Inequality kills them, you know?

It’s difficult, in this modern world, to find something that would still exist if we were more equal. The list of things that would disappear if only the nation’s Gini Index were lower is impressive. Murder, mental health problems, even the deaths of babbies, all would just float away if only we taxed rich people more and gave the money to the lumpenproletariat.

That is, at least, the claim, and it’s being made again in The Lancet:

Hundreds of babies are dying needlessly in England every year because their mothers smoke, drink, use drugs, or are obese, a new study suggests.

That, at least, has the merit of possibly being what the paper does find although even then I’m not sure.

Commenting on the study, Dr Ronny Cheung, of The Royal College of Paediatrics and Child Health (RCPCH), said: “We know that deprivation plays a major part and this can lead to higher rates of poor mental health, increased chance of alcohol or substance misuse, and obesity.

“Babies of the most deprived families are more likely to be born premature or with low weight than the most affluent ones, and twice as likely to die in the first year of life.

“As the gap between rich and poor continues to widen, we have little chance of catching up with our European neighbours without social inequalities being addressed.”

And there’s the claim which doesn’t stand up in the slightest. The paper itself is here.

Excess child mortality in England compared with Sweden was largely explained by the unfavourable distribution of birth characteristics in England. Socioeconomic factors contributed to these differences through associations with adverse birth characteristics and increased mortality after 1 month of age. Policies to reduce child mortality in England could have most impact by reducing adverse birth characteristics through improving the health of women before and during pregnancy and reducing socioeconomic disadvantage.

One point they don’t consider is the simple one that maybe the NHS isn’t as good as the Swedish health care system. Given that we are talking about something at least potentially amenable to health care interventions this looks like a bit of a gap in the analysis.

But there’s a much larger hole in the logic. The babbies die because – in their analysis recall – the English poor are fatty lardbuckets who smoke and drink like troopers during pregnancy. The claim is then that if economic equality were greater then the English poor would stop being fatty lardbuckets who smoke and drink like troopers during pregnancy.

That’s the little trick that “socioeconomic inequality” is playing there. Sure, if there were social equality to a greater extent – by which they mean that the rates of being fatty lardbuckets who smoke and drink like troopers during pregnancy were, among the English poor, more similar to those rates among the English middle classes – then this babbie death rate would be lower. But it’s a hell of leap from that to the idea that if economic inequality were lower then the English poor would stop being fatty lardbuckets who drink and smoke like troopers during pregnancy.

But that is the leap being made, the claim on the table. That others have more is what causes obesity, smoking and drinking. Thus if we reduce how much more others have we save the babbies.

But then, you know, this is how science is done these days, isn’t it?

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  1. Look it’s simple. We need to reduce inequality. We need a health campaign to to encourage the middle classes to be fatty lardbuckets who smoke and drink like troopers during pregnancy. Sorted.

  2. I once attended a presentation including a contribution from Lancet editor Richard Horton on evidence-based policy. He appeared to be a weasel. The Lancet is far from apolitical and he is at the root of it. There appears to be a determination to find ‘inequality’ as the cause for all social ills. Well, poor people are unequal. That is why they are poor, generally, discounting illness and bad luck.

  3. Babies are dying needlessly (Appeal to Pity) because their mothers do not manage their own lives as well as we busybodies cound. We call them and their offspring “deprived” and “DIS-advantaged” (by whom?). In fact, they are victims of don’t-give-a-bleep-itis, and one reason they don’t give a bleep about healthy living is that the existence of the NHS may give them the false impression their health is taken care of.

    Of course, a coercive “solution” to income inequality would, long before improving health, get the productive would become less so, and likewise those of comparatively low productivity. The UK would become poorer, which would not improve health. When the paper proposes to make outcomes more equal, it should have to specify what it means, short of imprisoning and dictating the diet of poor pregnant women.

  4. So the idea is that we take money from doctors, amongst others, give it to those who choose to drink, smoke, overeat and underexercise, and the latter won’t use the money to drink, smoke or overeat?
    If more money stops people drinking and smoking we could achieve the desired effect by subsidising these activities, not far from what is proposed.

  5. Crash the stock market, the source of much supercharged wealth. Gini coefficients will decline, the beer and tobacco industry will decline, gym memberships will apparently increase, and all will be right with the world.