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Background and objectives: Low social status increases risk of disease due, in part, to the psychosocial stress that accompanies feeling subordinate or poor. Previous studies report that chronic stress and chronically elevated cortisol can impair cardiovascular and immune function. We test whether lower status is more benign in small-scale, relatively egalitarian societies, where leaders lack coercive authority and there is minimal material wealth to contest.

Methodology: Among Tsimane’ forager-horticulturalists of lowland Bolivia, we compare informal political influence among men with urinary cortisol, immune activation (innate and acquired), and morbidity as assessed during routine medical exams.

Results: After controlling for potential confounds, we find that politically influential men have lower cortisol, and that this association is partly attributable to access to social support. Cortisol is positively associated with men’s income, which may reflect chronic psychosocial stress from market involvement. Greater influence is also associated with lower probability of respiratory infection, which is a frequent source of morbidity among Tsimane’. Among men who lost influence over a 4-year period, cortisol and probability of respiratory infection were higher the greater the decline in influence.

Conclusions and implications: Deleterious effects of low status on health are not merely ‘diseases of civilization’ but may result from how (even subtle) status differences structure human behavior.


This article was originally published in Evolution, Medicine, and Public Health, volume 2014, issue 1, in 2014.

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Oxford University Press

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Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.