At the 100-year-anniversary of the sinking of the RMS Titanic, it’s important to remember its significance: occurring in 1912, it represents one of the biggest boat disasters in our history. Even back then, the Titanic became instant news and has since been the subject of much fascination. The grandeur of the boat, the idea that it was “unsinkable,” and the pure scale of the disaster has captured the imagination and hearts of people ever since.
Yet, the Titanic disaster also represents a very concrete and extreme demonstration of how social class (wealth and status) impacts health. The richer you were, the more likely you were to survive. Although we’d like to believe that this is the relic of days gone by, unfortunately, the same is true today: wealth is still the greatest predictor of life expectancy.
Titanic, Social Class, and Survival
Only 33% of Titanic’s passengers survived. Yet, 63% of first class passengers survived, 43% of second class, and just 25% of third class. Put another way, passengers travelling in first class were 40% more likely to survive and passengers in second class were 16% more likely to survive than those travellers travelling in first class.
Why were first class passengers more likely to survive than second or third class passengers?
Many factors contributed to first class passengers having a better chance of getting off the Titanic alive, but by far the greatest was the physical structure of the ship itself. Titanic had 11 decks, eight of which were used by passengers. The top deck had all of the boat’s first class amenities, such as a promenade, restaurants, a gymnasium, squash court, swimming pool, cafe, and reading room. Importantly, this top deck also held all of the ship’s lifeboats. The next level down were the first class passenger cabins. As the deck levels descended, so did the class of the passengers, with most third class passengers and crew occupying a deck 5 levels lower than the first class passengers. Passengers from lower classes were not allowed on to certain parts of the ship, including the top deck where the lifeboats were.
When Titanic hit the iceberg, first class passengers were physically closer to the lifeboats than their second and third class counterparts, giving them quicker access to these life-saving devices. In fact, the poorer the passenger, the farther away they were from the lifeboats. Navigating the ship’s many levels was also somewhat challenging, so the passengers lower down had a harder time finding their way to the top. And, since second and third class passengers were not allowed onto the first class areas of the boats (where the lifeboats were), they did not know where they were and could not find them as easily.
Case in Point
To illustrate how class can impact the neighborhoods in which people live, I chose two suburbs near Boston that are adjacent to each other and looked up some facts about each.
What does this have to do with class and health today?
While it may not be as blatant as sunning oneself on the upper decks, class today still greatly influences health outcomes. In fact, wealth is the strongest predictor of health and life expectancy in the United States, with wealthier Americans living an average of 4.5 years longer than poorer Americans. At the extreme, affluent caucasian women are expected to live 14 years longer than poor african-american men.
It is well known that wealthier people have access to better healthcare options and can more easily afford related health care costs, such as co-payments, transportation to and from care, and optional or elective tests and procedures.
But, access to healthcare is only one piece of the puzzle.
Just like those passengers on the Titanic, wealthier Americans today have more ready access to physical environments (neighborhoods) that are health promoting. Take access to healthy foods as an example. Wealthier neighborhoods have higher numbers of grocery stores selling fresh fruits and vegetables, health food stores, and farmer’s markets. Low-income neighborhood boast more convenience stores, which have very limited fresh food options, and more fast food restaurants.
Studies make it clear that access to fresh fruits and vegetables improve diets and improve related health outcomes (for example, obesity, diabetes), but little has been done to change access in low-income neighborhoods, and people living in those communities continue to suffer the health consequences.
Newton is about 25 percent bigger than Waltham, both in terms of population and land mass. Yet, Newton has 250% more grocery stores as Waltham (5 versus 2), and boasts 2 Whole Foods Markets, whereas Waltham has none. Waltham, on the other hand, has almost twice as many national fast food chains as Newton: Newton has 2.4 fast food chains per 50,000 people whereas Waltham has almost 6 fast food chains per 50,000 people. Note: this chart only looked at three of the major US fast food chains.
Why this difference? Both cities are about the same distance from Boston. But, the major differences is that Newton is a wealthier community. This example isn’t even that extreme - Waltham is a relatively wealthy community located about the same distance from a major city. Even so, residents of the wealthier community have much greater access to healthier options than do their neighbors living in the less well off neighborhood. Imagine the differences we would see if we compared the most affluence with the lowest income neighborhoods.
Access to healthy food is just an example. The same analysis could be done for multiple factors that impact health, such as the availability of open green spaces to walk or bike in, safer streets, or the availability of alcohol.
How far have we really come?
While the Titanic disaster seems like a phenomenon unique to another era, many of the same problems that led to the scale of that disaster, especially for the poor, continue to exist today. On Titanic, poor people were literally trapped on a sinking ship. Wealthy passengers had easy access to fresh air, dining options, and other health-promoting amenities, while poor people were trapped below deck far away from those amenities and, importantly, from lifeboats that could literally save their lives. Today, wealthier Americans live in safer communities that boast healthier food options, and safer streets, making it easier for them to make healthy decisions about diet and exercise. Indeed, social class continues to play an important role in the health and well-being of all Americans.
unknown on January 09, 2020:
the titanic is a good topic to write about.
