Gina Castillo is the Agriculture Program Manager at Oxfam America.

Most of us think that accidents are unforeseeable and not preventable. But that is not the case when it comes to why people who are poor are hit again and again by events that make it difficult for them to escape poverty.

Today Oxfam released a new report, No Accident: Resilience and the Inequality of Risk. The report shows that disaster risk is being dumped on to millions of people living in poverty because of climate change and because of unfair practices.

Take weather-related events as an example. Due to urbanization and climate change, there are increasingly more people living in places that are susceptible to disasters. Since 1970 the number of people exposed to floods and cyclones has doubled. Those are the “big shocks”—the ones that get media attention and galvanize donors and governments into action, as was certainly the case when Haiti suffered its devastating earthquake in January 2010. Yet, there are also “small shocks” such as illness, death, or a harvest failure, that can push a family that is just hanging on to destitution.

Consider this figure below, which shows how one family in Port-au-Prince, Haiti coped in the year after the 2010 earthquake, which sadly killed two of their youngest boys. The father lost his job and the family was heavily reliant friends and neighbors who provided them with most of their meals until mid-May, as well as emergency-related grants and services. After this, they were forced to sell their livestock. An Oxfam grant allowed them to pay off their debts and to start a small business, but their household income still dropped by 88 per cent. Unfortunately, the shocks continued. The family invested in a market garden, which was later destroyed by Hurricane Tomas in October 2010. They also bought food to sell, but some of this was looted during election violence in November 2010.

Figure 1: One family’s experience after the 2010 Haiti earthquake

We highlight this family’s story because it is not atypical.  People work hard to get out of poverty, as studies have shown.

So why is it so difficult for people to get ahead? In the aid world, we talk often of vulnerability. But we cannot talk about vulnerability as a random twist of fate. It’s about politics, power, and inequality. As a result, risk is dumped on poor countries and their inhabitants, asis certainly the case for climate change. 50% of carbon emissions are generated by 11% of people, the consequences of which are left to poor countries and the most vulnerable are the hardest hit. Women often face higher risks because of gender discrimination and cultural norms, yet shoulder the burden of managing families. They have fewer opportunities economically, resulting in lower income and fewer options when it comes to managing risk.

Why does this happen? Our research showed that while measuring vulnerability is difficult, countries with more vulnerable populations also tend to be those with greater income inequality. Governments need to tackle inequality and ensure that risk is better shared across society. Thankfully there is increasing awareness that excessive inequality is corrosive to growth.

Aid cannot fix inequality and disproportionate risk. Governments can. Targeted action to support society’s most vulnerable (basic services such as education health, and access to decision-making) is needed to even out inequalities, reduce risk, and build resilience.

Because some accidents are preventable.

Andrew L. Yarrow is a senior research advisor at Oxfam America who studies inequality and low-wage work in the US.

What do high Gini coefficients and diabetes, regressive taxation and cardiovascular disease, and low minimum wages and respiratory ailments have to do with each other? More than most people—even physicians and economists—may think.

It’s not news that economic inequality in the United States has sharply increased during the last 30 years. It’s also not news that super-sized soft drinks, the easy availability of assault weapons, and the lack of health insurance for 49 million people are tragically cutting many American lives short.

What could be big news is that inequality in the United States may be a factor contributing to Americans’ poorer health, especially compared to Western Europeans, Japanese, Canadians, and Australians.  According to a massive new report by the National Research Council and the Institute of Medicine, “U.S. Health in International Perspective: Shorter Lives, Poorer Health,” the United States ranks dead last among 17 rich countries in life expectancy and at or near the bottom in nine key health indicators, ranging from infant mortality, obesity, and heart disease to homicides, chronic lung diseases, and sexually transmitted diseases (STDs).

Table courtesy the paper's authors.

These international health rankings look remarkably similar to inequality rankings by the Organization for Economic Cooperation and Development (OECD). Denmark, Norway, and Sweden hover near the top with the best health outcomes and the least social inequality; France, Germany, the Netherlands, and Canada are in the middle of both rankings. The US and Portugal are at the bottom.

