Income inequality and mortality: importance to health of individual income, psychosocial environment, or material conditions

In invoking the analogy of a long flight to illustrate the neo-
materialist explanation for inequalities in health Lynch and colleagues
may have overlooked another important explanation.[1] Davey Smith has
already shown that mortality risk is 50% lower in men with high frequency
of orgasm compared to those with low orgasmic frequency.[2] The UK
national media recently reported a sexual encounter between a male and a
female passenger travelling in business class on a transatlantic flight to
the UK[3] and although we are not informed whether orgasm was actually
achieved during the flight, undoubtedly the salubrious environment of
business class is more conducive to such an event, and to its greater
frequency, than the constraining conditions in economy class. Therefore
rather than it being solely the availability of more space and a wider,
more comfortable seat in the expensive areas of aeroplanes, perhaps it
could be the greater frequency of orgasm in these sections which leads to
improved health – at least for men.

However the authors may have been astute in their omission; the
couple in question were subsequently heavily fined and lost their jobs;
the adverse health effects of coming down to earth with such a detrimental
materialist thud are likely to outweigh the benefits gained in the air.

Interestingly it would appear that the aeroplane may not be the most
appropriate vehicle for demonstrating materialist explanations for health
inequalities. While being well off usually results in better health and
increased longevity, Davey Smith has also shown, in a large US study, that
increasing income resulted in a doubling of the risk of dying in a flying
accident, the only cause of death out of 44 examined, for which risk
increased with higher income![4] This is unlikely to have anything to do
with orgasms – unless they are happening in the cockpit.

Nevertheless given the growing number of people travelling by air the
scope exists for airline companies to play an increasingly important role
in improving the health of the public (although it is difficult to see how
Richard Branson’s airline could contribute to this health drive). Further
research is urgently required – at the very least a pilot study should be
undertaken.

No competing interests were given by the authors. I suggest they
come clean and declare those upgrades. As for me – my boss is George Davey
Smith!

1 Lynch JW, Davey Smith G, Kaplan GA, House JS. Income inequality and
mortality: importance to health of individual income, psychosocial
environment, or material conditions. BMJ 2000; 320: 1200-1204.

2 Davey Smith G, Frankel S, Yarnell J Sex and death: are they related?
Findings from the Caerphilly cohort study. BMJ 1997; 315: 1641-1644.

3 Strangers pay high price for flight of fancy. Jenkins R. The Times. 2000
Apr. 6.

4 Davey Smith G, Neaton JD, Wentworth D, Stamler J. Socioeconomic
Differentials in Mortality Risk among Men Screened for the Multiple Risk
Factor Intervention Trial: I. White Men. Am J Public Health. 1996;86:486-
496.