That Big-Fish-Little-Pond effect is seen to be relevant in a lot of places, including academic performance [1][2], depression, and suicide rates.
[1] http://aer.sagepub.com/content/47/2/390.abstract
[2] http://link.springer.com/article/10.1007/s10648-008-9075-6
http://www.tandfonline.com/doi/abs/10.1080/13504850701720197
"We investigate the relationship between inequality and intergenerational mobility. Proxying fathers' earnings with using detailed occupational data, we find that sons who grew up in countries that were more unequal in the 1970s were less likely to have experienced social mobility by the late-1990s."
We know there's a bunch of reasons why poor people are unhealthy - more smoking, more alcohol, worse food, less exercise, more dangerous jobs, less protection in those dangerous jobs, less exercise, less access to health treatment (even if it's free).
But this study:
> The findings, in Science, had nothing to do with the unhealthy behaviours that are more common in poorer groups.
This does not apply to Switzerland and the Nordic European countries. (It does clearly apply to the US, though.)
You mean outside of health choices made for financial reasons? That was news to me. Simply being in bottom hurts you, even if you are doing everything else the same.