Americans worship at two, contradictory altars - that of personal fame, success, and wealth, which everyone dreams about. And that of the happy layman or laborer; you know, those whose hoes and health place them leagues ahead of the tormented, addicted rich and famous. Oh, wait a second, the research uniformly finds better-off people to be healthier.

The Stanton Peele Addiction Website, February 25, 2011. This blog post also appeared on Stanton's Addiction in Society blog at PsychologyToday.com.

Americans Like to Think that Rich, Successful People Suffer: The Deadly Sin of Envy

Okay, there's Charlie Sheen, and more than a few entertainment figures who have had success, and yet who seem to be hell-bent on self-destruction (although this occurs more often after people's careers are already descending - not at the peak, like Sheen's).

Americans like to think this is typical - the rich and the successful aren't really happy. They may be wealthier, but they're really not "better" off, we surmise.

Here's a modest assessment of the evidence.

Are the rich healthier? Every indicator is that, the higher your social and economic status, the healthier you are and the longer you live. This is not only about the poor - who definitely suffer the worst health. If you Google "socioeconomic status and health", the most cited article is by Adler et al., now quite old (it has not been supplanted), which found that "there is a graded relationship with health at all levels of SES." That is, in an almost perfect straight line, the higher people's SES, the lower their death rate (Figure 1). In fact, figure 2 shows, there is an even steeper direct relationship between morbidity (chronic diseases) and SES.

Michael Marmot, a British epidemiologist, has studied social servants for decades . His work indicates:

The Whitehall study of British civil servants begun in 1967, showed a steep inverse association between social class, as assessed by grade of employment, and mortality from a wide range of diseases. Between 1985 and 1988 we investigated the degree and causes of the social gradient in morbidity in a new cohort of 10,314 civil servants (6900 men, 3414 women) aged 35-55 (the Whitehall II study). Participants were asked to answer a self-administered questionnaire and attend a screening examination. In the 20 years separating the two studies there has been no diminution in social class difference in morbidity: we found an inverse association between employment grade and prevalence of angina, electrocardiogram evidence of ischaemia, and symptoms of chronic bronchitis. Self-perceived health status and symptoms were worse in subjects in lower status jobs. There were clear employment-grade differences in health-risk behaviours including smoking, diet, and exercise. . . .

Okay, but are the better-off happier? First, we need to distinguish between the wealth of nations and that of individuals. We in the U.S. are wealthier, but there are many indicators that we are not the most contented. Note, in the following , that the critic takes issue with Stevenson and Wolfers' claims that richer countries have happier people - but not with the consistent finding that richer people in our and other countries are happier than their less well-off cohorts.

In April (2008), at the Brookings Institution in Washington, two enterprising young economists from Wharton, Betsey Stevenson and Justin Wolfers, addressed the age-old question of what money can and can't buy. Drawing on a wide variety of surveys, the duo claimed that rich people are happier than poor people, rich countries are happier than poor countries, and as countries get richer they get happier. Within weeks, newspapers around the world had picked up on the findings, and Wolfers was appearing on CNBC to brief viewers.

Why all the fuss? Stevenson and Wolfers' paper runs counter to a large body of evidence suggesting that, especially in rich countries, economic growth has failed to translate into greater subjective well-being.

What economic growth accomplishes for a nation is a question for another time - are people in urban America who makes tons of money happier than people in Tuscany who get by on sun, wine, and olive oil (but also family and community)? The latter is a philosophical and lifestyle question to ponder. But there is no seriously questioning that, within a society - our society - the better-off are happier people. (One reason is because they get to Tuscany more, and strive as much as possible to imitate a Tuscan lifestyle domestically.)

Except, everyone questions it. When I speak about the strange data on narcotics addiction which showed two groups of people generally were referred to the U.S. Public Health Service Hospital for narcotics addicts in Lexington, KY - street addicts and physicians - audiences uniformly shout out, "See, we said that doctors are just as likely to be addicted as anyone else - they're actually worse off, because of the stress they labor under, and their access to narcotics." 

But Charles Winick's study , "Physician Narcotic Addicts," showed a remarkable thing - a decisive majority of doctors recovered out of Lexington, compared with the reverse rate demonstrated by street addicts. For Winick, the answer was clear - the doctors had more to lose by being addicted, and more alternatives to replace their addictions - they had more stable, rewarding, supportive lives. "Nah," my audiences argue, "they're just better at concealing their drug use." 

As for doctors and smoking , "Derek Smith and Peter Leggat published a comprehensive international review of tobacco smoking in the medical profession from 1974-2004. The study showed that in countries like the United States, UK, Canada, Australia and New Zealand, smoking rates have dropped dramatically among doctors, from 15-20% in the 1970's to around 5% at the end of the 20th century."

The question really is why we like to think that those who outwardly seem more fortunate than us - the rich, the successful, the famous - are actually crying on the inside.

Or does it really require much of an explanation?