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Evidence-based policy

Written By: - Date published: 1:05 pm, April 11th, 2011 - 64 comments
Categories: Environment, equality, jobs, workers' rights - Tags:

In science or business we want some level of proof that things work.  Those drugs the doctor prescribes have huge amounts of testing done to prove the effects they will have.  When you go to the bank with a business case, they prefer it if you don’t just have a dream, but evidence that your plan will work.

Maybe it’s my science background, but I think we should also employ such a radical suggestion in politics.  When parties advocate a policy, they should look to see if it will indeed work.  Rather than the faith-based policy or theories that agree with one’s prejudices that this government (and some in the past) have gone with.

Tax cuts for the rich to stimulate a depressed economy?  History suggests they’ll save (or retire debt), not spend.  Trickle-down theory?  The poor have not got noticeably richer in New Zealand or the US when such policies have been to the fore, even before we look back to the Victorian era.  Selling state assets?  Evidence suggests they’ll be bought up by overseas-based multi-nationals and local profits will leave the country, with another slice of our economic sovereignty (Bill English reckons he doesn’t need evidence to know it’s the best thing for the country).  Limiting workers’ rights, leaving the market to decide?  Some companies will deliver the least possible to their employees.  Monopolies in private hands?  They’ll be abused.  The free market?  Can work well if people are well-informed and make rational decisions, but can go horribly wrong if it’s based on fear, greed and limited data.

So what are some policies that will work?

Firstly, what are we aiming for as a society?  I’d vote for happiness – as my Dalai Lama fridge magnet says: “The purpose of our lives is to be happy.”  It’s a big goal, one that governments (other than Bhutan) have shied away from, preferring to aim for wealth.  But money can’t buy you love, and as the Spirit Level shows, after a certain level of wealth it doesn’t buy you happiness either.

What does evidence suggest will bring you happiness?  Equality, fairness, work-life balance (both some striving and achievement and some rest – and some measure of control over both), education, a good environment, and, perhaps most importantly, a good early childhood.  Looking closer you find that you can’t gain happiness by aiming for it directly, it has to be an outcome of another endeavour.  As a first suggestion for that endeavour, volunteering is so good for society and the individual that one wit has suggested it be made compulsory…

So what policies should we be pursuing to make society better?

– A strong focus on early childhood is a necessity.  If you don’t get that basic grounding, it’s very hard to learn the self control and self awareness to maintain happiness.  Studies like the Dunedin Longitudinal one are showing how important it is to concentrate on those early years.  It’s not just ECE (although it definitely includes that), but parenting classes, health check-ups and much more – it’s critical enough that there should be a whole of government focus on policies that affect small children.

– An aim of full employment, rather than neo-liberalism’s structural unemployment, will mean the maximum number of people will feel they are usefully striving and contributing something to society.  And we must balance that with appropriate labour laws to mean that that employees can demand that that work is under conditions where there is time for rest, a life outside work and not too much stress while there.

– Access to quality education that focusses on the whole individual (rather than National Standards’ focus on passing Maths & English tests, to the detriment of creativity, Science, any other subject and the love of learning itself) needs to be available for everyone from pre-schoolers to adult education.  Learning is a good in itself, even before the financial benefits.  When National canned Adult & Community Education, it wasn’t just the massive economy benefits that were lost, but many social ones too.

– New Zealand does well on many happiness measures because of our blessings with our natural environment.  We need to protect it, not mine the most sacred parts of it.  We need to make sure our rivers aren’t polluted and our water tables aren’t depleted, so that our children can enjoy NZ’s beauty.  And we need to do our part to mitigate climate change; we need an ETS that doesn’t just reward polluters at taxpayers’ expense.  This may bring tourism dollars, but a clean green environment is an end in itself.

– Last but not least, we need to look at a fairer income distribution.  As The Spirit Level shows us, disparities in wealth destroy our happiness, health and social cohesion, leading to everything from more crime to more teenage pregnancies and greater drug use.  We can -and shouldn’t be afraid to – address this with a fairer, more progressive tax system; lessening the burden on those on the bottom, and allowing those at the top to pay their share.  There are other things we can work on to make our society more egalitarian too – from making co-ops easier to greater worker representation on company boards (and just greater diversity on boards).

