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	Will Development Goals ever be Enough? by Rajesh Makwana Share The World"s Resources   Governments must accept that the root causes of poverty, inequality and climate change will never be addressed without substantial reforms to the global economy.   In the meanwhile, the post-2015 development goals need to be much more ambitious about preventing avoidable poverty-related deaths within an immediate timeframe.   As international negotiations on a new set of Millennium Development Goals (MDGs) continue, it is worth reflecting on some of the limitations and failures of the MDG framework. Significantly, the program represents the only internationally agreed framework for trying to address some of the most pressing issues facing humanity, and it should be commended and supported on that basis.   Despite the many improvements that the eight existing goals have already made to peoples’ lives, however, they are also extremely unambitious and often fail to assist the most marginalised groups.   Of additional concern is the selective and target-driven approach they embody which conveniently avoids addressing the root causes of poverty and inequality. The inadequacy of the goals is often illustrated using MDG-1 as an example. From the very start of the MDG negotiation process it was clear that the goal for halving poverty was grossly insufficient given the significant resources and expertise available to governments.   The goal also marked a dangerous shift away from the concept of halving the number of people living in poverty as previously agreed by the 186 governments participating at the 1996 World Food Summit. Instead, MDG-1 sought to halve the proportion of people living in poverty by 2015, which is far less ambitious in light of a world population that is still expanding rapidly, especially in some of the poorest regions. The actual number of people living in extreme poverty in 2015 will remain unacceptably high at around a billion. Reducing hunger also remains a major challenge, with around 850 million people currently unable to access sufficient quantities of food to meet basic nutritional requirements according to the United Nations (although unofficial estimates are often far greater).   In a world where the annual incomes of the richest 100 people are enough to end poverty for 4 years, the existing poverty goals remain outrageously unambitious.   At the current rate of poverty reduction it is likely that we will never succeed in consigning poverty to the annals of history, even 65 years since the Universal Declaration of Human Rights was first established.   An analysis of data from the World Health Organisation suggests that around 40,000 people die every day (15 million per year) simply because they do not have access to the essentials of life such as food, water and healthcare.   Ending this unnecessary tragedy entirely and within a short number of years should constitute the number one priority for all nations.   Numerous international agencies already have the expertise needed to prevent these avoidable deaths, and the systems and institutions that can assist them have long been in place.   As demonstrated by our report Financing the Global Sharing Economy, governments could raise trillions of dollars annually to facilitate this process through a range of redistributive measures, from tax and debt justice to redirecting perverse government subsidies. Not since The Brandt Commission’s proposal for an international program of emergency relief have policymakers considered ending extreme poverty in a way that is commensurate with the vast scale of the crisis.   The post-2015 MDG negotiations provide an important opportunity for policymakers to be far more ambitious about securing basic human needs for all within an immediate time-frame, and not as a distant aspiration for the international community.   As a minimum, any poverty-related post-2015 development goals should set their sights on preventing all instances of life-threatening deprivation and needless poverty-related deaths.   While the intention to ‘end extreme poverty in all its forms’ was mentioned in the final statement of the recent High-Level Panel’s MDG meeting in Libera, governments will need to go far beyond their existing commitments to overseas aid and rapidly redistribute resources on a scale never before achieved if they intend to make such a program a reality.   Addressing the causes of inequality   Another prominent concern with the MDG framework is its highly depoliticised nature and its failure to address the structural causes of poverty. Clearly, an international emergency relief program will not address these all-important structural factors or provide any lasting solution to the poverty crisis. A more comprehensive approach will necessarily involve reforming the policies and institutions that underpin the global economy and perpetuate extreme poverty and inequality.   A new MDG that addresses inequality – an option now widely advocated by those in the development community - would be a step in the right direction, but it is unlikely to go far enough. Levels of inequality have been growing sharply over recent decades, with the incomes of the world’s top 1.75% of earners exceeding those of the bottom 77%.   Taking the world as a whole, income inequality has widened to a level far greater than inequality within even the most unequal nations.   