For at least 30 years, it has been recognized that poor people have poor health, and that their sickness is not the cause of their poor health. Health inequalities is the term used in the United Kingdom and Europe for this observation, while in the US, the observation is encapsulated in the phrase socioeocomic status and health. More attention has been paid to these effects since the publication of the Black Report in England in 1980. In most public health studies, however, the effects of social class or socioeconomic status on health are statistically controlled and this prevents looking at them and their causes. The reasons for the association are elusive, and not explained by differences in behavioral risk factors such as smoking or relative weight, or even by access to medical care. The range of income distribution, or relative deprivation is probably a key factor in producing this disparity. 

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