A peaceful world?

Many people around the world are celebrating Christmas this morning.  A central wish around this holiday is "peace and good will for all." Why is enduring peace so difficult to achieve?  What are the prospects for us in the twenty-first century?

Peace and conflict are related, but they aren't precise opposites.  Conflict between individuals and groups can take many forms, and it is possible to manage or resolve conflicts without violence or hatred.  This village uses its pasture and forest for gathering; that village begins to encroach with its livestock herd.  The two villages have a conflict over the pasture.  This conflict may eventually escalate into violence between the villages, with armed groups from each waging small-scale war against the others.  But it doesn't have to work out this way.  Leaders of the two villages may negotiate a set of land use customs that do something to satisfy the needs and interests of both villages, and they may be successful in getting their constituents to honor those agreements.  Or there may be a state capable of establishing and enforcing property rights that are binding on both groups, while permitting each group to pursue its most important life activities.  Or, perhaps, the two groups may have normative and religious bonds of solidarity that lead each member of the group to possess a reservoir of good will that makes resort to violence impossible to imagine.

So conflict of interests and wants doesn't necessarily lead to a breaking of the peace.  But these conflicts have the potential to do so.  And political theorists in the social contract tradition since Hobbes have held that this is the key role of the state -- to establish an acceptable set of rules for property and person that determine clear rights and obligations for everyone, and clear procedures for punishment if rights are violated.  Only through a system of law can we avoid the state of nature which is a state of war of all against all.

Other theorists, notably Elinor Ostrom, have argued that populations have solved the problems of conflict over resources in non-state ways, through "common property resource regimes" (Governing the Commons: The Evolution of Institutions for Collective Action).  The conditions under which a CPRR is stable are more complex than those of a state -- essentially, the CPRR needs to be supported by normative and cultural elements that give all participants a reason to honor the rules -- but Ostrom and fellow researchers have documented many successful instances.  And, of course, a common property resource regime needs to have some kind of processes for addressing and resolving conflicts among participants -- fishermen who disagree about the catch, water users who disagree about the management of upstream resources.

So what are some of the large causes of breakdowns of peace in populations of people?

A key source of sustained violent conflict on a large scale is perceived unresolved injustice.  One party or nation blocks access to resources or opportunities to which another party believes it has a moral right; demands are made; the situation persists; and violent acts begin to occur.

Another important source is conflict over access to important natural resources -- water, oil, minerals.  Conflicts over resources may occur at the local level, or they may rise to the level of inter-country armed conflict and war.

We can't overlook the religious and ideological origins of much conflict in humanity's history.  The prolonged conflict, often violent, between Hindus and Muslims over the Babri Mosque in India is a good example.  The site has religious importance for both communities; leaders are able to mobilize their followers in defense of their claims; violence ensues.

So what can humanity do to improve the prospects for peace and good will?

Sustained efforts at conflict resolution are a good place to start.  People of good will can often enough find the resources they need to bring down the degree of conflict and hostility between groups, and to find procedures that make resort to violence less likely.

Recognizing and addressing injustices between peoples and nations will help.  Justice and peace are intertwined.

Promoting the universality of human needs and the value of inter-group tolerance and respect is a very good step.  And spiritual leaders of all faiths are sometimes very committed to this work.  (Others are not, of course!)

So, this fine Christmas morning in 2011, let us all work for peace and justice for our grandchildren!

Structural adjustment for the middle class?

Working people in the US have suffered big economic losses in the past four years.  Losses of jobs in the economy have pushed many working people from high-wage to low-wage jobs, and as we all know, many people have been pushed out of jobs altogether.  The national unemployment rate was 8.6% in November, and very much higher in urban areas and African-American and Latino communities.  Michigan's rate was 10.6% in October 2011 (link).  White non-Hispanic households fell from $55,360 in 2009 to $54,620 (-1.3%), while black households fell from $33,122 to $32,068 (-3.2%) (Table 1).  These differences in household income across race are stunning: black households started out at only 63% the level of white households in 2009, and they fell by more than double the percentage rate of loss from 2009 to 2010.

Here is a report from the US Census Bureau,  Income, Poverty, and Health Insurance Coverage in the United States: 2010, that sheds some light on the changes of the past several years.  Here are a few important summary findings:

• Real median household income was $49,445 in 2010, a 2.3 percent decline from 2009 (Figure 1 and Table 1).
• Since 2007, the year before the most recent recession, real median household income has declined 6.4 percent and is 7.1 percent below the median household income peak that occurred in 1999 (Figure 1 and Tables A-1 and A-2).3
• Both family and nonfamily households had declines in real median income between 2009 and 2010. The income of family households declined by 1.2 percent to $61,544; the income of nonfamily households declined by 3.9 percent to $29,730 (Table 1).
• Real median income declined for White and Black households between 2009 and 2010, while the changes for Asian and Hispanic-origin households were not statistically significant (Table 1).
• Real median household income for each race and Hispanic-origin group has not yet recovered to the pre-2001 recession all-time highs (Table A-1). (5)

Here is what real median income looks like, broken down by racial group, since 1967.

Now consider the poverty statistics the report contains.  Here is a summary graph:

The national poverty rate reached a forty-year low in 2000, at about 12%.  Through the decade, however, the national rate has grown to 15.1% in 2010, representing 46.2 million people.  Here again there is a stunningly wide gap between white and black populations.  The poverty rate in 2010 for white non-Hispanic households is 9.9%, while the rate for black households in 2010 is 27.4% (Table 4).

We've tended to think of this period as a difficult economic time that will eventually come to an end.  But perhaps that's too optimistic.  Perhaps what we are witnessing is a structural adjustment of the US labor market, with a permanent downward shift in income for middle and low income people.  And perhaps these shifts will be most extreme for African-American households.  (The past decade seems to bear this out.  From 2000 to 2010 white non-Hispanic households had declined 5.5%, while black households declined 14.6% during that same period (8).)

Here the concern is that maybe Bruce Springsteen was right -- "these jobs are going, boys, and they ain't coming back to your hometown."  Jobs with decent wages -- manufacturing jobs, union jobs, professional service jobs -- have declined precipitously in the past twenty years (not just since the recession).  And that means that the opportunities for many workers to have "middle-class" incomes have become much more restricted. Here is a sober report from Chemical and Engineering News --

The severe national recession of the past several years is having a negative impact on the employment and the starting salaries of chemists and chemical engineers. The latest data from the American Chemical Society on graduates from 2009 found that median starting salaries fell about 5% for those receiving bachelor’s and doctoral degrees compared with the previous year. New graduates with master’s degrees appeared to have gotten a jump in pay.

Even the banking and financial sector has contracted (link):

The financial services industry, hammered by job cuts and record losses, is in for an even bigger contraction as the global recession deepens, said Marc Faber, publisher of the Gloom, Boom & Doom Report. 

“The financial sector will contract and it will contract much more than we’ve seen so far,” said Faber, who was in Tokyo to speak at an event hosted by CLSA Ltd. Financial professionals have “been in paradise for the past 25 years.”