64 comments on “Evidence-based policy ”

  1. Stan 1

    Every nail hit right on the head. At long last – a vision rather than a list of policies trying to win votes. Re education, we still can’t do better than to interpret this Peter Fraser vision in a 21st century context:

    “The government’s objective, broadly expressed, is that all persons, whatever their level of ability, whether they live in town or country, have a right as citizens to a free education of the kind for which they are best fitted and to the fullest extent of their powers.”

    “Schools that are to cater for the whole population must offer courses that are as rich and varied as are the needs and abilities of the children who enter them.”

  2. Gosman 2

    ‘The Spirit Level’ and Evidence based policy in the same article. You lefties are a riot of laughs aren’t you.

    • Draco T Bastard 2.1

      The Spirit Level uses a lot of evidence and facts which, not unsurprisingly, goes against your RWNJ delusion.

      • Gosman 2.1.1

        Read the link I provided below and then come back with why the points raised are not valid.

        • Draco T Bastard

          No point, you’re sticking to your delusion.

          • Bazar

            Bravo, That’ll teach him.
            The nerve of some people, to openly critic the spirit level. Its made even worse when they provide logic, facts, and even citations.
            Theres just no reasoning with people like him. Lets just badmouth him while getting the last word in, so we feel superior.

  3. JS 3

    ..have a right as citizens to a free inclusive education… (ie don’t make some kids go to segregated learning environments)

  4. Anthony 4

    To be honest I can’t see any modern political party basing policy on evidence when the almighty focus group or ‘public opinion’ says otherwise.

  5. Gosman 5

    To read a comprehensive debunking of the so called ‘facts’ contained within ‘The Spirit level’ check out http://www.velvetgloveironfist.com/pdfs/SpiritLevelDelusion_Chapter10.pdf

    The book is just leftist propaganda mascarading as a serious academic work.

    • Gosman
      This is just like climate change.  The intellectuals present a coherent theory to explain observed incidents, RWNJs froth and deny, intellectuals justify, RWNJs jump behind and support some weird counter study and use it as a club to bash the intellectuals and claim victory.  Meanwhile the polar caps melt and the deserts grow.
      The same is happening with inequality and it is exceedingly clear that increasing inequality causes more problems.
      Here is a counter to your link:  http://www.equalitytrust.org.uk/docs/response-to-snowdon.pdf
      Your link is to RWNJ propaganda masquerading as serious work.

      • Gosman 5.1.1

        Yes it is a bit like the Climate Change denial debate, those supporting the ‘facts’ in ‘The Spirit Level’ are on the wrong side.

        You obviously didn’t bother to read that link I provided as it was written in response to that laughable excuse of a counter attack from the authors of ‘The Spirit Level’.

        Please try and provide relevant and up to date information next time, and perhaps you might want to respond to the points raised after you have bothered to read them.

      • Gosman 5.1.2

        What did you actually do there Mickeysavage? Did you just google response to critique on ‘The Spirit Level’ and just post the first link you found?

        • mickysavage

          I recalled reading a rather vigorous debate at http://www.kiwiblog.co.nz/2010/08/the_spirit_level_delusion.html and got the link from there.

          • Gosman

            So you didn’t bother to find out that the link I provided was actually written to counter the one you provided BEFORE you posted your link to counter my one???

            Rather poor form there old chap.

            • Anthony

              Just read the Spirit Level rebuttal you provided. It’s absolute rubbish.
              The whole thing is a collection of straw-man arguments based on intentional misinterpretations.

              • Gosman

                Where are the Straw-man arguments in that article?

                  • Gosman

                    The chapter starts on page 173. There are no pages 1 – 35.  As you should have noted if you had bothered to read the article rather than dismiss it because of your inherent left wing bias.

                • Gossman you are not interested in analysis.  You just want a wingnut argument so that you can cite it and jump up and down and shout that you are right.
                  Remember the Hobbit?  Did you ever revise your arguments after the information came out that it was all a have?
                  Ever thought about accepting you might be wrong?

                  • Gosman

                    Whenever I have been involved with a debate where facts have been forthcoming that highlight that my position may not have been correct I am always willing to change my position. Are you? Take this for example. Are you now willing to admit your attempt to debunk my link fell incredibly flat and just highlighted your inherent left wing bias in your views?

