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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2009.05.039 Byline: Victoria Reyes-Garcia (a), Jose Luis Molina (b), Thomas W. McDade (c), Susan N. Tanner (d), Tomas Huanca (e), William R. Leonard (c) Abstract: Research on the social determinants of health has highlighted (a) the adverse effects of social inequality on individual health and (b) the association between individual social rank and health. In this paper, we contribute to the growing literature on the health consequences of social inequalities by assessing the association between village level inequality in social rank, a form of non-material inequality, and indicators of nutritional status. We use quantitative survey information from 289 men (18+ years of age) from a society of forager-farmers in the Bolivian Amazon (Tsimane'). We construct village level measures of non-material inequality by using individual measures of men's positions in the village hierarchy according to prestige (or freely conferred deference) and dominance (or social rank obtained through power). We find that village inequality in dominance, but not village inequality in prestige, is associated with short-term indices of individual nutritional status. Doubling the coefficient of variation of dominance in a village would be associated to a 6.7% lower BMI, a 7.9% smaller mid-arm circumference, and a 27.1% smaller sum of four skin folds of men in the village. We also find that once we decouple individual social rank based on dominance from individual social rank based on prestige, only prestige-based social rank is associated with nutritional status. Potential explanations for our findings relate to the differential forms of resource access derived from the two forms of social hierarchies and to the social and psychological benefits associated with prestige versus the social costs and psychological stress generated by dominance. Author Affiliation: (a) ICREA and Institut de Ciencia i Tecnologia Ambientals, Universitat AutA[sup.2]noma de Barcelona, 08193 Bellatera, Barcelona, Spain (b) Department of Social and Cultural Anthropology, Universitat AutA[sup.2]noma de Barcelona, 08193 Bellaterra, Barcelona, Spain (c) Department of Anthropology, Northwestern University, Evanston, Ill 60208, USA (d) Department of Anthropology, University of Georgia, Athens, GA 30602, USA (e) CBIDSI, San Borja, Beni, Bolivia Article Note: (footnote) [star] Research was funded by grants from the Cultural Anthropology and Physical Anthropology Programs, NSF (BCS-0134225, BCS-0200767, BCS-0322380).

Research with humans and non-human primate species has found an association between social rank and individual health. Among humans, a robust literature in industrial societies has shown that each step down the rank hierarchy is associated with increased morbidity and mortality. Here, we present supportive evidence for the social gradient in health drawing on data from 289 men (18+ years of age) from a society of foragers-farmers in the Bolivian Amazon (Tsimane'). We use a measure of social rank that captures the locally perceived position of a man in the hierarchy of important people in a village. In multivariate regression analysis we found a positive and statistically significant association between social rank and three standard indicators of nutritional status: body mass index (BMI), mid-arm circumference, and the sum of four skinfolds. Results persisted after controlling for material and psychosocial pathways that have been shown to mediate the association between individual socioeconomic status and health in industrial societies. Future research should explore locally-relevant psychosocial factors that may mediate the association between social status and health in non-industrial societies. Keywords: Bolivia Tsimane' Amerindians Social gradient Social rank BMI Nutrition