Do Wealth and Inequality Associate with Health in a Small-Scale Subsistence Society?

Adrian V. Jaeggi, University of Zurich
Aaron D. Blackwell, Washington State University
Christopher von Rueden, University of Richmond
Benjamin C. Trumble, Arizona State University
Jonathan Stieglitz, Institute for Advanced Study in Toulouse
Angela R. Garcia, Emory University
Thomas S. Kraft, University of California, Santa Barbara
Bret A. Beheim, Max Plank Institute for Evolutionary Anthropology
Paul L. Hooper, Chapman University
Hillard Kaplan, Chapman University
Michael Gurven, University of California, Santa Barbara

This article was originally published in eLife, volume 10, in 2021.


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], body mass index [n = 9,926], blood pressure [n = 3,195], 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 did not 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.