                    • Pascal's bookie

                      Like when you reckoned there was hardly any fighting in Baghdad? 

                      You just abandoned that discussion because it became evident that you didn’t have a clue what you talking about, so how can you claim to take the high ground on any topic?

                    • Gosman

                      You’ll have to provide a link on that one as I’m not sure what you are refering to here.

                      Edit: Don’t bother as I found the link. Once again your analysis is off as I never stated there was hardly any fighting in Baghdad.

                    • Pascal's bookie

                      I didn’t say you stated it, I said you reckoned it. Here’s what you said:

                      “Considering the insurgency was concentrated mainly in the Sunni Triangle areas outside Baghdad, and to a lesser extent down south it seems a bit rich to claim that a major part of the drop off in violence is the result of ‘ethnic’ cleansing in Baghdad. ”

                      This was in response to the idea that the fighting in Baghdad was intense, and that it’s resolution was a major part of the drop off in casualties.  It’s quite clear that you reckoned that Baghdad was a minor theatre compared even to the south of the country. Which is, you know, nonsense.

                      But there’s no need to re-litigate it here, people can go and watch you run away there:

                      Another sad day in Afghanistan

                    • Gosman

                      I didn’t reckon anythin of the sort. All I stated was that most of the fighting was undertaken outside Baghdad. The casualty figures for Coalition troops back this up.

                      Your view that the surge only worked because of ‘ethnic cleansing in Baghdad’ is not established fact merely your opinion.

                    • Pascal's bookie

                      The casualty figures for Coalition troops back this up

                      Considering most of the fighting was Iraqi on Iraqi, I’m not sure how the coalition casualties would back that up.

                      But like I said, no need to relitigate, folk can go and see that discussion if they are interested, where I provide links and you blather nonsensically.

                      They can draw their own conclusions regarding your comments both here and there, regarding this:

                      Whenever I have been involved with a debate where facts have been forthcoming that highlight that my position may not have been correct I am always willing to change my position.

  6. Shane Gallagher 6

    The Greens have all this covered already and more… So Anthony I take it you know who you are going to vote for? 🙂

    • Gosman 6.1

      A few questions for Mickeysavage, (and other lefties who have similar views).

      How can you dismiss the link I provided as “RWNJ propaganda masquerading as serious work” when it is obvious from your responses that you didn’t even bother to read the article in question?

      Is it because your massive left-wing bias has already made up your mind on this subject and therefore no amount of discussion will sway you from your beliefs?

      If it is, then how can you claim to take the intellectual moral high ground on this, or any other, topic?

      • mickysavage 6.1.1

        I was just paraphrasing you Gossman.
        I have read plenty on the subject and my world experiences reinforce the conclusions reached.  I then read the counter stuff and it does not explain anything.  It tries to limit the need for change and action by sowing confusion.  This has happened with climate change as well as inequality.
        And then RWNJs borrow the language of the left and try to stake out the moral high ground on the issue.
        BTW have you actually read the Spirit Level?

        • Gosman

          Yes I have. A quite terrible piece of leftist twaddle. The fact that the authors are left wing in their views and have been involved with left wing organisations for a number of years should have alerted most rational people to the fact that the book was not some sort of serious academic investigation but had a political purpose.

          • Draco T Bastard

            Reality has a radical left-wing bias. Rational people would realise that anything you say is pure delusion.

          • mickysavage

            Yep those humanist intellectuals are out to destroy society as we know it, hear me destroy it.  They are preparing the world for a take over by Borg who should be here in their invisible spaceships any time soon.

            • Colonial Viper

              Borg don’t tend to bother with cloaking their vessels. No need.

            • Gosman

              My opinion is no different to a leftist dismissing opinions based on some supposed right wing link or funding.

          • RedLogix

            Gosman has made his mind up; evidence is irrelevant.

            His null hypothesis is never advanced, ie if he wants to tell us that the argument in The Spirit Level is bunk, then he has to defend the proposition that inequality is either irrelevant to human welfare, or that more inequality is beneficial to it.
            Both propositions can be demolished with a few seconds thought, they are both so weak that notably even Gosman hasn’t attempted to go down this path.
            Instead he is opting for the now very familiar climate change denier delaying tactic; sowing confusion, doubt and discord, appealing to peoples’ fears and insecurities. The sole aim is to to derail the appearance of a consensus and delay action.

