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Socioeconomic status and health

from Psychology, health and illness

Published online by Cambridge University Press:  18 December 2014

By
Lion Shahab
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Lion Shahab
Affiliation:
University College London
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Background

Although the influence of wealth, status and power on health has been documented across different cultures for centuries (Liberatos, Link & Kelsey, 1988), it was not until the nineteenth century that more systematic scientific evidence emerged showing that those who were more affluent lived longer and healthier (e.g. by Villermé (1840) in France, Chadwick (1842) in Britain and Virchow (1848) in Germany). However, with the advance of bacteriology in the late nineteenth century and the ensuing dominance of the biomedical paradigm of health and illness, considerations of socioeconomic status (SES) in relation to health were largely put aside and confined to its role as a control variable (House, 2002).

With the realization of the limits of modern medicine, interest in social epidemiology and medical sociology grew again during the second half of the twentieth century (Bloom, 2002) and so did the output of research looking at SES, in particular poverty, and health. These early studies assumed a threshold effect of SES on health (Adler & Ostrove, 1999, see Figure 1); increases in income were thought to improve health only beneath, not above, a given ‘poverty line’. As discussed below, however, emerging evidence showed the picture to be far more complex than this.

Main observations

Socioeconomic status as used in research is a conglomeration of various concepts which centre around indicators of desirable social and material attributes.

Type
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Cambridge Handbook of Psychology, Health and Medicine , pp. 207 - 213
Publisher: Cambridge University Press
Print publication year: 2007

