Project 8: What do doctors and economists have in common?
Introduction:
Scholarly research from all sorts of disciplines have
tackled the issue of income inequality, perhaps most notably by the discipline
of economics. However, due to the growing concerns about the effects of income
inequality, academic disciplines unassociated with economic concerns are
venturing into the discussion. One such discipline, medicine, published a
research article in 2014 discussing the causal effects of income inequality on
health. Another research article from 2014, this time from economics, also
evaluated income inequality and health, specifically focusing on teen
pregnancies. This paper will analyze how researchers from two very different
fields, medicine and economics, approach the topic of income inequality in
relation to health with emphasis on their respective rhetoric conventions.
Since going into a specific field shapes a researcher’s worldview, such
differences can make productive collaboration difficult; thus, analysis of the
language used is a valuable tool in understanding those differences and can
foster stronger collaboration in the future.
Knowing the background of the researchers can help
understand the motivations behind why they picked their specific topic to
research. Two research articles were chosen for the purpose of this analysis.
The first is from the journal of Social
Science & Medicine published in 2014 by Kate Pickett and Richard
Wilkinson titled “Income inequality and
health: A causal review.” Kate Pickett is a British epidemiologist who is a
professor at the University of New York. She also has trained in biological
anthropology and nutritional science. Richard Wilkinson is also a British
epidemiologist who studied economic history for his undergraduate degree before
changing careers and getting a Masters of Medical Science and becoming an
epidemiologist. Given Wilkinson’s early economic background, it may explain the
researchers’ interest in causally linking income inequality to health outcomes.
The second research article, titled “Income Inequality and Early Nonmarital Childbearing,” is from The Journal of Human Resources, which
was published in winter 2014 by the University of Wisconsin Press and authored by
Melissa Kearney and Phillip Levine. Melissa Kearney is an economics professor
at University of Maryland. Her research mainly focuses on poverty, social
policy, and inequality. She has previously testified before Congress on the
issue of income inequality. Phillip Levine is a professor of economics at
Wellesley College who mainly researches the effects income inequality has on disadvantaged
youth later in life. Given the researchers’ previous focus on the effects of
income inequality, the research article aligns well with their respective field
and interests.
Rhetorical Analysis:
Differences in rhetorical choices and language are evident
early on between the two research papers. The more notable difference is how
both papers approach the topic of income inequality at the beginning. The Kearney
and Levine paper does not describe what income inequality is, but instead talks
about why it may impact behavior. “Various theories exist for why income
inequality, as distinct from absolute income, might affect individual-level
behavior. Social scientists, particularly political scientists and
sociologists, have emphasized the role of relative,
as distinct from absolute
deprivation—in leading to acts of social unrest,” (Kearney and Levine, 3). On
the other hand, Pickett and Wilkinson’s first sentence says “world leaders,
including the US President, the UK Prime Minister, the Pope and leaders at the
International Monetary Fund, the United Nations, World Bank and the World
Economic Forum have all described income inequality as one of the most
important problems of our time and several have emphasized its social costs.”
Already early into the papers, there are already strong
differences in how the two disciplines approach the topic. Pickett and
Wilkinson use an ethos mode of persuasion in their first paragraph by citing
world leaders, perhaps to establish why something unrelated to medicine is
important for them to study. In their second sentence, Pickett and Wilkinson actually
cite an earlier Kearney and Levine paper when they wrote that “there is a very
large literature examining income inequality in relation to health. Early
reviews came to different interpretations of the evidence, though a majority of
studies reported that health tended to be worse in more unequal societies.”
This once again is an ethos appeal to establish why income inequality is a
health issue that needs attention.
Kearney and Levine use both a logos an ethos approach to
explain how income inequality plays a role in teen pregnancy by citing other
well known research (unquoted for length) and then using it make a logical
connection to the topic of the paper. The language used by Kearney and Levine
is formal, referencing to specific terminology that the audience of economic
scholars is expected to know. The difference may come from Pickett and
Wilkinson writing about a topic unusual for epidemiology, causing them to
simplify the economic terms since their usual readership may not be familiar
with the language.
Although both papers look at health-related consequences of
income inequality, another major difference between the two approaches is how
income inequality itself is defined for the purpose of the research. Kearney
and Levine explicitly define what they mean by income inequality: “we focus on
lower-tail income inequality, defined as the ratio of household income at the
50th percentile to the 10th percentile of the distribution,” (Kearney and
Levine, 5). On the other hand, Pickett and Wilkinson, defined income inequality
“by the ratio of incomes among the richest compared with the poorest 20% in
each country.” What stood out about the Pickett and Wilkinson definition, aside
from the different focus, was that it was never defined in the paper itself.
Rather, income inequality was defined in one of the graphs attached to their
report that was from an earlier 2008 study that they both conducted. The
difference in defining income inequality likely comes from the focus of the
papers themselves; Kearney and Levine are focusing on a specific health outcome—teen
pregnancy in the United States—as opposed to Pickett and Wilkinson’s more broad
approach. Since the methodology of Pickett and Wilkinson’s research is a
literature review within an epidemiological causal framework, it is likely
impossible for them to consistently and clearly define income inequality as
each research paper will have its own definition specific to what it is
studying.