            • higherstandard

              A far better demonstration…..

              “Plotting life expectancy against income for every country since 1810, Hans shows how the world we live in is radically different from the world most of us imagine.”

              • RedLogix

                Irrelevant. Seen it before. And proof positive that you have not read The Spirit Level. Hans Rosling’s video makes a point, but a very basic and obvious one that scarcely rates his breathless delivery.
                For a start his use of ‘life expectancy’ is pretty unqualified. It’s a statistic that by itself is hugely influenced by infant mortality, which in turn is influenced hugely by the quality of public infrastructure such as clean public water supplies, and widespread free basic medical treatment. These things don’t take great wealth.. just sound, stable governance and decent social policy.

                By itself life expectancy is only one measurement of development, and one with numerous difficulties.
                Nor is ‘income’ very useful on the other axis. There is a well known effect with income levels below about U$10k GDP/per capita where absolute poverty dominates the ‘quality of life data’ , while above this level income tends to have a relatively weak effect on welfare. This isn’t the best link I’ve seen, but it does show this highly nonlinear effect quite clearly.
                For this reason the authors of The Spirit Level spend some time explaining exactly why they select only the OECD developed nations for their study. They explicitly excluded the undeveloped nations in order to avoid wholly unjustifiable comparisons.
                Moreover they also spend some time demonstrating how absolute income in the developed nations has only a weak correlation with human welfare and happiness.
                In other words the video you link to, while interesting from a historic perspective, is virtually mute on the topic we are discussing here.

                • higherstandard

                  “And proof positive that you have not read The Spirit Level. ”

                  I have read the Spirit Level you retard – it is a fairly boring load of pap which people who consider themselves either to the left or to the right of the spectrum wank on about interminably and make the kinds of vacuous assertions such as your typewank in relation to prehistoric humans being.

                  • RedLogix

                    OK… I attempted a reasoned response. In reply I get abuse from you.  I wonder what you thought that was going to achieve?
                    The book explains in great detail exactly why plotting ‘income versus life expectancy’ data across all countries fails to give meaningful information. Which is why the Hans Rosling video is interesting, but totally tangential to the argument.
                    The fact that you would reference to it with the phrase “a much better demonstration” is incontrovertible proof in my mind that you have not read the book.  Or if you did skim through it… you understood nothing.

                    • higherstandard

                      “Introconvertible proof in my mind.”

                      ha ha ha …….  

                      As I said previously ..it is a fairly boring load of pap which people who consider themselves either to the left or to the right of the spectrum wank on about interminably.

                      Although nature says it that far more eloquently..” [it uses ] statistics from reputable independent sources” and was “a brave and imaginative effort to understand the intractable social problems that face rich democratic countries”

                      He went on to say, “How can inequality affect such a diverse set of social problems so profoundly? The authors make a compelling case that the key is neuroendocrinological stress, provoked by a perception that others enjoy a higher status than oneself, undermining self-esteem”.

                      “The idea that income inequality within a society is more unsettling to health and welfare than income differences between societies has been hotly debated for more than two decades. In the past year alone, six academic analyses have been published in peer-reviewed journals, four of which contradict the hypothesis on statistical grounds.

                      Sargent, Michael (30 April 2009). “Why Inequality is Fatal”. Nature 458: 1109–1110. 

                      ….and even supporters of decreasing income inequality take issue with their findings.


                    • RedLogix

                      Indulging in juvenile LOL’s and haha’s as a form of sneering put down achieves nothing. Do you imagine we haven’t seen them before?
                      Yes The Spirit Level isn’t a page turning thriller… it’s not meant to be. There are a lot of statistics, numbers and detailed lines of argument that require some degree of thought and attention to absorb. It doesn’t surprise me you found it boring.
                      In reading the reference you linked to the conclusion drawn is:

                      Improving social outcomes is certainly a worthwhile aim. What’s the best way to do it? According to Wilkinson and Pickett,

                      “Attempts to deal with health and social problems through the provision of specialized services have proved expensive and, at best, only partially effective…. The evidence presented in this book suggests that greater equality can address a wide range of problems across whole societies.”

