Where You Live May Affect Your Health

By John Graham

A program instituted in the 1990s in larger cities in the US gave poor women the opportunity to move to better neighborhoods. Ten years later there was less incidence of Diabetes and morbid obesity among those who made the move — giving support to the idea that where you live can affect your health. This study goes along with a book entitled Mind the Gap: The New Class Divide in Britain, by Ferdinand Mount, which looks at the class divide in Britan and its effect on the lives of individuals. A reviewer concludes, “That it is right to worry about the effect of structural changes in our society and to try to seek solutions. And that worrying about inequality is something even one-nation Conservatives do.” Below find the review of Mount’s book and a copy of the article which appeared in the Houston Chronicle on Oct 20, 2011 and entitled “Study: Where you Live Can Affect Your Health.” To read these articles click below.

Mind the Gap: The New Class Divide in Britain by Ferdinand Mount, 320pp, Short Books, £14.99

In recent years, some of the most raging polemics against contemporary trends in global capitalism have been written by those who do not come from the left of the political spectrum. Now, to add to books such as John Gray’s False Dawn and Edward Luttwak’s Turbo-Capitalism , we have Ferdinand Mount’s Mind the Gap. Mount, a former head of the No 10 Policy Unit under Mrs Thatcher, takes as his central thesis the view that “the worst-off in this country live impoverished lives, more so than the worst-off on the Continent or in the United States… impoverished not simply in relation to the better-off in Britain today but in relation to their own parents and grandparents”.

In breathless and sweeping style, Mount seeks to demolish the myth that Britain is becoming a more classless society, arguing that on any axis of equality – income, lifestyle or opportunity -we find ourselves as divided as ever. What really concerns him is the sense of a nation split between what he calls the Uppers and Downers, terms borrowed from HG Wells’s The Time Machine . In Mount’s usage, these are infinitely flexible class categorisations: “What the Uppers are afraid of is the Downers. Just as Wells prophesied, the children of the light are afraid of the children of the dark and of the tribes who live in the dark.”

So Mount sees the working class, and in particular the underclass, as subject to a crude and one-sided portrayal in contemporary social discourse and media representation. And for him, it is part of a wider contempt that he perceives in the society, such that “the ultimate deprivation that the English working class has suffered – in fact the consequence of all other deprivations – is the deprivation of respect”. That is the gap which Mount seems to mind.

Unfortunately it is here, after what appears a promising opening, that his argument goes off the rails. In part, he succumbs to the stereotype about the working class with which he himself has just taken issue. And, predictably, he wishes to blame the state for the cultural deficit he sees. So he proceeds to a long and tedious discourse which faults government for having built the institutions of welfare capitalism, thereby destroying the friendly societies, private schools and other institutions that bound working-class communities together and fostered a sense of mutual aid and fraternity. Through council housing, the welfare state, the absence of tax incentives for marriage and the destruction of non-conformist religion, the state has robbed individuals of their independence.

Of course, sensible progressives should accept that some postwar innovations, such as the construction of social housing, owed too much to mechanistic reform without democratic consultation with tenants. But Mount slides between this argument and a more traditional outright condemnation of the whole concept of welfare capitalism, ignoring the massive advances of the 1945 settlement and failing to explain how exactly, beyond urban myths, the welfare state is indeed the parent of cultural impoverishment.

What is more, his critique of the state’s role is undermined because he is candid enough to recognise that the nature of today’s market institutions make the problems of inequality more, not less acute: “For all the benefits that capitalism brings, its cold indifference remains hard to cope with, both in theory and practice… Full-blooded capitalism has certain natural tendencies which may make life for the poorest insecure and unnerving, even if it makes them richer in cash terms.”

Here is Mount’s fundamental problem. Today’s labour market does tend towards increasing inequality, among other reasons because it increasingly rewards the high skilled relative to the low skilled. But if this is true and the resulting inequality is a concern, then the only answer is to support a role for government in both opening up opportunity and leaning against these inequalities. Prewar friendly societies, mutual aid organisations and good works are not an answer. Mount’s difficulty is that he spends part of the book attacking the institutions of the state, then bemoans the tendencies of the market, but he cannot square the circle.

At times, this contradiction leads him to some pretty bizarre arguments. For instance, he claims that the state is responsible for increased inequality because of higher taxes on the poor to pay for welfare. Indeed, he says that the present government has increased taxes on the poor and that the real problem of the past seven years is that the “Downers are overtaxed in a way they never used to be”. As a passing analysis of the statistics would have told him, he is just wrong. Direct tax and benefit measures since 1997 mean that families with children in the poorest one-fifth of the population are on average more than £50 a week better off. Far from government measures increasing inequality, it is through discretionary action that its rise has been stemmed.

What are his prescriptions to solve the problems of inequality that he sees? His main policy focus is described by the slogan “unlock and allot”: giving land, housing, shares, as well as school and health vouchers to individuals, ensuring more accountable forms of collective control (such as over the police, and over companies through employee share ownership) and bolstering the role of religious organisations in welfare services. As he explains it: “Our aim is to de-massify the masses by rebuilding the little platoons.”

The problem with all this is that in the case of at least some of his proposals, it is not at all clear that they will help to reduce inequality; in fact they may well increase it. This certainly applies to his proposals for vouchers and the replacement of parts of the welfare state by faith-based organisations. And it should not really surprise us because, in the end, his motivation seems at least as much about reducing the power of government as tackling inequality. That is the inherent tension at the heart of this book: between a worry about “cultural impoverishment”, for which he crudely blames the state, and economic inequality, about which he has a more nuanced analysis. If he is to tackle the latter, he must abandon the 1980s philosophy about government, which he is not willing to do.

Moreover, he fails to see that cultural impoverishment does not simply cohabit with economic inequality but is in part a consequence of it. The danger for our society is that we promise mobility in theory, but in practice stack the odds against those born into the wrong circumstances. That is the best recipe for a country where people are isolated and resentful. The solution to this is not to seek to recreate communities of the past, but to create a society with less structural inequality than today, one that is fair and open to all.

What, then, can the left learn from Conservatives like Ferdinand Mount? That one can believe in a role for markets and at the same time seek to correct the unfairness of market outcomes. That it is right to worry about the effect of structural changes in our society and to try to seek solutions. And that worrying about inequality is something even one-nation Conservatives do.

· Edward Miliband is chair of the council of economic advisers at HM Treasury.