Equality or Priority, Again

In a post titled “Inequality and Death,” Ezra Klein writes:

I guess this goes into the unsurprising category, but a new study shows that the risk of premature death plummets as you wander up the educational ladder. To make a meta-point, I post on these sorts of socio-health studies frequently for a reason: We tend to think of inequality in terms of some people having more stuff than other people. That’s true, to an extent. But the poor in our society are also sicker, in more everyday pain, and have a greater chance of dying young. We’re comfortable with inequality of stuff, but are we really very comfortable ignoring such gross inequality of pain, of illness, and of death? That’s not to suggest that we’ll ever have a society where everyone feels the same amount of pain, but it is to argue that the poor are not just different because they have less money, but because their lives are substantially worse, and worse in ways that better social policy could help alleviate.

Naturally, I share Ezra’s concern for the alleviation of illness, suffering, pain, and death and think better social policy would help. (We disagree about those policies, I’m sure.) But isn’t the problem here illness, suffering, pain, and death and not inequality? Don’t we have reason to worry about these things just because they are bad? Because it is possible to help? I accept that our standards for adequate health and our expectations about suffering are contextual. In a decent society, the acceptable minimum rises over time. But whether people have enough stuff or experience too much illness is not therefore a question of inequality.

That said, not having looked at the study Ezra cites, it seems natural that educational attainment and health will have a common cause: time preference. The causes of differences in dispositions to act now to gain distant future rewards are unknown to me. I guess it has a great deal to do with an early sense of the stability or volatility of one’s practical environment. If you come to feel that involved plans tend to be dashed and that resisting gratification leaves you with less than you could have had, you’ll learn not to form involved plans or defer desire. I think having consistently enough money is a major factor in developing the sense that long-term projects can be successfully carried through. But having enough is itself largely a function of being able to carry through long-term plans. Poverty can be so pernicious precisely because it carries with it the conditions for its own reinforcement.