Diseases of affluence are rampant; though we might not live in squalor with tuberculosis, malaria, or other sicknesses prevalent in poverty-stricken circumstances anymore, it does not mean we are free from health issues. Diseases of affluence can often encompass chronic non-communicable diseases (NCDs), such as Type 2 diabetes, asthma, coronary heart disease, alcoholism, gout, mental health conditions like depression, and many more.
Despite access to better resources, the structure of developed countries can also be a hot zone for many illnesses — a sickness of ‘affluenza‘, one might say. Whilst diabetes, gout and coronary heart disease may be linked to sedentary lifestyles perpetuated by corporate jobs and easy accessibility to food, there is another much darker and more sinister affliction that prevails in developed countries.
Status Anxiety
Psychosocial stress, also known as status anxiety, is quite like the plague; it is highly infectious and leaves no one behind. Status anxiety is a universal phenomenon, regardless of your current socioeconomic status. As Alain de Botton, author of Status Anxiety, puts it, “Even Bill Gates will suffer from status anxiety”, and this is because one tends to compare oneself with his peer group. Upward social comparison can often make people feel inadequate about their successes or perceive a lack thereof. Status anxiety occurs when we compare ourselves to others and fear that we are not meeting society’s standards of success, leaving us to feel trapped in our current economic or social status. Feelings of shame or anxiety can often lead to psychological disorders, alienation and distress. This can often lead to many physical symptoms of anxiety and social isolation.
A person’s rank in society can often significantly impact their health. Individuals who have a lower position in the social hierarchy often report worse health outcomes, regardless of their incomes. This phenomenon can be explained by a theory that societal inequalities create stressful environments for individuals that can often lead to worse physical as well as mental outcomes, which subsequently often have massively adverse outcomes. Some of these include an altered hypothalamic-pituitary-adrenal (HPA) axis function and chronically elevated cortisol levels, which may result in neural atrophy, cardiovascular damage, obesity or immunosuppression.
An individual who has lost the status competition can show signs of submissiveness and learned helplessness, often associated with depression in humans and other primates. Social stresses like these are also associated with increased inflammation and blunted immunological responses to cortisol, which can result in a compromised immune system, autoimmune diseases, cardiovascular diseases, and gastrointestinal disorders. This may explain the occurrences of hypertension, cardiovascular diseases, rampant depression and the prevalence of irritable bowel syndrome even in high-income countries — a response to the stress and negative health consequences from the perpetual status striving of socio-economic hierarchies.
Consequences of Psychosocial Stress
This endemic status anxiety can also lead to excessive consumerism, so much so that it breaks the bank and pulls in victims to predatory marketing schemes, consumer debt, overwork, “psychological disorders, alienation and distress”. This can then cause individuals to self-medicate with mood-altering pharmaceuticals, ranging from psychedelics to harder drugs, and invite excessive alcohol consumption, which is also highly detrimental to one’s health. It may also give way to many behavioural social ills and self-destructive behaviours due to addiction. Studies have shown that adults experiencing gambling-related harms live in areas of more significant deprivation, are unemployed, and have lower incomes. For example, in Australia, the more significant the socioeconomic disadvantage of a municipality, the higher its number of gambling opportunities (e.g. gaming machines), with statistics showing that people living in areas of high deprivation spend close to twice as much as the state’s mean expenditure on slot machines. Individuals who feel relatively deprived have more severe gambling problems and engage in more excellent risk-taking behaviours, as inequality facilitates the perception of need in that they are very far away from what one would call a “marketed” or “attainable” lifestyle.
When a perception of upward economic mobility via conventional means is low, this relative deprivation may be accompanied by feelings of anger and resentment, which can then encourage maladaptive behaviours to advance their financial position, much like the aforementioned disordered gambling. Under the eye of natural selection, outcompeting others for mates, resources, status, and other evolutionary relevant resources is often of utmost importance. And now that our society is structured in a capitalistic manner, wealth is often an indicator of success, with the lower classes, or those who perceive themselves as relatively deprived, willing to sacrifice their health to climb up the social ladder or risk the inadvertent consequences of status anxiety.
All in all, the development of a nation does not mean that it is automatically free of all ills. As British psychologist Oliver James asserted, “The greater the inequality of a nation, the greater the unhappiness of its citizens.” — a statement reflected in the presence of poor health amid affluence.
Consumerism isn’t always positive.
