Danny Kahneman, a psychologist, won the Nobel Prize in economic sciences for showing that the economics' emperor had no clothes. A basic tenet of neo-classical economics is that people make rational decisions to maximize their utility. Kahneman and Tversky showed that the outcome of so-called rational appraisal of information could be easily manipulated. It is hard to argue that people are making rational appraisals of the best option, if the outcome of that appraisal can be changed simply by presenting the information in a different way.
Kahneman has now turned his attention to the second part of the tenet—maximizing utility. It is common to look at how people behave and assume that the choices they make are in their best interest—they maximize utility. The reasoning is somewhat circular: we know people are maximizing utility, or they would not take the decisions they do. Kahneman wishes to break into this circular reasoning and reclaim the concept of utility, to make it a measure of human well-being—happiness.1 A prominent economist, Richard Layard, has reached a similar conclusion.2 Impact on happiness, argues Layard, should be the main way we evaluate social policies.
The argument that subjective well-being should be the measure of whether economic and social policies are delivering on their promises leads to an interesting finding: the Easterlin paradox.3 In many countries, the USA and Japan prominent among them, the rise in Gross National Product (GNP) in the last three decades has led to no change in the level of happiness. If consumption equates to well-being, then increased national income should mean well-being has increased. If reported happiness is the arbiter, we have to ask why things have not improved. Layard's answer is that the improvements brought by economic growth have been offset by a variety of social problems.4
Alain de Botton has a related but somewhat different answer—status anxiety. In his new book, Status Anxiety he argues:
Material conditions have improved for everyone (in the rich countries) but concerns about inequality in status have not. He might have been talking about health inequalities. Some of us have reached the view that relative position linked to status is of profound importance for health.5 There is, therefore, much relevance for health as well as interest in de Botton's charming book (Don't look for references or data—there are none—but there is a detailed argument supported by gleanings from philosophers through the ages, snippets of history, and an array of photographs ranging from Nixon and Kruschev in Moscow, to the engravings of the Bon Marche department store in 1860, medieval drawings, architecture, to the bohemians disporting themselves in a 1937 version of the Dejeuner sur l'Herbe). There are similarities between the thesis of relative position and health, and that of Status Anxiety, but also differences. Both warrant further study.
The advantage of two thousand years of Western civilization are familiar enough: an extraordinary increase in wealth, in food supply, in scientific knowledge, in consumer goods, in physical security, in life expectancy and economic opportunity … such impressive material advances may have gone hand in hand with … a rise in levels of concern about importance, achievement and income. A sharp decline in actual deprivation may—paradoxically—have been accompanied by a continuing and even increased sense of deprivation and a fear of it. (p.45)
Why do we have status distinctions? De Botton's answer is that status comes out of a fundamental need to be loved:
Readers of this journal may not be very used to finding discussions of love in its pages, sex perhaps, but not love. But for de Botton love is central. Elaborating on his thesis, he says that the impact of low status should not be read in material terms alone. The penalty of being low status is 'in the challenge low status poses to a sense of self-respect.' This is similar to the argument elaborated by Richard Sennett.6
Once food and shelter have been secured, the predominant impulse behind our desire to succeed in the social hierarchy may lie not so much with the goods we can accrue or the power we can wield, as with the amount of love we stand to receive as a consequence of high status. Money, fame and influence may be valued more as tokens of—and as means to—love rather than as ends in themselves.
De Botton's argument is that material well-being has brought with it expectations. William James, the father of American psychology, at Harvard at the end of the 19th century, proposed that self-esteem = success/pretensions. Increased wealth has brought with it increased pretensions, not always matched by success at meeting those pretensions. Hence a decline in actual deprivation has not necessarily led to a decline in perceived deprivation. But why should there be an increase?
De Botton's answer: it was not always thus—low status was not always accompanied by frustrated pretensions. Greek and Roman society endorsed Aristotle's statement that: ‘It is clear that some men are by nature free and others are by nature slaves, and that for these latter, slavery is both expedient and right’. De Botton suggests that the notion that inequality was fair or at least irrevocable was often shared by the oppressed themselves. If they had no expectations of achieving more, there was not the lack of self-respect in failing to achieve it.
