Customer Reviews

The Status Syndrome: How Social Standing Affects Our Health and Longevity

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You are a hot shot in a company, though not the boss. You are paid extremely well, but, again you have plenty of bosses above you (say the partners of an investment firm). Is it better than deriving a modest income being your own boss? The counterintuive answer is NO. You will live longer in the second situation, even controlling for diet, lifestyle, and genetic predispositions.
Marmot spent years poring over data; he left no stone unturned and is well read in the general literature on human nature. This idea of people living longer when they exert control over their lives has not spread yet. That people lead longer lives when they trust their neighbors and feel part of a community is far reaching. Just think of the implications on social justice etc. Also think that everything you learn on human preferences and well-being in both economics and medicine is either incomplete (medicine) or bogus (economics).
The book is well written, humorous at times, and rigorous --it reads like a well-translated scientific paper. But it feels that it is just the introduction to a topic. Please, write the continuation.

Marmot began his important work on social determinants of health with two long term studies of the British Civil Service finding that those who enjoyed higher status roles had better health and longer life expectancy than those who had lower status roles. This gradient from higher to lower applied throughout the service. Why was it so? And did it apply in other social and cultural contexts?

This book is a compelling exploration of the commonality of this phenomenum throughout both developed/transitional and developing country contexts, exploring the evidence and sifting the reasons for it. Status is found to be crucial - people with more opportunity to control their lives are more resiliant to stress and enjoy better health as a result (I simplify). It is not that healthier people enjoy better status because they are healthier - an argument carefully considered and dismissed - but people enjoying social contexts that enable them to secure status will enjoy better health and longer life. This applies as much to the rich social opportunities of Kerala in India as it does to an upper middle class suburb in the United States. Poverty, in itself, once basic needs are met, is not the issue as long as it is equally shared with all, what matters is the disequilibrium between people's status and being in the population denied access to opportunity to control one's life. The book is well-written, closely argued, and could change how you see the world for good.

This book is the perfect introduction to the study of Health Inequalities, especially in the context of occupational health. Students are gripped.

I got this book ONLY to read the research. Often it is true, that the truth, is not logical. ... or at least counter-intuitive. I ignored all the social ramblings. This book is WELL RESEARCHED. It seems status DOES predict life expectancy! Very interesting research and conclusions. Definitely motivating.

... I'll live longer if I get my PhD.

More control/autonomy in one's live = more life. Who knew!

Great book! Worth the read - or even a skim.

Michael Marmot's book, The Status Syndrome, is about how a person's social rank influences his or her health. The book's focus is on conditions in the richer countries, as opposed to those nations so poor that one would expect poor health. Social rank may be measured in a number of different ways, such as education, or income. Marmot, a British health researcher trained as a medical doctor, did much of his research on the British civil service, which ranks its employees with some precision. He emphasizes that rank does not act like a binary variable, leaving the poorest in poor health and everyone else in reasonably good health, but rather in a continuous fashion, with those of middling rank having health outcomes midway between those of the lowest and highest social ranks.

The great difficulty with social science research such as this is to disentangle confounding hypotheses in circumstances where an experiment is impossible. Here, besides the hypothesis that social rank has direct effects on health, there are at least two other major alternative hypotheses, first that its a sickly nature that reduces ones social rank, and second that those at the top of the pyramid are just generally more able people than those lower down. Studies of social mobility indicate a direct effect of one's current circumstances on health. Furthermore, experimental studies with non-human primates also show that the animal's place in the social hierarchy effects health in the same way observed in human populations. What an ecologist would call a natural experiment, the fall of communism in eastern Europe and the economic disruption that subsequently occurred, also provides evidence that a person's place in the social hierarchy affects his or her health. The proximal benefits of a higher social rank seem to be not just more money, but also more control over you life. Both of these reduce chronic stress, which appears to be the cause of the health problems of those lower down. Being busy or having a responsible job does not cause stress if you can control your own working conditions.

Marmot believes that humans have an innate dispoisition to form social hierarchies, based on his understanding of what is called evolutionary psychology. Or at least human males do; women may be somewhat inadvertantly caught up in the process. Womens' health responds to their social position similarly to men. The more cooperative nature of women may bring men to act more cooperatively, as mens' tendency to create hierarchy may cause women to act hirarchically. I cannot claim to know enough population genetics to comment on the validity of these ideas, which are however similar to those I was exposed to in a graduate ecology program which had a number of persons interested in animal behavior on its faculty.

Marmot believes that the effects of social hierachy can be ameliorated if not eliminated, through government policies to improve education among the disadvantaged and redistribute wealth. He was part of a committee which made recommendations along these lines to the Blair government in the 1990s. To me, these ideas (the recommendations are listed in an appendix to the book) seem utopian in an American context.

I published a similar review at goodreads.com

I recommend this book if you are interested in the distribution of health among strata of society. Marmot is a good writer and careful thinker. You'll appreciate his detailed analysis couched in engaging and occasionally humorous prose. I learned something important about the correlates of thriving. Marmot postulates a gradient of thriving that seems almost to be a universal rule.

My niece is a sociology/French major and loves this book. I got it as a gift for Christmas and she was quite pleased with it.

This book educates and motivates you by introducing how lifestyle affects health and wealth. It personifies negatives and illustrates how to change your social standing for the better. Real life examples make this easy to understand and actually quite enjoyable!

Open Professor Marmot's book to almost any page and see him make firm statements and firm conclusions about research and anecdotal evidence which are in fact quite uncertain. It seems reasonable that status affects health, indeed I believe it does, but Professor Marmot throws anecdotes or questionable research conclusions at the troublesome fact that healthier people will achieve greater status, or in other words that healthier people are healthier.

Professor Marmot cares only about "inequality", not evil. For example, he appears to see no difference between the millions of Russians murdered by Stalin during Communist rule and the millions of Russians who have had shortened life expectancies during the collapse and aftermath of Communist rule, supposedly as a result of "inequality". Could these tens of millions of deaths have been due to people like Professor Marmot who sought a government-mandated end to inequality, and not to inequality itself?

Perhaps because the book promotes a politically correct, leftist, government-solution, tax and spend agenda as a solution for "inequality", it does not appear to have attracted serious criticism of its scholarship.