Sir Michael Marmot has spent a lifetime studying the effects of relative status on health.
His new book - The Status Syndrome summarizes his findings.
Here is a snip from a review in the Washington post that is a wake up call in the context of the healthcare crisis. The key to better health is not more access to a healthcare system but more involvement in what is going on. As you read this, you can see that blogging is an ideal therapy.
The reason, Marmot argues, is that social participation -- rewarding relationships, access to a community, and the respect of others -- and individual autonomy are crucial determinants of health and happiness. High status usually affords more opportunities for social involvement and control of one's conditions. Low status means that external forces -- a mean-spirited boss, a company that dumps toxic waste near your neighborhood -- are more likely to determine one's fate, social support is less reliable, and insecurity is a feature of daily life. Although the meaning of full participation varies from places to place, Marmot claims that the beneficial effects of being connected are constant.
Lack of agency produces dangerous forms of stress. People who labor in dull, dead-end yet demanding jobs suffer from an imbalance between their efforts and rewards. As recent studies of coronary disease in Britain and seven Eastern European countries show, work that deprives men and women of control destroys the heart as well as the soul. Moreover, a daily onslaught of difficulties makes people less likely to focus on their long-term health. Marmot believes that the vulnerable understand their grim condition, and that they engage in dangerous but pleasurable behaviors such as smoking or overindulging in fast food because they prefer enjoying the moment to holding out for a future they might not reach.
Marmot concedes that bad jobs, wealth disparities and status hierarchies are inevitable features of modern societies. But some societies are more equal than others. Governments can, and in the most flourishing countries do, decrease the slope of the social gradient and improve public health. In England, for example, the government has been quietly redistributing income since 1997, using fiscal policies to compensate for social divisions produced by the labor market. In the United States, however, recent tax changes have steepened the gradient.
According to Marmot's surprising conclusion, the most effective and affordable health policies do not involve the medical system but programs that reduce income and educational inequalities, protect workers and families, provide access to housing and safe environments, and promote care for children and the elderly.
There's good evidence that skimping on these fundamental and wide-ranging social protections while spending lavishly on medical care is foolish public policy. Cross-nationally, the longevity gap tends to decrease during eras of social equalization and increase during periods of polarization. Americans have learned this the hard way. Outspending all competitor nations on health care has not helped to raise U.S. life expectancy above the level of Spain, Cyprus or Singapore, where the social gradients are more even. We've all heard officials say that the United States has the best medical system in the world. Whether or not that's true, longevity is greater in France, the United Kingdom and Canada.
Thanks to Limbic Nutrition for the update on the new book. I have just come across this site and am finding filled with material and a perspective that fits very closely to my own view of the world. Hi there