Do wealth and inequality associate with health in a small-scale subsistence society?
- University of Zurich, Switzerland
- Washington State University, United States
- University of Richmond, United States
- Arizona State University, United States
- Universite Toulouse 1 Capitole, France
- University of California, Santa Barbara, United States
- Max Planck Institute for Evolutionary Anthropology, Germany
- University of New Mexico, United States
- Chapman University, United States
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
Jonathan Stieglitz
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.
Reviewing Editor
- Milagros Ruiz
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.
Version history
- Received: May 29, 2020
- Accepted: May 10, 2021
- Accepted Manuscript published: May 14, 2021 (version 1)
- Version of Record published: June 24, 2021 (version 2)
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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Do wealth and inequality associate with health in a small-scale subsistence society?
eLife 10:e59437.
https://doi.org/10.7554/eLife.59437
Further reading
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- Cancer Biology
- Epidemiology and Global Health
Background:
Age is the most important risk factor for cancer, but aging rates are heterogeneous across individuals. We explored a new measure of aging-Phenotypic Age (PhenoAge)-in the risk prediction of site-specific and overall cancer.
Methods:
Using Cox regression models, we examined the association of Phenotypic Age Acceleration (PhenoAgeAccel) with cancer incidence by genetic risk group among 374,463 participants from the UK Biobank. We generated PhenoAge using chronological age and nine biomarkers, PhenoAgeAccel after subtracting the effect of chronological age by regression residual, and an incidence-weighted overall cancer polygenic risk score (CPRS) based on 20 cancer site-specific polygenic risk scores (PRSs).
Results:
Compared with biologically younger participants, those older had a significantly higher risk of overall cancer, with hazard ratios (HRs) of 1.22 (95% confidence interval, 1.18–1.27) in men, and 1.26 (1.22–1.31) in women, respectively. A joint effect of genetic risk and PhenoAgeAccel was observed on overall cancer risk, with HRs of 2.29 (2.10–2.51) for men and 1.94 (1.78–2.11) for women with high genetic risk and older PhenoAge compared with those with low genetic risk and younger PhenoAge. PhenoAgeAccel was negatively associated with the number of healthy lifestyle factors (Beta = –1.01 in men, p<0.001; Beta = –0.98 in women, p<0.001).
Conclusions:
Within and across genetic risk groups, older PhenoAge was consistently related to an increased risk of incident cancer with adjustment for chronological age and the aging process could be retarded by adherence to a healthy lifestyle.
Funding:
This work was supported by the National Natural Science Foundation of China (82230110, 82125033, 82388102 to GJ; 82273714 to MZ); and the Excellent Youth Foundation of Jiangsu Province (BK20220100 to MZ).
