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The Status Syndrome: How Social Standing Affects Our Health and Longevity
"Bold, important and masterful . . . Marmot's message is not just timely, it's urgent."
-The Washington Post Book World
You probably didn't realize that when you graduate from college you increase your lifespan, or that your co-worker who has a slightly better job is more likely to live a healthier life. In this groundbreaking book, epidemiologist Michael Marmot marshals evidence from nearly thirty years of research to demonstrate that status is not a footnote to the causes of ill health-it is the cause. He calls this effect the status syndrome.
The status syndrome is pervasive. It determines the chances that you will succumb to heart disease, stroke, cancers, infectious diseases, even suicide and homicide. And the issue, as Marmot shows, is not simply one of income or lifestyle. It is the psychological experience of inequality-how much control you have over your life and the opportunities you have for full social participation-that has a profound effect on your health.
The Status Syndrome will utterly change the way we think about health, society, and how we live our lives.
-The Washington Post Book World
You probably didn't realize that when you graduate from college you increase your lifespan, or that your co-worker who has a slightly better job is more likely to live a healthier life. In this groundbreaking book, epidemiologist Michael Marmot marshals evidence from nearly thirty years of research to demonstrate that status is not a footnote to the causes of ill health-it is the cause. He calls this effect the status syndrome.
The status syndrome is pervasive. It determines the chances that you will succumb to heart disease, stroke, cancers, infectious diseases, even suicide and homicide. And the issue, as Marmot shows, is not simply one of income or lifestyle. It is the psychological experience of inequality-how much control you have over your life and the opportunities you have for full social participation-that has a profound effect on your health.
The Status Syndrome will utterly change the way we think about health, society, and how we live our lives.
336 pages, Paperback
First published August 9, 2004
About the author
Michael G. Marmot
14 books75 followersSir Michael Gideon Marmot, FBA, FMedSci, FRCP (born 26 February 1945) is Professor of Epidemiology and Public Health at University College London.
Marmot was born in London on 26 February 1945. When he was a young child, his family moved to Sydney in Australia, where he attended Sydney Boys High School (1957–1961) and graduated with a Bachelor of Medicine, Bachelor of Surgery (MBBS) degree from the University of Sydney in 1968.
He earned a Master of Public Health in 1972 and a PhD in 1975 from the University of California, Berkeley for research into Acculturation and Coronary Heart Disease in Japanese Americans.
Currently Director of The UCL Institute of Health Equity, Marmot has led research groups on health inequalities for over 35 years. He was chair of the Commission on Social Determinants of Health (CSDH), which was set up by the World Health Organization in 2005, and produced "Closing the Gap in a Generation" in August 2008. He leads the English Longitudinal Study of Ageing (ELSA), and is engaged in several international research efforts on the social determinants of health. He served as President of the British Medical Association (BMA) from 2010 to 2011, and is the new President of the British Lung Foundation.
He is a fellow of the Academy of Medical Sciences, an honorary fellow of the British Academy, and an honorary fellow of the Faculty of Public Health of the Royal College of Physicians. He was a member of the Royal Commission on Environmental Pollution for six years and in 2000 he was knighted by Queen Elizabeth II, for services to epidemiology and the understanding of health inequalities.
Marmot is a Foreign Associate Member of the Institute of Medicine (IOM), and a former vice-president of the Academia Europaea. Marmot served as president of the World Medical Association for 2015–16.
Marmot is a Vice-President of the Academia Europaea, a Foreign Associate Member of the Institute of Medicine (IOM), and the chair of the Commission on Social Determinants of Health set up by the World Health Organization in 2005. He won the Balzan Prize for Epidemiology in 2004, gave the Harveian Oration in 2006 and won the William B. Graham Prize for Health Services Research in 2008. Marmot advises the WHO.
Marmot was born in London on 26 February 1945. When he was a young child, his family moved to Sydney in Australia, where he attended Sydney Boys High School (1957–1961) and graduated with a Bachelor of Medicine, Bachelor of Surgery (MBBS) degree from the University of Sydney in 1968.
He earned a Master of Public Health in 1972 and a PhD in 1975 from the University of California, Berkeley for research into Acculturation and Coronary Heart Disease in Japanese Americans.
Currently Director of The UCL Institute of Health Equity, Marmot has led research groups on health inequalities for over 35 years. He was chair of the Commission on Social Determinants of Health (CSDH), which was set up by the World Health Organization in 2005, and produced "Closing the Gap in a Generation" in August 2008. He leads the English Longitudinal Study of Ageing (ELSA), and is engaged in several international research efforts on the social determinants of health. He served as President of the British Medical Association (BMA) from 2010 to 2011, and is the new President of the British Lung Foundation.
