By ETHAN ELLIS

ADVOCATE

 

In 2001, while Executive of the New Jersey Developmental Disabilities Council, I began to teach a class on disability policy at the School of Public Health at The University of Medicine and Dentistry of New Jersey  (UMDNJ), now part of Rutgers University.

As a disability advocate, I had testified before five Congressional committees and participated in numerous public hearings conducted by the N.J. legislature. I had even drafted legislation passed by both bodies and served on the Task Force that drafted the transportation section of the ADA.

I knew a lot about disability policy but not about public health and I was about to lecture a bunch of graduate students who did. I rushed to Amazon and ordered a couple of books to cover my ignorance.

The work of one man stuck with me after my panic subsided. Richard Wilkinson, an English epidemiologist, had studied the impact of wealth on public health since 1973 and had found statistical evidence that the public health of a nation depended on the size of the gap between its richest and poorest residents, not on their average wealth.

Thus the Japanese were healthier than their richer American counterparts because the gap between rich and poor there was smaller. They lived longer, had lower infant and maternal death rates, less teen pregnancies, and lower rates of most diseases.

And this wasn’t just true of the Japanese. It was true of all the other developed countries with a smaller wealth gap than the United States, and that meant all of them because the gap here is largest and has grown much larger since Wilkinson first published his research.

Although he didn’t make a point of it, one thing in Wilkinson’s research. struck me where  I live. All of his results had implications for disability policy. High maternal death rates and teen pregnancies as well as high rates of the illnesses he studied were associated with high rates of disability. I knew that from my work as staff director of the Delaware Task Force on Disability Prevention (1988-89). Was there a direct cause and effect relationship? I waited for more data.

It came in 2007, when Wilkinson and his partner, Kate Pickett, published “The Spirit Level: Why Greater Equality Makes Societies Stronger.” In it, they summarized the research on the causal relationship between public health and other social problems that had been done since Wilkinson first published. In every instance, there was a cause and effect relationship between income inequality and social ills in developed countries.

The United States, where the gap between rich and poor is by far the largest, has the highest rates of child abuse, drug and alcohol addiction, juvenile delinquency, violence, crime, incarceration, homelessness, air and water pollution as well as discrimination, and police and civilian violence against racial, ethnic and LGBT minority groups, women and people with disabilities.

All of these social ills result in higher rates of disability.

Next month, I’ll look at why and what we can do about it.

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