“It is a remarkable paradox that, at the pinnacle of human material and technical achievement, we find ourselves anxiety-ridden, prone to depression, worried about how others see us, unsure of our friendships, driven to consume and with little or no community life. Lacking the relaxed social contact and emotional satisfaction we all need, we seek comfort in over-eating, obsessive shopping and spending, or become prey to excessive alcohol, psychoactive medicines and illegal drugs.” This is the opening to The Spirit Level, written by Richard Wilkinson and Kate Pickett in 2009 and which highlights the "pernicious effects that inequality has on societies: eroding trust, increasing anxiety and illness, (and) encouraging excessive consumption". It shows that for each of eleven different health and social problems: physical health, mental health, drug abuse, education, imprisonment, obesity, social mobility, trust and community life, violence, teenage pregnancies, and child well-being, outcomes are significantly worse in more unequal rich countries. It is one of the better known (and perhaps therefore more contested) analyses of the impact of inequality on well-being. Another significant British publication was the Marmot Review into health inequalities, Fair Society, Healthy Lives which was published in 2010. Both make a powerful case for a strong link between greater inequality and poorer health and wellbeing. The Spirit Level looks at the health and social problems identified above across a number of developed countries. It only looks at wealthy countries as it accepts that for poor countries a rise in absolute wealth will be beneficial, but argues that beyond a certain point this no longer holds true and that income inequality becomes the significant determinant. Of the countries he looks at, The USA has the greatest level of income inequality, followed by Portugal and the UK in third place. The Scandinavian countries and Japan have the lowest levels of income inequality. Consistently across the wellbeing measures, e.g. fear of crime, use of illegal drugs, there is an inverse relationship between income inequality and wellbeing. What I found particularly striking about the analysis is that it suggests that health and well-being outcomes are poorer in unequal societies for rich people as well as for poorer ones. The book traces an increase in income inequality from the 1980’s onwards. During the Labour government from 1997 the income of the poorest rose with the introduction of the minimum wage and there was a reduction in child poverty, however income inequality continued to increase as there was no restraint on the increased wealth of the richest. The Spirit Level research stops before the financial crisis of 2008 but other research would indicate that since then, and in particular since 2010, the increase in inequality has risen sharply with significant increases in the wealth of the richest and low wages and benefits cuts increasing poverty.