We are social creatures, down to our genes. We live together because it’s an advantage for us, individually and collectively. In exchange for being a good member of the society, we get societal benefits. Don’t break the law and you can live in a group that protects you from law breakers. This arrangement is known as the social compact. Of course, different societies strike different compacts.
The Canadian Social Compact
In his TED talk, Dr. Tony Iton contrasts the social compact in Canada, where he grew up, with that of the United States, where he went to medical school and eventually settled.
Dr Iton is Senior Vice President of the Building Healthy Communities program. The 10-year, $1 Billion program works to empower residents in 14 cities across California with the worst health outcomes to fight for changes in their communities that will help them lead healthier lives
Iton remembers a strong social compact while growing up in Canada. In exchange for being a good member of Canadian society–paying taxes, following the laws, and good citizenship–individuals received the societal support of universal healthcare, universal child care benefits, guaranteed sick leave, subsidized secondary education, public transit, and more.
When Iton moved to Baltimore for medical schools, he was exposed to the US inner city for the first time. Looking at the degraded neighborhoods and despondent residents, his immediate questions was, “When was there a war here?” This certainly wasn’t the social compact as he understood it.
What is the US Social Compact?
In exchange for being a good member of US society, we get a promise of non-intrusive government that won’t hamper our individual rights of worship, speech, assembly. We get the right to pursue life, liberty, and happiness. Arguably, we get lower taxes.
But we also get little group support: expensive private health care, no child care, no guaranteed sick leave, expensive secondary education, very little public transit.
In his talk, Iton shows that there’s so little social compact in the US–and so much reliance on private, individual resources–that low-income residents are physiologically different than high-income individuals.
Iton points out that 80 percent of what influences our health happens outside the healthcare system. (This matches OECD research findings about the ratio of spending on social services and healthcare.)
When it comes to health, your ZIP code can matter more than genetic code. Iton’s research found that ZIP codes in the same city have a variance in life expectancy of up to 15 years.
The Social Compact and Epigenetics
This health disparity in the US between rich and poor is the result of degraded environmental factors which lead to chronic stress. Chronic stress impacts your epigenetics–how your genes are expressed.
As I’ve written in previous posts, epigenetics can impact the health of future generations. With our disparities in the US, we are creating future generations that will start out compromised because of chronic stress that our social compact allows today. Those compromised future generations will require more in remedial services and be less productive.
In terms of the social compact, what is owed to the future members of society? The compact can’t be limited to just the people around us. If it did, self-interest will pilfer the present at the expense of the future. Arguably, this is already happening with government debts, carbon pollution, and habitat loss.
The US social compact was failing residents of Baltimore when Iton first viewed the inner city. It’s failing now, as shown in Iton’s research about disparities in chronic stress. Without change, the US compact will continue to fail, while other countries like Canada move ahead based on their collective strength.