Among the 17 countries studied, the United States now has the greatest disparity in wealth between the richest 1 percent of households, whose $16.4 million average net worth is 288 times that of the median household. The US also has the lowest male life expectancy and the lowest probability of its citizens surviving to age 50. Likewise, average incomes of the top 1 percent are more than 70 times higher than those of the poorest fifth of Americans—much greater than in Western Europe or Japan. And finally, the US has the dubious distinction of having the highest rates of infant mortality, STDs, and deaths from car crashes and gun violence.

Table courtesy the paper's authors.

Even fatal illnesses that our state-of-the-art medicine might be controlling, such as heart and lung diseases, are more likely to kill Americans than they are to kill citizens of all but one other country in the study. And the gaps have been widening, as America has been slipping farther behind other developed countries in health outcomes during the last 30 years.

Some might chalk this up to the fact that, prior to Obamacare, the US has had the highest proportion of people without health insurance. Others, pointing to the fact that the poor tend to be less healthy, would be right to note that the US has the highest poverty rate of the countries studied.

Yet, neither lack of health insurance nor poverty fully accounts for America’s miserable health ratings. Even well-to-do, white, college-educated Americans with health insurance fare less well than their counterparts in almost every other rich country.

While the report devotes only a paragraph to the role of high economic inequality, other researchers—notably Richard Wilkinson and Kate Pickett, authors of The Spirit Level: Why More Equal Societies Almost Always Do Better—argue that highly unequal income distribution harms all members of society. They posit that social stress, status anxiety, social competition, and lack of trust born of inequality lead to poorer health.

“Shorter lives and poorer health will ultimately harm the nation’s economy as health care costs rise and the workforce remains less healthy than that of other high-income countries,” concludes the authors of the National Research Council and the Institute of Medicine report.

Moral arguments against excessive inequality have recently been supplemented by macroeconomic evidence that inequality hinders economic growth and contributes to greater economic volatility. Now, we may add that inequality is medically harmful. This, in turn, brings the argument full circle.

As the President works to put the American economy back on track in his second term, I think the mandate of the election is clear, if Obama will listen.

Economic growth—the kind America enjoyed during its longest decades of prosperity (from the mid-1940s through the 1970s); where workers earn a fair wage and unemployment is low—does not happen in countries with chronic income inequality.

Among developed countries, the United States has the highest levels of inequality. This is an unsettling trend that has worsened over the past three decades. As we know, chronic inequality is bad for growth and threatens macroeconomic stability. Societies with high income inequality also suffer from greater health and social ills (including crime, sickness, violence, shorter life spans, & stress) than more equal ones.

Throughout America’s greatest period of prosperity and growth, inequality steadily declined. Part of the reason why was top earners carried a high tax burden, helping to create a society of real equal opportunities. From the end of World War II until the mid-1960s, the top marginal individual tax rate was 90%, falling to 70% in 1964. When the proponents of trickle-down economics came into power during the early 1980s, that rate fell to 50%, then 28% in 1988, turning higher to 35% (where it is now). The trickle-down theory, also called supply side economics, claims that privileging the super-rich somehow makes the poor and middle classes better off.

Instead, the era of falling tax rates for the highest earners has enriched the top, while everyone else’s wages have stagnated or declined. Worse, the privileging of top earners over the past 30 years has generated an inequality gap not seen since the eve of the Great Depression.

Though the very top earners were taxed heavily from the 1940s through 1970s, innovation and American capitalism flourished. Entrepreneurs competed to build world class industries and firms, ushering in new technologies that radically changed the human experience. And they were rewarded for their sweat and tears handsomely. At the same time, they helped ensure Americans at all income levels had access to education and other opportunities to pull themselves up the income ladder.

