a few cultural differences

matt b · Apr 30, 2010

Oh, and I'm also waiting on this to arrive, which was discussed on Thinking Allowed a couple of weeks ago, which is available to listen to here

scottdisco · Apr 30, 2010

matt b said:
The spirit level book (linked to in my above post) is ALL about the negative impact of inequality on a whole range of social outcomes, from mental health, to education, violence, teenage pregnancy etc etc.

It mainly uses statistical analysis to show the relationship and then sociological/psychological studies to suggest causes.

It focusses mainly on 'developed' nations- Portugal being the 'least developed' (Paraguay's not even in the index), mainly because the overall thrust of the argument is that increasing wealth/GDP alone doesn't create a 'better' society, despite the claims of politicians and economists.

all true facts

and the USA is the least equal nation on earth among wealthy countries of course

(goes w out saying i use 'developing economies' blah blah and all that as convenient shorthand)

matt b · Apr 30, 2010

scottdisco said:
(goes w out saying i use 'developing economies' blah blah and all that as convenient shorthand)

I know, but you can't be too careful!

USA is well out there on some of the graphs:

Mr. Tea · May 1, 2010

matt b said:
I know, but you can't be too careful!

USA is well out there on some of the graphs:

That's an interesting graph, but it does make me wonder: how exactly are they quantising "health and social problems"? I mean, there must be a virtually infinite number of different ways you could apportion weight and significance to all kinds of different indicators. In contrast to income inequality, which is well defined.

For example, the "social problems" index presumably doesn't attach too much significance to the suicide rate, which is twice as high in Sweden as is it in the (apparently highly dysfunctional) UK. And Japan's is far higher still. OK, so there's more to how 'healthy' a society is than how low or high the suicide rate is, but to me it seems a pretty significant figure.

grizzleb · May 1, 2010

Cheers for that Tea, I wanted to make a point along those lines but couldn't think of any way of showing that "Japan isn't all that good actually" so I just left it.

How do you quantify health and social problems?

nomadthethird · May 1, 2010

Mr. Tea said:
That's an interesting graph, but it does make me wonder: how exactly are they quantising "health and social problems"? I mean, there must be a virtually infinite number of different ways you could apportion weight and significance to all kinds of different indicators. In contrast to income inequality, which is well defined.

For example, the "social problems" index presumably doesn't attach too much significance to the suicide rate, which is twice as high in Sweden as is it in the (apparently highly dysfunctional) UK. And Japan's is far higher still. OK, so there's more to how 'healthy' a society is than how low or high the suicide rate is, but to me it seems a pretty significant figure.

I wondered the same thing.

These sorts of quantitative measurements of largely qualitative phenomena are almost inevitably skewed toward whatever the ideological bent of the data analyst happens to be. In statistics there are entirely different ways of dealing with straightforward "discrete" measurements (like height, income, etc) and the other stuff. I'm not sure what kind of test they used to determine statistical significance, but the margin of error *has* to be huge on this distribution.

I mean, it's not paradise here, by any stretch, but I'm guessing they don't count, say, extreme forms of social and sexual repression in that index, of the type that causes high suicide rates. And I would.

scottdisco · May 1, 2010

it's not addressing y'all very interesting interventions re suicide etc but i found the following from the bloke who wrote Matt's book (and so is therefore the man responsible for the framing of the graph i assume).

In societies where income differences between rich and poor are smaller, the statistics show that community life is stronger and more people feel they can trust others. There is also less violence - including lower homicide rates; health tends to be better and life expectancy is higher. In fact most of the problems related to relative deprivation are reduced: prison populations are smaller, teenage birth rates are lower, maths and literacy scores tend to be higher, and there is less obesity.

