The Cost of Getting Ahead

Many a young man rising fast in his profession is sinking fast physically. Doctors have long linked emotional stress with heart disease; but they have come to that conclusion after the fact: most of the patients they examined were already diseased. At last week's meeting in Atlantic City of the American Federation for Clinical Research, two doctors from New York Hospital-Cornell Medical Center--William N. Christenson and Lawrence E. Hinkle Jr.--reported that they had spent three years correlating stress and sickness in ostensibly healthy young men far from the usual age of heart attacks.

The Cornell team tried to assemble the most homogeneous group they could find, settled on 139 men, aged 22-32, who held low-rung executive jobs in a big corporation. Their type of work, income ($6,000-$10,000) and behavior patterns were much the same. They differed only in education: 55 were college graduates, 84 were high school only.

In spite of all the outward similarities, the difference in background was decisive when it came to disease. During the course of one year, the high school graduates suffered half again the number of illnesses that the college graduates did. Though few of these involved risk of death, the risk run by the high school men was ten times that of the college men. Above all, many more of the high school men showed telltale signs of future cardiovascular disease.

Why the marked difference in the two groups? Heredity was ruled out. Both groups came from white northern European stock, had similar histories of family disease. The grandparents of the high school men were even slightly longer-lived. Personal habits were not the answer. Both groups had about the same diet, though the high school men ate less for breakfast, more between meals.

The crucial factor turned out to be stress. The college men were almost all fourth-generation Americans from substantial middle-class families. They had adjusted without much difficulty to the life expected of them as adults. The high school graduates, on the other hand, were the sons or grandsons of immigrants, were raised in poorer families, had to cope with considerably more adolescent problems than the college men. They married earlier, had more domestic problems, more financial worries, embarked on more home do-it-yourself projects. Finally, they faced an unfamiliar life in a big corporation in which they struggled hard to succeed. The Cornell team concluded: "Their relative ill health might well be regarded as the price they are paying for getting ahead in the world."

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