Stress-related disease among the poor usually has more to do with feeling poor than actually being poor
Stress is heavily rooted in psychology once you are dealing with organisms who arenât being chased by predators, and who have adequate shelter and sufficient calories to sustain good health. Once those basic needs are met, it is an inevitable fact that if everyone is poor, and I mean everyone, then no one is. In order to understand why stress and psychological factors have so much to do with the SES/health gradient, we have to begin with the obvious fact that it is never the case that everyone is poor thereby making no one poor. This brings us to a critical point in this fieldâthe SES/health gradient is not really about a distribution that bottoms out at being poor. Itâs not about being poor. Itâs about feeling poor, which is to say, itâs about feeling poorer than others around you.
Beautiful work regarding this has been carried out by Nancy Adler of the University of California at San Francisco. Instead of just looking at the relationship between SES and health, Adler looks at what health has to do with what someone thinks and feels their SES isâtheir âsubjective SES.â Show someone a ladder with ten rungs on it and ask them, âIn society, where on this ladder would you rank yourself in terms of how well youâre doing?â Simple.
First off, if people were purely accurate and rational, the answers across a group should average out to the middle of the ladderâs rungs. But cultural distortions come inâexpansive, self-congratulatory European-Americans average out at higher than the middle rung (what Adler calls her Lake Wobegon Effect, where all the children are above average); in contrast, Chinese-Americans, from a culture with less chest-thumping individualism, average out to below the middle rung. So you have to correct for those biases. In addition, given that youâre asking how people feel about something, you need to control for people who have an illness of feeling, namely depression.
Once youâve done that, look at what health measures have to do with oneâs subjective SES. Amazingly, it is at least as good a predictor of these health measures as is oneâs actual SES, and, in some cases, it is even better. Cardiovascular measures, metabolism measures, cortisol levels, obesity in kids. Feeling poor in our socioeconomic world predicts poor health.
This really isnât all that surprising. We can be an immensely competitive, covetous, invidious species, and not particularly rational in how we make those comparisons. Hereâs an example from a realm unrelated to this subjectâshow a bunch of women volunteers a series of pictures of attractive female models and, afterward, they feel in a worse mood, with lower self-esteem, than before seeing the pictures (and even more depressingly, show those same pictures to men and afterward what declines is their stated satisfaction with their wives).
So itâs not about being poor. Itâs about feeling poor. Whatâs the difference? Nancy Adler shows that subjective SES is built around education, income, and occupational position (in other words, the building blocks of subjective SES), plus satisfaction with standard of living and feeling of financial security about the future. Those last two measures are critical. Income may tell you something (but certainly not everything) about SES; satisfaction with standard of living is the world of people who are poor and happy and zillionaires who are still grasping for more. And what is âfeelings about financial securityâ tapping into? Anxiety. So SES reality plus your satisfaction with that SES plus your confidence about how predictable your SES is are collectively better predictors of health than SES alone.
References
- Sapolsky, Robert. (2004). Why Zebras Donât Get Ulcers Chapter 17. The View from the Bottom (p. 522). New York, NY: Henry Holt and Company.
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Type:đ´ Tags: Biology / Neuroscience / Psychology / Neuropsychology / Social Psychology / Medicine / Politics / Economics Status:âď¸