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References

Adler, N. E.,Boyce, T.,Chesney, M. A.,Cohen, S.,Folkman, S.,Kahn, R. L. & Syme, S. L. (1994). Socioeconomic status and health. The challenge of the gradient. American Psychologist, 49(1), 15–24.Google Scholar
Adler, N. E.,Boyce, W. T.,Chesney, M. A.,Folkman, S. & Syme, S. L. (1993). Socioeconomic Inequalities in Health – No Easy Solution. JAMA – Journal of the American Medical Association, 269(24), 3140–5.Google Scholar
Adler, N. E. & Ostrove, J. M. (1999). Socioeconomic status and health: what we know and what we don't. Annals of the New York Academy of Sciences, 896, 3–15.Google Scholar
Avison, W. R. & Turner, R. J. (1988). Stressful life events and depressive symptoms – disaggregating the effects of acute stressors and chronic strains. Journal of Health and Social Behavior, 29(3), 253–64.Google Scholar
Bartley, M. & Plewis, I. (1997). Does health-selective mobility account for socioeconomic differences in health? Evidence from England and Wales, 1971 to 1991. Journal of Health and Social Behavior, 38(4), 376–86.Google Scholar
Black, D.,Morris, J. N.,Smith, C. & Townsend, P. (1980). Inequalities in health: report of a research working group. London, UK: Department of Health and Social Security.
Blane, D. (1997). Inequality and social class. In Scambler, G. (Ed.). Sociology as Applied to Medicine, (4th edn.) (pp. 103–20). London, UK: Bailliere Tindall.
Blane, D. (1999). The life course, the social gradient, and health. In Marmot, M. & Wilkinson, R. G. (Eds.). Social Determinants of Health, (1st edn.) (pp. 64–80). New York: Oxford University Press.
Bloom, S. W. (2002). The word as scalpel: a history of medical sociology. New York: Oxford University Press.
Bobak, M. & Marmot, M. (1996). East–West mortality divide and its potential explanations: proposed research agenda. BMJ – British Medical Journal, 312(7028), 421–5.Google Scholar
Booth-Kewley, S. & Friedman, H. S. (1987). Psychological predictors of heart- disease – a quantitative review. Psychological Bulletin, 101 (3), 343–62.Google Scholar
Bosma, H.,Marmot, M. G.,Hemingway, H.,Nicholson, A. C.,Brunner, E. & Stansfeld, S. A. (1997). Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ – British Medical Journal, 314(7080), 558.Google Scholar
Braveman, P. & Tarimo, E. (2002). Social inequalities in health within countries: not only an issue for affluent nations. Social Science and Medicine, 54(11), 1621–35.Google Scholar
Brischetto, C. S.,Connor, W. E.,Connor, S. L.&Matarazzo, J. D. (1983). Plasma-lipid and lipoprotein profiles of cigarette smokers from randomly selected families – enhancement of hyperlipidemia and depression of high-density lipoprotein. American Journal of Cardiology, 52(7), 675–80.Google Scholar
Brunner, E. & Marmot, M. (1999). Social organisation, stress, and health. In Marmot, M. & Wilkinson, R. G. (Eds.). Social Determinants of Health, (1st edn.) (pp. 17–43). New York, US: Oxford University Press.
Case, A.,Lubotsky, D. & Paxon, C. H. (2002). Economic status and health in childhood: the origins of the gradient. American Economic Review, 92(5), 1308–34.Google Scholar
Chadwick, E. (2000). Report of the sanitary condition of the labouring population of Great Britain (1842). London, UK: Routledge/Thoemmes.
Cohen, D. A.,Farley, T. A. & Mason, K. (2003). Why is poverty unhealthy? – Social and physical mediators. Social Science and Medicine, 57(9), 1631–41.Google Scholar
Cohen, S. & Williamson, G. M. (1991). Stress and infectious disease in humans. Psychological Bulletin, 109(1), 5–24.Google Scholar
Curry, S. J.,Wagner, E. H.,Cheadle, A.et al. (1993). Assessment of community-level influences on individuals' attitudes about cigarette-smoking, alcohol-use, and consumption of dietary-fat. American Journal of Preventive Medicine, 9(2), 78–84.Google Scholar
Daniels, N., Kennedy, B. & Kawachi, I. (2000). Justice is good for our health. In Cohen, J. & Rogers, J. (Eds.). Is inequality bad for our health?Boston, MA: Beacon Press.
Davey-Smith, G.,Neaton, J. D.,Wentworth, D.,Stamler, R. & Stamler, J. (1996). Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: I. White men. American Journal of Public Health, 86(4), 486–96.Google Scholar
Davey-Smith, G.,Wentworth, D.,Neaton, J. D.,Stamler, R. & Stamler, J. (1996). Socioeconomic differentials in mortality risk among men screened for the Multiple Risk Factor Intervention Trial: II. Black men. American Journal of Public Health, 86(4), 497–504.Google Scholar
Dembroski, T. M.,Macdougall, J. M.,Costa, P. T. & Grandits, G. A. (1989). Components of hostility as predictors of sudden death and myocardial infarction in the Multiple Risk Factor Intervention Trial. Psychosomatic Medicine, 51(5), 514–22.Google Scholar
Department of Health. (2003). Health survey for England, 2003. London, UK: The Stationery Office.
Devesa, S. S. & Diamond, E. L. (1980). Association of breast cancer and cervical cancer incidences with income and education among whites and blacks. Journal of the National Cancer Institute, 65(3), 515–28.Google Scholar
Dohrenwend, B. P. & Schwartz, S. (1995). Socioeconomic status and psychiatric disorders. Current Opinion in Psychiatry, 8(2), 138–41.Google Scholar
