Status and Wealth Do Influence Health

Vijai P. Sharma, Ph.D

A 10-year long study of 17,350 British workers says that top executives enjoy better health than even doctors and lawyers. The improvement in health was progressively higher throughout socioeconomic status. In other words, people at each rung of the socioeconomic ladder had fewer deaths and illnesses than those below them. Death rates were lowest for the top executives and second lowest for professional-executives. At the bottom were unskilled laborers whose death and illness rates were three time higher compared to the top executives.

A superior medical knowledge does not account for the difference. Could it be that those who are high up on the socioeconomic totem pole enjoy better health because they have greater and more timely access to medical care? That argument doesn't hold up either. Britain has a National Health Service which means that when you have a health problem, you go to the general practitioner(GP) in your geographical area, show your health card and get medical attention. The service you receive does not depend on the money in your wallet. Workers of all rank and file have equal access to medical care. Therefore access to medical care doesn't explain why there are such striking differences in the incidence of death and illnesses among the various socioeconomic classes.

Perhaps other explanations account for these differences. People in higher socioeconomic classes are more highly educated, smoke less, exercise more, eat more wisely, and maintain a more optimal weight. All these factors are associated with lower risk of illnesses and death. Granted that eating wisely, not smoking, exercising, and maintaining a proper weight are all good-health choices, and make some difference in terms of longevity and illness rate, but these differences just tell part of the story.

Stress plays a big role in these differences. People on the lower rungs of the socioeconomic ladder live a more stressful life. They encounter more stressful events, such as unemployment, poverty, crime, street violence, etc. They also have fewer personal and social resources to cope with such threats. For example, the less money one has, the greater the stress if the car breaks down, with the possibility of not having a car, or not having the money to pay the house rent and risking losing the roof over one's head. The physical and mental stress and the hostility and depression resulting from such life circumstances can take a heavy toll on one's health.

Incidentally, the only two diseases that occur more in higher socioeconomic groups are skin cancer and the breast cancer. Perhaps, skin cancer is due to more recreational sunbathing and the breast cancer due to a different pattern of breast feeding and childbearing.

Income, education, and job status make a critical difference in how much control we feel we have over our lives. An extremely low sense of control over one's life can make one feel hopeless and helpless. Those higher on the socioeconomic totem pole are more able to influence the events that affect their life compared to those below them. When people feel they somewhat control their lives, they experience greater job satisfaction and higher self esteem.

This is true for society as a whole, but individuals can always change and shape their physical and psychological health. An individual does not have to be rich to have a sense of control and self confidence. First you make yourself mentally "rich" before you can become financially rich. Richness and poverty are also states of the mind. We all have the power to become the unstoppable force if we make up our mind to be. People can transcend their circumstances and be in a terrific physical and mental shape. Therefore, it is not the "physical" conditions, such as, income, education, job status alone but also the "psychological" conditions, such as the stress tolerance, sense of control, self esteem, that translate in to the quality of health we enjoy.

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Copyright 1996, Mind Publications 



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