                      I wish it were that simple. I share Wilkinson and Pickett’s conviction that it would be good for America and some other affluent nations to reduce income inequality, but this book hasn’t convinced me that doing so would help us to make much headway in improving health, safety, education, and trust. To achieve those gains, my sense is that our best course of action is greater commitment to specialized programs and services, coupled with poverty reduction.
                      Then again, I’m not certain that Wilkinson and Pickett are wrong. I’ve focused here mostly on the effect of inequality on life expectancy, because that is the social outcome for which the hypothesized causal link (stress) seems most plausible and because it has received the most attention in prior research. I’m skeptical that income inequality has much of an impact on average life expectancy. But perhaps life expectancy will turn out to be the exception to the rule.

                      Which is scarcely a damming debunking. What exactly are you trying to say here hs?

          • Puddleglum

            As Karl Popper so persuasively argued, science does not depend upon the motives, morality or even abilities of individual scientists. It is an institutionalised, collective pursuit.

            What ‘guarantees’ (obviously not in any absolute, once and for all sense) its knowledge are the institutions within which it operates – primarily peer review, academic freedom, dissemination of findings via learned peer-reviewed journals, etc. (see his ‘Poverty of Historicism’ for the argument). These guarantee a ‘competition of ideas’ which – as those on the right should accept – can change the most base motives into the collective good (ever heard of what Adam Smith believes the ‘free market’ is capable of?).

            You like facts, well the ‘fact’ is that W & P – irrespective of their political views – have successfully published scores of peer-reviewed articles many of which argue along the same lines as their conclusions in the book. That means that if what they have to say is “leftist twaddle” then the scientific process may as well pack up and go home – and Popper was a fool.

  7. PeteG 7

    We can -and shouldn’t be afraid to – address this with a fairer, more progressive tax system; lessening the burden on those on the bottom, and allowing those at the top to pay their share.

    If those at the bottom pay no tax is that a fair share? How can you lessen their burden and more?
    You presumably know that those at the top pay far more than their share now, how can you determine what is “fair”. Fairer tax system seems to be used as a euphemism for “more money for me, less for them”.
    Beyond the grand sounding generalities, what specifics are you suggesting? Or are you just trying to sell something that sounds good?

    • Lanthanide 7.1

      “If those at the bottom pay no tax is that a fair share?”
      Yes, because they’ve already been crapped on by society.

      “How can you lessen their burden and more?”
      By using a universal income model where those who earn nothing have an effective negative tax rate, eg they receive a benefit.

    • RobC 7.2

      “those at the top pay far more than their share now”

      Bullshit. If you can be bothered, go and educate yourself at Public Address – OnPoint (Keith Ng). He’s written about this more than once.

      Or keep spouting shit, your choice.

    • Ben Clark 7.3

      a euphemism for “more money for me, less for them”.
      Hi Pete, I’m not particularly advocating less tax for me.
      As for specifics, well I don’t have Treasury behind me to calculate what are practical numbers, but Phil Goff’s suggestions of a tax-free band at the bottom and a return of a higher tax rate for those earning noticeably over $100K sounds a good start.  There’d no doubt need to be some other tweaking of the tax system to make up any shortfall, although stopping tax dodgers will do a fair bit.
      Oh, and RobC’s right – you should go read Keith Ng’s excellent analysis if you think wealthy people are paying more than their share.

      • PeteG 7.3.1

        It depends on how you define “share” and “fair share”.
        I do think a total rethink and simplification of our tax and benefit system is overdue, but I don’t think it will happen. As soon as one group think they may be “hard done by” – ie get less money than now – or one party want to exploit a group to push a political advantage then the ensuing furore scares plans of real reform off the table of either of the main parties.
        So we end up with tweak upon tweak that add to the complexities and loopholes. Is it an inadvertent result, or is all the complexity and confusion designed to mask who really pays (and avoids) what? I suspect a bit of both.

        • Colonial Viper

          It depends on how you define “share” and “fair share”.

          Classic National post-modernism = Nothing has any real meaning any more, except for the definition most convenient for us.
          Like National Ministers defining anyone they don’t like as not being “front line staff” so they can get rid of them and still tell the public that “no front line staff are being lost in these cuts”.
          Continuance of utter bullshit from NAT spinners.

