Project 8: What do doctors and economists have in common?

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