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The existence of inequality—a property of the population in question—thus has important consequences for the health of individuals and groups. Better understanding of the mechanisms involved may suggest concrete ways to improve the health of both individuals and population subgroups.
Social environments that are less divisive, less undermining of self-confidence, less productive of social antagonism, and more supportive of developing skills and abilities are likely to contribute to the overall health and welfare of the population.
Socioeconomic Factors Influencing Health An extensive literature, dating back more than a century Sorokin, ; Antonovsky, ; Bunker et al. These hierarchies have usually been defined by household income, years of education, and occupational prestige or grade.
In both industrialized and less industrialized countries, persons of higher socioeconomic status SES live longer and have lower rates of most diseases than their less favored counterparts Behm, ; Grosse and Auffrey, ; Holzer et al.
Some studies from less industrialized countries, such as a study of Nigerian civil servants Markovic et al. This may reflect differences in the historical time period across societies in the secular distribution of disease.
In the United States, for example, higher position in the SES hierarchy was associated with greater prevalence of heart disease earlier this century, but SES is currently inversely related to cardiovascular risk Morgenstern, Thus, apparently discrepant findings highlight the importance of attending to broader social and historical contexts.
Of particular importance is a gradient in the relationship between SES and health: Most of the evidence supporting this relationship derives from European and North American populations, where the data are consistent and robust.
At the same time, several studies document that the gradient is nonetheless characterized by a threshold, usually around the median for income, where additional increases in SES have a diminished effect in reducing morbidity and mortality rates Kitagawa and Hauser, ; Pappas et al.
Research is needed to provide greater understanding of the conditions under which particular markers of SES manifest patterns of linear or nonlinear associations with health status.
We need to identify the thresholds after which weaker SES effects are observed and to characterize the social, psychological, and material risks and resources that are associated with each level of the SES hierarchy. A growing body of research also reveals that even though overall mortality rates have been declining, socioeconomic differentials in mortality have been widening in recent decades.
Comparing data from the s to those for the late s and s, U. Similarly, widening socioeconomic differentials in mortality have been observed in England, Wales, France, Finland, Norway, and the Netherlands Department of Health and Social Security, ; Kunst and Mackenbach, ; Mackenbach et al.
Widening health disparities appear to be primarily driven by larger improvements in the health of high-SES groups compared to their lower-SES counterparts.
For some health conditions, however, there has been no change in health or worsening health status over time for economically disadvantaged populations Williams and Collins, Although differences between SES groups in access, utilization, and the quality of medical care probably play some role in the widening health inequality Makenbach et al.
A high degree of inequality in a given location e. The countries with the smallest spread of incomes and the smallest proportion of the population in relative poverty have the longest life expectancies Wilkinson, Evidence from multiple sources suggests that the greater the concentration of income at the upper end of the income distribution, the higher the mortality and morbidity rates Wilkinson, ; Kaplan et al.
Socioeconomic inequality also affects health in more complicated ways. It is widely recognized that at the aggregate level average health is negatively correlated to the degree of income inequality.
However, if health status depends not on absolute income but on income relative to that of some reference group, then the relationship between income and health is determined by the relative size of within-group and between-group inequality Deaton, When the ratio of between-group to within-group inequality changes, the mix of high- and low-income status in any particular group changes.
This change alters the measure of the relationship between health and income.Health, Income, and Inequality. NBER Reporter: Lower mortality and morbidity is associated with almost any positive indicator of socioeconomic status, a relationship that has come to be known as "the gradient." and the adverse health effects of lower permanent income accumulate over children's lives, so that the children of poorer.
Health and wealth have always been closely related (Wilkinson, ), and economically disadvantaged racial/ethnic minority populations in the United States experience worse health status on multiple indicators of physical health (Williams, in press).
Futhermore, the addition of both PA and NA revealed some attenuation of the effects of oral health status, socio-economic status, and dental visiting pattern indicating that some of the association of these variables with health-related quality of life reflects underlying mood states.
The literature makes it clear that positive and negative affect may have value for understanding the effects of health indicators such as symptom distress, depression, functional status, and health . Some positive health outcomes linked to demographic indicators show that disease rates are less in some parts of the world because of new vaccines but there are more negative health outcomes linked to demographic indicators.
Some positive health outcomes linked to demographic indicators show that disease rates are less in some parts of the world because of new vaccines but there are more negative health outcomes linked to demographic indicators.