Do wealth and inequality associate with health in a small-scale subsistence society?
Abstract
In high-income countries, one's relative socio-economic position and economic inequality may affect health and well-being, arguably via psychosocial stress. We tested this in a small-scale subsistence society, the Tsimane, by associating relative household wealth (n=871) and community-level wealth inequality (n=40, Gini = 0.15 – 0.53) with a range of psychological variables, stressors, and health outcomes (depressive symptoms [n=670], social conflicts [n=401], non-social problems [n=398], social support [n=399], cortisol [n=811], BMI [n=9926], blood pressure [n=3195], self-rated health [n=2523], morbidities [n=1542]) controlling for community-average wealth, age, sex, household size, community size, and distance to markets. Wealthier people largely had better outcomes while inequality associated with more respiratory disease, a leading cause of mortality. Greater inequality and lower wealth were associated with higher blood pressure. Psychosocial factors didn't mediate wealth-health associations. Thus, relative socio-economic position and inequality may affect health across diverse societies, though this is likely exacerbated in high-income countries.
Data availability
All data and R code are available at https://doi.org/10.5281/zenodo.4567498 with any updates at https://github.com/adblackwell/wealthinequality
Article and author information
Author details
Funding
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (PBZHP3-133443)
- Adrian V Jaeggi
National Science Foundation (BCS0136274)
- Hillard Kaplan
National Science Foundation (BCS0422690)
- Michael D Gurven
National Institutes of Health (R01AG024119)
- Hillard Kaplan
- Michael D Gurven
National Institutes of Health (RF1AG054442)
- Hillard Kaplan
- Michael D Gurven
National Institutes of Health (R56AG024119)
- Hillard Kaplan
- Michael D Gurven
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Human subjects: Institutional Review Board approval was granted by UNM (HRRC # 07-157) and UCSB (# 3-16- 0766), as was informed consent at three levels: (1) Tsimane government that oversees research projects, (2) village leaders and community meetings, and (3) study participants.
Copyright
© 2021, Jaeggi et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Funding: Supported by the Brazilian Ministry of Health and the Brazilian National Research Council.
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