He is a fellow of the Academy of Medical Sciences, an honorary fellow of the British Academy, and an honorary fellow of the Faculty of Public Health of the Royal College of Physicians. He was a member of the Royal Commission on Environmental Pollution for six years and in 2000 he was knighted by Queen Elizabeth II, for services to epidemiology and the understanding of health inequalities.
Marmot is a Foreign Associate Member of the Institute of Medicine (IOM), and a former vice-president of the Academia Europaea. Marmot served as president of the World Medical Association for 2015–16.
Marmot is a Vice-President of the Academia Europaea, a Foreign Associate Member of the Institute of Medicine (IOM), and the chair of the Commission on Social Determinants of Health set up by the World Health Organization in 2005. He won the Balzan Prize for Epidemiology in 2004, gave the Harveian Oration in 2006 and won the William B. Graham Prize for Health Services Research in 2008. Marmot advises the WHO.
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Displaying 1 - 30 of 34 reviews
September 6, 2012
Very convincing book on how social status affects health. Most of books on the topic of health focus on the usual suspects: smoking, diet, sleep, activity, i.e. physical causes. The book argues that autonomy and ability to participate fully in society should be added to that list. Although the author doesn't give any recommendations besides how to organize society to reduce the "Status Syndrome", there are some takeaways for the individual from the book. Although hierarchies are inevitable in human society, people still have some freedom to choose the hierarchies they want to be part of. Or when deciding on a job, it's best to avoid those which require high effort but offer little reward (if you are fortunate enough to be able to be picky). A separate book could probably be written on these takeaways.
October 7, 2011
Michael Marmot makes the case that health is on a gradient and the lower one's social standing the worse one's health--not so much because of the lack of money itself as because of the lack of control over one's life and the inability to fully participate in the activities of life that bring joy and are health promoting. This book is the end result of years of research (The Whitehall 1 and 11 studies) and it shows. I found it really interesting and it has definitely caused me to look at the whole issue of poverty and health in a different way. And, while it deals with some depressing stats, this is ultimately a hopeful book, because it shows that by making policy changes and starting programs that lessen inequality we can improve the health of entire societies.
May 19, 2008
The Status Syndrome: How Social Standing Affects Our Health and Longevity is a rare book. It is both detailed and well researched, something that usually brings to mind a textbook and visions of eyelids drooping. In this case that is not true. I am not a health professional and usually health books put me to sleep. This book is a page-turner, a real surprise for me. My copy is underlined and highlighted profusely, a testement to my involvement and my attention to this subject of health and how status determines our quality of life.
My regret is that Michael Marmot did not delve into the potential for an individual to raise his or her status by direct action or intent. If a father would like to raise the status of his children for instance, how would he plan for that in a five-year family plan, as an example? The question simply never comes up.
The issue and problem is well defined in this book. Marmot did place recommendations on issues in the back of the book for governments and communities to address. But he conspicuously left out the individual in his recommendations on what to do. Perhaps this subject is something that is planned for a forthcoming book.
As a retiree from the US Navy I can see so much of this subject better now after reading the book and I can also better relate to what I have not directly observed.
I wonder what additional data Marmot would have gathered if he had studied the British Navy? Sailors in the British Navy have a 20-year length of service, something that would have given his data field more stability in length if I understand some of his testing methodologies. Perhaps he will evaluate them in the future?
My query related to his investigation of the Royal Navy would include the often-observed phenomena of some retirees suffering an unusual frequency of severe health related issues soon after leaving the service, depending on his or her relationship with the service and the social relationships which are often severed upon ones retirement, which not only involved the physical departure from a unit but also often involves leaving the only job they know.
Individuals reading this book come away with tons of questions. Perhaps a policy maker has the podium to implement a plan or a call for action that this book recommends. But individuals do not. The real missing portion of this book is just that, the personal human individual who would like to have more control over their life and set up their kids for something better as well. This question simply was not answered, an unfortunate oversight to an otherwise outstanding book on a topic which everyone should care about.
My regret is that Michael Marmot did not delve into the potential for an individual to raise his or her status by direct action or intent. If a father would like to raise the status of his children for instance, how would he plan for that in a five-year family plan, as an example? The question simply never comes up.
