10 June 2004

Higher status leads to a longer life

Marmot cites the contrasting situations of Cuba, Japan and the US as an example. The US is a rich nation with a gross domestic product per person (GDP) of about $34,000 and a life expectancy of 76.9 years. But Cuba, with a GDP of only $5200 almost matches the US lifespan with an average of 76.5 years. And Japan, which has the longest life expectancy at 81.3 years, has a significantly lower GDP than the US - about $25,000.

Social arrangements, education and social cohesion may be crucial factors. Japan may enjoy better health because of factors like low crime, better care of the elderly, higher industrial productivity and a smaller gap between rich and poor than countries like the US.

Even within a country the impact of social status on health can vary with time, says Marmot. For example, the difference in life expectancy in the UK between the highest and lowest social classes jumped from about 5.5 years in the 1970s to 9.5 years by the 1990s, after years of Thatcherite government policies.

After seven years of government by the UK's Labour party, the gap is narrowing again and is currently about eight years now, he says.

The reason that low status may translate into poorer health is lack of control and fewer opportunities for full social engagement or participation, he believes. A person in a seemingly stressful top job may not be that stressed at all if the stress is predictable and within their control, and their status brings more support and more outlets.

We could have a whole new principle, that government governs best which has the least gap between rich and poor in terms of life span. Anthropometrics are as interesting as life span studies.

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