Coming to the 18th century, Rousseau argued that wealth does not consist in having many things, it consists in having what we long for. This suggests two ways to make people more successful, give them more money or restrain their desires—hence the noble savage. Modern society has been spectacularly successful in the former, giving people more, but has only served to inflame their desires. Status anxiety comes, therefore, not so much from the existence of status but from its consequences for individual perceptions.
In early Christian society, there were three stories that comforted the poor: the poor contributed more to society; there was no moral worth attached to social position; and the rich got where they did by robbing the poor. As a result of such ‘comfort’ being poor was not accompanied by status anxiety.
With the industrial revolution, there were three new stories that made life at the bottom less comfortable. First, Adam Smith, great 18th Century economist and philosopher, argued that the wealthy contributed more to society; it is not simply that they take a larger slice of the economic pie, by their efforts they enlarge the pie. By such efforts they are more worthy.
Second, with the rise of the meritocracy, status came to have moral connotations: if you were successful, you must have been worth it. In the 19th century, Thomas Carlyle wanted not a world where everyone was financially equal, but one in which both elite and poor would merit their inequalities. Meritocracy may have had the benefit of replacing hereditary privilege. The downside was the effect on those left behind. Meritocracy rewards natural endowments and consequent success. Low status came to seem not merely regrettable but also deserved.
Third, Social Darwinism in the 19th century deemed the poor to be sinful and corrupt and to owe their poverty to their stupidity. It is not a great leap from there to assume that those who don't make it must be genetically, or in other ways, inferior. As Condorcet said, this line of thinking ‘makes Nature herself an accomplice in the crime of political inequality.’
Whereas in the past status related to birth, the achievement of modern society is to make status depend on achievement, which in the modern market place commonly means financial success. This, in turn, means that ‘anxiety is the handmaiden of contemporary ambition because livelihoods and esteem depend on at least five unpredictable elements’: fickle talent, luck, an employer, the success of that employer, and the global economy. To the degree that success is out of control of the individual, dependent on other forces, ambition to achieve it engenders anxiety.
De Botton's solutions are not of the noble savage type as are those of Rousseau. They range from the uses of philosophy, religious thinking, art, and rejecting bourgeois values as the bohemians of the early 20th century did, to politics.
Reading de Botton's account of status and its consequences raises three questions in my mind: why should there be status differentials in society; the parallels and differences between findings on health and subjective well-being; and the degree to which status anxiety provides clues to the explanations for inequalities in health connected to status.
Why should there be status distinctions in society? De Botton's account has to do with love. A different account has to do with sex. This is the basis of the version I give in Status Syndrome, from a reading of evolutionary psychology. Essentially it argues that we were evolved to be modern humans more than 100 000 years ago as hunter-gatherers. Evolution determined not only anatomy and physiology, but predispositions of the mind.7 There may be a built-in motivation to seek status. The argument is that males seek status in order to have privileged access to resources, above all, females. As a result of this striving for status, hierarchies emerge. The hierarchy is a by-product of the motivation for status.
In species where successful males have multiple partners, there will be competition for females. Some males will miss out altogether, and their genes are consigned to oblivion. Other males will mate successfully with several females—their genes will be more numerous in the next generation. A genetic predisposition for characteristics that led to successful mating will flourish in the next generation. This is sexual selection.8 Status will be a characteristic linked to mating success for two reasons: fighting off other males and appealing to female choosiness.
Fighting off other males seems straightforward. If we were bull seals, the characteristic that would get all the females would be bulk, sheer size. The biggest male would beat all the other males and protect his harem. We aren't bull seals, although our species is no stranger to fighting off the competition. But one characteristic of humans is that children need nurturing for a long time before they achieve independence. Having a man around to contribute resources and, even, to share in child rearing is helpful. Males who are high in status will not only beat off other males, they are likely to have more resources to contribute to the union with a female and the children that are the products of that union. Females will, it is suggested, therefore favour males of status who appear willing to contribute resources to their offspring. This combination of female choosiness and male status and access to resources is a combination that is likely to increase reproductive success. Both characteristics, female choosiness and male drive for status, will have been passed on to us the descendents of these hunter-gatherer ancestors.