Perhaps the most notable difference in rhetorical approaches
is how both papers go about the conclusion portion of the research. The
epidemiologists’ conclusion explicitly outlines ways to solve income inequality,
whereas the economists’ conclusion restated the research findings and ended on
saying that they “consider this a topic worthy of future research.” What is
most interesting about the differences in the conclusions is that the
epidemiologists who are not experts when it comes to economics also had the
most to say about what should be done
to fix it. To better analyze these two differences, the conclusions will be separately
quoted.
Pickett and
Wilkinson:
“The world leaders we mentioned at the start of this paper
have all referred to inequality as a cause of social and economic harm. But to
recognize the problem is not the same as tackling it effectively… the reason
why politicians do not do more is almost certainly a reflection of the
undemocratic power of money in politics and the media … narrowing the gap will
require not only redistributive tax policies but also a reduction in income
differences before tax. The halving of top tax rates since the 1970s has led
not only to a widening of income differences after tax but, more surprisingly,
to a more rapid rise in pre-tax incomes at the top – particularly in the
private sector where CEO pay seems unrelated to company performance.”
Since the purpose of Pickett and Wilkinson’s research was to
identify if income inequality had a causal effect on negative health outcomes,
the ending reads nearly like a persuasive paper rather than academic
literature. To compare, when it came to methodology and analysis in the
body of the paper, Pickett and Wilkinson used observational epidemiology
techniques to establish that causal relationship, using formal terminology
respective to their field of study to describe what they did (unquoted for
length purposes). At the conclusion itself, the language again simplified much
like the introduction portion. What was even more surprising was the astounding
conclusion unrelated to their finding regarding income inequality. Pickett and Wilkinson said that “the reason
why politicians do not do more is almost certainly a reflection of the
undemocratic power of money in politics and the media.” Nothing mentioned
earlier in their research paper would indicate this conclusion. Similarly,
their recommendation suggests that to fix the problem it “will require not only
redistributive tax policies but also a reduction in income differences before
tax.” As their paper discussed the health consequences of income inequality,
this recommendation does not appear to be based on their research findings. However,
it is possible given their background in medicine that they felt compelled to
write a solution, the cure if you will, to a health problem. The health problem
in this sense is all the negative health effects associated with income
inequality. To Pickett and Wilkinson, the solution may be to have strong
government policies eliminate the cause of a health issue regardless of
economic outcomes since their discipline’s focus is medicine. Pickett and
Wilkinson’s solutions have socialist undertones, which may also come from their
European background where social programs and high taxes are popular.
Kearney and Levine:
“In conclusion, we have presented robust empirical evidence
that income inequality is associated with higher rates of early nonmarital
childbearing among economically disadvantaged women. Our results suggest that
inequality itself, as opposed to other correlated geographic factors, is a
primary driver of this relationship. We have proposed a model that could
explain these findings: to the extent that income inequality leads to a
heightened sense of economic despair among the poor, it will lead to higher
rates of early nonmarital childbearing among those at the bottom of the
distribution. This could also be part of the explanation for why high-inequality
states and countries see higher rates of a host of “drop-out” behaviors,
including lower educational attainment and higher rates of crime. We consider
this a topic worthy of future research.”
The conclusion by Kearney and Levine reads very differently
than the one by Pickett and Wilkinson. Kearney and Levine summarize their
findings while maintaining a thoroughly neutral tone. They do not prescribe
policy or suggest what needs to be done to fix the problem the way Pickett and
Wilkinson did in their conclusion. Their only recommendation is further
research, and that is stated in a way that directly states that it is their
opinion, without trying to distance themselves from their opinion like Pickett
and Wilkinson did. The usage of the word “we” makes it clear that it is an
opinion, not a fact.
Conclusion:
Kearney and Levine would likely have umbrage with the way
Pickett and Wilkinson wrote their conclusion since in the discipline of
economics, policy is never prescribed unless the entire point of a research
paper is to research a specific policy. Recommending a drastic policy change
the way Pickett and Wilkinson did would make productive cooperation between
Pickett and Wilkinson with Kearney and Levine a challenge. This likely comes
from the difference in the two disciplines. Medicine is focused on finding the
solution, the cure, while economics is more about looking at what may cause a
problem and what the effects of a policy change may be. However, understanding
these differences through analysis of rhetorical features can help bridge this
gap.
Works Cited:
Kearney, M. S., & Levine, P. B.
(2014). Income Inequality and Early Nonmarital Childbearing. The Journal of
Human Resources, 49(1), 1-31. Retrieved from http://muse.jhu.edu.prox.lib.ncsu.edu/article/537400/pdf
Pickett, K. E., & Wilkinson, R.
G. (2015). Income inequality and health: A causal review. Social Science
& Medicine, 128(March), 316-326. Retrieved from
http://www.sciencedirect.com.prox.lib.ncsu.edu/science/article/pii/S0277953614008399