Catherine Conlon: Government needs to listen to the marginalised
The riots in Dublin last Thursday were kindled by a knife attack on Parnell Square involving young schoolchildren and their carer. Picture: Stephen Collins/Collins
The Government needs to listen to marginalised elements of society and be seen to do so — to ensure their concerns are not exploited by elements of the far right intent on sowing division in society, President Michael D Higgins said recently, following riots in Dublin, kindled by a knife attack on Parnell Square involving young schoolchildren and their carer.
"This necessary development, challenging as it may be, of offering economic, social and cultural policies that can improve conditions for marginalised groups and help drive the creation of a more equal and inclusive society, while confronting policies that marginalise ‘the other’ can help confront the exploitative targeting of marginalised groups and their scapegoating in conditions of crisis," the President said.
The prevailing view among policy makers across the globe is that political discourse must be embedded in one thing — economic growth at the expense of almost everything else.
When pressed, they emphatically state growth is responsible for the extraordinary improvements in welfare and life expectancy that we’ve witnessed over the last century. Growth is essential to improve people’s lives and to abandon it would be to abandon progress itself.
But recent evidence questions the validity of this universally entrenched belief. The economic anthropologist Jason Hickel in (2020) says the relationship between growth and human progress is not quite as obvious as we once thought.
"And past a certain point, more GDP isn’t necessary for improving human welfare at all."
Mounting evidence shows the relationship between GDP and human welfare plays out on a saturation curve, with sharply diminishing returns. After a certain point, which high-income nations have long surpassed, more GDP does little to improve core social outcomes and the relationship begins to break down.
Hickel explains that in fact there are many countries that manage to achieve strikingly high levels of human welfare with relatively little GDP per capita. The key factors are distribution and investment in universal public goods.
Take life expectancy. In 2020, life expectancy in the US was 78.7 years, with a GDP per capita of $59,000. Japan, by comparison had a life expectancy of 84 years — the highest in the world, with a GDP per capita over a third (35%) less than the US. Portugal had almost two thirds (65%) less income in 2020 and a life expectancy of 81.1.
The EU has over a third (36%) less income than the US and yet beats the US not only on life expectancy but on virtually every other indicator of human welfare.
The most impressive example of all is Costa Rica. Despite 80% less income, life expectancy in Costa Rica is higher than the US. Not only that but the rainforest-rich Central American country achieved some of its most impressive gains in life expectancy during a time when its GDP per capita was one seventh of the US and not growing at all.
Hickel asks what explains these remarkable results.
"It’s simple," he says. "They’ve all invested in building high-quality universal healthcare and education systems. When it comes to delivering long, healthy flourishing lives for all, this is what counts."
Not only that, it’s not that expensive. Universal public health services are significantly more cost-effective. Spain spent $2,300 per person in 2020 to deliver high-quality healthcare to everyone as a fundamental right and its life expectancy figures of 83.5 show the system is delivering.
By contrast, private healthcare in the US cost a monstrous $9,500 per person while simultaneously delivering much lower life expectancy and much worse health outcomes.
Repeatedly, the evidence shows it is possible to achieve high levels of human development without high levels of GDP. According to UN data, countries can reach the very highest levels with as little as $8,000 per capita and very high levels on the education index with as little as $8,700.
In fact, countries can succeed on a wide range of key social indicators — health, education, employment, nutrition, social support, democracy, and life satisfaction with less than $10,000 per capita.
What is the situation in Ireland? Luxembourg, Ireland and Norway lead the ranking with more than $100,000 in GDP per capita. Luxembourg is a key financial services centre in Europe, Ireland is headquarters to many multinational corporations and Norway is one of the largest energy exporters in the region, explaining their relative prosperity.
Despite these extraordinary figures, recent data shows the gap between Ireland’s most disadvantaged areas and the national average has increased.
Almost 200,000 (195,992) people now live in areas classed as very or extremely disadvantaged and urban areas contain more extremes of both highly disadvantaged and highly affluent areas, according to the 2022 Pobal HP Deprivation Index launched earlier this month.
The index found a countrywide improvement in measures such as employment and population growth but persistent disadvantages remains for many communities.
Disadvantaged communities experience significantly higher levels of unemployment and low educational attainment, with higher rates of lone parents. Urban areas contain the highest proportion of both highly disadvantaged and highly affluent areas, while rural areas tend to see less of these extremes.
Disadvantage is disproportionally experienced in small pockets in Dublin city centre, north and west suburbs, on the outskirts of Cork, Waterford and Limerick, as well as a small number of towns. Relative affluence continues to be seen in south Dublin as well as the commuter belts surrounding Dublin, Cork and Galway.
We don’t need figures to tell us this. Taking the Luas from Heuston Station to Abbey Street any day of the week confirms the prevailing sense of menace that stalks streets on the northern side of the city.
The other key finding from recent research is that after a certain threshold, more growth actually begins to have a negative impact.
At a certain point, growth begins to "uneconomic". Ecologist Herman Daly puts it succinctly — it begins to create more "illth" than wealth.
The continued pursuit of growth in high-income nations is exacerbating inequality and political instability and contributing to poor mental health, stress from overwork and lack of sleep, and high levels of chronic illness.
Mounting research points to the importance of meaning in people’s lives — when they have an opportunity to express compassion, co-operation, community and human connection.
In Costa Rica, research from the Stanford School of Medicine showed the people who lived the longest were people from one of the poorest parts of Costa Rica in monetary terms. People from the Nicoya Peninsula had access to excellent public health but more importantly and something completely unexpected: community.
"The Nicoyans who lived the longest had strong relationships with friends, family and neighbours. Even in old age they felt connected. They felt valued."
"Imagine," people living in subsistence lifestyles in rural Costa Rica enjoy longer, healthier lives than people in the richest economies on Earth," Hickel concludes.
Isn’t it time we listened to the data, opened our eyes to widening inequality in our cities and valued all our citizens equally? Isn’t it time we organised the economy around the needs of humans rather than the other way round?
- Dr Catherine Conlon is a public health doctor in Cork and former director of human health and nutrition at Safefood
