For monkeys and humans alike, social status alters the body

Researchers are building a case that being stuck at the bottom of the social pecking order can be hazardous to your health. While popular belief holds that poorer, less-educated people have higher rates of diabetes and heart disease because they take worse care of themselves, some studies, including one published last month in Science, suggest that low status can have a direct, toxic effect on physical well-being.

“There’s something about the mere experience of being high versus low on the social totem pole that changes the way our bodies work,” said Steven Cole, a neuro-immunologist at UCLA who was not part of this latest study. This counterintuitive finding could transform the medical community’s understanding of why some people get sick, and what to do about it.

The idea may sound fantastical — how on Earth could social status change people’s internal body chemistry? But consider that in orangutans, only males with the potential for high status develop to full sexual maturity, while underlings remain in perpetual adolescence. In some fish, status changes trigger a sex change. For female blue-headed wrasses, reaching the top of the social ladder will trigger hormonal changes that turn them into males. Among male clownfish, getting to the top will transform a new king into the queen.

Regarding the human animal, the seminal study connecting status and health followed British civil servants starting in 1967, and revealed that lower-ranked workers were at higher risk for heart disease and overall mortality. Since Britain had socialized medicine, everyone had access to the same quality and quantity of medical care.

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“Social adversity has a really powerful predictive effect on health-related outcomes,” said Duke University anthropologist Jenny Tung, lead author on the new study in Science. And perhaps surprisingly, animal studies offer unique insight into social adversity. You can’t blame smoking or junk food for health disparities in lab monkeys, but you can blame status differences. And to tease out cause and effect, researchers can manipulate animals’ status and observe the results.

Consider rhesus macaques. These monkeys sort themselves into a hierarchy whether they’re in the wild or in captivity. But when the top monkey of one cage is put in with strangers, she is forced to assume lower rank, and lower-rank females from her old cage can rise up a rung. (When confronted with this situation, males are more prone to try and claw each other to shreds.)

In Tung’s experiment, done in collaboration with University of Montreal and Emory University, researchers moved female rhesus macaques from one group enclosure to another and then back again. They then took blood samples from the monkeys, isolated their immune cells, and introduced viruses or bacteria to see how they reacted.

Their conclusion: Lowering the monkeys’ status triggered a stronger inflammatory response — good for killing bacteria, but bad for long-term health. Raising their status tamped down the inflammatory response and beefed up killer cells — a kind of white blood cell that fights viruses.

Steven Cole, the neuro-immunologist, said this makes evolutionary sense: High-status animals get more grooming, rendering them more vulnerable to whatever viruses are going around. The low-status monkeys tend to be physically attacked, and this makes them more likely to have wounds that can fill with bacteria.

“Our bodies mortgage the long-term future” when threatened, Cole said. Inflammation can help the body fight infection, but it produces collateral damage. The social factors triggered changes in the way the monkeys’ bodies responded to hormones called glucocorticoids, which are associated with stress. The researchers also discovered that lowered status changed the activity of more than 1,000 genes. Though people tend to think of genes as immutable, many environmental factors can alter the way genes are either activated or suppressed.

Researchers can’t rule out the possibility that the healthiest monkeys in this experiment simply had better genes from the outset. But what gives the study such power is that the researchers uncovered changes in stress hormones, gene activation and immune cells, and showed that the status effect reversed when the monkeys returned to their original social orders.

That’s not necessarily good news if it applies to humans, because it’s hard for us to escape our cages. Cole and Tung agreed that the worst situation is being bullied at work. Once you get shoved to the bottom, others can accrue bits of social value by kicking you. Cole calls this a toxic death spiral.

Walking away has its own risks. Cole’s research has shown that loneliness can also be hazardous. He doesn’t measure this by the amount of time spent alone, but with questions about whether people felt they have any true friends or allies. What matters isn’t how you behave around other people, but how they behave toward you.

Is there any hope? Cole points to one solution: Studies show that people who find personal meaning by getting involved in something bigger than themselves — say, by becoming engaged in social and political movements — not only feel better but look healthier, right down to the molecular level.

It’s hard to hear such a statement today and not consider those Trump rallies. All kinds of people supported Trump, but many were from the lower end of the socioeconomic scale. Trump’s policies may do nothing to help those people get better access to doctors, but by rallying around something — and sticking it to the higher-status humans — they may end up less likely to need one.

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