More than 275,000 jobs in the financial industry have been lost in the last two years, according to Bloomberg data, while losses and writedowns at global companies exceeded $1 trillion in the past year. Faber said the contraction could rival declines seen in the 1970s following the collapse of Bernard Cornfeld’s Investors Overseas Services that shook confidence in the industry for a decade.

So the financial industry isn't providing ready opportunities for young MBAs; many of them too will need to find other, less well-paying jobs.

Does this mean that everyone in the US economy is facing downward pressure on wages and salary? Not exactly.  There is a segment of the American economy that is doing very well indeed. Here is a graph provided by Lane Kenworthy demonstrating the growth in income of the top 1% (link).  (Kenworthy's discussion is very good.)  The top line is the median household income of the top 1%.  The lower lines, showing virtually no growth, represent the median of the middle three quintiles and the median of the bottom quintile of households.

source: Consider the Evidence (Lane Kenworthy)

So here are two important questions.  Is the US economy on a path towards a shift to lower-paid jobs for a large segment of its working population?  And are there policies that could be chosen that would result in an outcome that looks more fair than this graph of the recent past, with reasonable growth of income for all American workers and less extreme growth at the very top?

(Here is an interesting Google resource, the Public Data Explorer, that provides visualization tools for basic US economic and demographic data. This particular screen shows the growth of personal income per capita since about 1930, across the regions of the United States.  (This is money income, not adjusted for inflation.) The second graph shows personal income per capita for selected metropolitan areas.  The third graph shows the unemployment rates for Wayne County and Oakland County in Michigan.)

Structural adjustment for the middle class?

Working people in the US have suffered big economic losses in the past four years.  Losses of jobs in the economy have pushed many working people from high-wage to low-wage jobs, and as we all know, many people have been pushed out of jobs altogether.  The national unemployment rate was 8.6% in November, and very much higher in urban areas and African-American and Latino communities.  Michigan's rate was 10.6% in October 2011 (link).  White non-Hispanic households fell from $55,360 in 2009 to $54,620 (-1.3%), while black households fell from $33,122 to $32,068 (-3.2%) (Table 1).  These differences in household income across race are stunning: black households started out at only 63% the level of white households in 2009, and they fell by more than double the percentage rate of loss from 2009 to 2010.

Here is a report from the US Census Bureau,  Income, Poverty, and Health Insurance Coverage in the United States: 2010, that sheds some light on the changes of the past several years.  Here are a few important summary findings:

• Real median household income was $49,445 in 2010, a 2.3 percent decline from 2009 (Figure 1 and Table 1).
• Since 2007, the year before the most recent recession, real median household income has declined 6.4 percent and is 7.1 percent below the median household income peak that occurred in 1999 (Figure 1 and Tables A-1 and A-2).3
• Both family and nonfamily households had declines in real median income between 2009 and 2010. The income of family households declined by 1.2 percent to $61,544; the income of nonfamily households declined by 3.9 percent to $29,730 (Table 1).
• Real median income declined for White and Black households between 2009 and 2010, while the changes for Asian and Hispanic-origin households were not statistically significant (Table 1).
• Real median household income for each race and Hispanic-origin group has not yet recovered to the pre-2001 recession all-time highs (Table A-1). (5)

Here is what real median income looks like, broken down by racial group, since 1967.

Now consider the poverty statistics the report contains.  Here is a summary graph:

The national poverty rate reached a forty-year low in 2000, at about 12%.  Through the decade, however, the national rate has grown to 15.1% in 2010, representing 46.2 million people.  Here again there is a stunningly wide gap between white and black populations.  The poverty rate in 2010 for white non-Hispanic households is 9.9%, while the rate for black households in 2010 is 27.4% (Table 4).

We've tended to think of this period as a difficult economic time that will eventually come to an end.  But perhaps that's too optimistic.  Perhaps what we are witnessing is a structural adjustment of the US labor market, with a permanent downward shift in income for middle and low income people.  And perhaps these shifts will be most extreme for African-American households.  (The past decade seems to bear this out.  From 2000 to 2010 white non-Hispanic households had declined 5.5%, while black households declined 14.6% during that same period (8).)

Here the concern is that maybe Bruce Springsteen was right -- "these jobs are going, boys, and they ain't coming back to your hometown."  Jobs with decent wages -- manufacturing jobs, union jobs, professional service jobs -- have declined precipitously in the past twenty years (not just since the recession).  And that means that the opportunities for many workers to have "middle-class" incomes have become much more restricted. Here is a sober report from Chemical and Engineering News --

The severe national recession of the past several years is having a negative impact on the employment and the starting salaries of chemists and chemical engineers. The latest data from the American Chemical Society on graduates from 2009 found that median starting salaries fell about 5% for those receiving bachelor’s and doctoral degrees compared with the previous year. New graduates with master’s degrees appeared to have gotten a jump in pay.

Even the banking and financial sector has contracted (link):

The financial services industry, hammered by job cuts and record losses, is in for an even bigger contraction as the global recession deepens, said Marc Faber, publisher of the Gloom, Boom & Doom Report. 

“The financial sector will contract and it will contract much more than we’ve seen so far,” said Faber, who was in Tokyo to speak at an event hosted by CLSA Ltd. Financial professionals have “been in paradise for the past 25 years.”

More than 275,000 jobs in the financial industry have been lost in the last two years, according to Bloomberg data, while losses and writedowns at global companies exceeded $1 trillion in the past year. Faber said the contraction could rival declines seen in the 1970s following the collapse of Bernard Cornfeld’s Investors Overseas Services that shook confidence in the industry for a decade.

So the financial industry isn't providing ready opportunities for young MBAs; many of them too will need to find other, less well-paying jobs.

Does this mean that everyone in the US economy is facing downward pressure on wages and salary? Not exactly.  There is a segment of the American economy that is doing very well indeed. Here is a graph provided by Lane Kenworthy demonstrating the growth in income of the top 1% (link).  (Kenworthy's discussion is very good.)  The top line is the median household income of the top 1%.  The lower lines, showing virtually no growth, represent the median of the middle three quintiles and the median of the bottom quintile of households.

source: Consider the Evidence (Lane Kenworthy)

So here are two important questions.  Is the US economy on a path towards a shift to lower-paid jobs for a large segment of its working population?  And are there policies that could be chosen that would result in an outcome that looks more fair than this graph of the recent past, with reasonable growth of income for all American workers and less extreme growth at the very top?

(Here is an interesting Google resource, the Public Data Explorer, that provides visualization tools for basic US economic and demographic data. This particular screen shows the growth of personal income per capita since about 1930, across the regions of the United States.  (This is money income, not adjusted for inflation.) The second graph shows personal income per capita for selected metropolitan areas.  The third graph shows the unemployment rates for Wayne County and Oakland County in Michigan.)

Structural adjustment for the middle class?

