We often hear and believe that wealthy people tend to be physically and mentally healthier than less wealthy ones. A common rationale for that belief is that people with money can buy better healthcare, better food, and other resources. And that rationale undoubtedly is correct regarding some aspects of health pertaining to some people some time. However, there is an additional explanation by Michael Daly and Alex Christopher (2015) contained within their English study that raises some interesting and informative issues.
What Daly and Christopher did that was innovative was not merely to consider an individual's absolute wealth, but wealth relative to those in his reference group. For instance, the individual's wealth was compared to others within his region within the United Kingdom, within his educational group, and within his/her gender group. In so doing, the investigators discovered that one's social rank was a primary determinant of their health. That is, within one's wealth, educational, and gender groups, those with higher social standing were healthier physically and mentally than those of lower standing. So, whether of low, middle, or high wealth, persons of higher rank had fewer chronic illnesses, body pain, functional deficits, and obesity.
In support of their findings, Daly and Christopher mentioned a previous paper by Rablen & Oswald (2008) claiming that even such high status individuals as Nobel Prize winners evidenced a health-social rank relationship such that the Noble winners lived longer than non-winning Nobel nominees matched for country of origin and year of birth. (You can decide how much credibility to attribute to the Nobel Prize information.) More convincing was their referencing the fact that studies of populations from poor countries also show the health-social rank relationship, implying that it is not just an artifact relevant to affluent nations.
If it is true then that relative social rank is a more powerful factor in determining health than is absolute wealth, what could account for that finding? I agree with Michael Daly and Alex Christopher's implication that social rank is associated with stress levels such that those of high rank are generally more insulated from stress. They point to the robust finding that prediction and control help mitigate the most damaging stressors. If a person can predict stress it is reasonable to expect that she can better control it and vice-versa. Since high rank persons have more power to within their situations, they are better equipped both to predict and to control.
Does this mean that individuals of low wealth and low rank are doomed? Not really. If the key factor in wealth and health is the prediction and control of stressors, forewarned is forearmed (praemonitus, praemunitus). Some stressors have a minimal or no relationship to money, such as the quality of one’s interpersonal relationships. Everyone can make it a point to maximize their time among supportive people and minimize their time among offensive ones. Where money does influence stress, the situation can be trickier. Not being able to meet the financial demands of day-to-day living will stress almost anyone. However, strategies to manage money and bills better will “pay off” financially, physically, and mentally in both the short- and long-term. Moreover, if you accept that the rank you hold relative to your reference group is important, you can attend to those features of reference group rank that are independent of wealth. While the possibilities are endless, the most powerful ones again are likely to be interpersonally-oriented. If you treat others with respect, egalitarianism, and kindness, your peers will rank you high in the human qualities that all people value, and you will reap the health rewards..
References
Daly, M. & Wood, Christopher (2015). A social rank explanation of how money influences health. Health Psychology, 34, 3, 222-230. doi: http://dx.doi.org/10.1037/hea0000098
Rablen, M. & Oswald, A. (2008). Mortality and immortality: The Nobel Prize as an experiment into the effect of status upon longevity. Journal of Health Economics,27, 1462–1471. http://dx.doi.org/10.1016/j.jhealeco.2008.06.001
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