Sick of Poverty by Robert Sapolsky

Presented by: Ernesto Villasenor Sustainability StudiesRensselaer Polytechnic Institute

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Sick of Poverty Published in 2005 on the Scientific American Journal

Examines as to how the stress of being poor affects health

Looks at psychosocial stresses that are associated with poverty and how they increase the risk of illnesses

Examines the correlation between socioeconomic status (SES) and it’s correlation to poorer health, as well as cross examines the psychosocial stresses inhibited by SES on poor health

Done through the analysis of other publications and examples seen through American Society and cross-comparison of other countries

Observes areas where universal health care is in place and where there isn’t universal health care

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Robert Sapolsky

American NeuroscientistProfessor of Biology, Neuroscience, and Neurosurgery at Stanford University

Research Associate at the National Museums of Kenya

Bachelor’s in Biological Anthropology from Harvard

Ph.D in Neuroendocrinology from Rockefeller University

Research focused on the social behaviors of baboons in the wild

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Key Terms

Socioeconomic Status (SES)

Composite measure that includes income, occupation, education, and housing conditions

When examined (starting with the wealthiest stratum of society), every step down in SES correlates with poorer health

Psychosocial StressA threat that disrupts the balance in the body that is caused by members within the species (in this case, stressors caused by humans)

Involve the anticipation of an impending challenge

Can be long-term

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Rudolph Virchow

19th century German neuroscientist, physician, and political activist

Exposed to two dramatic events in Germany:

Typhoid outbreak in 1847

Failed revolution of 1848

“Physicians are the natural attorneys of the poor”

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Socioeconomic Status and Health

Beginning with the wealthier stratum of society, every step downward in socioeconomic status correlates with poorer health

SES “gradient” has been documented throughout Westernized societies for problems that are stress-sensitive diseases.

What causes this correlation between SES and health?

Lower SES may give rise to poorer health, but conversely, poorer health could also give rise to lower SES.

Bulk of facts suggest that the arrow goes from economic status health.

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Or does it?

Robert Sapolsky "Sick of Poverty"

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Inadequate Explanations for SES

and Health? So how does socioeconomic status get under our skin and influence health?

Health care may be less easily accessible and of lower quality? Unhealthy lifestyles?

Low-income communities within Westernized societies are less likely to have access to clean water, healthy food and clubs, heat in the winter and a/c in the summer.

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Psychosocial Stress

Health care access, health care utilization, and exposure to risk & protective factors the SES gradient far less than one might have thought.

Must look at another gradient with different considerations

What about the psychosocial consequences of socioeconomic status? Why are psychosocial consequences of SES more plausible than the previously stated examples?

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Homeostasis and Psychosocial Stress

Stimulus (Change occurs in internal environment)

Receptors

Control Center (set point)Effectors (muscles or glands)

Response (change is corrected)

Most stressors concern interactions with our own species, and few physically disrupt homeostasis. Instead, they involve anticipation of an impeding challenge.

Striking attribute of psychological and social stressors are the chronicity.

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How well does the argument hold its water?

Individuals are more likely to activate a stress response and are more at risk for a stress-sensitive disease if they:

Feel as if they have minimum control over the stressor(s) Feel as if they have no predictive information about the duration and intensity of the stressor(s)Have few outlets for the frustration caused by the stressor Interpret the stressor as evidence of circumstances worseningLack social support for the duress caused by the stressor

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Subjective Feelings and Objective Results

A relatively poor person in the US may objectively have more financial resources to purchase health care and protective factors than a relatively wealthy person in a less developed country, yet, on average, will still have a shorter life expectancy.

People in Greece on average earn half the income of Americans yet have a longer life expectancy.

Once the minimal resources are available to sustain a basic level of health through adequate food and housing, absolute levels of income are of remarkably little importance to health.

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Psychosocial Stress of Income Inequality on Health and Social Capital

An analyzed study conducted by Richard Wilkinson from the University of Nottingham in the UK stated that the psychosocial stress of income inequality on health is higher in countries where there are larger gaps between the rich and the poor.

The more unequal income in a community is, the more psychosocial stress there will be for the poor

Higher income inequality intensifies a community’s hierarchy and makes social support less available

Social capital refers to the broad levels of trust and efficacy in a community

Low social capital predicts bad health, bad self-reported health, and high mortality rates.

The strongest route from income inequality to poor health is observed through social capital measures

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Final Remarks and Summary

Psychosocial factors and their implications on SES/health generate a critical conclusion: when it comes to health, there is far more to poverty than simply not having enough money.

Some of the arguments that are made within one community/country would not hold water in another country.

Psychosocial stress causes further health implications, and needs to be thoroughly investigated within the US.

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Possible Investigation to Consider

Are there various psychosocial stressors that are felt much stronger within one ethnic/racial group than another?

If so, how much more intense are the consequences from such psychosocial stressors?

Why are they not seen within other groups?

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Bibliography

1. Sapolsky, Robert. Sick of Poverty. Scientific American. 293. 6 (December 2005): pg. 92-99.

2. Edge.org: People, Robert Sapolsky. Retrieved on 20 Nov 2012 from: http://edge.org/memberbio/robert_sapolsky

3. Wilkinson, Richard. Mind the Gap: Hierarchies, Health and Human Evolution. Weidenfield and Nicolson (2000).

4. Kawachi, Ichiro & Kennedy, Bruce. The Health of Nations: Why Inequality is Harmful to Your Health. New Press (2002)