Working people in the US have suffered big economic losses in the past four years.  Losses of jobs in the economy have pushed many working people from high-wage to low-wage jobs, and as we all know, many people have been pushed out of jobs altogether.  The national unemployment rate was 8.6% in November, and very much higher in urban areas and African-American and Latino communities.  Michigan's rate was 10.6% in October 2011 (link).  White non-Hispanic households fell from $55,360 in 2009 to $54,620 (-1.3%), while black households fell from $33,122 to $32,068 (-3.2%) (Table 1).  These differences in household income across race are stunning: black households started out at only 63% the level of white households in 2009, and they fell by more than double the percentage rate of loss from 2009 to 2010.

Here is a report from the US Census Bureau,  Income, Poverty, and Health Insurance Coverage in the United States: 2010, that sheds some light on the changes of the past several years.  Here are a few important summary findings:

• Real median household income was $49,445 in 2010, a 2.3 percent decline from 2009 (Figure 1 and Table 1).
• Since 2007, the year before the most recent recession, real median household income has declined 6.4 percent and is 7.1 percent below the median household income peak that occurred in 1999 (Figure 1 and Tables A-1 and A-2).3
• Both family and nonfamily households had declines in real median income between 2009 and 2010. The income of family households declined by 1.2 percent to $61,544; the income of nonfamily households declined by 3.9 percent to $29,730 (Table 1).
• Real median income declined for White and Black households between 2009 and 2010, while the changes for Asian and Hispanic-origin households were not statistically significant (Table 1).
• Real median household income for each race and Hispanic-origin group has not yet recovered to the pre-2001 recession all-time highs (Table A-1). (5)

Here is what real median income looks like, broken down by racial group, since 1967.

Now consider the poverty statistics the report contains.  Here is a summary graph:

The national poverty rate reached a forty-year low in 2000, at about 12%.  Through the decade, however, the national rate has grown to 15.1% in 2010, representing 46.2 million people.  Here again there is a stunningly wide gap between white and black populations.  The poverty rate in 2010 for white non-Hispanic households is 9.9%, while the rate for black households in 2010 is 27.4% (Table 4).

We've tended to think of this period as a difficult economic time that will eventually come to an end.  But perhaps that's too optimistic.  Perhaps what we are witnessing is a structural adjustment of the US labor market, with a permanent downward shift in income for middle and low income people.  And perhaps these shifts will be most extreme for African-American households.  (The past decade seems to bear this out.  From 2000 to 2010 white non-Hispanic households had declined 5.5%, while black households declined 14.6% during that same period (8).)

Here the concern is that maybe Bruce Springsteen was right -- "these jobs are going, boys, and they ain't coming back to your hometown."  Jobs with decent wages -- manufacturing jobs, union jobs, professional service jobs -- have declined precipitously in the past twenty years (not just since the recession).  And that means that the opportunities for many workers to have "middle-class" incomes have become much more restricted. Here is a sober report from Chemical and Engineering News --

The severe national recession of the past several years is having a negative impact on the employment and the starting salaries of chemists and chemical engineers. The latest data from the American Chemical Society on graduates from 2009 found that median starting salaries fell about 5% for those receiving bachelor’s and doctoral degrees compared with the previous year. New graduates with master’s degrees appeared to have gotten a jump in pay.

Even the banking and financial sector has contracted (link):

The financial services industry, hammered by job cuts and record losses, is in for an even bigger contraction as the global recession deepens, said Marc Faber, publisher of the Gloom, Boom & Doom Report. 

“The financial sector will contract and it will contract much more than we’ve seen so far,” said Faber, who was in Tokyo to speak at an event hosted by CLSA Ltd. Financial professionals have “been in paradise for the past 25 years.”

More than 275,000 jobs in the financial industry have been lost in the last two years, according to Bloomberg data, while losses and writedowns at global companies exceeded $1 trillion in the past year. Faber said the contraction could rival declines seen in the 1970s following the collapse of Bernard Cornfeld’s Investors Overseas Services that shook confidence in the industry for a decade.

So the financial industry isn't providing ready opportunities for young MBAs; many of them too will need to find other, less well-paying jobs.

Does this mean that everyone in the US economy is facing downward pressure on wages and salary? Not exactly.  There is a segment of the American economy that is doing very well indeed. Here is a graph provided by Lane Kenworthy demonstrating the growth in income of the top 1% (link).  (Kenworthy's discussion is very good.)  The top line is the median household income of the top 1%.  The lower lines, showing virtually no growth, represent the median of the middle three quintiles and the median of the bottom quintile of households.

source: Consider the Evidence (Lane Kenworthy)

So here are two important questions.  Is the US economy on a path towards a shift to lower-paid jobs for a large segment of its working population?  And are there policies that could be chosen that would result in an outcome that looks more fair than this graph of the recent past, with reasonable growth of income for all American workers and less extreme growth at the very top?

(Here is an interesting Google resource, the Public Data Explorer, that provides visualization tools for basic US economic and demographic data. This particular screen shows the growth of personal income per capita since about 1930, across the regions of the United States.  (This is money income, not adjusted for inflation.) The second graph shows personal income per capita for selected metropolitan areas.  The third graph shows the unemployment rates for Wayne County and Oakland County in Michigan.)

David Graeber on the anarchist movement

Progressives seem to be confronted with some real conundrums (or is it conundra?), here in the early part of the 21st century. We want to see a world that is genuinely committed to some basic principles of social justice, equality, and personal freedom. And we generally acknowledge the point that the modern world can only function on the basis of social, political, and economic structures that have a degree of authority over individual conduct. These two framing ideas are in tension, once we recognize the permanent likelihood of "institutional capture" of social structures by privileged individuals and groups. Capture may result from the access a privileged party has to the sources of wealth and power (the CCP in China) or the astronomically disproportional influence that corporations and private interests have in the legislative and regulatory process (lobbyists in France, the UK, and the US). So is it possible to create a society in which organizing structures exist, but that are genuinely governed by the constraints of justice,equality, and democracy? Can democratic institutions be established and defended that genuinely embody the interests and dignity of poor and working people? In a word, is social democracy actually a feasible outcome in the conditions of the 21st century?

There is a strand of radical thought that answers these questions in the negative.  The "autonomist" theories and practices within the labor movement of the 1950s that were described in an earlier post represent one thread in this world. Another is the body of thinking, rhetoric, and action that is involved in the anarchist organizations associated with current anti-globalization activism.  David Graeber has done an important service to the rest of us by offering an extended ethnography of this loosely connected movement in Direct Action. The book is the first I've seen to offer a nuanced description of the thinking, practices, and networks that have emerged within this movement over the past fifteen years or so. Unlike much of the journalism that this movement has produced, it resists both caricature and polemic. Graeber is a participant within the movement as well as an observer, and his voice helps to make sense of the thinking and actions that have surfaced in Seattle, Washington, Quebec, Madrid, and London in the past 15 years. And it certainly helps to put voices and faces into the OWS movement. Graeber is, by the way, an unusually appealing writer, so the book is a very engaging read.  (It is also very long -- 538 pages of text.)