There is an urgent need to redress this imbalance as it is now widely accepted that inequality is an impediment to economic growth, weakens efforts to reduce poverty, undermines social cohesion and distorts the democratic process.   As the director of the Overseas Development Institute Kevin Watkins argued in a recent presentation on inequality and the MDGs, the real causes of inequality stem from public policy choices that governments make and the policies that underpin economic globalisation at the international level.   Both of these factors are far removed from the rather limited discussions around MDG targets and goals, but we can no longer afford to ignore them.   For several decades, economic development has been driven by a very narrow set of ‘neoliberal’ policies that prioritise free markets at the expense of social justice and environmental sustainability.   As a consequence of this ideological approach, the fundamental role that the state can play in providing opportunities for the poor has been increasingly disregarded.   Furthermore, the importance of sharing a nation’s resources more equitably through progressive taxation and spending on social protection and public services has been critically undermined.   Reforming the global economy   Countless NGO reports already highlight how to restructure the global economy in a way that can reduce poverty and inequality, covering everything from reforming international systems of trade and finance to re-generating local economies. As progressive thinkers have long argued, the model of development pursued by multilateral agencies like the World Bank can no longer hinge on a ‘global trickle-down’ effect which attempts to increase the size of the economic pie without ensuring that the proceeds of growth are redistributed more equitably.   Moreover, governments and people in general have to accept that a growth-based economic system - and the consumerist lifestyles it encourages - is not sustainable.   Globally, we already consume 50% more resources than the planet can produce and it is therefore imperative to follow an entirely different economic model that puts human and environmental welfare before economic growth and wealth generation.   The need to address social and environmental issues simultaneously has slowly gained traction since the Earth Summit in Rio in 1992, and it seems increasingly likely that the new MDGs will be known as the ‘Sustainable Development Goals (SDGs)’ - as even scientists are now urging. But creating a truly sustainable world will require a wholesale shift in public policy within both the economically-advanced and the less industrialised nations, on a scale that is still unthinkable for most mainstream policymakers.   Perhaps most importantly, a sustainable global economy will ultimately require an entirely new approach to managing the world’s finite natural resources and in a way that guarantees equitable access for people in all countries. A binding global agreement on curbing carbon emissions is an obvious and urgent pre-requisite to any such reforms on the international level.   There is still insufficient public acknowledgement that the many crises we face are ultimately caused by an unjust global economy that maintains a skewed distribution of wealth, power and resources within and between nations.   Given the limited remit of the MDG framework it is highly unlikely that new sustainable development goals will tackle these structural causes, even if they do shine an urgent public spotlight on them and force governments to take structural reform more seriously.   In the meanwhile, an unwillingness to tackle structural causes cannot be an excuse for inaction to alleviate the devastating human impacts of an unjust global economy. Whether as part of the MDG process or outside of it, the international community – and rich countries in particular – must act with far more urgency to prevent needless hunger and life-threatening deprivation.   In a world of abundant resources and wealth, nothing less than an immediate end to extreme poverty will suffice as a first step towards a sustainable future.   * Published by Share The World"s Resources, 25th March 2013 Visit the related web page
	Status and Stress by Moises Velasquez-Manoff NYT: The Great Divide - a series about inequality USA   Although professionals may bemoan their long work hours and high-pressure careers, really, there’s stress, and then there’s Stress with a capital “S.” The former can be considered a manageable if unpleasant part of life; in the right amount, it may even strengthen one’s mettle. The latter kills.   What’s the difference? Scientists have settled on an oddly subjective explanation: the more helpless one feels when facing a given stressor, they argue, the more toxic that stressor’s effects.   That sense of control tends to decline as one descends the socioeconomic ladder, with potentially grave consequences. Those on the bottom are more than three times as likely to die prematurely as those at the top. They’re also more likely to suffer from depression, heart disease and diabetes. Perhaps most devastating, the stress of poverty early in life can have consequences that last into adulthood.   