The blog post about hierarchy and the responses to it have made me realise that this is an important topic to which we need to return.  As always I am drawn to thinking about the groups for whom Chris is an advocate, the poorly paid, the mentally ill and those working in low status and demeaning jobs.  In any hierarchy, in any society there are always going to be people who for various reasons are at the bottom of the pile.  However we describe such people who do not succeed, we need to be aware of them, the large number of people who occupy a place of disempowerment.  These disadvantaged may suffer in various ways, poor education, indifferent health and an upbringing that may have been inadequate in some way.

It is the issue of poor health and low life expectancy that I want to focus on today.  In some reading I did in the past year or two, I came across some fascinating research by one Sir Michael Marmot, an epidemiologist (one who researches issues of public health).  He had a commission from the Government to study ill-health and life expectancy among civil servants.  A Google search will provide further details of this research so I will limit my comments to the broad outlines.  Marmot had the health histories of some eighty thousand civil servants to study, what illnesses they contracted and the age at which they died.  None of the subjects for study was poor in a material sense and their medical histories were carefully screened to take out of the calculation any genetic factors leading to ill-health.  His conclusions were startling and alarming.  The lower down the civil service hierarchy an individual worked, the more they were susceptible to ill health and relatively early death.  The ones who lived the longest and who enjoyed the highest standards of health were those who had reached the top levels of the Civil Service.  The ones below the top did not achieve the same levels of health and this pattern was repeated right down the pay grades to the least paid and those with the lowest status.   Marmot and his fellow researchers tried to test this observation again and again but it seemed every time that high rank in the Civil Service predicted good health.  It was far more important than diet, exercise and other healthy life-styles.  Only smoking seemed to be a greater hazard than low rank.

The reader is invited to look at the research for themselves to check that I have represented the findings accurately.  But it is the speculation about the reasons for this imbalance in health between those of high and low status that is the intriguing part of the research.  Marmot surmised that the one factor that could account for the mismatch of health between the different levels within the Civil Service was stress.  It would appear that he identified a particular type of stress associated with looking over your shoulder at your boss.  In short having your work priorities determined by someone else and also having to work following other people’s orders is deemed to be stressful in a way that is different from simply working hard.  It is only when you are the boss that you escape this particular threat to your health.

Giving and receiving orders is no doubt  a normal working out of the dynamics of a hierarchical organisation.     Marmot’s research in a nutshell suggested that the stress caused by a constant need to obey orders and to please those set over you is not only unpleasant but is also a physical threat to your health.  We can surmise that when the ordinary giving of orders has added to it actual abusing of power, we have a very stressful and toxic mix.

The word ‘stress’ is a slippery word but we all have experience of it.  It is one of the privileges of retirement that for the first time in my life I can control the external stressors on my life as I have the power to use the word ‘no’ if something comes up and I do not want to do it.  Speaking personally I also find that opportunities for taking extra exercise also help to counter any residual stress in my life.

But to return to Marmot’s research.  It confirms how serious is a situation when power manipulation and even the simple giving of orders can be experienced by the vulnerable, those at or near the bottom of the hierarchy, whether in a church, the workplace or as a member of a despised social group.  The conclusion of the research indicates that those at the bottom do not just suffer indignity, they also suffer severe threats to their long-term physical health.  That observation should compound our concern for any group that lies at the bottom of a social hierarchy.

One of the ‘good news’ stories of 2013 was Pope Francis’ decision to speak up for the poor.  By the poor, no doubt, he meant not only those who have little money, but also all those who come at the bottom of the hierarchies in societies across the world.  His example may help in identifying those who suffer, emotionally and physically, from the experience of disempowerment and bring them properly to the attention of the ‘powerful’.  Those of us who follow this blog, although we are only a tiny number of people, can play our part in firstly becoming aware of the powerless people around us but also by helping in small ways to help lift them up.  The words of the Magnificat come to mind.  ‘He hath put down the mighty from their seat and hath exalted the humble and meek’.  Would that the church became a place where exalting the humble and meek was a reality.