The first half of the book provides a detailed chronological ethnography of the preparations that several Direct Action groups made to engage in demonstration and resistance at the Summit of the Americas in Quebec in April, 2001. Graeber gives a textured understanding of the personalities and debates that unfolded. (Here is an activist-produced video of the protests; link.)  As his description makes clear, this was a transnational network from the start, with alliances and affinities extending from Chiapas to Italy to Spain to Switzerland to the Mohawk Nation spanning the US and Canada border.

The second part of the book is a more analytical exposition of direct action and anarchism.  He offers a clear description of what these activists mean by "direct action" (chapter 5), and attempts to capture something of the culture of anarchist activism (chapter 6). Here is an interesting observation about the social composition of anarchist networks in the US, which may also shed some light on OWS:

Speaking broadly, it seems to me activist milieu can best be seen as a juncture, a kind of meeting place, between downwardly mobile elements of the professional classes and upwardly mobile children of the working class. (252)

The groups that Graeber describes include various Direct Action Networks (DAN), including the one based in New York in which he was involved, NYC DAN. Another is Ya Basta!, also anarchist but with a decided taste for performance.  These groups conduct their discussions, planning, and decision-making according to egalitarian, consensual practices: no leaders, no executive committees, no authority. These practices are described in the principles endorsed by one of the oldest Direct Action groups, the Peoples' Global Action (PGA) (link). Here is how Graeber describes the principles of consensus:

DAN employed a formal consensus process with rotating facilitators, an elaborate system of “stacking” designed to ensure no small group of voices dominated the conversation. Smokey and Flamma hated DAN. Like a number of other anarchists in New York—I’ll call them the “hardcores,” for lack of a better name, the sort that were likely to have more experience in Black Blocs, tree sits, or the squatter scene, or anyway used to working in small, intimate collectives—they saw DAN’s formal structure as itself stifling and oppressive. (20)

But the ideal of consensus doesn't imply inability to act as a group. In fact, Graeber describes an extended process of brainstorming, planning, and decision-making leading up to coordination with the Mohawk Warrior Society, Ya Basta!, the International Socialist Organisation (ISO), and other sympathetic groups, and execution of complex actions in Quebec. (Graeber and other DAN participants seem to find the socialist ISO activists particularly annoying because of their apparent opportunism and vanguardism; and yet their egalitarian principles make it impossible for them to exclude them.)

The detailed notes about the tactics and actions in Quebec once the demonstrations began read like an urban combat novel: anarchist groups approaching the fence surrounding the core Summit area, police firing tear gas and water cannons, many injuries and arrests, molotov cocktails from a variety of Blocs against water cannon.  Graeber's narrative gives a vivid depiction of what must have been similar actions and tactics in Strasbourg, London, and Seattle, with activists learning new tactics (and equipment) from one siege to another.  (The horrendous video and photos from UC-Davis of police methodically pepper-spraying seated demonstrators give another current exposure to the potential for police violence in circumstances of protest and resistance.)

I find some interesting affinities between the movements and ideas that Graeber describes and the views of economic development advocated by Arturo Escobar in Encountering Development: The Making and Unmaking of the Third World. Escobar articulates much of the radical critique of globalization and its effects on poor people that lies at the core of the worldview expressed by the anarchist movement Graeber describes.  Escobar's position is strongly anti-neoliberal, taking issue with foundational development ideas about growth and the general beneficence of markets. He too favors a view of the future in which people exercise continuing control over the processes that affect them. And he too likes a future built around fairly autonomous communities, cooperatives, and non-market institutions.

Also resonant are new ideas about deliberative and participatory democracy being developed by Archon Fung and Erik Olin Wright under the rubric of "empowered deliberative democracy"-- for example, in Deepening Democracy. Here is a representative statement of their view of the challenge facing existing democracies:

As the tasks of the state have become more complex and the size of polities larger and more heterogeneous, the institutional forms of liberal democracy developed in the nineteenth century—representative democracy plus techno-bureaucratic administration—seem increasingly ill suited to the novel problems we face in the twenty-first century. “Democracy” as a way of organizing the state has come to be narrowly identified with territorially based competitive elections of political leadership for legislative and executive offices. Yet, increasingly, this mechanism of political representation seems ineffective in accomplishing the central ideals of democratic politics: facilitating active political involvement of the citizenry, forging political consensus through dialogue, devising and impleenting public policies that ground a productive economy and healthy society, and, in more radical egalitarian versions of the democratic ideal, ensuring that all citizens benefit from the nation's wealth. (3)

There are quite a few political values and perceptions embodied in the Direct Action movement that many progressive people can relate to. It isn't surprising that OWS has caught the attention of many young people. But are the mini-movements of activists that Graeber describes really a potential solution to the conundrum mentioned above? Can we get to a more just world through this kind of activism? Seattle and Quebec can claim some successes in achieving negative goals -- discrediting the IMF, challenging the World Bank, exposing a latent violence in democratic societies through excessive police force and brutality. And perhaps OWS will be successful in pushing back against over-greedy financial institutions.  This kind of effect can plausibly come about through spontaneous popular protest. And as Graeber makes clear, these large anarchist actions are organized and planned, even if they are collective and mass-based.

But this just delays the problem, because it doesn't give a basis for creating institutions and structures that really work from the point of view of social justice and participatory democracy.  The kinds of activism Graeber describes might be compared to an "immune system" for the periodic disorders of imperfect democracy: activists and their organizations (lymphocytes) swarm around important causes of distress (infections, inflammation), provoking repair responses within the society. But the movement doesn't contribute to the basic metabolism of society and politics. "Direct Action" isn't really a prescription for organizing society in its routine work; the approval of food and drug safety, the plans that states make for energy production, the creation and maintenance of social safety nets. The voice of the people can demand these protections. But then we need institutions that actually do the work. And the funny suits of Ya Basta! and spokescouncils don't fill the bill for this task.  In the end, I am more attracted to the kind of work begun by Fung and Wright, which is aimed at creating sustainable institutions of participatory democracy.

David Graeber on the anarchist movement

Progressives seem to be confronted with some real conundrums (or is it conundra?), here in the early part of the 21st century. We want to see a world that is genuinely committed to some basic principles of social justice, equality, and personal freedom. And we generally acknowledge the point that the modern world can only function on the basis of social, political, and economic structures that have a degree of authority over individual conduct. These two framing ideas are in tension, once we recognize the permanent likelihood of "institutional capture" of social structures by privileged individuals and groups. Capture may result from the access a privileged party has to the sources of wealth and power (the CCP in China) or the astronomically disproportional influence that corporations and private interests have in the legislative and regulatory process (lobbyists in France, the UK, and the US). So is it possible to create a society in which organizing structures exist, but that are genuinely governed by the constraints of justice,equality, and democracy? Can democratic institutions be established and defended that genuinely embody the interests and dignity of poor and working people? In a word, is social democracy actually a feasible outcome in the conditions of the 21st century?