Evolutionists give a good account of why human males should have a drive for status that leads to stratification in society. One of the consequences of this stratification is the social gradient in health. But women, too, show a social gradient in health, how does evolution account for social gradients in women?
In some primate species, baboons and macaques, there are also clear social hierarchies in females, and health follows the hierarchy.9 However, given the role of status competition in human males in producing hierarchies one would expect hierarchies to be less obvious in human females—at least in the hunter-gatherer state for which we were evolved. Women do not have the same motivation for social dominance as men. David Buss suggests that women express their dominance in different ways. Men tend to express their dominance as superiority over others; women through actions that are more orientated to the success of the group.10 Where females competed for male attention one would predict that certain traits would become selected for, but these are more likely to be related to signals of reproductive fitness than status per se.
I come back, then, to the fundamental question that this evolutionary account raises: if status hierarchies arose from male competition for resources, why should women show a social gradient in health, as men do? My answer to the question about women is actually fundamental to the understanding of why there should be a gradient in health in men as well as in women. The answer is in two parts. First the mere existence of hierarchies does not, itself, produce the health gradient. The health gradient arises because of what position in the hierarchy implies in a given society. If resources are unevenly distributed the social gradient in health will be steeper than if they are more equitably allocated. This leads to the second part of the answer. Remember the rather obvious point that we were evolved to be hunter-gatherers. For 2 million years, there were few material goods; the consequences of hierarchies for people were quite different then from what they are today, in modern urban society. The hierarchies in wealth, social resources, and access to societal goods that we see around us are far greater than they would have been for our ancestors living on the Savannah. These hierarchies in access to resources, including the possibility to lead a flourishing life will affect women as well as men. Men may have created the hierarchies in society, but women suffer their consequences as well as men. Women are, so to speak, caught in the slipstream of male hierarchies. Women, therefore, will show a social gradient in health as men do.
Following Amartya Sen, I have argued that health is a good measure of the success of a society.11 Layard makes a similar claim for happiness.2 Are findings on health and subjective well-being interchangeable? I should add that I am using health loosely here. Most international studies, or those of time trends, rely on mortality or life expectancy. One clear difference between health and happiness relates to time trends. The Easterlin paradox arises precisely because happiness did not improve at a time when GNP per capita was growing; but life expectancy did. Another difference relates to international comparisons. Table 1 shows life expectancy and self-reported happiness for a few rich countries. The French are just plain miserable compared with Americans, the Japanese even more so. If happiness were to be the arbiter we could conclude that the US was a more successful society than Japan. Yet life expectancy is 4.4 years longer in Japan than in the US. It may be that what survey respondents tell researchers does not reflect how happy they are: the Japanese and French really are happy, but surveys don't pick it up. The Americans aren't really happy, they just feel it is the right thing to say. Possibly, but before we concluded that health and happiness were tapping into the same process, we would need better evidence.
Life expectancy, GDP (gross domestic product in US dollars at purchasing power parities) in 2001 and life satisfaction
|Life expectancy at birth||GDP per person||Life satisfaction|
|Life expectancy at birth||GDP per person||Life satisfaction|
The similarity between research on health and on happiness relates to the importance of relative position. Frank reports that surveys within a country show consistently that people of higher income have higher levels of subjective well-being than those of lower income. This contrasts sharply with the lack of improvement in national levels of happiness with improvements in national income. Frank relates the within-country findings to status, i.e. to relative position.12 It is possible to reach similar conclusions from Table 1. Among these rich countries, there is simply no clear relationship between level of income and life expectancy. For example, Spain has a national income at purchasing power parities of $20 150 compared with $34 000 in the USA, but life expectancy is 2.2 years longer in Spain. Within the US, however, studies that relate household income of individuals to mortality show that people with an income of $20 000 have about twice the mortality risk of those with $34 000.13 In both cases, subjective well-being and health, the explanation is likely to be that it is relative position that is important.
