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Posted February. 25, 2006 03:05,   


Everyone wants to live a healthy and long life. That is why people exercise and try to change their diet. But what if there is a bigger factor in determining your health and life span?

What if it is better for your health to live in a house with three bathrooms and five bedrooms than to live in a house with two bathrooms and four bedrooms? What if those who have a master’s degree live longer than those with a bachelor’s degree? What if a president of a company is more likely to live a long and healthy life than a general manager?

If you go from the southeastern part of downtown Washington D.C. to Montgomery County on the Metro, you will learn that the average life span of people on the subway increases by 1.5 years every 1.6 kilometers that the subway runs. It is said that the wealthy people living at one end of downtown Washington live 20 years longer than the poor African-Americans living at the other end. What a difference a distance of a few kilometers makes.

The outcome of a survey of 8,500 U.S. men and women about their risk of death according to their levels of household income, a study which was conducted for nearly 20 years from 1972 to 1991, is shocking. The risk of death of those who are in the bottom fifth bracket of household income was four times higher than that of those in the top tier.

The “health spectrum” goes from one extreme to another, depending on the level of wealth. So speaks the joke: “It is bad news that poverty makes you miserable. But it is good news that you don’t have to live long in such a state.”

Are these all related to money? When the same survey studied the risk of death according to levels of educational background, the result was similar: The lower the level of educational background, the higher the risk of death. The outcome was the same when the risk of death was measured according to job category: the more decent the job, the lower the risk of death.

In 1976, as a professor of Public Health at London University, the author of the book released survey outcomes, which show that British public officials’ rate of disease infection differs, depending on their levels of position. Having studied social inequality factors of health over the past 30 years by touring around the world, the author concludes, “Those who are in a higher social status are healthier. Money and power are distributed unequally, and so are health and life span. This is the ‘status syndrome.’”

Social status does not just mean affluence of material source. It determines how much control one has in his life and how many opportunities he or she has to intervene and participate in society.

The income level of Kerala state, India is lower than the national average. But the infant death rate, an index most sensitive to poverty, is the lowest in the country. The average life span of this state is also far higher than that of others. Why?

In Kerala, in which a democratically elected socialist political party rules, women’s educational background is very high. It is a society in which women are respected. A society that invests in women is an inclusive society. Education is a symbolic index of that. This implies that social support and attention improve people’s health. Amartya Sen, a Nobel laureate in economics, calls it an “effect induced by support.”

There are classes and the resulting inequality of health. This seems inevitable. However, inequality of health is not a biological nature. It is not a fixed feature of society. By changing people’s way of thinking of the correlation between health and society and by broadening the “window of opportunity” for every class of society, people can bridge the gulf of inequality.

“When Titanic sank, the fate of passengers was decided according to their social status. The largest number of deaths occurred among those in the third-class cabins that lacked lifeboats. If it is unfair that those with lower social status are exposed to higher risks of drowning, it is also an unfair situation that they are more exposed to stroke, lung cancer, metal disease, suicide and violence.”

The “status syndrome” is a blot of a civilized society!

The original title of the book published in 2004 is “The Status Syndrome.”

Gi-U Lee keywoo@donga.com