There is a strand of radical thought that answers these questions in the negative.  The "autonomist" theories and practices within the labor movement of the 1950s that were described in an earlier post represent one thread in this world. Another is the body of thinking, rhetoric, and action that is involved in the anarchist organizations associated with current anti-globalization activism.  David Graeber has done an important service to the rest of us by offering an extended ethnography of this loosely connected movement in Direct Action. The book is the first I've seen to offer a nuanced description of the thinking, practices, and networks that have emerged within this movement over the past fifteen years or so. Unlike much of the journalism that this movement has produced, it resists both caricature and polemic. Graeber is a participant within the movement as well as an observer, and his voice helps to make sense of the thinking and actions that have surfaced in Seattle, Washington, Quebec, Madrid, and London in the past 15 years. And it certainly helps to put voices and faces into the OWS movement. Graeber is, by the way, an unusually appealing writer, so the book is a very engaging read.  (It is also very long -- 538 pages of text.)

The first half of the book provides a detailed chronological ethnography of the preparations that several Direct Action groups made to engage in demonstration and resistance at the Summit of the Americas in Quebec in April, 2001. Graeber gives a textured understanding of the personalities and debates that unfolded. (Here is an activist-produced video of the protests; link.)  As his description makes clear, this was a transnational network from the start, with alliances and affinities extending from Chiapas to Italy to Spain to Switzerland to the Mohawk Nation spanning the US and Canada border.

The second part of the book is a more analytical exposition of direct action and anarchism.  He offers a clear description of what these activists mean by "direct action" (chapter 5), and attempts to capture something of the culture of anarchist activism (chapter 6). Here is an interesting observation about the social composition of anarchist networks in the US, which may also shed some light on OWS:

Speaking broadly, it seems to me activist milieu can best be seen as a juncture, a kind of meeting place, between downwardly mobile elements of the professional classes and upwardly mobile children of the working class. (252)

The groups that Graeber describes include various Direct Action Networks (DAN), including the one based in New York in which he was involved, NYC DAN. Another is Ya Basta!, also anarchist but with a decided taste for performance.  These groups conduct their discussions, planning, and decision-making according to egalitarian, consensual practices: no leaders, no executive committees, no authority. These practices are described in the principles endorsed by one of the oldest Direct Action groups, the Peoples' Global Action (PGA) (link). Here is how Graeber describes the principles of consensus:

DAN employed a formal consensus process with rotating facilitators, an elaborate system of “stacking” designed to ensure no small group of voices dominated the conversation. Smokey and Flamma hated DAN. Like a number of other anarchists in New York—I’ll call them the “hardcores,” for lack of a better name, the sort that were likely to have more experience in Black Blocs, tree sits, or the squatter scene, or anyway used to working in small, intimate collectives—they saw DAN’s formal structure as itself stifling and oppressive. (20)

But the ideal of consensus doesn't imply inability to act as a group. In fact, Graeber describes an extended process of brainstorming, planning, and decision-making leading up to coordination with the Mohawk Warrior Society, Ya Basta!, the International Socialist Organisation (ISO), and other sympathetic groups, and execution of complex actions in Quebec. (Graeber and other DAN participants seem to find the socialist ISO activists particularly annoying because of their apparent opportunism and vanguardism; and yet their egalitarian principles make it impossible for them to exclude them.)

The detailed notes about the tactics and actions in Quebec once the demonstrations began read like an urban combat novel: anarchist groups approaching the fence surrounding the core Summit area, police firing tear gas and water cannons, many injuries and arrests, molotov cocktails from a variety of Blocs against water cannon.  Graeber's narrative gives a vivid depiction of what must have been similar actions and tactics in Strasbourg, London, and Seattle, with activists learning new tactics (and equipment) from one siege to another.  (The horrendous video and photos from UC-Davis of police methodically pepper-spraying seated demonstrators give another current exposure to the potential for police violence in circumstances of protest and resistance.)

I find some interesting affinities between the movements and ideas that Graeber describes and the views of economic development advocated by Arturo Escobar in Encountering Development: The Making and Unmaking of the Third World. Escobar articulates much of the radical critique of globalization and its effects on poor people that lies at the core of the worldview expressed by the anarchist movement Graeber describes.  Escobar's position is strongly anti-neoliberal, taking issue with foundational development ideas about growth and the general beneficence of markets. He too favors a view of the future in which people exercise continuing control over the processes that affect them. And he too likes a future built around fairly autonomous communities, cooperatives, and non-market institutions.

Also resonant are new ideas about deliberative and participatory democracy being developed by Archon Fung and Erik Olin Wright under the rubric of "empowered deliberative democracy"-- for example, in Deepening Democracy. Here is a representative statement of their view of the challenge facing existing democracies:

As the tasks of the state have become more complex and the size of polities larger and more heterogeneous, the institutional forms of liberal democracy developed in the nineteenth century—representative democracy plus techno-bureaucratic administration—seem increasingly ill suited to the novel problems we face in the twenty-first century. “Democracy” as a way of organizing the state has come to be narrowly identified with territorially based competitive elections of political leadership for legislative and executive offices. Yet, increasingly, this mechanism of political representation seems ineffective in accomplishing the central ideals of democratic politics: facilitating active political involvement of the citizenry, forging political consensus through dialogue, devising and impleenting public policies that ground a productive economy and healthy society, and, in more radical egalitarian versions of the democratic ideal, ensuring that all citizens benefit from the nation's wealth. (3)

There are quite a few political values and perceptions embodied in the Direct Action movement that many progressive people can relate to. It isn't surprising that OWS has caught the attention of many young people. But are the mini-movements of activists that Graeber describes really a potential solution to the conundrum mentioned above? Can we get to a more just world through this kind of activism? Seattle and Quebec can claim some successes in achieving negative goals -- discrediting the IMF, challenging the World Bank, exposing a latent violence in democratic societies through excessive police force and brutality. And perhaps OWS will be successful in pushing back against over-greedy financial institutions.  This kind of effect can plausibly come about through spontaneous popular protest. And as Graeber makes clear, these large anarchist actions are organized and planned, even if they are collective and mass-based.

But this just delays the problem, because it doesn't give a basis for creating institutions and structures that really work from the point of view of social justice and participatory democracy.  The kinds of activism Graeber describes might be compared to an "immune system" for the periodic disorders of imperfect democracy: activists and their organizations (lymphocytes) swarm around important causes of distress (infections, inflammation), provoking repair responses within the society. But the movement doesn't contribute to the basic metabolism of society and politics. "Direct Action" isn't really a prescription for organizing society in its routine work; the approval of food and drug safety, the plans that states make for energy production, the creation and maintenance of social safety nets. The voice of the people can demand these protections. But then we need institutions that actually do the work. And the funny suits of Ya Basta! and spokescouncils don't fill the bill for this task.  In the end, I am more attracted to the kind of work begun by Fung and Wright, which is aimed at creating sustainable institutions of participatory democracy.

