In Lewis's response (1) to Russ et al's finding (2) of a linear link between psychological distress and mortality, one sentence merits expansion: 'social stresses related to inequalities and socioeconomic status might contribute to the incidence of cardiovascular disease'.
Human families and societies buffer the physiological and psychological effects of stress -- which is ubiquitous -- via Attachment (3). As social animals, humans' response to separation, threat and fear is regulated with the help of a proximate caregiver, their Secure Base. But where care-giving is compromised, although the insecure show little outward sign of (dis)tress, and appear to be 'coping', cortisol responses and HPA axis function are consistently different from their secure counterparts (4), with, as Lewis suggests, potentially lethal long-term consequences
While the self-help CBT approach Lewis advocates has its uses, it runs the risk of perpetuating the very difficulty at the heart of the problem. Prevention calls for a radically relational perspective. At a micro-level, families need encouragement in mutual support and processing of emotional pain. At a societal level flattened inequality gradients and enhanced trust are essential if stress is to be resilience-enhancing rather than death-dealing.

(1) Lewis, G. psychological distress and death from cardiovascular disease. bmj 2012; 354: e5177
(2) Russ, T, et al Association between psychological distress and mortality: individual participant p[oled analysis of 10 prospective cohrt studies. bmj 2012; 345: e4933.
(3) Cassidy, J. & Shaver, P. Handbook of Attachment 2nd edition. 2008. New York: Guilford.
(4) Dozier, M. & Kobac, R. Psychophysiology in attachment interviews. Child Development 1992 63 1473-1480

Competing interests: None declared