneficiary Equal ($0) Equal ($10) Mishra, Son Hing, & Lalumière (2015) Ev Psyc

39 Inequality and situational cues Unnecessary risk-taking is costly Most beneficial to modulate risk-taking based on immediate situational cues

40 Can the effects of inequality be eliminated by modifying people s immediate situations?

41 Income inequality stability and risk 96 participants in same-sex pairs, 2 part study Inequality either ameliorated or maintained Inequalityamelioration Inequalitymaintenance Initial Beneficiary à à Initial Victim à à

42 Income inequality stability and risk Same-sex pairs, 2 part study Inequality either ameliorated or maintained Inequalityamelioration Inequalitymaintenance Initial Beneficiary à à Initial Victim à à

43 Experimental design Same-sex pairs, 2 part study Inequality either ameliorated or maintained Inequalityamelioration Inequalitymaintenance Initial Beneficiary à à Initial Victim à à

44 Income inequality stability and risk Risky Choices (CT) Inequality- Amelioration Initial Victim Inequality- Maintenance Inequality- Amelioration Inequality- Maintenance Initial Beneficiary Mishra, Son Hing, & Lalumière (2015) Ev Psyc

45 Income inequality stability and risk First Decision Second Decision Risky Choices (CT) Inequality- Amelioration Initial Victim Inequality- Maintenance Inequality- Amelioration Inequality- Maintenance Initial Beneficiary Mishra, Son Hing, & Lalumière (2015) Ev Psyc

46 Income inequality stability and risk First Decision Second Decision Risky Choices (CT) Inequality- Amelioration Initial Victim Inequality- Maintenance Inequality- Amelioration Inequality- Maintenance Initial Beneficiary Mishra, Son Hing, & Lalumière (2015) Ev Psyc

47 Competitive disadvantage and risk Income inequality is an extrinsic source of inequality Same pattern of results found for intrinsic inequality Perceived competitive disadvantage relative to peers Mishra, Barclay, & Lalumière (2015) Evol Hum Behav

48 Summary Disparity and risk Inequality motivates risk-taking consistent with risk-sensitivity theory Income inequality (extrinsic) Competitive disadvantage (intrinsic) Effects of inequality on risk-taking are modifiable

49 Inequality, risk, and health Why do inequality and risk matter? Individual-level effects of inequality Disparity, risk-taking, and deprivation Deprivation, risk, and health in a community sample Environmental-level effects of inequality Inequality and health in the workplace Summary and implications

50 Relative deprivation Relative deprivation hypothesis Effects of inequality manifest through individuallevel relative deprivation Wilkinson & Pickett (2007) Soc Sci Med Epidemiological evidence links relative deprivation to risk and health broadly Mental and physical health Wilkinson (1997) Brit Med J Antisocial behavior Kawachi et al. (1999) Soc Sci Med Do these effects extend to individuals?

51 Community sample details Relationships with community organizations Lethbridge Homeless Shelter Womanspace Resource Center (office) Drug rehabilitation centers Family services, immigrant services, food banks N = 328 (age: M = 31.0, SD = 12.5, Range = 16 to 73) Includes drug addicts, gambling addicts, the homeless, convicts, exconvicts, affluent community members, average community members, students Mishra et al. (2012) OPGRC Research Report

52 Measures Predictor measures Feelings of relative deprivation Outcome measures Behavioral risk-taking (future discounting) Health related risk-taking Mental and physical health Gambling addiction and behavior Participants paid for participation plus earnings from decision-making tasks Mishra et al. (2012) OPGRC Research Report

53 Are feelings of relative deprivation associated with risk and health-related outcomes?

54 Deprivation and risk Future discounting: behavioral impulsivity Would you rather have $16 tonight or $30 in 35 days? rho =.25, p <.001 Health/safety related risk-taking How likely are you to engage in unprotected sex? r =.20, p <.001 Mishra & Novakowski (2016) Pers Indiv Diff

55 Deprivation and antisocial tendencies Antisocial behavior in the last year Property crime, violence/aggression, misdemeanors, social transgressions rho =.16, p =.005 Antisocial behavior over the lifetime rho =.19, p =.001 Mishra & Novakowski (2016) Pers Indiv Diff