David Graeber on the anarchist movement

Progressives seem to be confronted with some real conundrums (or is it conundra?), here in the early part of the 21st century. We want to see a world that is genuinely committed to some basic principles of social justice, equality, and personal freedom. And we generally acknowledge the point that the modern world can only function on the basis of social, political, and economic structures that have a degree of authority over individual conduct. These two framing ideas are in tension, once we recognize the permanent likelihood of "institutional capture" of social structures by privileged individuals and groups. Capture may result from the access a privileged party has to the sources of wealth and power (the CCP in China) or the astronomically disproportional influence that corporations and private interests have in the legislative and regulatory process (lobbyists in France, the UK, and the US). So is it possible to create a society in which organizing structures exist, but that are genuinely governed by the constraints of justice,equality, and democracy? Can democratic institutions be established and defended that genuinely embody the interests and dignity of poor and working people? In a word, is social democracy actually a feasible outcome in the conditions of the 21st century?

There is a strand of radical thought that answers these questions in the negative.  The "autonomist" theories and practices within the labor movement of the 1950s that were described in an earlier post represent one thread in this world. Another is the body of thinking, rhetoric, and action that is involved in the anarchist organizations associated with current anti-globalization activism.  David Graeber has done an important service to the rest of us by offering an extended ethnography of this loosely connected movement in Direct Action. The book is the first I've seen to offer a nuanced description of the thinking, practices, and networks that have emerged within this movement over the past fifteen years or so. Unlike much of the journalism that this movement has produced, it resists both caricature and polemic. Graeber is a participant within the movement as well as an observer, and his voice helps to make sense of the thinking and actions that have surfaced in Seattle, Washington, Quebec, Madrid, and London in the past 15 years. And it certainly helps to put voices and faces into the OWS movement. Graeber is, by the way, an unusually appealing writer, so the book is a very engaging read.  (It is also very long -- 538 pages of text.)

The first half of the book provides a detailed chronological ethnography of the preparations that several Direct Action groups made to engage in demonstration and resistance at the Summit of the Americas in Quebec in April, 2001. Graeber gives a textured understanding of the personalities and debates that unfolded. (Here is an activist-produced video of the protests; link.)  As his description makes clear, this was a transnational network from the start, with alliances and affinities extending from Chiapas to Italy to Spain to Switzerland to the Mohawk Nation spanning the US and Canada border.

The second part of the book is a more analytical exposition of direct action and anarchism.  He offers a clear description of what these activists mean by "direct action" (chapter 5), and attempts to capture something of the culture of anarchist activism (chapter 6). Here is an interesting observation about the social composition of anarchist networks in the US, which may also shed some light on OWS:

Speaking broadly, it seems to me activist milieu can best be seen as a juncture, a kind of meeting place, between downwardly mobile elements of the professional classes and upwardly mobile children of the working class. (252)

The groups that Graeber describes include various Direct Action Networks (DAN), including the one based in New York in which he was involved, NYC DAN. Another is Ya Basta!, also anarchist but with a decided taste for performance.  These groups conduct their discussions, planning, and decision-making according to egalitarian, consensual practices: no leaders, no executive committees, no authority. These practices are described in the principles endorsed by one of the oldest Direct Action groups, the Peoples' Global Action (PGA) (link). Here is how Graeber describes the principles of consensus:

DAN employed a formal consensus process with rotating facilitators, an elaborate system of “stacking” designed to ensure no small group of voices dominated the conversation. Smokey and Flamma hated DAN. Like a number of other anarchists in New York—I’ll call them the “hardcores,” for lack of a better name, the sort that were likely to have more experience in Black Blocs, tree sits, or the squatter scene, or anyway used to working in small, intimate collectives—they saw DAN’s formal structure as itself stifling and oppressive. (20)

But the ideal of consensus doesn't imply inability to act as a group. In fact, Graeber describes an extended process of brainstorming, planning, and decision-making leading up to coordination with the Mohawk Warrior Society, Ya Basta!, the International Socialist Organisation (ISO), and other sympathetic groups, and execution of complex actions in Quebec. (Graeber and other DAN participants seem to find the socialist ISO activists particularly annoying because of their apparent opportunism and vanguardism; and yet their egalitarian principles make it impossible for them to exclude them.)

The detailed notes about the tactics and actions in Quebec once the demonstrations began read like an urban combat novel: anarchist groups approaching the fence surrounding the core Summit area, police firing tear gas and water cannons, many injuries and arrests, molotov cocktails from a variety of Blocs against water cannon.  Graeber's narrative gives a vivid depiction of what must have been similar actions and tactics in Strasbourg, London, and Seattle, with activists learning new tactics (and equipment) from one siege to another.  (The horrendous video and photos from UC-Davis of police methodically pepper-spraying seated demonstrators give another current exposure to the potential for police violence in circumstances of protest and resistance.)

I find some interesting affinities between the movements and ideas that Graeber describes and the views of economic development advocated by Arturo Escobar in Encountering Development: The Making and Unmaking of the Third World. Escobar articulates much of the radical critique of globalization and its effects on poor people that lies at the core of the worldview expressed by the anarchist movement Graeber describes.  Escobar's position is strongly anti-neoliberal, taking issue with foundational development ideas about growth and the general beneficence of markets. He too favors a view of the future in which people exercise continuing control over the processes that affect them. And he too likes a future built around fairly autonomous communities, cooperatives, and non-market institutions.

Also resonant are new ideas about deliberative and participatory democracy being developed by Archon Fung and Erik Olin Wright under the rubric of "empowered deliberative democracy"-- for example, in Deepening Democracy. Here is a representative statement of their view of the challenge facing existing democracies:

As the tasks of the state have become more complex and the size of polities larger and more heterogeneous, the institutional forms of liberal democracy developed in the nineteenth century—representative democracy plus techno-bureaucratic administration—seem increasingly ill suited to the novel problems we face in the twenty-first century. “Democracy” as a way of organizing the state has come to be narrowly identified with territorially based competitive elections of political leadership for legislative and executive offices. Yet, increasingly, this mechanism of political representation seems ineffective in accomplishing the central ideals of democratic politics: facilitating active political involvement of the citizenry, forging political consensus through dialogue, devising and impleenting public policies that ground a productive economy and healthy society, and, in more radical egalitarian versions of the democratic ideal, ensuring that all citizens benefit from the nation's wealth. (3)

There are quite a few political values and perceptions embodied in the Direct Action movement that many progressive people can relate to. It isn't surprising that OWS has caught the attention of many young people. But are the mini-movements of activists that Graeber describes really a potential solution to the conundrum mentioned above? Can we get to a more just world through this kind of activism? Seattle and Quebec can claim some successes in achieving negative goals -- discrediting the IMF, challenging the World Bank, exposing a latent violence in democratic societies through excessive police force and brutality. And perhaps OWS will be successful in pushing back against over-greedy financial institutions.  This kind of effect can plausibly come about through spontaneous popular protest. And as Graeber makes clear, these large anarchist actions are organized and planned, even if they are collective and mass-based.

