The Inequity of Inequality

Abstract

A crucial, but unexamined, assumption motivating research into socio-economic health differentials is that such differentials are unjust. An equal distribution of health, as well as of economic resources, is regarded as the proper goal of policy. I suggest that this assumption of 'the inequity of inequality' has its basis in 'human nature'. Sustained selection pressures operating in immediate-return nomadic hunter-gatherer societies led to the evolution of 'counterdominant' behaviours in order to promote cooperation and social living. Modem humans have therefore inherited 'egalitarian instincts' that are activated when inequalities of resources (and of health) are personally encountered. This activation is qualitative, and amelioration of differentials that fall short of equality would not necessarily diminish perceived injustice. Rather than attempting to adjust the abstract statistical measures of economic and health differentials derived from population data, the goal of policy should be to address the subjective experience of the inequity of inequality at the level of individuals.

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