Evans, G. W. & Kantrowitz, E. (2002). Socioeconomic status and health: the potential role of environmental risk exposure. Annual Review of Public Health, 23, 303–31.Google Scholar
Field, K. S. & Briggs, D. J. (2001). Socio-economic and locational determinants of accessibility and utilization of primary health-care. Health and Social Care in the Community, 9(5), 294–308.Google Scholar
Goldman, D. P. & Smith, J. P. (2002). Can patient self-management help explain the SES health gradient?Proceedings of the National Academy of Sciences of the United States of America, 99(16), 10929–34.Google Scholar
Goldman, N. (2001). Social inequalities in health disentangling the underlying mechanisms. Annals of the New York Academy of Sciences, 954, 118–39.Google Scholar
Guralnik, J. M.,Land, K. C.,Blazer, D.,Fillenbaum, G. G. & Branch, L. G. (1993). Educational status and active life expectancy among older blacks and whites. New England Journal of Medicine, 329(2), 110–16.Google Scholar
Helmert, U.,Herman, B.,Joeckel, K. H.,Greiser, E. & Madans, J. (1989). Social-class and risk-factors for coronary heart disease in the Federal Republic of Germany – Results of the baseline survey of the German Cardiovascular Prevention Study (GCP). Journal of Epidemiology and Community Health, 43(1), 37–42.Google Scholar
Helmert, U.,Mielck, A. & Classen, E. (1992). Social inequities in cardiovascular disease risk factors in East and West Germany. Social Science and Medicine, 35(10), 1283–92.Google Scholar
Hemingway, H.,Nicholson, A.,Stafford, M.,Roberts, R. & Marmot, M. (1997). The impact of socioeconomic status on health functioning as assessed by the SF-36 questionnaire: the Whitehall II Study. American Journal of Public Health, 87(9), 1484–90.Google Scholar
House, J. S. (2002). Understanding social factors and inequalities in health: 20th century progress and 21st century prospects. Journal of Health and Social Behavior, 43(2), 125–42.Google Scholar
House, J. S.,Lepkowski, J. M.,Kinney, A. M.,Mero, R. P.,Kessler, R. C. & Herzog, A. R. (1994). The social stratification of aging and health. Journal of Health and Social Behavior, 35(3), 213–34.Google Scholar
Jarvis, M. J. & Wardle, J. (2005). Social patterning of individual health behaviours: the case of cigarette smoking. In Marmot, M. & Wilkinson, R. G. (Eds.). Social Determinants of Health, 2nd edn. New York: Oxford University Press.
Kaplan, G. A. & Keil, J. E. (1993). Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation, 88(4 Pt 1), 1973–98.Google Scholar
Karasek, R. A. (1979). Job demands, job decision latitude, and mental strain – implications for job redesign. Administrative Science Quarterly, 24(2), 285–308.Google Scholar
Krieger, N. & Sidney, S. (1996). Racial discrimination and blood pressure: The CARDIA study of young black and white adults. American Journal of Public Health, 86(10), 1370–8.Google Scholar
Kuh, D.,Ben Shlomo, Y.,Lynch, J.,Hallqvist, J. & Power, C. (2003). Life course epidemiology. Journal of Epidemiology and Community Health, 57(10), 778–83.Google Scholar
Lachman, M. E. & Weaver, S. L. (1998). The sense of control as a moderator of social class differences in health and well-being. Journal of Personality and Social Psychology, 74(3), 763–73.Google Scholar
Lantz, P. M.,House, J. S.,Lepkowski, J. M.et al. (1998). Socioeconomic factors, health behaviors, and mortality: results from a nationally representative prospective study of US adults. JAMA – Journal of the American Medical Association, 279(21), 1703–8.Google Scholar
Leary, M. R. & Kowalski, R. M. (1995). Social anxiety. New York: Guilford Press.
Liberatos, P.,Link, B. G. & Kelsey, J. L. (1988). The measurement of social class in epidemiology. Epidemiologic Reviews, 10, 87–121.Google Scholar
Link, B. G. & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior, 35(Special Issue), 80–94.Google Scholar
Lucas, R. E. B. (1974). Distribution of job characteristics. Review of Economics and Statistics, 56(4), 530–40.Google Scholar
Lynch, J. W.,Everson, S. A.,Kaplan, G. A.,Salonen, R. & Salonen, J. T. (1998). Does low socioeconomic status potentiate the effects of heightened cardiovascular responses to stress on the progression of carotid atherosclerosis?American Journal of Public Health, 88(3), 389–94.Google Scholar
Lynch, J. W.,Kaplan, G. A.,Cohen, R. D.,Tuomilehto, J. & Salonen, J. T. (1996). Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction?American Journal of Epidemiology, 144(10), 934–42.Google Scholar
Macintyre, S. (1997). The Black Report and beyond: what are the issues?Social Science and Medicine, 44(6), 723–45.Google Scholar
Macintyre, S.,Maciver, S. & Sooman, A. (1993). Area, class and health – should we be focusing on places or people. Journal of Social Policy, 22, 213–34.Google Scholar
Mackenbach, J. P. (2005). Genetics and health inequalities: hypotheses and controversies. Journal of Epidemiology and Community Health, 59(4), 268–73.Google Scholar
Mackenbach, J. P.,Kunst, A. E.,Cavelaars, A.E.J.M.et al. (1997). Socioeconomic inequalities in morbidity and mortality in western Europe. Lancet, 349(9066), 1655–9.Google Scholar
Maher, J. & Macfarlane, A. (2004). Inequalities in infant mortality: trends by social class, registration status, mother's age and birthweight, England and Wales, 1976–2000. Health Statistics Quarterly, Winter (24), 14–22.Google Scholar