The issue and problem is well defined in this book. Marmot did place recommendations on issues in the back of the book for governments and communities to address. But he conspicuously left out the individual in his recommendations on what to do. Perhaps this subject is something that is planned for a forthcoming book.
As a retiree from the US Navy I can see so much of this subject better now after reading the book and I can also better relate to what I have not directly observed.
I wonder what additional data Marmot would have gathered if he had studied the British Navy? Sailors in the British Navy have a 20-year length of service, something that would have given his data field more stability in length if I understand some of his testing methodologies. Perhaps he will evaluate them in the future?
My query related to his investigation of the Royal Navy would include the often-observed phenomena of some retirees suffering an unusual frequency of severe health related issues soon after leaving the service, depending on his or her relationship with the service and the social relationships which are often severed upon ones retirement, which not only involved the physical departure from a unit but also often involves leaving the only job they know.
Individuals reading this book come away with tons of questions. Perhaps a policy maker has the podium to implement a plan or a call for action that this book recommends. But individuals do not. The real missing portion of this book is just that, the personal human individual who would like to have more control over their life and set up their kids for something better as well. This question simply was not answered, an unfortunate oversight to an otherwise outstanding book on a topic which everyone should care about.
November 22, 2008
In this book, Michael Marmot outlines his famous Whitehall studies, which showed that health (life expectancy, infant mortality) follows a social gradient. That is, the higher a person's education or income level, the better his/her health. He shows that this is not a dichotomous phenomenon, restricted only to 'poor' and 'not poor.' Rather, there are incremental differences along the continuum. Marmot makes the case that being more healthy is due to having more 'control' and autonomy.
I really enjoyed the book. It was a bit heavy-handed in the beginning. I thought the author was a bit long-winded and redundant in laying out his theory and explaining the Whitehall studies. It made just want to read the shorter papers. However, the book picked up as it went along. I really liked the chapters with comparative analyses of countries. Other parts of the book were a bit more suspect; I'm not sure if I agree that it was all good science, but I think most of it was. In the end, Marmot makes an excellent case for narrowing disparities. I also appreciated that he is a serious scientist, physician, and public heath professional who is deeply humanistic.
I really enjoyed the book. It was a bit heavy-handed in the beginning. I thought the author was a bit long-winded and redundant in laying out his theory and explaining the Whitehall studies. It made just want to read the shorter papers. However, the book picked up as it went along. I really liked the chapters with comparative analyses of countries. Other parts of the book were a bit more suspect; I'm not sure if I agree that it was all good science, but I think most of it was. In the end, Marmot makes an excellent case for narrowing disparities. I also appreciated that he is a serious scientist, physician, and public heath professional who is deeply humanistic.
February 13, 2011
Pretty good book looking at the impact of the social determinants of health on morbidity and mortality. Primarily focused on relaying his theories from Whitehall I and Whitehall II studies, which are groundbreaking to be sure. I feel he spent too much time talking about biology, someone reading the entire book would understand that he means biologic makeup of humans, but I could see how some reading excerpts could misunderstand and think he's comparing genes between people. Also there was little if no discussion on the intersections of race and gender - how these inform and modify social relationships, sense of control and one's ability to fully participate in life. Having said that, I would still recommend for anyone interested in SDOH and anyone who believes just "teaching" poor people to eat better and stop smoking is the answer to improving social inequalities in the US, UK and other post-industrial countries.
July 31, 2011
This is so obvious it shouldn't need to be pointed out in words of one syllable. Unfortunately those are the things that so often pass us by! It's how much control we feel we have over our lives that influences our health and contentment. This is based on the Whitehall study, so no homelessness or absolute poverty, just a comparison between those people who push buttons, those who actually make major decisions and all those in the middle ranks. Financial security makes a huge difference but there is so much more to it than that. Would recommend this to anyone with any interest in social justice and what really makes us tick! Links in very well with Spirit Level to show how more equal societies promote more (self-assessed) happiness for all. When we create divides it's not just those at the bottom who suffer. Maybe we should seriously consider the implications of that and DO SOMETHING ABOUT IT!
April 3, 2015
The basic idea here is really important and not necessarily intuitive - not only is poverty bad for your health, but being of lower status is in all cases less healthy than being high status (even within a population of relatively privileged people). The idea has a lot of implications, which the book goes in to in detail.
I had some quibbles with some of the explication - the pieces on gender difference didn't ring true to me and the chapters on evolutionary psychology were not my favorite - but the book deserves at least a four just for the main idea.
