It’s Good to Be the King: Social Status and Health

In gaining high social status, being born well helps, but so does behaving well.

Posted Jun 19, 2020

It is an uneasy truth of humanity that we are by nature hierarchical. Our brain is a meaning-making operation, and one of its basic procedures is to organize concepts hierarchically. Hierarchies make order in chaos, and the order they make is useful for survival. A system that ranks threats and opportunities hierarchically by their likelihood and level of urgency has the edge over a system that responds randomly, or identically, to every threat and opportunity.

For a social animal like us, hierarchical organization offers distinct advantages. As the political scientists Dominic Johnson (University of Oxford) and Bradley Thayer (University of Iceland) write:

“A species that lives communally could have two broad forms of social organization. The group can accept organization with some centralization of power (dominance hierarchies), or it can engage in perpetual conflict ('scramble competition'), which incurs costs in terms of time, energy, and injuries, as well as depriving the group of many benefits of a communal existence, such as more efficient resource harvesting. Among social mammals, and primates in particular, dominance hierarchies have emerged as the primary form of social organization.”

Alas, hierarchical order, like any order, creates winners and losers; thus, it generates discontent. Over time, social hierarchies inevitably exact a toll, begetting tension and strife. Such difficulties become particularly consequential in market economies, where status disparities often manifest in terms of relative wealth.

Needpix
Source: Needpix

As the work of British social epidemiologist Richard Wilkinson has shown, large status disparities predict poorer health outcomes, more social conflict, and more violence. Status disparities, in fact, predict societal wellbeing better than per capita income. The citizens of a wealthy yet highly unequal society tend to have worse health outcomes than those who live in a poorer but more equal society. 

Generally, human societies try to deal with these inherent problems of the hierarchical structure by either looking to reduce inequality (through progressive taxation, etc.) or by promoting cultural narratives ("rags to riches") and myths (“the land of opportunity”) that camouflage it. Yet, while reducing extreme social disparities is a worthy goal, eliminating them altogether is likely untenable.

I should know. I grew up on an Israeli kibbutz, a radical 20th-century social experiment in which young socialist revolutionaries sought to create a new non-hierarchical social order—an equal, egalitarian, cooperative, and truly classless system. For example, the kibbutz labor force had no "career ladder." Jobs were assigned by rotation. Communal income was shared equally between the members, who also received equal housing, education, and communal services. All members participated equally in communal decision making, via a direct democratic voting process. The kibbutz system, in other words, demolished all structural and formal hierarchies.

Alas, in the absence of material and formal hierarchies, other, more intangible but no less consequential hierarchies sprung up. For example, since the kibbutz movement was revolutionary, agricultural, and democratic, true believers gained status over doubters, well-spoken members gained outsize influence, and the physically fit gained clout over the dreamers and poets. To paraphrase the old saying, you can take humans out of the status hierarchy, but not vice versa.

Social status” is a multidimensional construct, consisting of both "ascribed" elements, attached to the individual at birth (think genderethnicity, and age), and "achieved" ones, gained through individual agency (think income, education level). Social status is coveted because its implications are profound. For one, humans live in groups, and the group will offer greater protection to highly esteemed members. Group protection, in turn, is the most effective type of protection humans have. High status improves your survival odds.

In addition, high social status also confers reproductive advantages. Evolutionary psychologist David Buss writes: “Reproductively relevant resources, including food, territory, mating opportunities, powerful coalitional alliances, and group-provided health care, flow to those high in status and trickle only slowly to those low in status.”

Beyond survival and reproduction, a vast literature has also documented the effects of social status on health and longevity. The general findings are quite intuitive: higher social status begets better health. For example, “studies in Sweden have shown that men with a doctorate had 50 percent lower mortality than men who had tertiary education. In the U.S., those in the poorest households have nearly four times the risk of death of those in the richest. In the U.K., office workers are more likely to die of coronary heart disease the lower down the hierarchy they go.”

Once we establish that status affects health, the next question is: How? Generally, it is quite apparent that low status is a stressor, and we know that stress affects health adversely. But what specifically is stressful about low social status?

Perhaps the best answer to this question was provided by the British researcher Sir Michael Marmot, who spent over three decades documenting the health trajectories of British white-collar civil servants—a group characterized by similar working conditions and equal access to health care. Marmot’s work revealed the existence of a robust "health gradient," by which workers’ health improved in direct proportion to their rank.

These status benefits were not, however, a function of access to health care (they all had it) or income disparities (small in this group). Rather, higher status conferred better health by improving two main psychosocial factors: personal autonomy and social connectedness. "The lower in hierarchy you are, the less likely it is that you will have full control over your life and opportunities for full social participation… Autonomy and social participation are so important for health that their lack lead to deterioration in health."

Once we understand that status is strongly linked to health, and once we’ve figured out the mechanisms underlying this link, the next question becomes: How does one achieve high status? Clearly, being born to the right parents at the right time and in the right place–the "ascribed" status elements—is a good start. To wit: In the U.S., the best predictor of success is parental wealth. Yet one’s personal traits and habits—the "achieved" status elements—matter as well.

A 2020 study by David Buss and colleagues makes this point. The authors had 2,751 participants in 14 countries rate multiple behaviors and traits by how much they promote (or demote) social status in men and women. The results provide, “the first systematic documentation of potentially universal and sex-differentiated status criteria.”

The study identified several behaviors that serve to promote higher status across genders and cultures. Among them are (in order of importance): Being a trusted group member; being intelligent; getting accepted at a prestigious university; being an exceptional leader; having a wide range of knowledge; being creative; always being honest; being able to speak well in public; having a job that pays well; having a good sense of humor; having an executive position; being kind; being brave in the face of danger; having a college education; and being a hard worker.

In contrast, the top "status decreasing" traits were as follows: Failing to perform a group task; getting dismissed from school; being lazy; being unable to control one's sexual behavior when drunk; being unreliable; acting immature or irresponsible; being mean or nasty to others; expressed racist remarks; bringing social shame on one's family; having bad manners; takes illegal drugs; getting a sexually-transmitted disease; being stupid; being unclean or dirty; and being known as a thief.

Several gender differences did, however, emerge. For example, across nations, drug use and delinquency were rated as harming men’s status much less than women’s, while crying in front of one’s friends was rated as more damaging to men’s status than women’s. The ability (and willingness) to protect others through risk-taking, acts of bravery, and physical strength were more status-enhancing for men, while qualities related to domestic skills (i.e., cooking ability, parenting) and physical attractiveness (hygiene, appearance) tended to matter more to women’s status. And while sexual promiscuity decreased the status of both genders, it hurt women's status more, even in sexually egalitarian cultures. Long-term committed relationships, on the other hand, increased the status of both genders, albeit more so for women.

Buss and colleagues conclude thus: “many status criteria… appear to have similar effects across nations… suggesting possible universality. Acts, characteristics, and events that are associated with general value to the group and to individuals within the group, value to one’s kin, and physical health are three candidates for universal status criteria.” 

In other words, while being born well is important, so is behaving well. Prosocial habits such as trustworthiness, honesty, conscientiousness, creativity, and kindness are likely to raise your social status, and with that, improve your health and longevity.

The old saying may have to be revised thus: Nice guys (and gals) die last.