Unknown on January 10, 2019:
Hey, Thank you so much for taking my comment off, one person asked me about it, I knew I made a mistake, thank you! And I was nerviours people might find out, thank you.
Unknown on January 08, 2019:
The Titanic is kind of like a human, kinda. Think of it, Shes been around for a hundred years, like a human, now, a human can't always live that long, but she, the Titanic lived Long, and she will live long. She is History, long as we remember her, she lives! And She Will Live For Many, Many Years!
Unknown on December 13, 2018:
I like the Titanic, because we only found it a few years ago, and all young kids think we found the Titanic many years before we really found it. I like how it was the biggest boat in the world ever made; the Titanic made History! The movie "Titanic" made me cry about all the people who died.
dsmith on May 02, 2018:
LauraGT (author) from MA on September 27, 2012:
Thanks KCap. Glad to provide another perspective!
Kelly Capozzi on September 27, 2012:
I really like the comparison you made here. I never thought about it. Great hub! Voted up!
LauraGT (author) from MA on June 04, 2012:
JamaGenee: Thanks for reading. Yes, that is a very clear example of how classism cost the poorer passengers their lives. Talk about lack of access! They physically were barred from trying to save their lives.
Joanna McKenna from Central Oklahoma on June 03, 2012:
Most of the Third Class (steerage) passengers on the Titanic couldn't get to the upper decks to escape because the gates to the stairways were padlocked. The captain, realizing the ship was in distress but in denial that it was going down, didn't want the "riff raff" in the lower decks looting the First Class areas of the ship. What a guy!
LauraGT (author) from MA on April 20, 2012:
Thanks Wilderness. I do want to push you a little about the assumptions you make. Do you really think poor people inherently would prefer to eat less healthy foods? Obviously, more expensive food will sell better in wealthier neighborhoods and people who have less money want cheaper options, eon't you think that if fresh fruits and vegetables were cheap and more readily available, people in poorer communities might choose them over fast food? My point is that access makes a big difference in people's health decisions. I think we need to do more to make healthy options accessible (price and location) to more people. Thanks for sharing your viewpoint.
Dan Harmon from Boise, Idaho on April 20, 2012:
I understand your point about the Titanic but I personally find nothing wrong with charging more for more desirable staterooms, and those are always on the upper decks. If you've ever been on a cruise that is pretty standard.
Your comparison of the two neighborhoods, however, is very flawed. The differences in food is because that is what the population wants, not because of cost. Fast food is more expensive than even the organic foods that typically carry a premium price but that is what is in the poorer neighborhoods because that is what sells. Maybe because there are more two earner families, maybe because there is no hired help to cook, maybe because poorer people haven't taken cooking classes. Whatever the reason, it is what sells even though it is more expensive.
Mary Hyatt from Florida on April 15, 2012:
This is one of the most interesting Hubs I have read in a long time. I like the way you did the graphs and comparisons of the neighborhoods. I live in an area where the rich can influence the town to install a traffic light for their neighborhood to get out onto a major highway, but the poorer neighborhool has been fighting for years to get the same lifesaving traffic light to no avail. This is SO wrong.
Katharella from Lost in America on April 13, 2012:
I just watched the "DiCaprio" version last night. Out of all the sadness of deaths of the lower class, I think my favorite part is when the older Rose let the diamond go back to its home. I can't help but say every time I see it, it's wrong to even touch it. Regardless it's at the bottom of the ocean, it's the grave site of many people. Because they were poor doesn't give anyone rights to disturb it.
I am also on the side of Molly "what's the matter with ya's, I don't understand a one of ya." The woman with "new money" was the most compassionate as she knew why she made it in a boat.
It is expensive to eat healthy as well. Not many people understand that. People often wonder why the poor are overweight. But the fact remains, fruits as and veggies absorb into our bodies and we're hungry again soon. Really our bodies are craving natural water and sugars. The poor get filled up with breads and hamburger and pastas because it lasts longer.
Until the rich learn to be more compassionate unfortunately the resulting health impact still will thrive. Sadly.
LauraGT (author) from MA on April 10, 2012:
Thanks for commenting Mazzy. It's true that some viewpoints and awareness have changed, but the underlying classism and the resulting health impacts are still there.
Mazzy Bolero from the U.K. on April 10, 2012:
Thanks for referring me to this hub. The figures from Massachusetts illustrate the situation well, and it's repeated all over the western world. As to the Titanic, I understand they had to keep the steerage passengers locked in the lower decks by law - they were regarded as dirty and disease-ridden. When a few finally got out, they were told to go back down as there was no problem. Apparently they swarmed up when all the lifeboats had left. Nowadays the discrimination is not so open, but it's still there. Very interesting hub.
markbennis on April 09, 2012:
I can't believe it is 100 years already where does the time go, well obviously I was not around at the time but it still creeps in faster and faster, great Hub and voted up!