From Joseph Heath at In Due Course:
Many of our outstanding social problems remain outstanding because they occur in areas that are outside the immediate jurisdiction of the state: either because they occur in the private sphere (e.g. the gendered division of labour within the family), or because they involve an exercise of individual autonomy, (e.g. students dropping out of high school). As a result, there is no obvious “policy lever” than can be pulled to solve the problem, because the state simply lacks the authority (and sometimes even the power) to intervene directly in these areas.
As a result, when people who would like to see these problems solved analyze them, there can be an enormous temptation to believe that they are causally connected to some other area, in which the state does have an effective policy lever. The case in which I have seen this most clearly is the tendency to overestimate the causal effects of inequality – because the distribution of wealth is something that the state does have the ability to control. So if “intractable social problem A” can be shown to be caused by “poverty of group B,” then that gives the state leverage over the intractable social problem, because it can always redistribute wealth to B.
To take a concrete example, one hears a lot these days about the “social health gradient” — basically, the strong correlation between various health outcomes and SES (“socio-economic status”), which remains surprisingly strong despite the relatively egalitarian distribution of health care resources. Now SES is an explicitly hybrid concept, designed to represent relative inequality of wealth and social status. But of course, while the state can quite easily redistribute wealth, social status is a much trickier thing, and the state’s ability to intervene, much less modify, these status hierarchies is pretty close to zero (except perhaps indirectly, by redistributing wealth, but even then that often backfires, as the recipients of those transfers find themselves losing status precisely for being in receipt of those transfers). So to the extent that the social health gradient is related to inequalities of status, there is practically nothing the state can do about it. As a result, I can’t count the number of presentations on public health I’ve heard that start out talking about SES and then just subtly shift toward talking about wealth inequality, in order then to recommend some form of income redistribution.