But this just delays the problem, because it doesn't give a basis for creating institutions and structures that really work from the point of view of social justice and participatory democracy.  The kinds of activism Graeber describes might be compared to an "immune system" for the periodic disorders of imperfect democracy: activists and their organizations (lymphocytes) swarm around important causes of distress (infections, inflammation), provoking repair responses within the society. But the movement doesn't contribute to the basic metabolism of society and politics. "Direct Action" isn't really a prescription for organizing society in its routine work; the approval of food and drug safety, the plans that states make for energy production, the creation and maintenance of social safety nets. The voice of the people can demand these protections. But then we need institutions that actually do the work. And the funny suits of Ya Basta! and spokescouncils don't fill the bill for this task.  In the end, I am more attracted to the kind of work begun by Fung and Wright, which is aimed at creating sustainable institutions of participatory democracy.

Health disparities in the US and China

Health disparities across a population are among the most profound indicators of social inequalities that we can find.  And the fact of significant disparities across groups is a devastating statement about the circumstances of justice under which a society functions.  These disparities translate into shorter lives and lower quality of life for whole groups of people, relative to other groups.

Both the United States and China appear to display significant health disparities across their populations. Here are a couple of studies that draw attention to these facts.

United States

Here is an important new study on the question of health disparities in the United States by public health researchers at Harvard and UCSF.  The study is "Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States". And the answer the researchers provide to the question above is that the US possesses very significant health disparities across segments of its population. The study is worth reading in detail.

The authors analyze mortality statistics by county, and they break the data down by incorporating racial and demographic characteristics. The data groups fairly well around the eight Americas mentioned in the title:


Here is how they describe their findings:

The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the “eight Americas,” to explore the causes of the disparities that can inform specific public health intervention policies and programs.

And here is their conclusion:

Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.

For example, their data show that "the life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001." This is an enormous difference in longevity for the two groups; and it is a difference that tags fundamental social structures that influence health and risk across these two populations.

Here is a time-series graph of the behavior of longevity for the eight Americas:
So what are the factors that appear to create these extreme differences in mortality across socioeconomic and racial groups in America? They consider health care access and utilization; homicide; accidents; and HIV as primary potential causes of variations in mortality for a group. Most important of all of these factors for the large populations appear to be the health disparities that derive from access and utilization.  And here they offer an important set of recommendations:

Opportunities and interventions to reduce health inequalities include (1) reducing socioeconomic inequalities, which are the distal causes of health inequalities, (2) increasing financial access to health care by decreasing the number of Americans without health plan coverage, (3) removing physical, behavioral, and cultural barriers to health care, (4) reducing disparities in the quality of care, (5) designing public health strategies and interventions to reduce health risks at the level of communities (e.g., changes in urban/neighborhood design to facilitate physical activity and reduce obesity), and (6) designing public health strategies to reduce health risks that target individuals or population subgroups that are not necessarily in the same community (e.g., tobacco taxation or pharmacological interventions for blood pressure and cholesterol).

These findings are squarely relevant to assessing the justice of our society. The country needs to recognize the severity of the "health/mortality equity" issue, and we need to make appropriate policy reforms so that these disparities begin to lessen.

China

Several research papers address these issues for the case of China.  One is a World Bank working paper by David Dollar called "Poverty, Inequality, and Social Disparities During China's Economic Reform" (link).  Dollar notes that China has dramatically reduced its poverty rate over the past 25 years, whereas its income inequality measures have increased sharply during the same period. (Albert Park and Sangui Wang review the poverty statistics for this period in China Economic Review; link.)  They conclude that these inequalities between rural and urban populations, and between well educated urban professionals and the urban working class, have also resulted in significant inequalities in health status and outcomes for the various sub-populations.

Shenglan Tank, Qingyue Meng, Lincoln Chen, Henk Bekedam, Tim Evans, and Margaret Whitehead review the current evidence available on health equity in China in "Tackling the challenges to health equity in China" (link).  "Although health gains have continued, concern for the equitable distribution of social benefits of economic progress has grown" (25).  Further:

Disparities in income and wealth between the urban and rural areas, between the eastern and western regions, and between households have widened substantially. In 1990, the richest province had a GDP per person more than seven times larger than the poorest province, but by 2002, the same ratio had grown to 13 times greater.41The Gini coefficient, a measure of income inequality,42increased for China as a whole from 0•31 in 1978–79 to 0•45 in 2004. The level of income inequality in China is now similar to that in the USA, roughly comparable to that in the most inequitable Asian countries—Philippines and Thailand—and approaching the notoriously inequitable levels in Brazil and Mexico. (29-30)

The authors quote Amartya Sen on health equity (Amartya Sen, Why health equity"; link):

Health equity cannot be concerned only with health in isolation. Rather it must come to grips with the larger issue of fairness and justice in social arrangements, including economic allocations, paying attention to the role of health in human life and freedom.  Health equity is most certainly not just about the distribution of health, not to mention the even narrower focus on the distribution of health care. Indeed, health equity has an enormously wide reach and relevance.

And inequalities in personal income in different provinces lead to highly different levels of ability to fund public amenities in these provinces, with large effects on public health in poor provinces:

Living conditions differ greatly between areas of different affluence. Safe drinking water is available to 96% of the population of large cities but to less than 30% in poor rural areas. Differences in access to effective sanitation are even larger, 90% of residents in large cities have adequate sanitation, compared with less than 10% in poor rural areas (figure 6).

Two graphs capture the big picture:

In figure 1 the data demonstrate a strong correlation between life expectancy and average income for China's provinces and municipalities, from just about 65 years for the poorest regions to 78 years in Shanghai region.  Figure 2 demonstrates major inequalities in child health between rural and urban locations.  The authors further report that infant mortality also varies dramatically across regions: "Rural infant mortality rates are nearly five times higher in the poorest rural counties than in the wealthiest countries -- 123 versus 26 per 1000 live births, respectively" (26). One important source of data on these issues that these researchers use is the Chinese National Health Service survey of 1998; link.

The most detailed analysis of health disparities in China I've been able to find is a paper published in 2010 by Feinian Chen, Yang Yang, and Guangya Liu, "Social Change and Socioeconomic Disparities in Health over the Life Course in China: A Cohort Analysis" (link).  They make use of the China Health and Nutrition Survey to allow for a longitudinal study of health in several segments of China's population. (Here is a description of the CHNS.) Their conclusion:

Using data from the China Health and Nutrition Survey, we find significant socioeconomic status (SES) differences in the mean level of health and that these SES differentials generally diverge over the life course. We also find strong cohort variations in SES disparities in the mean levels of health and health trajectories. (126)

It would appear that studies of health status in China disaggregated by population segments are not yet as fully developed as one would wish.  The CHNS appears to have limited data coverage (much more limited than the national census, for example), and none of the studies mentioned in these articles appear to disaggregate down to levels lower than the province.  But the summary findings of all three of these articles point in the same direction: it is probable that there are significant inter-regional and inter-sectoral inequalities in health outcomes for the sub-populations corresponding to these segments.