I had some quibbles with some of the explication - the pieces on gender difference didn't ring true to me and the chapters on evolutionary psychology were not my favorite - but the book deserves at least a four just for the main idea.
July 23, 2019
Any book or idea that is statistically oriented --- barring the book on statistics per se --- should be taken with a truckload of skepticism; however, the fact this book falls in the mediocristan radar of statistics made my read like a walk through boulevards. The author in this book made a salubrious effect in exposing the health gradient seen in the society --- the higher the status in the pecking order the healthier people are likely to be: which is what author calls status syndrome. Michael Marmot, in his dialectic and syllogistic approach --- lays bare --- no holds barred --- how one's social standing in society affects health adversely or favorably. For a given biological agent and cause, the author soberly writes, the people in the lower strata are more likely to be affected. This cannot be mistaken for lack of money or other facilities. In fact, the author trenchantly says that when the problems of privation have been solved, how much money you have is not as important as how much you are relative to others in society. More emphatically, what characterizes being poor and lower in the hierarchy is a great sense of helplessness -- lack of control over life circumstances. The author ominously adds that poverty is more than a lack of money, it is more of circumstances we live. The line from John Kenneth: who can say for sure that the deprivation which afflicts him with hunger is more painful than the deprivation which afflicts him with the envy of his neighbors car -- is as gravely a concern as it appears sardonic. It is this sense of helplessness, this lack of control that affects one's biological stress pathways.
What separates one from another in the pecking order, according to the author, are the control, predictability, degree of support, threat to status. These factors modulate the impact of psychologically threatening stimulus --- and all of them likely to be linked with social hierarchy. While the point the authors makes drives home already, my view on the observed support from the bottom-up social hierarchy directly follows from my favorite line by Lyndon Johnson: it is no longer easy to get the help you need when you are no longer on the top of the world (here replace the world with social hierarchy). This support one relishes in the comportment of a fawning man indulging in the excess of hobnobbing. To conclude --- each of us has several roles, whether as a parent, partner, child, employer, employee, resident, citizen, opinion former, etc.; and whatever roles we assume has an important influence on our own opportunities for self-realization, or autonomy and social-participation. These are not just pleasant things to have, but also immensely affects health if thwarted. The fact we systematically thwart these for people lower in the hierarchy is a massive blot on a civilized society.
"Your chances of being in a favorable or unfavorable situation in adulthood will have much to do with what happened to them earlier in life: security of attachment, pre-school environment, schooling, the neighborhoods in which they grew up, opportunities for higher education, quite apart from the genetic endowment."
What separates one from another in the pecking order, according to the author, are the control, predictability, degree of support, threat to status. These factors modulate the impact of psychologically threatening stimulus --- and all of them likely to be linked with social hierarchy. While the point the authors makes drives home already, my view on the observed support from the bottom-up social hierarchy directly follows from my favorite line by Lyndon Johnson: it is no longer easy to get the help you need when you are no longer on the top of the world (here replace the world with social hierarchy). This support one relishes in the comportment of a fawning man indulging in the excess of hobnobbing. To conclude --- each of us has several roles, whether as a parent, partner, child, employer, employee, resident, citizen, opinion former, etc.; and whatever roles we assume has an important influence on our own opportunities for self-realization, or autonomy and social-participation. These are not just pleasant things to have, but also immensely affects health if thwarted. The fact we systematically thwart these for people lower in the hierarchy is a massive blot on a civilized society.
"Your chances of being in a favorable or unfavorable situation in adulthood will have much to do with what happened to them earlier in life: security of attachment, pre-school environment, schooling, the neighborhoods in which they grew up, opportunities for higher education, quite apart from the genetic endowment."
August 31, 2017
Well, it's an interesting idea to connect social status with one's health and not in the basic way of just seeing the connection between it in the amount of money one has, one's hygiene or ability to get better medical attention. The author believes that even more important for one's health is one's autonomy over his-/her-own life and one's involvement in social activities. The higher the status, the higher are rates of autonomy and social relationships. The author wanted to tell the readers everything he knows and that's really a lot and there are quite a lot of other research mentioned, so it's a great book to start with if you are interested in this topic or medicinal sociology. However, it's a bit boring and repetitive.
