A personal sense of control over one's life circumstances, particularly in the workplace, is a powerful determinant of health. Those working in the trades or as manual laborers are three times as likely to die in a given year as those in administrative positions. Perhaps most striking is the fact that civil servants in one of the professions are twice as likely to die within a year as their administrative bosses. The gradient remains even for specific and very different causes of death such as coronary heart disease and suicide, and after controlling for all known medical and genetic risk factors. It appears as if one's position in the workplace hierarchy in some way becomes imbedded in one's biology.
Education is another powerful factor in determining health over a person's entire life span.
More education generally means greater earning power, a higher place on the social ladder, and a greater ability to find and use information about how to stay healthy. A country's economic health depends on many factors-two of the most important being technological innovation and a productive workforce. An early environment rich with sensory stimulation and emotional nurturing greatly increases the likelihood of a child becoming a productive, emotionally stable and resilient adult. Even the development of children born into very adverse circumstances can be positively influenced by preschool enrichment programs. They were also considerably less likely to have committed crimes, received welfare assistance or other social services, or have had an illegitimate child than their counterparts in a control group.