Friday, August 6, 2010

Life is Better at the Top, but Why?

Jonah Lehrer of Wired summarizes a famous long-term health study:

Just ask Michael Marmot, a professor of epidemiology and public health at University College London. For the past 25 years, he’s been running the Whitehall study, an exhaustive longitudinal survey launched in 1967 that has tracked some 28,000 British men and women working in central London. What makes the Whitehall study so compelling is its uniformity. Every subject is a British civil servant, a cog in the vast governmental bureaucracy. They all have access to the same health care system, don’t have to worry about getting laid off, and spend most of their workdays shuffling papers.

The British civil service comes with one other feature that makes it ideal for studying the health effects of stress: It’s hierarchical, with a precise classification scheme for ranking employees (in other words, it’s the human equivalent of a baboon troop). At the bottom are messengers, porters, and security guards. Just above them are the clerical officers, followed by staff scientists and other professionals. This last group implements the policies dictated by powerful administrators who run the governmental agencies. Marmot wanted to investigate how differences in status “in people who are neither very poor nor very rich” might lead to measurable differences in health.

The differences are dramatic. After tracking thousands of civil servants for decades, Marmot was able to demonstrate that between the ages of 40 and 64, workers at the bottom of the hierarchy had a mortality rate four times higher than that of people at the top. Even after accounting for genetic risks and behaviors like smoking and binge drinking, civil servants at the bottom of the pecking order still had nearly double the mortality rate of those at the top.

This confirms everything we already know on this subject: the powerful live longer, whether we are talking about people or any other social mammal.

But Lehrer goes on to discuss this phenomenon entirely in terms of the damage done by stress. It is, so the theory goes, stressful to be at the bottom of the hierarchy, because you have no control over your circumstances, and we now know a great deal about the long-term damage done to our bodies by stress hormones. I think this is foolishly narrow minded. There are a lot of differences between being a leader and being a drone; why focus on stress? Maybe what hurts is feeling bad about yourself because you see those around you doing better, that is, maybe depression (another proven killer) is at work, too. Or maybe there are positive factors associated with success that are more important than the negative factors associated with subordination, that is, maybe succeeding or having our excellence recognized by promotion makes us feel good in a way that helps our bodies. I am usually a fan of Lehrer's, but I think this time he has fallen into the hammer and nail fallacy: just because we understand the damage done by stress doesn't mean that stress is the only way our social situations impact our health.

2 comments:

Unknown said...

I note that both you and the commentator are assuming that long life is a consequence of success. But perhaps the same qualities that bring one to the top are those that make for a long life. Perhaps if you're the sort of person who feels less stress, you're more likely to be successful. Other factors that make for social and professional success--energy, slimness, good looks, an unrealistically positive attitude toward oneself, others, and situations--also probably tend to make for a long life.

John said...

You are right, the causality could go the other way in some cases. Happy, energetic people could both live longer and be more successful. But inherited wealth also makes you live longer.