January 1, 2022
This book, along with Putnam's Bowling Alone represents the gold standard on how to summarize research findings and articulate them in an accessible manner. Unlike many a pop sci book the author is very measured in his claims and provides copious amounts of evidence in order to build up his arguments. It is quite apparent by the end of the book how serious of an impact hierarchical social arrangements have on health and how these observations are consistent across not just humans but the entire animal kingdom. At the end of the book are a set of policy guidelines, dubbed the "Acheson recommendations", which serve as a framework for administrations seeking to eradicate or mitigate the status syndrome.
May 5, 2019
an important topic but the way that he described his data frustrated me to no end and also all that weird evolutionary psych stuff about morality arising because of men wanting to impress women was cringy and out-of-place.
August 9, 2019
Realistic, scientific & gets to to bottom of the issue with no pretentious jargons. If your thinking about the behaviour of society get marred by opinions of others, this book will help you understand issues with clarity and structure.
April 26, 2020
This book is both fascinating and disheartening. While Marmot speaks from a British vantage point, what he experienced across the proverbial pond translates to America. A most valuable and informative book!
April 14, 2022
LOVED, very interesting perspective about how social standing affects health from a physician with really well documented resources. Autonomy and social engagement is linked to cardiovascular health and mortality which is fascinating.
August 17, 2020
Heavy going at a times but an educational read.
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January 7, 2021☽ 1 / 100 ☾
read for school // sociology
read for school // sociology
September 7, 2022
This is a little bit different than your usual "poverty leads to poor health" book. A truly brilliant and novel concept, but could have been a 2-page essay. Maybe 4 pages with figures.
Read
March 7, 2023Review from the March 2006 issue of the Socialist Standard:
https://socialiststandardmyspace.blog...
https://socialiststandardmyspace.blog...
August 15, 2023
Väldigt intressant bok, men överger den för tillfället eftersom jag har annan kurslitteratur som jag behöver prioritera.
October 14, 2023
Everyone should read this book. The message is powerful, the writing is brilliant. Shocking, galvanising, thought provoking
June 21, 2023
Filled with empirical evidences and careful analysis, this book provides an outstanding account on the impact of one’s place in social hierarchy on one’s health.The author goes to show that the findings,though often neglected by medical practitioners and society at large, bear tremendous impact on health of individuals and can’t be overlooked at all !
January 14, 2022
I think for everyone having big interest on how health inequality is shaped, Sir Marmot's books are always great choice to begin with. However, I personally believe that it is better to read this book first, and then moving to his next publication (the health gap).
Here, Sir Marmot tries to explain that the status syndrome is not merely about the have and have nots; it's everything in between. Nor about the illness for the poor and good health for everyone else; it's a gradient. It's not always about money, but rather about the autonomy --how much control you have over your life-- and the opportunities for you to actively engage in your social environment. Thus, if we dream of better health, we should look at both ourselves and the society where we live in.
He'll be my favourite professor ever!
Here, Sir Marmot tries to explain that the status syndrome is not merely about the have and have nots; it's everything in between. Nor about the illness for the poor and good health for everyone else; it's a gradient. It's not always about money, but rather about the autonomy --how much control you have over your life-- and the opportunities for you to actively engage in your social environment. Thus, if we dream of better health, we should look at both ourselves and the society where we live in.
He'll be my favourite professor ever!
September 16, 2013
Sigh okay the description made me so excited to read a book that is presumably an enlightened look at the powerful impact of our environment on our health and a call for social justice. The general ideas are spot-on, but I noticed little problematic things along the way... For example, in an effort to be "balanced" in the nature vs. nurture argument, Marmot endorses some tired misinformation about the "nature" of men and women (and seems to rely heavily on observations of monkeys). Is "icky vibes" a valid criticism in a book review, idk. Could have been so much better.
July 10, 2013
Great information in this book. It's very readable, relatable, and the information tells a comprehensive story about the health effects of social status. Really intriguing; I feel changed, and far better-informed because of this book. It should be required reading everywhere.
April 30, 2007
Fantastic analysis of how social status impacts health. This will change the way you think about how society is structured.
December 27, 2007
Fascinating and nuanced study of status, access to resources and what it implies about us.
February 29, 2008
This book is awesome, especially for anyone in the field of healthcare. Or anyone who's ever wondered about the connection between race, class, money, and health.
January 18, 2009
Excellent new perspective on health care and human nature.
September 12, 2008
This book gave me a new insight on solving America's health problems. Its not as easy as eating right and exercising, but involves social policy and such....kinda interesting!
November 19, 2009
As much as I wanted to read this I just couldn't get past the first couple chapters.
Displaying 1 - 30 of 34 reviews