Human beings value social status over anything else. Why? It’s good for your health.

Achieving and maintaining social status is the driving force of human behavior, hard-wired into the structure of our brain and endocrine systems, and honed by millions of years of evolutionary fine-tuning.

Social status doesn’t necessarily refer to the drive to become the top banana –  it basically means a sense of confidence and safety in one’s place in the social hierarchy and the expectation of social support that goes along with that place.

Attaching importance to social standing is an essential part of being human. Above all else, we can only thrive within a community. Sheer survival depends on a village – very few people would last more than a few days alone in the wild.   We are utterly dependent on others. And because of that, our emotional and neurological wiring ensures that we place a high value on social interaction.

This makes evolutionary sense. Once a group of primates began cooperating in hunting, food gathering, food sharing, control over territory, grooming, alertness to predators, and other matters, that group easily out-competed other groups or solo individuals. Thus, once pro-social behavior emerged, evolutionary forces inevitably led to greater and greater levels of cooperation. Humans are a supreme example of this tendency.

Here are some other indications of the significance we place on social support:

• Prisoners in solitary confinement experience emotional and cognitive problems – solitary confinement literally drives them crazy.
• When scientists create rodent models of mental illness or chronic depression, a tested method is to raise a baby mouse in social isolation.
• Infant monkeys will bond to a surrogate mother that provides coziness (a terry cloth-wrapped wire frame) more than to a surrogate mother providing calories.
• Our visual system devotes a lot of brain real estate to recognizing the emotional significance of subtle shifts in facial expression; our auditory system, likewise, pays exquisite attention to the aspects of speech (pitch, inflection, phrasing) that convey the emotional and social content of the message.
• Baboons are keenly aware of social structures. For instance, baboons will pay more attention to vocalizations being emitted from a neighboring troop of baboons when those vocalizations communicate a switch in the social status within the neighboring group, even though this very fascinating switch in social status has no bearing on the social hierarchy established in the baboons’ local troop.

The experience of stress and its inverse, social support, play a huge role in health. Integral to a stress response is a hormonal shift that causes internal behaviors to focus on mobilizing body energy for vigilance and action, de-emphasizing digestion, absorption, recuperation and tissue rebuilding. Those who experience an unremitting stress response literally wear their body out faster.

Here’s a chart derived from data in the UK about the relationship of socioeconomic status to health and longevity.

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This chart compares different neighborhoods in Great Britain. In a neighborhood with residents on the lower end of the socioeconomic scale (a 5^th percentile neighborhood), residents can expect an average of 55 years of disability-free living (and a total life expectancy of about 74 years.)

As you can see, both disability-free life and total life expectancy rise consistently as a neighborhood’s socioeconomic status rises. And there’s an even bigger spread in the social toll of low status between high- and low-status individuals as compared to the aggregate effects in neighborhoods as a whole.

About 40-60% of the health gap in poor neighborhoods can be blamed on low quality nutrition, exposure to more pollutants, and lack of access to medical care. But an equal fraction is due directly to lower socioeconomic status by itself, and the higher stress and lack of social support that goes along with it.

Social support plays a significant role in health care. That’s why in my practice I’m guided by these three goals:

• To answer your phone calls and e-mails personally. Because you’re important.
• To see my patients promptly at the time the appointment is scheduled. Because your time is important.
• To use a heavy dose of touch in my treatment, applying it with sensitivity. Because caring touch is one of the strongest communicators of social support.

These elements of health care are not mere peripheral add-ons to the provision of the “substantive,” i.e. “technological” health care procedure. Basic human caring and support is the central and most effective aspect of health care.

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