That is a lot to attribute to inequality, but all these relationships have been demonstrated in at least two independent settings: among the richest developed societies, and among the 50 states of the USA. In both cases, places with smaller income differences do better and the relationships cannot be dismissed as chance findings. Some of them have already been shown in large numbers of studies - there are over 170 looking at the tendency for health to be better in more equal societies and something like 40 looking at the relation between violence and inequality. As you might expect, inequality makes a larger contribution to some problems than others, and it is of course far from being the only cause of social ills. But it does look as if the scale of inequality is the most important single explanation for the huge differences in the prevalence of social problems between societies. The relationships tend to be strongest among problems which show the sharpest class differences and are most closely related to relative deprivation.
The most obvious explanation for these patterns is that more unequal societies have more social problems because they have more poor people. But this is not the main explanation. Most of the effect of inequality is the result of worse outcomes across the vast majority of the population. In a more unequal society, even middle class people on good incomes are likely to be less healthy, less likely to be involved in community life, more likely to be obese, and more likely to be victims of violence. Similarly, their children are likely to do less well at school, are more likely to use drugs and more likely to become teenage parents.
The first thing to recognise is that we are dealing with the effects of relative rather than absolute deprivation and poverty. Violence, poor health or school failure are not problems which can be solved by economic growth. Everyone getting richer without redistribution doesn't help. Although economic growth remains important in poorer countries, across the richest 25 or 30 countries, there is no tendency whatsoever for health to be better among the most affluent rather than the least affluent of these rich countries. The same is also true of levels of violence, teenage pregnancy rates, literacy and maths scores among school children, and even obesity rates. In poorer countries both inequality and economic growth are important to outcomes such as health, but rich countries have reached a level of development beyond which further rises in material living standards do not help reduce health or social problems. While greater equality is important at all levels of economic development, the connection between life expectancy and Gross National Income per head weakens as countries get richer until, among the very richest countries, the connection disappears entirely.

However, within each country, ill health and social problems are closely associated with income. The more deprived areas in our societies have more of most problems. So what does it mean if the differences in income within rich societies matter, but income differences between them do not? It tells us that what matters is where we stand in relation to others in our own society. The issue is social status and relative income. So for example, why the USA has the highest homicide rates, the highest teenage pregnancy rates, the highest rates of imprisonment, and comes about 28th in the international league table of life expectancy, is because it also has the biggest income differences. In contrast, countries like Japan, Sweden and Norway, although not as rich as the US, all have smaller income differences and do well on all these measures. Even among the 50 states of the USA, those with smaller income differences perform as well as more egalitarian countries on most of these measures.

the rest of it is from a blurb taken from here (no discussion of statistics or anything there i admit, it's more a sourced thinkpiece).
the author is Richard Wilkinson, a professor of social epidemiology, University of Notts Medical School.

just to throw some light on the terms in which the graph was (presumably) wove together

mixed_biscuits · May 1, 2010

I think the 'strangely' high suicide rates in Scandinavia and Japan may be related to the stigma attached to admitting weakness/claiming difference (which itself may be a reflection of cultural homogeneity and the presence of strong normative values) - many people may choose not to disclose their problems until late, or never. So, suicide may either be the 'tip of the iceberg' and a fair reflection of the real extent of mental health problems or, more charitably, may also be the outcome of less serious problems that were exacerbated by not having been dealt with at an earlier stage.

In societies that place high value on being seen as homogeneous and strong ('don't let the side down') - I'm thinking of Japan here, especially - there may also be less of an inclination to collect data that may undermine this self-conception (as well as to 'create' non-problems (cf. supposed over-medicalisation in the US) or identify actual problems).

Socially less homogeneous societies (eg. UK) may provide more opportunities for honest self-assessment of health and happiness, as there is greater scope for the individual to critique cultural norms and his/her relation to them: 'there's more than one side to the story.'

I would ask, 'What does it take to be in the bottom-left of that graph?' and I would say that these are the prerequisites:

- very strong economy, so that income equalising measures can be financed
- high cultural homogeneity, with attendant strong sense of obligation to the collective
- low reporting of health/social problems, as individuals feel obliged to the collective
- poor collection of health/social problem data, as collective self-concept comes first

In order to maintain its position in the bottom-left, a country would need to be un-accepting both to cultural outliers and to outlying individuals (with health/social problems), hence the restrictive Scandinavian and highly restrictive Japanese immigration policies.

scottdisco · May 1, 2010

i admire anyone who has a sociological stab at this Biscuits, and realise the following tiny nitpicking is going to look churlish in the context of a thoughtful, sizeable post from you, but

(my bolded emphasis follows)

mixed_biscuits said:
- poor collection of health/social problem data, as collective self-concept comes first

End result: general intolerance of outliers, either culturally or in terms of health.

purely wrt the frames of reference of Matt's graph (which sparked these fascinating suicide etc debates) it's clear what the author of the piece regards as health/social problems to be discussed in relation to his thesis, and his sorts of stats, for better or worse (obesity, violence, educational achievement rates in the 'three R's' among kids, imprisonment figures and so on) are easily collectable and verifiable by statisticians, public agencies etc (indeed, mandated as such in most wealthy nations you'd think), certainly in any stable, mature democracy.

as i say, sorry to butt in w one tiny little thing as the meat of your post has something, i think, (and your conclusion very much worth pondering) but i just wanted to note the above.

mixed_biscuits · May 1, 2010

scottdisco said:
as i say, sorry to butt in w one tiny little thing as the meat of your post has something, i think, (and your conclusion very much worth pondering) but i just wanted to note the above.

