Tuesday, 21 February 2012

The poor are unhealthy for the same reasons they're poor

An item on the BBC’s local London TV news had me scratching my head the other day (you can read an article about it here). “Experts” from the University of London produced a map of three East London Boroughs (Tower Hamlets, Hackney and Newham - lovely!), showing the geographical location of those adjudged to be most at risk of developing type 2 diabetes. And blow me down if this map didn’t show a “startling” correlation to the Charles Booth poverty maps compiled using observations made in 1898 and 1899.

Trisha Greenhalgh, professor of primary health care at Queen Mary, concludes: "This study, which concentrates on three of the 'Olympic boroughs', highlights the dire need for a major and lasting Olympic legacy to improve health and longevity in east London."

Wow, there’s an awful lot of assumptions and extrapolations wrapped up in that little lot!

Apart from the delicious “we are all guilty in a very real sense” left-wing message underlying this sort of pointless exercise, I'm not sure what it's supposed to actually prove. And, if these researchers wanted to prove anything, why didn’t they simply use figures based on the number of people actually suffering from diabetes, rather than dreaming up a spurious figure for people who are merely “prone” to it? After all, the original poverty maps were based on direct observation of actual poverty.

That there’s a link between ill-health and poverty just isn’t that suprising. Poor people don’t look after themselves as well as the better-off: this is partly because of lack of money (well, durr!), and partly, one suspects, because nobody has successfully impressed upon them the benefits of a healthy lifestyle. The link between areas packed with recent immigrants and ill health isn’t surprising either – recently-arrived immigrants are poorer than most of us and, for obvious reasons, suffer higher levels of stress. Besides, the three boroughs covered by the “research” area contain a higher-than-average percentage of South-East Asians, and this ethnic group is apparently particularly susceptible to diabetes 2.

One of Liberalism’s cherished myths is that poverty “breeds” bad housing, crime, addiction and ill-health (among other things). Once you stop people being poor – by upping their benefits or finding them work (because, as we know, it's government's job to find people work) - the argument goes, bad housing, crime, ill-health etc. will all but disappear.

But there’s another way of looking at this. What if the character traits which make people poor in the first place result in the behaviour which produces bad housing AND crime AND addiction AND ill-health? In other words, these things don’t all flow from poverty – they’re the result of the character flaws (stupidity, laziness, fecklessness and a lack of self-control) that make people poor in the first place. 

I’m not for a moment arguing that bad luck, poor upbringing, lack of available jobs and the enervating effects of rampant welfarism don’t play a part in reducing people to poverty – and it seems unfair to cast aspersions on the character of recent immigrants trying to make sense of an alien culture. But, given that many people drag themselves out of poverty thanks to superior intelligence, grit, energy and emotional intelligence – or a mixture of all four – it seems futile to deny the role of character in reducing many people to or keeping them in poverty.

The kind of behaviour that makes people poor also tends to lead them to destroy their immediate environment: the reason why tower blocks in Chelsea and Kensington don’t reek of urine and have working lifts is that the occupants use lavatories and don’t vandalise the lifts. Similarly, the moral flaws that almost guarantee you’ll end up poor – mainly, the inability to defer gratification and being too useless to hold down a proper job – will tend to lead to crime: it isn’t just a lack of policing that leads poverty-stricken areas to be blighted by crime.

As for ill-health, there's a fascinating article by Theodore Dalrymple (available here) on the appalling dietary habits of the criminal classes, whose health invariably improves once they're incarcerated. Although, as Dalrymple points out, many prisoners spend enough on drugs to afford a banquet every night, the criminal poor have apparently given up eating proper meals (too much discipline required to buy food in advance and to cook it, one presumes), so they spend all day grazing on crisps and sweets and crappy fast food, or drinking and doing drugs and not eating at all. These are the sorts of eating habits that  often lead to diabetes.

Powerhosing (no doubt mainly imaginary) money from this summer’s Olympics at poor people in the boroughs concerned won’t make a blind bit of difference to their long-term health, because it won't improve their self-discipline or intelligence.

I have type 2 diabetes. I’ve always lived in nice parts of London and I’ve never been poor. I developed diabetes because I’m greedy, and because I didn’t pay the slightest attention to my health between the ages of 25 and 35. Why do the results of our character defects always have to be someone else's fault?

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