Social Inequality Handout The aim of our mini-series on systems thinking is to act as an introduction to this way of seeing the world. It is no different to critical thinking – it’s something you may already be doing and haven’t realised there’s a term for; and like critical thinking, systems thinking is a skill that only gets stronger the more you use it. Put in its simplest form, systems thinking gets you to look at an issue from multiple angles and not just one, which is how we’re often taught to think of things. It’s useful to think about why that might be the case… but wait until you get to the end of the handout before you go down that track. It gets you to look at the different parts of an issue and how they inter-connect, rather than the ‘linear’ or ‘reductive’ way of zooming in to just one thing. It’s the difference between understanding how the different parts of your digestive system work together to digest and process food with the aim of keeping you nourished and alive vs just looking at the stomach as a standalone ‘thing’. Developing this way of thinking – seeing the bigger picture – can give you a more comprehensive understanding of yourself, of others, and of the world you live in. One major benefit of this bigger picture understanding is that it helps to develop compassion for yourself and others. A reductive way of thinking of addiction might be to say that it’s because you’re a bad person that made bad choices. It hands you a stick to beat yourself up with. Repeatedly. The systemic way of looking at addiction would say that you used substances because they helped take away the emotional pain you experienced from some kind of childhood trauma; that this trauma is related to growing up with significant disadvantage; that the neglect you experienced from your parents was related to how they were brought up and their childhood, etc, etc. It’s a much more accurate and a much kinder way to understand yourself. Systems thinking can be applied to anything in life as life is complex and interconnected. Now that you have a basic understanding of what systems thinking is (the first podcast of the miniseries); and that you understand that we often don’t see the systems we live in because unless we’re taught to question them, we take them as givens; we’re ready to apply the skill to something else to help strengthen our systems thinking muscle. Let’s look at social inequality. Social inequality is ‘the extent to which there are differences between different groups in society’. It can relate to differences in income, gender, ethnicity, disabilities and health issues, age, sexuality, and more. In the podcast and in this handout, we will get even more to grips with systemic thinking by looking at a specific example of social inequality: the fact that Black, Asian and Minority Ethnic (BAME) groups have been significantly more affected by COVID-19 (in terms of severity and fatalities) when compared to non-BAME groups. It’s important to say that COVID-19 hasn’t created these inequalities but exposed and exacerbated longstanding inequalities affecting BAME groups. A medicalised view – note that this is just ONE view so can be considered REDUCTIVE (as it’s reducing a complex problem down to just one thing) – might say that the difference in severity is related to people from BAME groups having higher levels of diabetes, cardiovascular disease, asthma and obesity which puts them at greater risk of being more severely affected by COVID-19. End of. No further inquiry needed. A systems thinker would not accept this as a reason but instead ask ‘BUT WHY?’. They would see this not as the problem but as symptoms of a problem to uncover and understand. A systems thinker would be curious about why people from BAME groups have such underlying health conditions. Some reasons could be: People from BAME groups tend to be blue collar workers that earn a lower living. Lower incomes mean that people don’t have access to higher quality food and may eat higher levels of fast/junk food and ready meals as they are often cheaper. Lower incomes mean people are more likely to live in rented accommodation of a lower standard in low income areas (where incidentally, there are more fast food outlets). They may struggle to pay heating bills and/or live in a place that experiences damp and poor ventilation – leading to a higher incidence of asthma. Health conditions such as obesity, pulmonary lung disease, cardiovascular disease, autoimmune diseases and more have been linked to ‘Adverse Childhood Experiences’ – the more ACEs a person experiences, the higher the incidence of such conditions along with others such as mental health problems and substance misuse problems. People from BAME communities are often affected by intergenerational trauma – they had parents who experienced forced immigration, slavery, they may have experienced war. The list is a long one. Experiences of racism – often frequent and distressing – are also a form of trauma that may be ‘added’ to the trauma a person is carrying from their parents. Continuing on with exploring social inequality within this example, other reasons that can go towards explaining the difference in the impact of COVID-19 and that would be missed if a person settles for just one or limited perspectives are: People from BAME populations are unable to store Vitamin D for as long as non-BAME. They simply never had to. Over 80% of people who have been severely or fatally affected by COVID-19 had low levels of Vitamin D in their bodies. Blue collar workers are unable to work from home making them more at risk of contracting COVID-19. They are more likely to be poorer paid and doing casual work which means they don’t have access to private health care, higher quality food, and have limited or no savings – this latter one particularly leading to psychological distress at the thought or reality of unemployment. High stress levels affect the immune system and lower the immune response. People from BAME groups are less likely to own their own property and be at greater risk of eviction through job loss and loss of income. They are more likely to live in crowded and cramped conditions meaning that there is a greater risk of transmission and that it’s difficult or impossible to self-isolate. People from BAME groups have frequently experienced racism within the healthcare system and have higher levels of mistrust as a result. They may be more reluctant to seek care on a timely basis. People from BAME groups are over represented in key worker roles (almost a third of the working age population of black Africans are employed as key workers; 1 in 5 BAME work in health and social care) and will be at greater risk. We could go on but I think the point is clear. All of the above example are interlinked and provide a solid example of social inequality which, when looked at this way, is also called ‘systemic inequality’ – the system is unequal. Looking at the issue in a reductive way conceals the complexity and enormity of the problem. This makes it easier for decision makers in government to swerve the issue and not take responsibility. It is through understanding as many parts of the system as possible, breaking a complex problem down into small parts, that solutions begin to emerge and seem possible. Prompts for the seminars: What other social issues can be looked at in a systemic way? Try to contrast what might be a reductive or simplistic view of an issue with a more comprehensive systemic view. What practical steps can you take to continually build your systems thinking muscles?