But why is relative position important? De Botton's answer is because of the need to be loved and the consequent anxiety of failing to meet that need. Indeed, some of the criticism of conclusions about relative position and health has assumed that it is deficient precisely because it is only about envy and anxiety associated with being low status. That is not my view.5
Amartya Sen suggests that we should give consideration to the ‘space’ (dimension) within which we measure inequality. In his scheme the primary space of interest should be capabilities—not so much what a person has but what he or she is able to do. He says: ‘Relative deprivation in the space of incomes can yield absolute deprivation in the space of capabilities’.14 Relative position may be important for well-being because it induces anxiety in those lower in the hierarchy. The importance of relative position for health is that it deprives people of fundamental human needs; autonomy and opportunities for full social participation.15
In making the case that material goods are important beyond the satisfaction of basic needs, both de Botton and I quote the famous excerpt from Adam Smith:
De Botton argues that relative position is important because it deprives people of well-being—it induces anxiety. I argue that relative position is important for health because it relates to degrees of autonomy and ability to take your place in public without shame, to become a full social participant which is related both to the protective effects of social networks and self-esteem and the respect of others.
By necessaries I understand not only the commodities which are indispensably necessary for the support of life, but what ever the customs of the country renders it indecent for creditable people in the lowest order to be without. A linen shirt, for example, is, strictly speaking, not a necessary of life. The Greeks and Romans lived, I suppose, very comfortably though they had no linen. But in the present times, through the greater part of Europe, a creditable day-labourer would be ashamed to appear in public without a linen shirt, the want of which would be supposed to denote that disgraceful degree of poverty which, it is presumed, nobody can well fall into without extreme bad conduct. Custom, in the same manner, has rendered leather shoes a necessary of life in England. The poorest creditable person of either sex would be ashamed to appear in public without them.
If relative ranking in a hierarchy were always important for health, simply because of the existence of rankings, there could be little we could do about health inequalities, as all societies have hierarchies. De Botton concludes that status would not be related to anxiety if we conducted our affairs differently. I conclude that the importance of relative social position is the degree to which it leads to an absolute change in degree of capabilities—control over life and opportunities for social participation—and there is, therefore, much that can be done. The solutions will be political, economic, and social, and will entail interventions throughout the life course from early child development to old age.
The Public Interest
2000, pp. 278–89.
The Econ J
Am J Public Health
Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2005; all rights reserved.
Two Men Meet, Each Believing the Other to be of Higher Rank.
Paul Klee, 1903—Kunstmuseum, Bern, Switzerland
© DACS 2005.
Two Men Meet, Each Believing the Other to be of Higher Rank.
Paul Klee, 1903—Kunstmuseum, Bern, Switzerland
© DACS 2005.
Anyone who’s ever lost sleep over an unreturned phone call or the neighbor’s Lexus had better read Alain de Botton’s irresistibly clear-headed new book, immediately. For in its pages, a master explicator of our civilization and its discontents turns his attention to the insatiable quest for status, a quest that has less to do with material comfort than with love. To demonsAnyone who’s ever lost sleep over an unreturned phone call or the neighbor’s Lexus had better read Alain de Botton’s irresistibly clear-headed new book, immediately. For in its pages, a master explicator of our civilization and its discontents turns his attention to the insatiable quest for status, a quest that has less to do with material comfort than with love. To demonstrate his thesis, de Botton ranges through Western history and thought from St. Augustine to Andrew Carnegie and Machiavelli to Anthony Robbins.
Whether it’s assessing the class-consciousness of Christianity or the convulsions of consumer capitalism, dueling or home-furnishing, Status Anxiety is infallibly entertaining. And when it examines the virtues of informed misanthropy, art appreciation, or walking a lobster on a leash, it is not only wise but helpful....more
Paperback, 306 pages
Published May 10th 2005 by Vintage (first published January 1st 2004)