Status and Mortality

Some of the most impactful variables that shape our lives are not individual things, but a confluence of many things that can at times be bundled up and referenced as if they were a single thing.

The Whitehall Effect, for instance, refers to a finding from the Whitehall Studies, which explored the connections between social status and health; in particular, whether one's status influences one’s mortality rate.

The findings from these studies indicate that, in the white-collar world at least, one's position within one's professional hierarchy may be inversely related to one's mortality rate.

In other words: if you're higher-status, you tend to live longer, while lower status people within the same organizations tend to die younger than their managers, bosses, or coworkers with more celebrated roles.

The original Whitehall study, which began in the 1960s, looked at this possibility through the lens of people working in the British Civil Service, and the second study (which began in the mid-1980s) did the same, but included female workers alongside their male colleagues—the first one only studied men.

That second study is ongoing, as the cohort they were looking at is still living and dying in measurable ways, but the general consensus (from these and from similar studies that have been conducted in other organizations and other countries in the decades since) is that social position influences one’s risk of dying, at least to some degree.

The primary question at this point is how far this effect spreads—to what sorts of organizations and other social structures—and how exactly the effect works: why would lower-status people die at younger ages than their colleagues, if most seemingly directly applicable things, like quality of employer-provided health coverage, are accounted for?

What we seem to know right now—and this is not at all complete, it's just a collection of generally supported theories—is that stress- and anxiety-related issues are highly correlated with lower social statuses.

Someone who occupies a lower social niche will, on average, be more prone to a smoking or drinking habit, will be more likely to have high blood-pressure and other cardiovascular issues, and will be more likely to have issues that can be sparked or amplified by lifestyle choices, like diabetes.

These bad habits and the higher likelihood to suffer from chronic issues, are all associated with persistently elevated levels of cortisol which manifests as a stressed-out feeling, which in turn tends to reduce the effectiveness of one's immune system. And over time, the anticipation of stress-triggers can lead to an always-on stressed, less immunologically defended state.

It's also been pointed out that heart- and broader cardiovascular-issues are the leading cause of death in the wealthy world (which is where almost all of these studies have been conducted), so it makes sense that people with less power, influence, and prestige, and who consequently suffer from elevated levels of anxiety and stress (among other heart-problem-associated issues), might die at higher rates: it's an additional nudge, basically, and anyone suffering such a nudge would be statistically more likely to die at a younger age than those who remain un-nudged.

This is a controversial concept, though, as many researchers who have tackled it have gone on to argue that although work-world status-stress probably contributes to our mental state, the degree to which this matters more than other, non-work, non-status variables like lifestyle choices, our relationship with money (and money-related stress), our relationships with other people, how much control we have over our lives and our futures, how much sleep we get, how we cope with stress, whether or not we exercise (and what sorts of exercise we do), and countless other things, is debatable.

This is almost certainly a thing—that latter group argues—but is it the main thing that influences health and mortality outcomes? Or even in the top five?

Unfortunately, we can't really know until and unless we do more, and more expansive studies that allow us to control for all those additional variables.