Tuesday, September 25, 2012

Health Follows a Social Gradient


One would reasonably infer from the following article in today’s Los Angeles Times that the findings of the study are novel or unusual, yet as Michael Marmot writes, “British statistics have shown, for as long as one has cared to look, that health follows a social gradient: the higher the social position, the better the health. I became aware of this gradient only when I started to analyze data from the first Whitehall study of British civil servants [Marmot, M.G., G. Rose, M. Shipley, and P.J.S. Hamilton, ‘Employment grade and coronary heart disease in British civil servants,’ Journal of Epidemiology and Community Health (1978) 32: 244-249].” See: Michael Marmot and Richard G. Wilkinson, eds., Social Determinants of Health (New York: Oxford University Press, 2nd ed., 2006). For a brief introduction to the Whitehall study and further discussion, please see Gopal Sreenivasan’s entry, “Justice, Inequality, and Health,” in the (online) Stanford Encyclopedia of Philosophy.

“Stressful at the Top? Not Really, Study Finds”

Harvard researchers find leaders in business, politics, and the military report lower anxiety levels than others. The key to their serenity is control.

By Melissa Healy (September 25, 2012)

“Management consultants say 60% of senior executives experience high stress and anxiety on a regular basis, and a thriving industry of motivational speakers teaches business leaders how to manage their corrosive burden of stress. But just how uneasy lies the head that wears the crown? Not so uneasy, it turns out.

A new study reveals that those who sit atop the nation’s political, military, business and nonprofit organizations are actually pretty chill. Compared with people of similar age, gender and ethnicity who haven’t made it to the top, leaders pronounced themselves less stressed and anxious. And their levels of cortisol, a hormone that circulates at high levels in the chronically stressed, told the same story. The source of the leaders' relative serenity was pretty simple: control.

Compared with workers who toil in lower echelons of the American economy, the leaders studied by a group of Harvard University researchers enjoyed control over their schedules, their daily living circumstances, their financial security, their enterprises and their lives.

‘Leaders possess a particular psychological resource — a sense of control — that may buffer against stress,’ the research team reported Monday in Proceedings of the National Academies of Sciences. [….]

‘It’s clear that having a sense of control is protective against stress,’ said Nichole Lighthall, who researches stress and its effects at Duke University and was not involved in the new study. ‘People in a company at all levels may be affected by the market and its unpredictability,’ she said. But while rank-and-file employees may worry about being laid off, chief executives can pretty much rest assured that ‘they’ll keep their position in society, their superiority, their lifestyle and their income’ even if the organization over which they preside suffers, she said.

To gather leaders for study, the Harvard team took advantage of the university’s array of programs for mid-career and senior professionals. Such students — some at Harvard for just a week, others for as long as a year or two — are generally rising stars being groomed for promotion within their organizations. Members of Harvard’s Decision Science Laboratory invited them to take part in their studies.

Social psychologist Gary Sherman and his colleagues recruited 148 people who managed others in military, government, business and nonprofit organizations. Each participant was asked to complete an inventory of psychological traits and a questionnaire that captures the extent to which a person feels a sense of power in general and in his relationships with others. Participants also were asked to describe their jobs and count the workers below them in the hierarchy. Finally, the study members provided a sample of their saliva so the researchers could measure their level of cortisol.

For comparison, the study drew 65 people from the general community who did not exercise management control over others. Researcher had these participants complete the same inventories and measured their cortisol. They ensured that both groups — leaders and non-leaders — were identical in terms of their age, gender and ethnic composition. The results showed that compared to non-leaders, leaders’ sense of control and propensity toward anxiety were lower. So were their cortisol levels, providing physiological proof that they were less stressed. When the researchers focused on differences within a group of 75 leaders, they found that the larger the pool of workers an individual managed, the lower he or she scored on measures of stress and anxiety.

Samuel Barondes, director of UC San Francisco’s Center for Neurobiology and Psychiatry, said the study didn’t reveal whether leaders became less stressed as they climbed toward the top or whether they were less prone to stress in the first place, facilitating their ascent. He suspects it’s a combination of both, but either way, ‘once you’ve made it and are not at the whim of capricious meanies above you in the hierarchy, you are less stressed,’ said Barondes, author of Making Sense of People: Decoding the Mysteries of Personality.” [….]

So we await another study reaffirming what we already know with regard to the converse case: those at the bottom of the occupational hierarchy (leaving aside the unemployed) suffer more stress, and thus the cumulative deleterious health effects associated with same over time, than those above them in occupational rank (or in any of the other social determinants of health: education, income, and social class, for example).

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