Social Status and Mortality

• Academy award
• Life expectancy
• Social class
• Self concept
• Outcome and process assessment (health care)

Few societies, even modern Scandinavian welfare states, avoid the uncomfortable fact of social inequalities in health. In the United Kingdom, ever since accurate mortality data first became available early in the 19th century, life expectancy has been shown to be more favorable for persons in higher-status occupations. Their relative advantages are also enjoyed by their households. Currently, boys born to families with a parent in a professional or managerial occupation can expect to live 5 years longer than a counterpart born to a parent working in a partly skilled or unskilled occupation (1). Similar inequalities in life expectancy prevail in the United States (2, 3). Until recently, the most plausible explanation for such inequalities has been that lower-status jobs were associated with lower income, which in turn resulted in damage to the health of an individual and his or her family through poorer diet and housing, lack of access to appropriate health care, and higher levels of social stress. Recently, however, accumulating evidence suggests that such explanations may not be sufficient and that social status itself, regardless of associated material and economic advantages, may confer health benefits.

Redelmeier and Singh (4) now provide further intriguing evidence by showing that actors and actresses who win Academy Awards live an average of 3.9 years longer than comparable performers who were nominated for an award but did not win. At first sight, this study will strike readers as one of those typically whimsical and serendipitous findings peculiar to epidemiology. However, the authors have considered …