Is Status a Life Sentence?
We have no control over our status at birth. Does this dictate our lives or can we change our status? If so, does this improve our health prospects and our life expectancy?
What is status?
Status is our social or professional standing. This is sometimes also described as our socio-economic status. It can be determined by:
- Our birth i.e. inherited (ascribed status). If you are born into a royal family, for instance, you start life with high status.
- Our own success (achieved status). This depends on what we achieve in our lives, for example through education, at work, in our families and communities or in other fields (like sport, music or volunteering) – and possibly even who we marry.
How status works in practice isn’t necessarily straightforward. For instance a plumber may earn more than a junior doctor or a retired professor, but is often seen as having lower status. This suggests that our views of social status are probably stronger than our views of economic status. Other factors also apply. For instance, in some societies old age confers status, whereas in others age related retirement may mean a loss of status. The impact of status may also vary according to ethnic origin. This was one of the findings from a review of studies published in the BMJ in 2016.
What has this got to do with health?
Our status is thought to affect both our life expectancy and how many years of good health we’ll enjoy.
Why might status make a difference?
Professor Sir Michael Marmot is an expert in health inequalities. Over thirty years of research have led him to conclude that social status influences how long we live.
Why? - He explains that the lower our status, the less control we have over our working lives (resulting in greater stress) and the less opportunity for social participation. He believes this combination means less protection against illness.
However, it isn’t just a question of how long people live. How long people live in good health, rather than being burdened with chronic illness, is important too. Status seems to matter here as well.
- The UK’s Office for National Statistics reports that healthy life expectancy in the London borough of Richmond upon Thames, is around 70 years for male and females, compared with less than 57 years for both males and females in the London Borough of Tower Hamlets. It is unlikely to be just a coincidence that Richmond’s residents tend to have a higher socio economic status than their counterparts in Tower Hamlets.
What can we do to avoid status becoming a life sentence?
- Between 1924 and 1984 there were five General Secretaries of the Trades Union Congress (TUC). They lived to an average age of 80 – well above average for that time. All were from working class backgrounds, such as Len Murray the son of a farmworker. However they achieved higher socio-economic status through their own efforts. This is a small sample, but fits the pattern and suggests that one option is to improve our status through what we achieve in life.
- Studies have shown that being part of a social network may help protect us from poor health if we were born into a low socio-economic status. For example a 2015 review of four long term studies concluded that social integration had a number of physical health benefits - while being socially isolated had adverse effects on health, for instance being worse than diabetes for blood pressure when people get older.
- Volunteering could benefit our status, by providing a new role and new social networks. While more research is needed, early investigations suggest volunteering improves longevity.
- Being married may also help us live longer. That's according to a large study in the US. Presumably this refers to being reasonably happily married.
- Sporting success may be good for our life expectancy too. A review of studies in this field, published in 2015, concluded that elite athletes (in sports such as baseball, football, soccer, basketball and cycling) tended to live longer than the general population and other athletes.
- Overall, countries with greater social cohesion and a more equal society, like Japan and some Scandinavian countries seem to have a health advantages.
- As reported elsewhere on this website, and as Sir Michael Marmot recognises, the four pillars of good health are clearly important too i.e. not smoking, drinking alcohol in moderation, eating a healthy diet and getting enough exercise.
The value of education
Education has long been known to increase our chances of living longer. Not everyone may have the same educational opportunities early in life. However, in the UK there are many opportunities to return to education later in life, as a mature student. One study published in 2011 suggested (with some possible caveats) that men and women who leave school without any qualifications may be able to ‘catch up’ to some extent with more qualified people in terms of lowered coronary heart disease risk (like heart attack and stroke), if they obtain qualifications later on in life.
Professor Marmot discovered that education appeared to have the power to reduce social inequality, increase people’s status and improve longevity.
For instance, in Status Syndrome, he reports that Kerala (in southern India), Cuba, Costa Rica and Sri Lanka have all invested in education, including education for girls, and the population enjoy greater longevity than in most other developing countries.
Changing our status may not be easy. However, being born into a family with a low socio-economic status doesn’t have to be a life sentence. Health and life expectancy can potentially be improved through:
Professor Marmot also recognised that factors such as lifestyle influence our health and longevity. So whatever your status, try to eat as healthily as possible, get enough exercise, don’t smoke and drink in moderation.
Reviewed and Updated March 2014, then March 2017 by Diana Harvey. Next review date March 2020.