Status Syndrome questions
Please complete, with concise, typed responses, and submit for homework next week.
1) Define the Status Syndrome in one sentence.
2) What is the Whitehall study and why were the findings important to understanding the full range of the status gradient in health?
3) What does Marmot mean when he says that the Whitehall participants were “…far from representing an atypical postimperial backwater” and why might this be important when examining health inequalities in the U.S.?
4) What are two conventional explanations Marmot mentions for the status differential in non-communicable diseases and what does he say about their explanatory power?
5) What are the two fundamental human needs which Marmot suggests are differentially accessible according to one’s place in the social hierarchy and how are these connected physiologically with increased disease risk. For the physiological explanation, draw both on the initial discussion and his more detailed discussion on the last page of the article.
6) Marmot refers to Murray et al’s examination of a 12 mile Metro ride from downtown DC to Montgomery County. What did this Metro ride show?
7) How do the traditional and current causes of premature death in black men compare and what does this change suggest for health policy and public health initiatives?
8) Access to health care is usually cited as a primary reason for heath differences by class in the U.S., which is the only rich country without universal health care. Based on what the
Whitehall study shows and on Marmot’s argument, can we expect that the increased access afforded by the ACA (Affordable Care Act) will significantly reduce the status gradient in health once there is time to see its full effects?
9) If one controls (holds constant) for risk factors such as smoking, cholesterol, blood pressure, etc., what happens to the health gradient in CHD (Coronary Heart Disease)?
How do primate studies add to our knowledge of the impact of risk factors in the status syndrome?
10)
If autonomy and participation are associated with one’s place in the social hierarchy, what is a concrete example of how less of these can increase disease risk? You can just make up an example.
11) How does the U.S. compare to other countries, such as Sweden, in terms of the steepness of our health gradient and what does this suggest in terms of public health goals?
12) What does Marmot propose as a way to reduce the effects of the status syndrome?