Life & Death on the Social Ladder HELEN EPSTEIN July 16, 1998 BOOKS DISCUSSED IN THIS ARTICLE Unhealthy Societies: The Afflictions of Inequality by Richard G. Wilkinson 255 pages, $75.00 (hardcover), $20.99 (paperback) published by Routledge Healthy Work: Stress, Productivity, and the Reconstruction of Working Life by Robert Karasek and Töres Theorell 381 pages, $16.00 (paperback) published by Basic Books Why Zebras Don't Get Ulcers: A Guide to Stress, Stress-Related Diseases, and Coping by Robert M. Sapolsky 368 pages, $14.95 (paperback) published by W.H. Freeman The Power of Clan: The Influence of Human Relationships on Heart Disease by Stewart Wolf and John G. Bruhn 192 pages, $21.95 (paperback) published by Transaction Last October I went for a walk in Sighthill Cemetery on the outskirts of Glasgow. Glasgow is a gloomy Victorian city of silent monuments in green squares and heavy stone buildings with streaks of damp trailing from their windows like tears. It was a time of year when one is very aware of Scotland's winter darkness closing in. Even at mid-day, in bright sunshine, a reddish haze hung in the air around the weathered, lichen-stained graves. The oldest burials at Sighthill date from the 1840s, when it was surrounded by open hilly countryside. Today this grassy slope with its obelisks and pillars and swaying trees lies on the edge of one of the city's main eastbound arterial roads. It is surrounded by derelict industrial sites and overlooks the gray tower blocks, barbed wire, and broken glass of the Sighthill housing project. Built in the 1960s as an experiment in social housing for the working class, the Sighthill estate is now, like similar projects in New York or Chicago, a ghetto for the socially excluded. On the ground floor of the buildings are the boarded-up premises of shops that closed long ago. Thousands of people live in these buildings, but when I was there the streets were nearly deserted. Paper trash blew here and there; a stray dog rummaged in a pile of garbage in the central courtyard. A heavyset woman in a pink tracksuit, ponytail swinging down her back, pushed a stroller with a tiny child inside. For many of the children growing up here, Sighthill graveyard will be the only countryside they will ever know. The Industrial Revolution sprang from northern towns like this, but the slow decline of manufacturing in Britain left a long shadow on the region. Most of Britain's old northern industrial cities, such as Manchester, Sheffield, Leeds, and Liverpool, have high-rise slums like Sighthill, where as many as a third of workers may be unemployed, and two thirds of children leave school without passing their final exams. However, nothing about these places is so alarming as their death rates. Life expectancy in places like Sighthill can be as much as ten years less than it is in well-to-do neighborhoods in the southern shires, such as Hampshire, Essex, and Hertfordshire. If Britain were divided into two nations, one containing the richer regions and the other the poorer ones, there would be nearly 80,000 more deaths every year in the poorer nation, equivalent to twice the number of deaths from lung cancer. This is what epidemiologists would ordinarily call a plague, and it is killing more people in Britain every year than AIDS ever has. Yet we barely even know it is there. The difficulty in recognizing this hidden epidemic is partly due to the protean nature of the afflictions of poverty in modern industrialized countries like Britain. Compared to the rich, the poor in Britain are more prone to about eighty different causes of death, including stroke, diabetes, heart disease, cancers of the lung, bowel, and stomach, emphysema, and asthma, as well as infant death, accidents, and mental illnesses such as depression and senile dementia. I had come to Glasgow to visit Sally Macintyre, a social scientist who has studied health in Scotland for twenty years. She is part of a growing number of people who are concerned about early death among the poor in industrialized countries, where obvious health hazards such as inadequate sanitation, malnutrition, and infectious diseases, which kill millions in the developing world, are relatively unimportant. Unlike such traditional diseases of poverty as malaria and cholera, which can kill in days, Macintyre sees the poverty of the industrialized world as a sort of chronic disease that slowly eats away at the body throughout life. As we sat in Macintyre's office, she told me how she thought people age, as though they are obeying the signals of an internal, biological clock that seems to run much faster for the urban poor. (The full article is on the NY Review of Books webpage at: http://www.nybooks.com/nyrev/index.html) Louis Proyect (http://www.panix.com/~lnp3/marxism.html)
