If you haven’t read it, read my post here about what Academic August is and why I’m doing it!
This week I am highlighting public health literature. When I entered university, I was dead set on majoring in biomedical sciences, minoring in psychology, and eventually going to med school to become a psychiatrist. And then I learned about public health, and what do you know. That path has changed significantly. One of the studies that has stuck with me is the Whitehall Study.
The Whitehall Study
Lead by Michael Marmot in 1967, the Whitehall Study is perhaps the most influential study in public health and epidemiology. Essentially, the study examined 18,000 British civil servants and their risk of death overall and coronary heart disease. Differences in obesity, smoking, reduced leisure time, lower levels of physical activity, higher prevalence of underlying illness, higher blood pressure, and shorter height were controlled for (which means they did a statistical test to account for differences in these factors).
Those in the lowest level in the hierarchy had significantly higher rates of death and cardiovascular disease when compared to the highest level, even when all those factors were controlled. BUT WAIT those in the lowest had higher rates compared to those in the second lowest. And those in the second lowest had higher rates than those in the third lowest.
Basically, the lower in the hierarchy you were, the more likely you were going to die. Even when lifestyle factors were accounted for. CRAZY.
This study has been replicated in tons of different contexts with tons of different outcomes, and it. holds. up. In Alberta, where I live, material deprivation was examined in regards to a bunch of health outcomes, including death by suicide, rates of STIs and teen pregnancy, cancer, and heart disease. Those with the most material deprivation had the highest rates of ALL OF THESE, consistently, EXCEPT cancer. Cancer doesn’t care.
In the US, you can fairly accurately predict someone’s risk of having a heart attack based on their postal code. I KNOW.
This study is one of my favourites and I think it’s so cool. You can read more about it here, or just ask me and I’ll happily yell about it with you.
If you’re interested in differences in health based on non-biological things (which are referred to as social determinants of health, aka the loves of my life), I’d highly recommend this documentary series by PBS. Parts 11-15, 18 and 19, 24, 26, and 28 talk about things similar to the Whitehall study, and Michael Marmot is in some of them! We watched these in that first class that switched my interests, and I’ve thought about them ever since.
Thanks for reading! I hope you thought this study was as cool as I think it is.