Lynch J. Social position and health. Annals of Epidemiology 1996; 6: 21-3

This editorial reflects on the increasing interest in the relationship between socioeconomic status (SES) and health. This is termed health inequalities in Europe where the bulk of the research has been done. Characterizing a particular societal niche is difficult and varies over time and place. Income is seen as an important characteristic, because it is most easily changed by structural means. Furthermore, income affects health all the way up the ladder, not just those at the bottom where the effect is much more pronounced. Family incomes less than $25,000 US appear to be where the mortality risk is most strongly related to income level, a niche where most US families sit. Wealth may have a more profound effect on health. Attempts to explain this relationship are varied, and include higher exposure to the usual risk factors for poor health. However, these adverse health behaviors such as smoking may be merely the pathways by which low SES leads to poor health. Changing health behaviors is easier in higher SES groups. Disentangling race and ethnicity is difficult as well, reports suggest that SES is the over-riding factor. Economic inequality looms as the ominous measure affecting health, although there is relatively little information on the likely impacts. What is needed, perhaps, is a document in the US like the British Black Report on inequalities in health that acted as a catalyst for research and debate over economic policies. 

Keywords

• behavioral factors
• health inequalities
• income
• income inequality
• medical care
• mental illness
• mortality
• poverty
• psychosocial factors
• race
• relative deprivation
• social cohesion
• socioeconomic status
• wealth inequality