Mao, Y.,Hu, J. F.,Ugnat, A. M.,Semenciw, R.&Fincham, S. (2001). Socioeconomic status and lung cancer risk in Canada. International Journal of Epidemiology, 30(4), 809–17.Google Scholar
Markowe, H. L. J.,Marmot, M. G.,Shipley, M. J.et al. (1985). Fibrinogen – a possible link between social class and coronary heart disease. BMJ – British Medical Journal, 291(6505), 1312–14.Google Scholar
Marmot, M. G.,Davey Smith, G. D.,Stansfeld, S.et al. (1991). Health inequalities among British civil servants – the Whitehall II Study. Lancet, 337(8754), 1387–93.Google Scholar
Marmot, M. G.,Shipley, M. J. & Rose, G. (1984). Inequalities in death – specific explanations of a general pattern?Lancet, 1(8384), 1003–6.Google Scholar
Mcewen, B. S. & Seeman, T. (1999). Protective and damaging effects of mediators of stress – elaborating and testing the concepts of allostasis and allostatic load. Annals of the New York Academy of Sciences, 896, 30–47.Google Scholar
Mcleod, J. D. & Kessler, R. C. (1990). Socioeconomic status differences in vulnerability to undesirable life events. Journal of Health and Social Behavior, 31(2), 162–72.Google Scholar
Merlo, J. (2003). Multilevel analytical approaches in social epidemiology: measures of health variation compared with traditional measures of association. Journal of Epidemiology and Community Health, 57(8), 550–2.Google Scholar
North, F.,Syme, S. L.,Feeney, A.,Head, J.,Shipley, M. J. & Marmot, M. G. (1993). Explaining socioeconomic differences in sickness absence – the Whitehall II Study. BMJ – British Medical Journal, 306(6874), 361–6.Google Scholar
Oakes, J. M. & Rossi, P. H. (2003). The measurement of SES in health research: current practice and steps toward a new approach. Social Science and Medicine, 56(4), 769–84.Google Scholar
Pamuk, E.,Makue, D.,Heck, K.,Reuben, C.&Lockner, K. (1998). Socioeconomic status and health chartbook: health, United States, 1998. Hyattsville, MD, US: National Center for Health Statistics.
Pappas, G.,Queen, S.,Hadden, W. & Fisher, G. (1993). The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. New England Journal of Medicine, 329(2), 103–9.Google Scholar
Pickett, K. E. & Pearl, M. (2001). Multilevel analyses of neighbourhood socioeconomic context and health outcomes: a critical review. Journal of Epidemiology and Community Health, 55(2), 111–22.Google Scholar
Rahkonen, O.,Lahelma, E. & Huuhka, M. (1997). Past or present? Childhood living conditions and current socioeconomic status as determinants of adult health. Social Science and Medicine, 44(3), 327–36.Google Scholar
Scambler, G. & Higgs, P. (2001). ‘The dog that didn't bark’: taking class seriously in the health inequalities debate. Social Science and Medicine, 52(1), 157–9.Google Scholar
Sennett, R. & Cobb, J. (1973). The hidden injuries of class. New York:Knopf.
Stansfeld, S. A.,Head, J. & Marmot, M. G. (1998). Explaining social class differences in depression and well-being. Social Psychiatry and Psychiatric Epidemiology, 33(1), 1–9.Google Scholar
Takano, T. & Nakamura, K. (2001). An analysis of health levels and various indicators of urban environments for Healthy Cities Projects. Journal of Epidemiology and Community Health, 55(4), 263–70.Google Scholar
Theorell, T. (2005). Life events before and after the onset of a premature mycardial infarction. In Dohrenwend, B. S. & Dohrenwend, B. P. (Eds.). Stressful life events: their nature and effects, (pp. 101–17). New York: Wiley.
Thoits, P. A. (1995). Stress, coping, and social support processes – where are we – what next?Journal of Health and Social Behavior, 35(Special Issue), 53–79.Google Scholar
Townsend, P. (1974). Inequality and the health service. Lancet, 1(7868), 1179–90.Google Scholar
Turner, R. J.,Wheaton, B. & Lloyd, D. A. (1995). The epidemiology of social stress. American Sociological Review, 60(1), 104–25.Google Scholar
Mheen, H.,Stronks, K.,Schrijvers, C. T. & Mackenbach, J. P. (1999). The influence of adult ill health on occupational class mobility and mobility out of and into employment in The Netherlands. Social Science and Medicine, 49(4), 509–18.Google Scholar
Villermé, R. L. (1840). Tableau de l'etat physique et moral des ouvriers employés dans les manufactures de coton, de laine et de soie, Vol. 2. Paris: Renouard.
Virchow, R. (1985). Report on the typhus epidemic in Upper Silesia (1848). In Rather, L. J. (Ed.). Collected essays on public health and epidemiology, (pp. 205–319). Madison, WI: Watson Publishing International.
Whitehead, M. (1990). The concepts and principles of equity and health. Copenhagen: World Health Organization.
Wilkinson, R. G. (1999). Health, hierarchy, and social anxiety. Annals of the New York Academy of Sciences, 896, 48–63.Google Scholar
Willems, S.,Maesschalck, S.,Deveugele, M.,Derese, A. & Maeseneer, J. (2005). Socio-economic status of the patient and doctor-patient communication: does it make a difference?Patient Education and Counseling, 56(2), 139–46.Google Scholar
Young, F. W. (2004). Socioeconomic status and health: the problem of explanation and a sociological solution. Social Theory and Health, 2, 123–41.Google Scholar

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