I ask myself why do more than 30% of boys attend school now on drugs? What is the root of ADD? For when I was a boy 50 years ago in the dark ages, there was no such thing. Might it be a desperate need to get attention of the real sort – the full engagment with the parent?

This is speculation on my part, what is now clearly proven is that the kind of bureaucratic hierarchy that is the norm makes most of us ill. If you are at the bottom of the pile, you are 4 times more likely to get ill or die early. The issue is control – people at the bottom feel that they have no say.

Sir Michael Marmot argues that having a healthier interaction inside organizations may do more than any single act to improve health outcomes. Here is some back up to this statement.

http://smartpei.typepad.com/robert_patersons_weblog/2004/08/blogging_is_goo.html

“The reason, Marmot argues, is that social participation — rewarding relationships, access to a community, and the respect of others — and individual autonomy are crucial determinants of health and happiness. High status usually affords more opportunities for social involvement and control of one’s conditions. Low status means that external forces — a mean-spirited boss, a company that dumps toxic waste near your neighborhood — are more likely to determine one’s fate, social support is less reliable, and insecurity is a feature of daily life. Although the meaning of full participation varies from places to place, Marmot claims that the beneficial effects of being connected are constant.

Lack of agency produces dangerous forms of stress. People who labor in dull, dead-end yet demanding jobs suffer from an imbalance between their efforts and rewards. As recent studies of coronary disease in Britain and seven Eastern European countries show, work that deprives men and women of control destroys the heart as well as the soul. Moreover, a daily onslaught of difficulties makes people less likely to focus on their long-term health. Marmot believes that the vulnerable understand their grim condition, and that they engage in dangerous but pleasurable behaviors such as smoking or overindulging in fast food because they prefer enjoying the moment to holding out for a future they might not reach.

Marmot concedes that bad jobs, wealth disparities and status hierarchies are inevitable features of modern societies. But some societies are more equal than others. Governments can, and in the most flourishing countries do, decrease the slope of the social gradient and improve public health. In England, for example, the government has been quietly redistributing income since 1997, using fiscal policies to compensate for social divisions produced by the labor market. In the United States, however, recent tax changes have steepened the gradient.

According to Marmot’s surprising conclusion, the most effective and affordable health policies do not involve the medical system but programs that reduce income and educational inequalities, protect workers and families, provide access to housing and safe environments, and promote care for children and the elderly.

There’s good evidence that skimping on these fundamental and wide-ranging social protections while spending lavishly on medical care is foolish public policy. Cross-nationally, the longevity gap tends to decrease during eras of social equalization and increase during periods of polarization. Americans have learned this the hard way. Outspending all competitor nations on health care has not helped to raise U.S. life expectancy above the level of Spain, Cyprus or Singapore, where the social gradients are more even. We’ve all heard officials say that the United States has the best medical system in the world. Whether or not that’s true, longevity is greater in France, the United Kingdom and Canada.” Washington Post reviewing marmot’s new book – The Status Syndrome