The status syndrome

Michael Marmot’s research should be an alarm call to our societies. I deeply recommend his 2005 book “The Status Syndrome” (, which brings together a wealth of research showing the devastating effects of lack of control over one´s life and lack of social participation on health (several diseases, including cancer and especially cardiovascular disease) and longevity. Marmot’s work is revolutionary in showing that the problem is broader than simple categorization of poor/rich people and their health differences. He shows clearly that there is a health gradient in population no matter the society and, after taking into account the usual causal suspects (smoking, for instance), the great culprit is the way societies are structured to channel or to mute basic human needs like control (autonomy).
The research and the book have deep implications for social marketing. The central thesis reminds me of the social marketing metaphor of the (downstream) drowning people and their initial behavior at the (upstream) river.
It has also profound implications for work and the way it is structured. Control (or lack of) one has in work is a strong causal agent in the process described by Marmot: lack of control activates the stress mechanisms that are behind the progress of cardiovascular and other diseases. Nobody can develop her capabilities in life while feeling like a pawn on a daily basis.