Sixtytwo people and their "wealth" -- are they really better off than the rest of us?

Several news media including BBC World, the NY Times and the Guardian, have reported the interesting fact that sixtytwo (62) people own half the wealth in the world. The rest of us, more than 7.4 billion now, own the other half. Within this other half of the human population, the distribution of wealth is very uneven. I am fortunate, comfortably off, with an income and a net worth in the top 5 percentile in Canada. In an absent-minded sort of way, I've worked very hard to get into this position. I've never consciously set out to get wealthy. I've just done my job as a university tenured professor, teaching (I describe my 'teaching' as corrupting the minds of innocent medical students with subversive ideas, like the notion that it's preferable to keep people as healthy as possible rather than wait for them to get sick and try to treat their ailments one at a time). I've also done some research, much of it rather trivial and ephemeral, a small part of it highly relevant and of perennial importance. And I've advised governments at local, regional, national and international levels about general and specific actions that can be taken to control diseases, injuries and premature deaths; I've consulted on aspects of medical education and on assessing educational approaches and methods. I've written and edited about 25 weighty technical books, chapters in more than 50 books, and several hundred articles and editorials in medical journals that deal with these topics. None of these activities pay as well as writing sexy books, for instance, or hitting a hard rubber disk about on a smooth icy surface, but over a long professional lifetime that hasn't been encumbered by costly bad habits other than buying a great many books, I've ended well off enough to subsidize the youngest of my three kids and to provide large loans to my other two.

I feel competent to comment on the shockingly uneven distribution of wealth in the world. I do so after long experience of observing and studying the relationship between health and wealth. My beloved wife Wendy and I talked about this relationship as we ate our lunch on the day we met. As a nurse, she'd had enough interaction with sick infants and children (and sick parents) to have ideas of her own about this. She was near tears as she talked about this, and that conversation when we'd known each other for 4-5 hours went a long way towards convincing me that she was the maid for me.

But I digress. What is wealth? It's not money in the bank, land from which food or other resources are extracted, it's not gross national product or other arcane economic indicator. Those of us who treat populations rather than individual persons have conceived new notions about wealth that have less to do with the amount of money, land, servants or dwelling places we possess than with other tangible factors. Our notion is closer to that of people in the Himalayan nation of Bhutan, who speak of Gross National Happiness. Our indicator of national well being is called the Genuine Progress Indicator. In the Dictionary of Public Health (2007) I described it as a composite measure of economic wellbeing. It takes into account much more than the pay packet brought home by the wage or salary earner(s) in the household. It considers more than 20 social and environmental factors and distinguishes between economic transactions that enhance wellbeing and those that diminish it. The per capita gross domestic product (GDP) in the USA and similar nations more than doubled from 1950 to 1990 and the GPI increased from 1950 to 1969; but it declined from then until and after 1990, for instance because much national wealth had to be diverted into fixing problems caused by earlier errors, such as cleaning up industrial wastelands. Since about 1970, the costs of the economic trajectory of the USA and similar nations have begun to outweigh the benefits.  This cost to benefit ratio is rapidly increasing the costs, notable the costs associated with climate change, while the benefits are getting smaller, sometimes virtually imperceptible. Just one component of costs, the cost of climatic extremes and catastrophes (droughts, food shortages, massive wild fires, hurricanes, floods that follow torrential rainstorms) far outweigh the often imperceptible benefits of longer and warmer growing seasons.  

The "value" of the investments that pay my pension has gone down considerably in the current stock market crisis, which seems to be getting worse. Even those 62 families who own half the world's wealth are feeling this reduction of their wealth. I manage to feel a little schadenfreude as I reflect on this. I can't take it with me and I'm a great deal closer to the end than the beginning of my life span. That thought contributes to my personal gross domestic happiness.

I'll say more about the genuine progress indicator and about other measurements, including the interesting scale of gross national happiness, in a future post. Here I will just add that there is a close correlation between health and wealth, not quite such a close correlation between wealth and happiness. 

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