Health disparities in the US and China

Health disparities across a population are among the most profound indicators of social inequalities that we can find.  And the fact of significant disparities across groups is a devastating statement about the circumstances of justice under which a society functions.  These disparities translate into shorter lives and lower quality of life for whole groups of people, relative to other groups.

Both the United States and China appear to display significant health disparities across their populations. Here are a couple of studies that draw attention to these facts.

United States

Here is an important new study on the question of health disparities in the United States by public health researchers at Harvard and UCSF.  The study is "Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States". And the answer the researchers provide to the question above is that the US possesses very significant health disparities across segments of its population. The study is worth reading in detail.

The authors analyze mortality statistics by county, and they break the data down by incorporating racial and demographic characteristics. The data groups fairly well around the eight Americas mentioned in the title:


Here is how they describe their findings:

The gap between the highest and lowest life expectancies for race-county combinations in the United States is over 35 y. We divided the race-county combinations of the US population into eight distinct groups, referred to as the “eight Americas,” to explore the causes of the disparities that can inform specific public health intervention policies and programs.

And here is their conclusion:

Disparities in mortality across the eight Americas, each consisting of millions or tens of millions of Americans, are enormous by all international standards. The observed disparities in life expectancy cannot be explained by race, income, or basic health-care access and utilization alone. Because policies aimed at reducing fundamental socioeconomic inequalities are currently practically absent in the US, health disparities will have to be at least partly addressed through public health strategies that reduce risk factors for chronic diseases and injuries.

For example, their data show that "the life expectancy gap between the 3.4 million high-risk urban black males and the 5.6 million Asian females was 20.7 y in 2001." This is an enormous difference in longevity for the two groups; and it is a difference that tags fundamental social structures that influence health and risk across these two populations.

Here is a time-series graph of the behavior of longevity for the eight Americas:
So what are the factors that appear to create these extreme differences in mortality across socioeconomic and racial groups in America? They consider health care access and utilization; homicide; accidents; and HIV as primary potential causes of variations in mortality for a group. Most important of all of these factors for the large populations appear to be the health disparities that derive from access and utilization.  And here they offer an important set of recommendations:

Opportunities and interventions to reduce health inequalities include (1) reducing socioeconomic inequalities, which are the distal causes of health inequalities, (2) increasing financial access to health care by decreasing the number of Americans without health plan coverage, (3) removing physical, behavioral, and cultural barriers to health care, (4) reducing disparities in the quality of care, (5) designing public health strategies and interventions to reduce health risks at the level of communities (e.g., changes in urban/neighborhood design to facilitate physical activity and reduce obesity), and (6) designing public health strategies to reduce health risks that target individuals or population subgroups that are not necessarily in the same community (e.g., tobacco taxation or pharmacological interventions for blood pressure and cholesterol).

These findings are squarely relevant to assessing the justice of our society. The country needs to recognize the severity of the "health/mortality equity" issue, and we need to make appropriate policy reforms so that these disparities begin to lessen.

China

Several research papers address these issues for the case of China.  One is a World Bank working paper by David Dollar called "Poverty, Inequality, and Social Disparities During China's Economic Reform" (link).  Dollar notes that China has dramatically reduced its poverty rate over the past 25 years, whereas its income inequality measures have increased sharply during the same period. (Albert Park and Sangui Wang review the poverty statistics for this period in China Economic Review; link.)  They conclude that these inequalities between rural and urban populations, and between well educated urban professionals and the urban working class, have also resulted in significant inequalities in health status and outcomes for the various sub-populations.

Shenglan Tank, Qingyue Meng, Lincoln Chen, Henk Bekedam, Tim Evans, and Margaret Whitehead review the current evidence available on health equity in China in "Tackling the challenges to health equity in China" (link).  "Although health gains have continued, concern for the equitable distribution of social benefits of economic progress has grown" (25).  Further:

Disparities in income and wealth between the urban and rural areas, between the eastern and western regions, and between households have widened substantially. In 1990, the richest province had a GDP per person more than seven times larger than the poorest province, but by 2002, the same ratio had grown to 13 times greater.41The Gini coefficient, a measure of income inequality,42increased for China as a whole from 0•31 in 1978–79 to 0•45 in 2004. The level of income inequality in China is now similar to that in the USA, roughly comparable to that in the most inequitable Asian countries—Philippines and Thailand—and approaching the notoriously inequitable levels in Brazil and Mexico. (29-30)

The authors quote Amartya Sen on health equity (Amartya Sen, Why health equity"; link):

Health equity cannot be concerned only with health in isolation. Rather it must come to grips with the larger issue of fairness and justice in social arrangements, including economic allocations, paying attention to the role of health in human life and freedom.  Health equity is most certainly not just about the distribution of health, not to mention the even narrower focus on the distribution of health care. Indeed, health equity has an enormously wide reach and relevance.

And inequalities in personal income in different provinces lead to highly different levels of ability to fund public amenities in these provinces, with large effects on public health in poor provinces:

Living conditions differ greatly between areas of different affluence. Safe drinking water is available to 96% of the population of large cities but to less than 30% in poor rural areas. Differences in access to effective sanitation are even larger, 90% of residents in large cities have adequate sanitation, compared with less than 10% in poor rural areas (figure 6).

Two graphs capture the big picture:

In figure 1 the data demonstrate a strong correlation between life expectancy and average income for China's provinces and municipalities, from just about 65 years for the poorest regions to 78 years in Shanghai region.  Figure 2 demonstrates major inequalities in child health between rural and urban locations.  The authors further report that infant mortality also varies dramatically across regions: "Rural infant mortality rates are nearly five times higher in the poorest rural counties than in the wealthiest countries -- 123 versus 26 per 1000 live births, respectively" (26). One important source of data on these issues that these researchers use is the Chinese National Health Service survey of 1998; link.

The most detailed analysis of health disparities in China I've been able to find is a paper published in 2010 by Feinian Chen, Yang Yang, and Guangya Liu, "Social Change and Socioeconomic Disparities in Health over the Life Course in China: A Cohort Analysis" (link).  They make use of the China Health and Nutrition Survey to allow for a longitudinal study of health in several segments of China's population. (Here is a description of the CHNS.) Their conclusion:

Using data from the China Health and Nutrition Survey, we find significant socioeconomic status (SES) differences in the mean level of health and that these SES differentials generally diverge over the life course. We also find strong cohort variations in SES disparities in the mean levels of health and health trajectories. (126)

It would appear that studies of health status in China disaggregated by population segments are not yet as fully developed as one would wish.  The CHNS appears to have limited data coverage (much more limited than the national census, for example), and none of the studies mentioned in these articles appear to disaggregate down to levels lower than the province.  But the summary findings of all three of these articles point in the same direction: it is probable that there are significant inter-regional and inter-sectoral inequalities in health outcomes for the sub-populations corresponding to these segments.