How your social standing directly affects your health and life expectancy

Main Category: Public Health
Article Date: 09 Jun 2004 - 9:00 PST


Autonomy, a sense of control over your life and social connectedness - rather than actual financial resources or access to medical services - have the greatest impact on your health and life expectancy. That is the core argument of Michael Marmot's, Professor of Epidemiology and Public Health and Director of the International Centre for Health and Society at University College London (UCL), new popular science book "Status Syndrome," launched by Bloomsbury Publishing, on 7th June from 6pm at UCL, Gower Street.

"The lower in hierarchy you are, the less likely it is that you will have full control over your life and opportunities for full social participation," says Michael Marmot in the book. "Autonomy and social participation are so important for health that their lack lead to deterioration in health."

"Status Syndrome" is based on more than three decades of research by Michael Marmot that began with the Whitehall Studies in the 1970s. These showed that even among white-collar employees with steady jobs there is a clear social gradient in health. Marmot's subsequent work took him round the world as he puzzled out the relationship between health and social circumstances. From the US to Russia, from the Mediterranean to Australia, from Southern India to Japan, similar patterns emerged.

In addition, class systems are not just at play in England - they are just as bad, if not worse in Australia, America and other so-called classless societies. Studies in Sweden have shown that men with a doctorate had 50 per cent lower mortality than men who had tertiary education. In the US those in the poorest households have nearly four times the risk of death of those in the richest. In the UK, office workers are more likely to die of coronary heart disease the lower down the hierarchy they go.

Some of the key questions raised within "Status Syndrome" include: Why are the poor more likely to get heart disease, AIDS, cancer, mental illness and all of today's other common killers?

Why do Oscar winners live for an average of four years longer than their Hollywood actors?

Who experiences most stress - the decision-makers or those who carry out their orders?

Why does life expectancy rise by twenty years over the twelve-mile subway ride that divides poor black downtown Washington DC and rich white Montgomery County?

Why does Japan have better health than other rich populations of the world and the province of Kerala in southern India have much better health than other poor populations of the world - and what do they have in common?

In the Whitehall Study 11 of British Civil Servants, the higher their position in the hierarchy, the more happiness they enjoyed. This is not a quirk of the British Civil Service. Colleagues in Wisconsin looked at two American studies - and found exactly the same thing: the higher the social position the greater the level of happiness.

Michael Marmot answers these questions and more in an agenda-setting book with huge implications for social and health-care policy and the worlds of education and finance.

Contact: Alex Brew
a.brew@ucl.ac.uk
207-679-9726 University College London

• Additional
• References
• Citations