Even those who later ascend economically may show persistent effects of early-life hardship. Scientists find them more prone to illness than those who were never poor. Becoming more affluent may lower the risk of disease by lessening the sense of helplessness and allowing greater access to healthful resources like exercise, more nutritious foods and greater social support; people are not absolutely condemned by their upbringing. But the effects of early-life stress also seem to linger, unfavorably molding our nervous systems and possibly even accelerating the rate at which we age.   Even those who become rich are more likely to be ill if they suffered hardship early on.   The British epidemiologist Michael Marmot calls the phenomenon “status syndrome.” He’s studied British civil servants who work in a rigid hierarchy for decades, and found that accounting for the usual suspects — smoking, diet and access to health care — won’t completely abolish the effect. There’s a direct relationship among health, well-being and one’s place in the greater scheme. “The higher you are in the social hierarchy,” he says, “the better your health.”   Dr. Marmot blames a particular type of stress. It’s not necessarily the strain of a chief executive facing a lengthy to-do list, or a well-to-do parent’s agonizing over a child’s prospects of acceptance to an elite school. Unlike those of lower rank, both the C.E.O. and the anxious parent have resources with which to address the problem. By definition, the poor have far fewer.   So the stress that kills, Dr. Marmot and others argue, is characterized by a lack of a sense of control over one’s fate. Psychologists who study animals call one result of this type of strain “learned helplessness.”   How they induce it is instructive. Indiscriminate electric shocks will send an animal into a kind of depression, blunting its ability to learn and remember. But if the animal has some control over how long the shocks last, it remains resilient. Pain and unpleasantness matter less than having some control over their duration.   Biologists explain the particulars as a fight-or-flight response — adrenaline pumping, heart rate elevated, blood pressure increased — that continues indefinitely. This reaction is necessary for escaping from lions, bears and muggers, but when activated chronically it wears the body ragged. And it’s especially unhealthy for children, whose nervous systems are, by evolutionary design, malleable.   Scientists can, in fact, see the imprint of early-life stress decades later: there are more markers of inflammation in those who have experienced such hardship. Chronic inflammation increases the risk of degenerative diseases like heart disease and diabetes. Indeed, telomeres — the tips of our chromosomes — appear to be shorter among those who have experienced early-life adversity, which might be an indicator of accelerated aging. And scientists have found links, independent of current income, between early-life poverty and a higher risk of heart disease, high blood pressure and arthritis in adulthood.   “Early-life stress and the scar tissue that it leaves, with every passing bit of aging, gets harder and harder to reverse,” says Robert Sapolsky, a neurobiologist at Stanford. “You’re never out of luck in terms of interventions, but the longer you wait, the more work you’ve got on your hands.”   This research has cast new light on racial differences in longevity. In the United States, whites live longer on average by about five years than African-Americans. But a 2012 study by a Princeton researcher calculated that socioeconomic and demographic factors, not genetics, accounted for 70 to 80 percent of that difference. The single greatest contributor was income, which explained more than half the disparity. Other studies, meanwhile, suggest that the subjective experience of racism by African-Americans — a major stressor — appears to have effects on health. Reports of discrimination correlate with visceral fat accumulation in women, which increases the risk of metabolic syndrome (and thus the risk of heart disease and diabetes). In men, they correlate with high blood pressure and cardiovascular disease.   Race aside, Bruce McEwen, a neuroscientist at Rockefeller University in New York, describes these relationships as one way that “poverty gets under the skin.” He and others talk about the “biological embedding” of social status. Your parents’ social standing and your stress level during early life change how your brain and body work, affecting your vulnerability to degenerative disease decades later. They may even alter your vulnerability to infection. In one study, scientists at Carnegie Mellon exposed volunteers to a common cold virus. Those who’d grown up poorer (measured by parental homeownership) not only resisted the virus less effectively, but also suffered more severe cold symptoms.   Peter Gianaros, a neuroscientist at the University of Pittsburgh, is interested in heart disease. He found that college students who viewed their parents as having low social status reacted more strongly to images of angry faces, as measured by the reactivity of the amygdala — an almond-shaped area of the brain that coordinates the fear response. Over a lifetime, he suspects, a harder, faster response to threats may contribute to the formation of arterial plaques. Dr. Gianaros also found that, among a group of 48 women followed for about 20 years, higher reports of stress correlated with a reduction in the volume of the hippocampus, a brain region important for learning and memory. In animals, chronic stress shrinks this area, and also hinders the ability to learn.   