56 Deprivation and antisocial tendencies 18 Yes No Feelings of Relative Deprivation Arrested Charged Convicted Incarcerated Mishra & Novakowski (2016) Pers Indiv Diff

57 Deprivation and health Mental health: anxiety and mood r = -.38, p <.001 Physical health (absolute) r = -.19, p =.001 Physical health (relative) r = -.29, p <.001 Mishra & Carleton (2015) Soc Sci Med

58 Are feelings of relative deprivation associated with gambling and problem gambling?

59 Deprivation and gambling $13B in annual Canadian gambling revenue 30-40% of revenue derived from problem gamblers Williams & Wood (2005) AGRI Report Problem gamblers represent 1-4% of population Mishra et al. (2011) J Gamb Stud

60 Deprivation and gambling General gambling involvement Frequency and variety of gambling in last year rho =.12, p =.03 Problem gambling severity index (PGSI) rho =.28, p <.001 Mishra, Meadows, & Carleton (under review) J Exp Soc Psyc

61 Deprivation and gambling 18 Feelings of Relative Deprivation Non-Problem Low-Risk Moderate Problem Categorical Problem Gambling Severity Mishra, Meadows, & Carleton (under review) J Exp Soc Psyc

62 Risk-persistence and risk-sensitivity Risk-persistent populations engage in risk-taking behavior consistently Generality of deviance Non-specialization of offenders Why are people risk-persistent? Environments may require risktaking to obtain reasonable outcomes (e.g., high inequality) Sensitivity to immediate costs/benefits Mishra et al. (under review) J Gamb Stud, Mishra et al. (2011) Pers Indiv Diff, Mishra et al. (2009) Soc Sci Med

63 Inequality and situational cues If risk-persistence is stable (via personality, developmental environment, socialization, low embodied capital, etc.) individuals from riskpersistent populations will consistently engage in risk-taking If risk-persistence is environmentally modulated individuals from risk-persistent populations will engage in risk-sensitive choice

64 Are risk-persistent individuals risksensitive decision makers?

65 Community sample Risk-persistent populations (antisocial) Convicts (usually also problem gamblers, drug addicts, delinquents), n = 85 Control populations Community controls, students, n = 243

66 Risk-propensity 2 Self-Reported Risk Propensity (Composite) Community (General) Students Problem Gamblers Ex-convicts Mishra (under review) Psyc Sci

67 Decision-making from description Decision-making from explicit descriptions Rode et al. (1999) Cognition 20 decisions: low-risk vs. high-risk Each decision made under a condition of either high disparity or low disparity

68 Decision-making from description 0.6 Proportion Risky Decisions High Need Low Need Mishra (under review) Psyc Sci

69 Decision-making from description Proportion Risky Decisions Community/student Risk-Persistent 0 High Need Low Need Mishra (under review) Psyc Sci

70 Decision-making from description Proportion Risky Decisions Community/student Risk-Persistent 0 High Need Low Need Mishra (under review) Psyc Sci

71 Summary Deprivation, risk, and health Relative deprivation associated with risk, health, and gambling at individual level Risk-persistent populations are risk-sensitive People sensitive to immediate costs/benefits, on average, regardless of stable traits Risk-persistence may be product of consistent exposure to disparity cues (inequality) Convergent evidence from experimental and survey studies

72 Executive summary Inequality has individual-level effects on risk-taking Risk-taking is acutely influenced by inequality Feelings of relative deprivation are associated with risk and health outcomes Risk-persistent people are rational, risk-sensitive decision makers

73 Executive summary Inequality has individual-level effects on risk-taking Risk-taking is acutely influenced by inequality Feelings of relative deprivation are associated with risk and health outcomes Risk-persistent people are rational, risk-sensitive decision makers

74 Implications The environment and situational cues matter in affecting risk and health behavior Plasticity of behavior Targeting modifiable conditions facilitating relative deprivation and inequality Equal access to health care, education, social support Social mobility

75 Inequality is a justice issue What kind of society do we want to live in? Normative ethical question: Emphasis on status and individual outcomes, or collective health and wellbeing?

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