      • Carol 7.3.2

        On the right wing repeated claims that tax is stealing the money of the wealthy:  English acknowledges that Kiwis are earning 30% than Aussies in the same jobs, while working really hard at those jobs. However, Bill E. says that’ll be good for business in NZ.  Who owns that “30%” that the Kiwi workers are not getting, while businesses still make a profit?

    • Colonial Viper 7.4

      You presumably know that those at the top pay far more than their share now, how can you determine what is “fair”.

      Bull shit.
      The top one percent of asset owners in this country can afford to pay far more in tax.
      And those above the top 5% of income earners (~$90K p.a. income) can pay quite a bit more too.
      “Fair” is a very simple test. Can you pay more tax to financially contribute to the running of NZ society without it being a difficult financial burden on yourself and on your family.
      Not like these a-holes who view it as their god-given duty to avoid as much tax as possible and get their kids on to student allowances even though their net worth is in the millions.
      PeteG defending the rich and the influential what a fraking star you are mate. Singing for your supper against the interests of the people in your own neighbourhood and against the interests of your own family and friends.

      • RobC 7.4.1

        CV, no need to worry about Pete’s family – remember he has two daughters overseas currently creaming it with 30%+ better wages than here. Although one has seemingly inherited her father’s intelligence by wanting to come back here to live.

      • neoleftie 7.4.2

        CV 90k or there abouts isnt exactly wealthy these days in our society – sure it gives you afew more choices and opportunities, i might suggest looking a bit higher to the true outliers of societal income figures i.e our elite ownership class to find true inequal wealth and power. Take out the elite ownership class and redistribute their wealth fairly and everyone would have similar opportunities – maybe just maybe this should be the long term aspiration and goal of Labour and the left block parties.

  8. Simon C 8

    Right on.

    It’s immensely frustrating to me that empiricism isn’t closer to the heart of government policy-making. There’s not much separating Labour and National in this regard. If Labour’s policies are more often supported by the evidence, it’s by accident more than by design. Neither party has a strong policy for evidence-based practice.

    I’d like to see a basis in empirical evidence become a requirement for new legislation. Of course there will still be arguments about interpretation and best value, but is it too much to ask that our Parliamentary debate be based on fact rather than opinion and appearance? 

    • Gosman 8.1

      You mean like the ‘facts’ in “The Spirit Level”?

      • Simon C 8.1.1

        I mean that it would be nice if the debate in parliament was about the issues you’re debating here.

        Is “The Spirit Level” useful for policy makers? I don’t know. It would be cool if we could have that debate in Parliament, based on the evidence presented by both sides. Instead, it’s irellevant to both major parties, since they’re both more interested in “brand identity” and vacant populism than in policy that actually works.

      • Mac1 8.1.2

        Sounds like a cracking good read, Gosman. Thanks for your hearty recommendations- along the lines of “a book that my opponent dislikes must be a book I should read.” Can I recommend “Deer Hunting with Jesus” by Joe Baigent. It’s got religion and guns in it.

        • Galeandra

          ….and a lot of Bageant’s old school mates & acquaintances who would make Gosman feel right at home.
          BTW it was sad to hear of Bageant’s death last week. His website here if you’re interested: http://www.joebageant.com 

      • Puddleglum 8.1.3

        Hi Gosman,

        Small point – ‘facts’ and ‘evidence’ are different concepts. There are rarely cast iron ‘facts’ in economic and social analyses that go beyond mere counting.

        Longer point to follow …

        On The Spirit Level Delusion, you might want to read (yourself) some of the studies noted in the Epilogue that supposedly expose the ‘delusion’. This paper notes in the conclusion (that is part of the abstract):

        “The results suggest a modest adverse effect of income inequality on health, although the population impact might be larger if the association is truly causal. The results also support the threshold effect hypothesis, which posits the existence of a threshold of income inequality beyond which adverse impacts on health begin to emerge. The findings need to be interpreted with caution given the heterogeneity between studies, as well as the attenuation of the risk estimates in analyses that attempted to control for the unmeasured characteristics of areas with high levels of income inequality. “

        Now, if you think ‘aha,  look at the caution expressed in the last sentence’ go to the actual conclusion and read what is meant by “heterogeneity between studies”:

