It is not just those at the bottom who are at greater risk. Even on the middle and higher rungs, the socioeconomic ladder is a health ladder. A similar pattern holds for cancer and other diseases that might be assumed to choose their victims more randomly. Thus, Greece, where the average citizen earns about one-half as much as the average American, outdoes the United States in most indices of good health, including longevity. Costa Rica, a relatively egalitarian nation, has somehow managed to achieve an average life expectancy of 76 years despite a per capita gross national product that is barely one-tenth of the United States's.
Inequality helps to explain contrasts within as well as among nations.
Some people see these links mainly as expressions of the material or practical consequences of low economic status. For others, the psychosocial effects are critical. In such a context, they argue, people are more likely to feel stressed and lonely and, as a result, will be more vulnerable to a wide range of ailments. In the United States nowadays, there is little support for new policies on the scale of Social Security, the GI Bill, Medicare, or any of the other great initiatives that arguably played a role in the equalizing trend of the postwar years. Softer-hearted nations are counseled to adopt a reward structure more like that of the United States, if they know what's good for them.