The Spirit Level: Why Greater Equality Makes Societies Stronger by Richard Wilkinson, Kate Pickett

is largely based on others’ perception of one’s worth’ (p. 357).
    A quite separate strand of health research corroborates and fills out this picture. One of the most important recent developments in our understanding of the factors exerting a major influence on health in rich countries has been the recognition of the importance of psychological stress. We will outline in Chapter 6 how frequent and/or prolonged stress affects the body, influencing many physiological systems, including the immune and cardiovascular systems. But what matters to us in this chapter is that the most powerful sources of stress affecting health seem to fall into three intensely social categories: low social status, lack of friends, and stress in early life. All have been shown, in many well-controlled studies, to be seriously detrimental to health and longevity.
    Much the most plausible interpretation of why these keep cropping up as markers for stress in modern societies is that they all affect – or reflect – the extent to which we do or do not feel at ease and confident with each other. Insecurities which can come from a stressful early life have some similarities with the insecurities which can come from low social status, and each can exacerbate the effects of the other. Friendship has a protective effect because we feel more secure and at ease with friends. Friends make you feel appreciated, they find you good company, enjoy your conversation – they like you. If, in contrast, we lack friends and feel avoided by others, then few of us are thick-skinned enough not to fall prey to self-doubts, to worries that people find us unattractive and boring, that they think we are stupid or socially inept.
    PRIDE, SHAME AND STATUS

    The psychoanalyst Alfred Adler said ‘To be human means to feel inferior.’ Perhaps he should have said ‘To be human means being highly sensitive about being regarded as inferior.’ Our sensitivity to such feelings makes it easy to understand the contrasting effects of high and low social status on confidence. How people see you matters. While it is of course possible to be upper-class and still feel totally inadequate, or to be lower-class and full of confidence, in general the further up the social ladder you are, the more help the world seems to give you in keeping the self-doubts at bay. If the social hierarchy is seen – as it often is – as if it were a ranking of the human race by ability, then the outward signs of success or failure (the better jobs, higher incomes, education, housing, car and clothes) all make a difference.
    It’s hard to disregard social status because it comes so close to defining our worth and how much we are valued. To do well for yourself or to be successful is almost synonymous with moving up the social ladder. Higher status almost always carries connotations of being better, superior, more successful and more able. If you don’t want to feel small, incapable, looked down on or inferior, it is not quite essential to avoid low social status, but the further up the social ladder you are, the easier it becomes to feel a sense of pride, dignity and self-confidence. Social comparisons increasingly show you in a positive light – whether they are comparisons of wealth, education, job status, where you live, holidays, or any other markers of success.
    Not only do advertisers play on our sensitivity to social comparisons, knowing we will tend to buy things which enhance how we are seen, but, as we shall see in Chapter 10, one of the most common causes of violence, and one which plays a large part in explaining why violence is more common in more unequal societies, is that it is often triggered by loss of face and humiliation when people feel looked down on and disrespected. By playing on our fears of being seen as of less worth, advertisers may even contribute to the level of violence in a society.
    It was Thomas Scheff, emeritus professor of sociology at the University of California,