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Longevity, Olympians, high status and inequality

There were 2 articles in the BMJ this week about longevity and Olympic athletes. One of them  [1] found that those who won medals lived several years longer than those in the general population and longer than other athletes.  One assumption was that this is linked to fitness, but that is probably unlikely. Another study also published in the BMJ this very week found that high intensity exercise does not give a survival advantage [2]. I suspect that in fact the increased longevity comes from feeling better about themselves, which will do all kind of positive things for our immune system and overall health.

 

In fact we learnt about 10 years ago that Oscar winners tend to live about 4 years longer than those who come 2nd, and this increases to 6 years if the Hollywood stars win more than one Oscar [3]. This of course fits with much that we have learnt in recent years about inequality. Michael Marmot’s studies [4] for example showed that the more senior one is in organisations such as the British Civil Service, the less likely one is to succumb to health problems such as heart attacks. Contrary to the myths, more senior people enjoy better health and live longer.

Richard Wilkinson has produced similarly convincing analyses [5], [6], alongside Kate Prickett, and what he has done is to also explain this at a psychological and neurobiological level. Low status and stress are bad for our health, we all know that and the research backs it up, and Wilkinson and Marmot have shown that the more unequal a society the worse the health and mental health of the population as a whole, including those at the top.

Such findings link with many other ones. Living in a close, egalitarian and trusting community reduces the likelihood of an over-active stress system, which affects health and immune systems, and increases the likelihood of psychobiological states which are replenishing, such as seen when the hormones involved in love, bonding and mutual trust, oxytocin, is released, as the work of scientists such as Paul Zak has shown [7].

We are unfortunately likely to see many more such studies coming through in the next few years as inequality levels rise. One from the University of Cambridge that came out just this week has shown conclusively that there is a link between schizophrenia levels and levels of income inequality . As the lead author of this large study, Dr James Kirkbride, said: “Although we already know that schizophrenia tends to be elevated in more urban communities, it was unclear why. Our research suggests that more densely populated, more deprived and less equal communities experience higher rates of schizophrenia and other similar disorders. This is important because other research has shown that many health and social outcomes also tend to be optimal when societies are more equal.”.  People with the worst lives, and indeed children with the highest number of bad early experiences, such as abuse or trauma, basically have worse and shorter lives [8]. Another study just out this week showed that psychosocial stress increase the risks of strokes. On the other hand, as one might expect, those of high status, often the wealthiest, live longer than the others. It seems particularly unfair, a kind of double whammy, that those dealt the worst hands are then affected in this way.

The wealthiest live longest

Schizophrenia linked to social inequality

Psychosocial stress increases the risk of strokes

 

[1]        P. M. Clarke, S. J. Walter, A. Hayen, W. J. Mallon, J. Heijmans, and D. M. Studdert, ‘Survival of the fittest: retrospective cohort study of the longevity of Olympic medallists in the modern era’, BMJ, vol. 345, no. dec13 8, pp. e8308–e8308, Dec. 2012.

[2]        R. Zwiers, F. W. A. Zantvoord, F. M. Engelaer, D. van Bodegom, F. J. G. van der Ouderaa, and R. G. J. Westendorp, ‘Mortality in former Olympic athletes: retrospective cohort analysis’, BMJ, vol. 345, no. dec13 8, pp. e7456–e7456, Dec. 2012.

[3]        D. A. Redelmeier and S. M. Singh, ‘Survival in Academy Award-winning actors and actresses’, Annals of Internal Medicine, vol. 134, no. 10, pp. 955–962, 2001.

[4]        M. Marmot, Status Syndrome: How Your Social Standing Directly Affects Your Health. London: Bloomsbury, 2005.

[5]        R. Wilkinson, The impact of inequality: How to make sick societies healthier. London: Routledge, 2005.

[6]        R. Wilkinson and K. Pickett, The Spirit Level: Why More Equal Societies Almost Always Do Better. London: Allen Lane, 2009.

[7]        P. J. Zak, The Moral Molecule: the new science of what makes us good or evil. Bantam Press, 2012.

[8]        V. J. Felitti and R. F. Anda, ‘The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders and sexual behavior: implications for healthcare’, The hidden epidemic: The impact of early life trauma on health and disease, pp. 77–87, 2010.

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Comments 1

Guest - Liz Anderson on Sunday, 16 December 2012 09:51

This research raises yet more issues for those of us working therapeutically. If we accept that many of those who seek therapy feel a lack of power, agency and success, we are challenged by this research to consider ideas of mutuality in our work. (Aron 1991)
I wonder if anyone has looked at the long-term outcomes of psychotherapy comparing a more collaborative approach with one where the therapist maintains a stance of being in charge. Although the research discussed is based on employment and economic factors, it seems likely that there might be some valuable insights that are applicable to therapeutic work.

This research raises yet more issues for those of us working therapeutically. If we accept that many of those who seek therapy feel a lack of power, agency and success, we are challenged by this research to consider ideas of mutuality in our work. (Aron 1991) I wonder if anyone has looked at the long-term outcomes of psychotherapy comparing a more collaborative approach with one where the therapist maintains a stance of being in charge. Although the research discussed is based on employment and economic factors, it seems likely that there might be some valuable insights that are applicable to therapeutic work.
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