Reading: Sapolsky Chapter 17 - The View From the Bottom

Question 1

Animals

Answer 1

• In animals dominance hierarchies are important to consider i.e. for a subordinate animal, life is filled with a disproportionate share not only of physical stressors but of psychological stressors as well- lack of control, of predictability, of outlets for frustration.
• This is reflected in higher basal glucocorticoid levels and also in response to a real stressor. Additionally, elevated blood pressure, immune response is dampened, testosterone levels more supressed by stress etc.
• Studies have isolated that rank drives the distinctive stress profile not the other way around.
• The exact nature of this link i.e. if it’s being subordinate that has the negative consequences or being dominant depends on the animal. If it is actually more stressful to be dominant e.g. you have to constantly get in fights to reassert your rank than this can be damaging in terms of chronic stress = RANK MEANS DIFFERENT THINGS TO DIFFERENT SPECIES AND EVEN TO GROUPS WITHIN THE SAME SPECIES.

Question 2

Humans

Answer 2

• The idea of rank for humans is complex
• It’s importance in the stress response depends on the internal rationalisation of that rank based on the knowledge of what determined their placement e.g. a runner may finish 500th in a marathon and feel less stressed about it than someone who comes 3rd and was expecting to come 1st.
• Additionally people have multiple different ‘ranks’ depending on the specific situation e.g. leader of a sport team, but worst in the class so it depends which they give more weight to.

Question 3

Socioeconomic Status, Stress, and Disease

Answer 3

• One way to conceptualise rank is socioeconomic status (SES)
• Being poor comes with a range of both psychological and physical stressors
• And also a decrease in time/ funds/ ability to cope with stressors e.g. can’t run as a coping mechanism if you live in a neighbourhood where running alone is likely to get you killed/ attacked.
• Huge link between SES and health outcomes e.g. a five to ten year difference in expectancy in life expectancy is some countries when you compare the wealthiest and poorest individuals.

Question 4

The Puzzle of Health Care Access

Answer 4

• Plausible explanation of the link between SES and health outcomes? –> less access to health care, worse treatment when do access due to lack of money? Inability to pay for expensive treatments etc.
• Is a factor but can’t explain everything as we see a link between SES and health outcomes even in countries where there is universal free access to health care.

-Additionally, there is a gradient i.e. there each step up in terms of SES sees an increase in health outcomes and the gradient exists for diseases that have nothing to do with access e.g. rheumatoid arthritis.

Question 5

Risk Factors and Protective Factors

Answer 5

• Poor—-> worse education—> inability to engage in protective health behaviours e.g. don’t know the risks associated with smoking and so continue to smoke.
• But again cannot fully explain because if you control for risk factors e.g. smoking you still get the gradient
• Additionally in counties that are wealthier and therefore have more opportunities to buy protective factors and avoid risk factors individuals aren’t any healthier.

Question 6

Being Poor Versus Feeling Poor

Answer 6

• Subjective SES
• Feeling poor seems to predict poor health (controlling for depression).
• Built around education, income and occupational position, and satisfaction with standard of living.

Question 7

Poverty Versus Poverty and Plenty

Answer 7

• The more income inequality in society the worse the health and mortality rates
• In societies that have more income equality both the poor and the wealthy are healthier than their counterparts in a less equal society with the same average income.

Question 8

How Does Income Inequality and Feeling Poor Translate into Bad Health

Answer 8

• Social capital = the depth and range of social resources and can draw on in a troubled time.
• The more income inequality in a society the less social capital there is.
• Social capital means there is less isolation, information about health behaviours circulates faster and there are more public constraints on unhealthy behaviours.
• America has very little social capital due to a constant drive to remove yourself from your roots, seek independence, pursue new better jobs in bigger places and this might health explain why as a country America has a lot of wealth but poor health.
• The punch - line of the human -primate differences is that when humans invented poverty they came up with a way of subjugating the low-ranking like nothing ever before seen in the primate world.