Health Disparities

In The Progress Paradox, Gregg Easterbrook draws upon three decades of wide-ranging research and thinking to make the persuasive assertion that almost all aspects of Western life have vastly improved in the past century—and yet today, most men and women feel less happy than in previous generations. Why this is so and what we should do about it is the subject of this book.

The rich are not only getting richer, they are becoming more dangerous. Starting in the early 1980s the top one percent broke away from the rest of us to become the most unstable force in the economy. An elite that had once been the flat line on the American income charts - models of financial propriety - suddenly set off on a wild ride of economic binges. Not only do they control more than a third of the country's wealth, their increasing vulnerability to the booms and busts of the stock market wreak havoc on our consumer economy, financial markets, communities, and government finances.

Retirement insecurity is an increasingly serious manifestation of the vast inequality that risks destroying the social fabric in America. The nearly inevitable consequence of lifetime wage discrepancies, security in retirement is linked to the kinds of jobs we hold during our work lives. That, in turn, is a product of all the forces leading to historic levels of inequality, forces that have protected the very wealthy, destroyed any hold on stability for the poor, and gradually eroded the security of the vast middle class.

For African Americans in the southern United States, the social determinants of health are influenced by a unique history that encompasses hundreds of years of slavery, injustices during the Jim Crow era, the Great Migration, the civil rights era, and contemporary experiences like the Black Lives Matter movement. Black activists, physicians, and communities continue to battle inequities and structural problems that include poverty, inadequate access to health care, incarceration, a lack of transportation, and food insecurity.

There was a time in this country when people who were well-off had two homes, and the super-rich may have had three residences. In 2008 a prominent politician was asked how many homes he had. He didn’t know. The number was eight...and in the ensuing years the income gap has only widened. Billionaires now have so much money and power that the very fabric of our nation is coming unraveled. Tax policy is fundamental to a nation’s stability. We need to return to the system that brought us a large, dynamic, educated middle class.

For over 60 million people, work in America has been a story of declining wages, insecurity, and unsafe conditions, especially amid the coronavirus epidemic. This new and troubling reality has galvanized media and policymakers, but all the while a different and little-known story of rebirth and struggle has percolated just below the surface. On the Job is the first account of a new kind of labor movement, one that is happening locally, quietly, and among our country's most vulnerable - but essential - workers.