That's fine - hadn't looked into the context of the graph. Just taking an idea and running/stumbling with it.

I guess the conclusion to the particular line I have presented is that one might be faced with a choice: between equalising incomes within nations and equalising incomes between nations.

scottdisco · May 1, 2010

mixed_biscuits said:
That's fine - hadn't looked into the context of the graph. Just taking an idea and running/stumbling with it.

I guess the conclusion to the particular line I have presented is that one might be forced with a choice: between equalising incomes within a nation and equalising incomes between nations.

yeah, interesting that.

incidentally, i know Scandinavian countries are - of course - not as ethnically diverse societies as say Canada, but i gather - i have no hard stats here, just half-remembered readings etc - these days aren't they becoming more and more cosmopolitan, more and more immigration (i don't want to make it sound like i am a 'flooding' narrative tool, just noting) etc changing the face of these societies (literally). i admit the impression i have of Japan is it definitely remains a fairly ethnically homogeneous country, granted. (this is a sidenote to a sidenote really, and i'm not making a 'point' here, just observing. i guess i could think out loud and say i don't think we need to bring immigration into any discussion of this nature.)

scottdisco · May 1, 2010

mixed_biscuits said:
there may also be less of an inclination to collect data that may undermine this self-conception (as well as to 'create' non-problems (cf. supposed over-medicalisation in the US) or identify actual problems).

bit off-topic maybe but i thought as long as Nomad (or anyone really, but i respect Nomad's background on these matters) has recently been on thread i would ask her a question inspired by something M_B says here.

over-medicalisation in the US: what does anyone think?

my following own formulation is totally not backed up w any knowledge, just a very hazy set of views (that might be out of date or totally off-beam) but the very general impression i tend to get of a lot of medication that is prescribed for mental or emotional health issues in the US is over-medicalising (and obviously big pharma is a very powerful sector in the USA, even more so than it is in fairly comparable countries * like the UK)

obviously this simple assertion of opinion is problematic; what would my suggested alternatives be? (in the absence of oh i don't know a massive state-funded programme of psychotherapy and free fruit, which is clearly cloud-cuckoo.)

etc.

and so on.

it is fair to say though, isn't it, that chucking drugs at mental and emotional health issues in the States is a fairly standard response from the medical profession there, right? (if not, my bad.)

if this is the case, then i would say that this is over-medicalising (though, again, w the caveat my alternatives of what could be done instead in the USA as it is today are hooey, tbh).

anyway, what does anyone think about this? is all i really meant.

i appreciate the above is very personalised, no stats etc, just sayin'...

* ie similarly unequal societies, confident and very vocal private sector, influentiual small-state lovin' press that acts as cheerleader for private enterprise and attacks the overbearing govt. at every opportunity, etc.

p.s.
total anecdotage so obv of no worth other than incidental but i always, always, always remember being strangely impressed that an (American) ex of mine, she just knew all sorts of (over the counter) drugs, for all sorts of ailments, all sorts of things. and she was no hypochondriac or anything. (all i can remember about medical drugs is i had Calpol as a kid for bad throats, and of course there's paracetamol for headaches etc.)

obv i just walked into the local NHS surgery and the nice doctor did things for me if i ever needed it in Britain... ...i should probably educate myself more tbf about these sorts of things, and obv if i was brought up in the States i probably would have done...

scottdisco · May 1, 2010

incidentally i've just been reading Nomad talking about SSRIs in the 'bloody miserable' thread (in Misc., that swears commented in today)...

scottdisco · May 1, 2010

btw i am acquainting myself w a few things four_five_one and Nomad, etc, said from around page 14 of the night owl or lark thread here re SSRIs, etc, (came across it accidentally when searching for board mentions of Sasha Grey * so please take my simplistic warblings re these issues w a kindly, and large, pinch of salt please folks)

* make of that what you will!!

polystyle · May 1, 2010

scottdisco said:
yeah, interesting that.
i admit the impression i have of Japan is it definitely remains a fairly ethnically homogeneous country, granted. (this is a sidenote to a sidenote really, and i'm not making a 'point' here, just observing. i guess i could think out loud and say i don't think we need to bring immigration into any discussion of this nature.)

