Michael Marmot, professor of epidemiology at University College London, cites research on groups as diverse as baboons in captivity, British civil servants and Oscar nominees, to show the higher rates of ill health among those in more modest walks of life can be attributed to what he calls the “status syndrome”. People in privileged positions think they are worth the effort of behaving healthily, and find the will-power to do so. More directly, higher status itself protects people’s health, he argues, not just by reducing their propensity to behave riskily, but also by changing their body chemistry in ways that protect them against disease.
The implication is that it is easier to improve a person’s health by weakening the connection between social position and health than by targeting behaviour directly. Some public-health experts talk of changing an environment where the worst choices are the easiest to make, especially for those without the time and money to seek out better ones-supermarkets crammed with ready meals, happy hours in pubs, roads too dangerous for children to walk to school.
Others speak of social cohesion, support for families and better education for all. These are bigger undertakings than a bossy ad campaign; but more effective, and quieter.