        “Several local factors seem to account for this heterogeneity, including the possibility of a “threshold” effect of income inequality on health (with Gini values ≥0.3 indicating a more consistent association with adverse health effects), the time period in which the analyses were carried out (with studies after 1990 indicating a more consistent association), and the length of follow- up in the cohort studies. Consideration of these factors might help to improve our understanding of the speci- fic circumstances under which income inequality is damaging to population health.
        A further source of heterogeneity is the spatial unit across which income inequality indices are evaluated. Among the cross sectional studies, between country stu- dies showed a significantly stronger association between income inequality and self rated health than within country studies. This observation is consistent with the conclusion of a recent systematic review suggesting that studies with smaller reference groups are less likely to show an association with health because the spatial scale does not reflect the social stratification of societies.”

        What you’ll also find if you read this BMJ Editorial by Wilkinson and Pickett is that, far from being unaware of the debate over the exact links between income inequality and population health, W&P openly acknowledge it.

        As they say:

        “Perhaps because of the deep political implications of a causal relation between better health of the population and narrower differences between incomes, interpretations of the evidence have come to different conclusions.3 4 5 6 The controversial question is not whether more equal societies really do have better health, but why they do and whether it is an effect of inequality itself.”

        The cited studies (3,4,5 and 6) give these different interpretations.

        In their book they present their view, and it has to be said that, on any review of the studies, there is substantial evidence that there is a link between income inequality and population health. Substantial evidence of a link is not evidence of a substantial (‘silver bullet’) link. That is, income inequality is not the cause of all bad health (of course). W & P never argue this. But they do argue that more equal societies are better on a range of factors.

        Notice also that in this paper in Epidemiological Reviews – which is exceptionally cautious about taking more from the evidence than is there – their analyses done to take account of scepticism over the relationship based on an argument for (a) confounding by misspecification of individual incom; (b) confounding by educational attainment and (c) confounding by racial composition show, respectively:

        “Across the six different specifications of individual-level income, therefore, the differences in odds ratio for poor health associated with a 5 percent increase in the Gini coefficient were not substantial, suggesting that the relation between state income inequality and individual health is independent of the income-health relation at the individual level.”

        “These findings suggest that, while individual race, educational attainment, and income attenuate the baseline effect of state income inequality, they do not fully account for the observed association between self-rated poor health and state income inequality in the United States.

        “As the results in table 4 clearly demonstrate, accounting for racial composition—as measured through the individual clustering of racial groups—does not explain the state income inequality-health relation. However, it has been argued that the “proportion Black” in a state confounds the income inequality-health relation (4762). It may be noted that proportion Black is a state-level variable, as distinct from the individual-level clustering (within states) of Blacks, even though the two are in some ways related. We have demonstrated elsewhere that racial composition—whether measured as individual clustering of races within states or measured as proportion Black—does not account for the state income inequality-health relation (2558). While additionally including state proportion Black attenuates the effect of state income inequality (from an OR of 1.30 to 1.22), the effect estimate of the state proportion Black was itself not significant (table 5).”

        Notice that the quotes just above are about state-level income inequality and health in the US – the very subject of the so-called ’embarrassing interview’ that Kate Pickett had in the UK that was cited in The Spirit LEvel Delusion – good tv, but wasn’t an advance in terms of understanding the central issue.

        The point of all of the above is to show that, far from having some wild, non-fact-based, politically motivated account of the relationship between income inequality and population health, W & P’s argument is perfectly respectable in the scientific literature and has considerable support. Furthermore, many of the ‘disagreements’ in the literature are over aspects of this methodologically complex research.

        They also are often disagreements over what form of inequality (income or wealth, for example) matters in relation to population health. 

        It looks to me that you have done no more than those you criticise: you have latched on to a ‘popular’ book (The Spirit Level Delusion) – and not bothered to go to the primary literature – because it happens to support your prejudices.

    • PeteG 8.2

      Neither party has a strong policy for evidence-based practice.

      Both seem strong on evidence based practice – if there is evidence they might get enough votes.

  9. JaJ 9

    I find it sort of ironic that a post titled with “evidence based policy” doesn’t have a single citation of  apeer reviewed academic journal article in it.

    I would suggest starting with google scholar and entering “privatisation efficiency” and later “foreign direct investment wages”.

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