Scott I would raise you on that , I would venture Japan is still a quite 'ethnically homogeneous country',
with many issues that one just doesn't talk about > do anything about.
It's got to be the most ossified , overly static 'cratic country .
No hope is a large problem there.
A current NHK TV drama's subject is ... the coming of the black ships to Japan, obv. still a topic.
The flip side of 'cool japan'.

scottdisco · May 1, 2010

polystyle desu said:
Scott I would raise you on that , I would venture Japan is still a quite 'ethnically homogeneous country',
with many issues that one just doesn't talk about > do anything about.
It's got to be the most ossified , overly static 'cratic country .
No hope is a large problem there.
A current NHK TV drama's subject is ... the coming of the black ships to Japan, obv. still a topic.
The flip side of 'cool japan'.

agreed yes; the quiet stultifying and repressed salaryman cliches, etc etc etc., "no hope" for reals i guess.
think the most ossified is a fair shout.

to get back to that graph, i knew that the USA, followed by Portugal and the UK, were the least equal wealthy societies, but seeing it in that form was kinda shocking. i didn't quite know income inequality, rendered graphically, was that far out...

(btw re my 'the impression i get' etc type mealy-mouthed language, for various boring reasons i am almost always phrasing over-delicately and unnecessarily politely on the board, esp these days, rather appropriate of me perhaps to explicitly admit that for once, on this thread of all places!! haha.)

polystyle · May 1, 2010

Yeah, maybe I shouldn't THE most ossified, but it's right up there , in a gray politicorp way.
My wife (Japanese ) and I hear about so many suicides over the years, have dealt with some close to home.

scottdisco · May 1, 2010

polystyle desu said:
Yeah, maybe I shouldn't THE most ossified, but it's right up there , in a gray politicorp way.
My wife (Japanese ) and I hear about so many suicides over the years, have dealt with some close to home.

ach man, that's horrible to hear. i'm sorry

isn't it the case (please stop me if i'm crossing over into some mythic line the outside world gets wrong about Japan) that you do get plenty of office joes offing themselves for (the ostensible 'reason', anyway) some minor professional infringement?

apologies to any/all if i sound so dim-witted on this issue, suicide, suicide stats, etc isn't something i've considered really at all since i was 16 and reading up on Durkheim and anomie etc etc for sociology class...

nomadthethird · May 1, 2010

Basically, there has been a problem with over-prescription of some psychiatric medications due to misdiagnosis. But this 'problem' is far less wide-spread and far less of a gravely serious issue than a lot of people would have you believe.

People reeeeally, reeeally need to get over the 'commonsense' notion that chemicals are somehow going to disrupt the precious sanctity of the magical noumenal entity that is the "mind". The "mind" IS chemicals, and the only way to make a "mind" better will always be to alter its biochemical balance. Whether this is achieved by pharmaceutical modalities, or electrical stimulation, or brain surgery, or any number of things, will be the real issue in the future.

Another thing people need to get over, because it's ridiculous: the idea that people are more depressed now than they ever were. CITATIONS PLEASE on that one... it's one of those ridiculous conservative nostalgic-for-and-imaginary-past canards that I absolutely hate to see "leftists" parroting.

Molecular genetics has been and will be winning the argument against "over-medicalization" for years to come. This sort of argument tends to come from places and people who simply don't know the science. More and more, America is losing it's scientific edge over other countries; it's no longer just Americans who understand neurochemistry anymore.

I'm not worried; Chinese and other researchers are poised to take the lead on a lot of this stuff. You *will* see an increase in effective treatments for mental illness, and you *will* see increasingly better trained physicians who make good diagnostic decisions. It has nothing to do with America and everything to do with the fact that certain key discoveries have been made- to go into it all here would take too long, but I'll try looking up some decent reading for people who are interested.

scottdisco · May 1, 2010

thanks much Nomad, you're a star, your first two paragraphs are the sort of thing i was hoping to hear about.

and agreed re yr fisking 'people are now more depressed than ever'...

a few cultural differences

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