Intended for healthcare professionals

Analysis Essay

Equality, sustainability, and quality of life

BMJ 2010; 341 doi: (Published 02 November 2010) Cite this as: BMJ 2010;341:c5816
  1. Richard G Wilkinson, professor emeritus 1,
  2. Kate E Pickett, professor of epidemiology2,
  3. Roberto De Vogli, lecturer3
  1. 1University of Nottingham, Nottingham, UK
  2. 2University of York, York, UK
  3. 3Department of Epidemiology and Public Health, University College London, UK
  1. Correspondence to: R Wilkinson Richard{at}
  • Accepted 6 September 2010

Action on climate change is hampered by the view that reducing carbon emissions will involve a sacrifice in living standards. But Richard Wilkinson, Kate Pickett, and Roberto De Vogli argue that greater equality will not only help achieve sustainability but also enhance the real quality of life

When former US vice president Al Gore produced his hard hitting documentary on the dangers of climate change, he called it “An Inconvenient Truth,” because dealing with climate change was likely to require unwelcome changes in our way of life. And yet it is clear, from research that we summarise in our report for the London Sustainable Development Commission1 and in The Spirit Level,2 that not only is greater equality a prerequisite for coping with climate change, it is essential for future improvements in the overall quality of life of whole populations. Physical and mental health are better and a wide range of social problems are less prevalent in more equal societies.

Uncertain future

The International Panel on Climate Change (IPCC) estimates that the rise in global temperature this century will be somewhere between a tolerable 1.1°C and a catastrophic 6.4°C.3 Most people would sacrifice a lot to avoid the higher figure but much less to avoid the lower. A rational response seems to depend on a difficult calculation: weighing up the costs and challenges of reducing carbon emissions against the probabilities of various amounts of warming.

Estimates of the damage done by global warming are subject to similar uncertainty, but environmentalists suggest that a 2°C rise above pre-industrial levels (1.4°C above current temperatures) is the “critical threshold” above which some of the larger effects of climate change are likely to occur, the so called point of no return.4 Climate change will affect global public health, with increased …

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