Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer

by Barbara Ehrenreich

Fitness, or the efforts to achieve it, quickly took on another function for the middle class—as an identifying signal or “class cue.” Unfit behavior like smoking or reclining in front of the TV with a beer signified lower-class status, while a dedication to health, even if evidenced only by carrying a gym bag or yoga mat, advertised a loftier rank.

If this trend were to continue, everyone who participated in the fitness culture—as well as everyone who sat it out—will at some point be dead.

Jobs was horrified to see Kapor slathering butter on his bread, and asked, “Have you ever heard of serum cholesterol?” Kapor responded, “I’ll make you a deal. You stay away from commenting on my dietary habits, and I will stay away from the subject of your personality.”7

In John Steinbeck’s 1936 novel In Dubious Battle, a cynical older labor organizer offers a young migrant worker a fresh-rolled cigarette, along with some advice: You ought to take up smoking. It’s a nice social habit. You’ll have to talk to a lot of strangers in your time. I don’t know any quicker way to soften a stranger down than to offer him a smoke, or even to ask him for one. And lots of guys feel insulted if they offer you a cigarette and you don’t take it. You better start.14

When the notion of “stress” was crafted in the mid-twentieth century, the emphasis was on the health of executives, whose anxieties presumably outweighed those of a manual laborer who had no major decisions to make. It turns out, however, that the amount of stress one experiences—measured by blood levels of the stress hormone cortisol—increases as you move down the socioeconomic scale, with the most stress being inflicted on those who have the least control over their work.

as Linda Tirado reported about her life as a low-wage worker with two jobs and two children: I smoke. It’s expensive. It’s also the best option. You see, I am always, always exhausted. It’s a stimulant. When I am too tired to walk one more step, I can smoke and go for another hour. When I am enraged and beaten down and incapable of accomplishing one more thing, I can smoke and I feel a little better, just for a minute. It is the only relaxation I am allowed.18

Chronic anxiety, taking the form of “neurasthenia” in the nineteenth century, seems to be another disease of modernism. The self that we love and nurture turns out to be a fragile, untrustworthy thing.