These associations raise profound questions about stress’s role in hindering life achievement. Educational attainment and school performance have long been linked to socioeconomic class, and a divergence in skills is evident quite early in life. One oft-cited study suggests that 3-year-olds from professional families have more than twice the vocabulary of children from families on welfare. The disparity may stem in part from different intensities of parental stimulation; poorer parents may simply speak less with their children.   But Martha Farah, a neuroscientist at the University of Pennsylvania, has also noted differences not just in the words absorbed but in the abilities that may help youngsters learn. Among children, she’s found, socioeconomic status correlates with the ability to pay attention and ignore distractions. Others have observed differences in the function of the prefrontal cortex, a region associated with planning and self-control, in poorer children.   “You don’t need a neuroscientist to tell you that less stress, more education, more support of all types for young families are needed,” Dr. Farah told me in an e-mail. “But seeing an image of the brain with specific regions highlighted where financial disadvantage results in less growth reframes the problems of childhood poverty as a public health issue, not just an equal opportunity issue.”   Animal studies help dispel doubts that we’re really seeing sickly and anxiety-prone individuals filter to the bottom of the socioeconomic heap. In primate experiments females of low standing are more likely to develop heart disease compared with their counterparts of higher standing. When eating junk food, they more rapidly progress toward heart disease. The lower a macaque is in her troop, the higher her genes involved in inflammation are cranked. High-ranking males even heal faster than their lower-ranking counterparts. Behavioral tendencies change as well. Low-ranking males are more likely to choose cocaine over food than higher-ranking individuals.   All hope is not lost, however. Gene expression profiles can normalize when low-ranking adult individuals ascend in the troop. “There are likely contextual influences that are not necessarily immutable,” says Daniel Hackman, a postdoctoral scholar at the University of Pittsburgh. And yet, as with humans, the mark of early-life hardship persists in nervous systems wired slightly differently.   A nurturing bond with a caregiver in a stimulating environment appears essential for proper brain development and healthy maturation of the stress response. That sounds easy enough, except that such bonds, and the broader social networks that support them, are precisely what poverty disrupts. If you’re an underpaid, overworked parent — worried, behind on rent, living in a crime-ridden neighborhood — your parental skills are more likely to be compromised. That’s worrisome given the trends in the United States. About one in five children now lives below the poverty line, a 35 percent increase in a decade. Unicef recently ranked the United States No. 26 in childhood well-being, out of 29 developed countries. When considering just childhood poverty, only Romania fares worse.   “We’re going in the wrong direction in terms of greater inequality creating more of these pressures,” says Nancy Adler, the director of the Center for Health and Community at the University of California, San Francisco. As income disparities have increased, class mobility has declined. By some measures, you now have a better chance of living the American dream in Canada or Western Europe than in the United States. And while Americans generally gained longevity during the late 20th century, those gains have gone disproportionately to the better-off. Those without a high school education haven’t experienced much improvement in life span since the middle of the 20th century. Poorly educated whites have lost a few years of longevity in recent decades.   A National Research Council report, meanwhile, found that Americans were generally sicker and had shorter life spans than people in 16 other wealthy nations. We rank No. 1 for diabetes in adults over age 20, and No. 2 for deaths from coronary artery disease and lung disease. The Japanese smoke more than Americans, but outlive us — as do the French and Germans, who drink more. The dismal ranking is surprising given that America spends nearly twice as much per capita on health care as the next biggest spender.   But an analysis by Elizabeth H. Bradley, an economist at the Yale School of Public Health, suggests that how you spend money matters. The higher the spending on social services relative to health care, she’s found, the greater the longevity dividends.   Some now argue that addressing health disparities and their causes is not just a moral imperative, but an economic one. It will save money in the long run. The University of Chicago economist James Heckman estimates that investing in poor children yields a yearly return of 7 to 10 percent thereafter to society.   Early-life stress and poverty aren’t a problem of only the poor. They cost everyone. Visit the related web page
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