About a year ago, my undergrad lab section replicated a study by Dr. Schommer and colleagues in which the activity of the endocrine system was investigated after we repeatedly induced stress in participants (yes, you can be a jerk if it’s for science) in a lab setting. About 157 subjects, both male and female were exposed to something called the Trier Social Stress Test, which basically asks participants a bunch of math and oral english comprehension questions. Saliva and blood samples were taken before and after the test to measure changes in the activation of something called the Hypothalamic-Pituitary-Adrenal Axis (or the HPAA), which is a set of interactions of the pituitary gland, hypothalamus and adrenal glands that control the hormones linked to stress.
What we found were levels of cortisol (stress hormone), epinephrine and norepinephrine (adrenaline), and heart rates repeatedly increased after participants were stressed out.
That last part: kinda obvious.
The next part: less so.
The participants in this case were ranked and separated via something called SES, or Socioeconomic Status. SES is basically a measure of how relatively well off they were in relation to everybody else. They were ranked by taking into account their postal code, and in effect, where they lived (good neighborhoods or bad neighborhoods). It turned out that those lower on the SES hierarchy experienced greater spikes in cortisol and had an overall more disregulated HPAA and stronger heart palpitations. The worse off you were economically relative to everybody else, the worse the effects of stress actually were, and the better off you were, the more negligible the effects of stress were. One conclusion that can be drawn from this is that simply being born poor(er than other people) means you’re also likely to be more stressed (even when placed in the EXACT same stressful situations as those higher on the SES hierarchy). This is called a monotonic gradient, which means the relationship is the same starting from all the way at the top down to all the way at the bottom of the ladder. Doctor Robert Sopolsky of Stanford cites the reason as being a feeling of relative shame or inadequacy as compared to everybody that’s relatively better off than you.
And of course, higher stress is also correlated with depression, which is correlated with poor health choices, which impacts health indirectly (poorer eating habits, not exercising, smoking and/or drinking), as well as directly. For instance, epinephrine triggers the release of glucose in the blood, and inhibits insulin protection. In the worse case scenario, this may lead to higher cases of diabetes. Likewise, higher cortisol is correlated with thicker blood platelets and also a narrowing of the arteries (poor eating and health habits are also a contributory factor). This can and does lead to increased chances of heart attack.
So, to go full circle, simply being poor(er than other people) means you’re also likely to be unhealthier.
Just last week, I got back from a short trip to Buffalo New York to visit some family friends. On my way there, I had to pass several smaller towns, like Amherst and Pembroke, and it was jarring to see the differences between the living conditions from place to place. Among the smaller, pristine greenery surrounded country localities were huge mega-mansions with multiple cars and even boats parked in their driveway (Seriously, boats. You know, for functionality. In places surrounded by concrete). Like the American flags that were weirdly ever proudly displayed on each household (In case people forget they’re in America) these extravagances to me seemed less about pragmatic functionality, but more about serving as sorts of self-identifiers to the people that owned them – “legitimizers” of the gilded stories people write for themselves and for their lives.
Buffalo, at least some of the parts where we visited, was a completely different story. Cracked concrete, graffiti-littered buildings, and beggars replaced the pristine greenery and triple decker houses. People wore plain white t-shirts and sagging pants, and proudly displayed their sparse wealth around their necks in the form of heavy chainlink necklaces and jewelry; different sorts of “legitimizers” of the types of self-stories they wrote for themselves. It was jarring to see such different lifestyles and living conditions being carried out in such relatively short distances from each other. I remember reading statistics a few years ago that income inequality in the U.S. has reached records as high as they were during the Depression, and now I can believe those numbers a little bit more.
Going back to the study cited, it isn’t hard to imagine that the HPAA hormone levels of people in low SES conditions would spike up, considering the constant stress experienced as a daily occurrence correlated to those conditions (low income jobs, bills piling up, high crime rates). What’s more, this creates chronic stress, which is waaay worse than one instance of lab induced artificial stress. Chronic stress, which are basically little stressors experienced daily, chip at us, and keep our bodies in a constant fight-or-flight mode (highly aroused), which causes a slew of health problems, including increased cardiac issues, diabetes, etc.
So where you were born, by pure chance, has a mediating factor in how healthy you are, perhaps for most of your life. This hidden tax on health can be called “Structural Violence,” and it’s constantly punching everyone repeatedly (in the face). And not just the poorest of us, because remember, the relationship found was monotonic. It’s the same all the way down, or up, the SES ladder. Just by being a dollar poorer than Bill Gates, you suffer an intrinsic health handicap, and the inequality rampant in Western society means a poorer society healthwise as well.
Yeah, I know, I must be fun at parties right? Okay let me end on a somewhat positive postulation (I’m still no fun at parties though).
The family friends we visited weren’t the ones who had boats parked in their driveway unfortunately. But they had boatloads of information on the internet, which the kids accessed daily to help with their homework, or just for their own curiosity. They were able to record, edit and upload their own videos (mostly of their cat) to YouTube to share with a community of millions. They could curate their lives visually via photo apps like Instagram. If you think about it, all of these luxuries were not necessarily available to the middle or even upper classes just a decade or two ago.
All of this can be done for relatively very cheap, and helps a lot with stress relief, not to mention self expression, creativity and exposure to ideas outside of what their immediate environment provides. It has certainly democratized content creation. 30 years ago, shooting and distributing a music video was a costly endeavor involving expensive equipment, lots of people, etc. Now you can shoot your music video on an iPhone and upload it to YouTube in an afternoon.
One constant on both sides of the wealth gap seems to be modern technology use, and that seems to be proving the great equalizer. Technology, which is at its most basic tools to extend human capacity, has always made life easier, from the plow, to the light switch, to the transistor, to the internet. It’s already leveling the playing field, and as it gets ever cheaper and more ubiquitous as Moore’s Law, The Law of Accelerating Returns and ephemaralization trends are proving, maybe it’ll finally land the knock out punch to structural violence (in the face… with like, a cool robot fist).