Importantly, it’s not just about raising taxes on the highest earners. It’s also about dismantling politically driven rents that transfer wealth from society to elites. These include ending corporate welfare, curbing Wall Street’s moral hazard problem through tougher regulations and enforcement (so tax payers don’t get stuck bailing out firms taking unsound risk), and demanding tough policies for monopolistic behavior that stifles competition, and raises prices on consumers.

Last week, the World Bank released a new report assessing declining income inequality over the 2000s in Argentina, Brazil, and Mexico. Each country experienced significant reductions in inequality over the last decade. This finding is not new, but the authors helpfully tease out some nuance behind the trend.

Their findings suggest two factors drove the contraction in inequality. First, the skills premium (the wage distribution based on education) fell. In other words, the difference in pay between skilled versus unskilled workers declined. In Argentina, declining labor income inequality was driven by a boom in trade that caused a drop in demand for skilled workers. These conditions were bolstered by strong unions and a rise in the minimum wage. Focused government spending on higher education increased the supply of skilled labor in Mexico. Both factors—reduced demand and increased supply for skilled workers—were in play in Brazil.

The second factor is more progressive government transfers, as expanding coverage of cash transfer and social security programs played a significant equalizing force in the distribution of non-labor income in each country.

All three cases put in relief that solving inequality is fundamentally a problem of politics, not economics. In each, government spending on education, conditional cash transfers, and other social expenditures helped drive down inequality.

The authors provide some astounding figures highlighting why tackling inequality is crucial.

In Mexico, nearly 60 percent of the poverty decline since 1996 is attributed to reducing inequality. Argentina’s inequality drop accounts for 40 and 50 percent of extreme and moderate poverty declines, respectively. For Brazil, 50 to 60 percent of extreme poverty decline is attributable to reducing inequality.

These figures remind us that the fight against inequality and the fight against poverty are one in the same.

Today’s New York Times picked up on an important research paper by two IMF economists. The Fund’s Andrew Berg and Jonathan Ostry argue chronic income inequality is detrimental to economic growth. In contrast, more equal countries are likely to experience durable and sustainable growth spells.

This research couldn’t be more timely, as inequality across the globe continues to grow worse. In the US, the top 1%  captured roughly 8% of GDP in the late 1970s. Today, they command more than 23%; a figure not seen since the eve of the Great Depression. Among OECD nations, the U.S. has one of the highest rates of inequality. The only countries with higher rates are Portugal, Turkey, and Mexico. As the US tries to recover from the financial crisis, the link between inequality and growth should be instructive to lawmakers.

Among developing countries, the Fund’s research is especially important. Economic growth has long been hailed as the silver bullet to poverty reduction. Yet, the economic and social benefits of growth accrue to countries that can sustain it over many years (decades, really). Developing countries have demonstrated that igniting growth spells—even robust ones—is not impossible.  Unfortunately, they typically run dry after only a couple of years. The difficulty is generating growth that remains strong over a long horizon. As the Fund’s research makes clear, investments that reduce inequality hold the payoff of stronger and longer growth.

This raises an uncomfortable question for the Fund. If strong, empirical evidence suggests inequality diminishes growth, then why doesn’t the Fund more forcefully recommend combating inequality in its Article IV consultations? This is especially puzzling, since the objective of these consultations is to promote “sound economic growth” as a fundamental goal.

The rigor of Berg and Ostry’s research reinforces calls for the Fund to take inequality seriously. Their evidence assesses inequality against other determinants historically understood to correlate with growth. These include strong political institutions; education, health, and infrastructure; financial development; trade liberalization; Foreign Direct Investment (FDI); and resilience to external shocks. Among these variables, inequality proves to be one of the best predictors of how long a growth spell will last. Because of such strong correlations, the authors conclude that economic growth cannot be understood without accounting for inequality. In their own words, “Inequality is thus a more robust predictor of growth duration than many variables widely understood to be central to growth.”

For further reading, see the Oxfam report, Left Behind by the G-20: How inequality and environmental degradation threaten to exclude poor people from the benefits of economic growth