One estimate is that almost half of lost life expectancy is attributable to behavior, but good health depends on more than just healthy lifestyle behaviors. Studies show that both having a sense of purpose that goes beyond self-interest and positive social relationships are correlated with avoidance of disease and longevity. Studies have attributed 40% of premature deaths—those before age 70—to behavior that you can change, 30% to heredity, 15% to social circumstance, and surprisingly just 10% to the health care we receive. Of modifiable behaviors, smoking, obesity, and lack of physical inactivity are causing the largest number of premature deaths.

Social variables, including income, education, social status, housing, occupation, and access to transportation, have an important influence on health and life expectancy. Perhaps you are wondering how does your social setting make you likely to be less or more healthy—what is the biological mechanism? To some degree, poor social circumstances lead to unhealthy behaviors. In addition, the odds are higher that you will suffer from chronic stress if you are socially isolated, suffering from adverse childhood experiences, poorly educated, experiencing job insecurity, subject to racial bias, crime, and violence, or live in poor housing and “food deserts” without easy access to healthy food. The factors that contribute to the wear and tear of everyday life are called “allostatic load.” High levels of stress contribute to allostatic load and increase the risk of physical and mental ill-health and death.

Chronic stress leads to overeating, obesity, high blood pressure, insulin resistance, diabetes, and the chronic inflammation that is associated with cardiovascular and many other diseases. Other environmental factors related to socioeconomic status may also be important if they lead to smoking, drug misuse, undiagnosed high blood pressure, physical inactivity, and a high saturated fat, high salt, junk food diet. People with low socioeconomic status are also more likely to live in communities with environments that have polluted air and water and are exposed to toxins such as lead. They are also less likely to have the knowledge and means to stay healthy and have less access to high-quality health care.

One estimate is that the wide-ranging and unhealthy effects of stress and chronic inflammation caused by poverty and low social status contribute as much as half of the gap in health compared to those who are better off. Although Americans with higher incomes are likely to live longer, the gap is much lower in some places, like New York City, and it is narrowed by healthier lifestyles, including avoiding obesity, not smoking, and getting exercise. Unfortunately, this blog cannot improve many of the socioeconomic variables associated with ill health. Still, it can help an individual adopt many preventive health behaviors that avoid or minimize the environmental risks of low socioeconomic status. In the ongoing debate about who should pay for health care, consider that it is estimated that only 10% to 20% of health outcomes are attributed to health care, and most disease is more closely linked to the modifiable lifestyle behaviors described in this blog.

This blog presents opinions and ideas and is intended to provide helpful general information.  I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in the book or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Wellness with a Lifestyle Checklist. References for most of the health related information in this blog can be found in the book, The Building Blocks of Health now available on Amazon at Copyright 2020 by J. Joseph Speidel.