Socioeconomic disparities in health: pathways and policies.

Socioeconomic status (SES) underlies three major determinants of health: health care, environmental exposure, and health behavior. In addition, chronic stress associated with lower SES may also increase morbidity and mortality. Reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health. Lessons for U.S. policy approaches are taken from the Acheson Commission in England, which was charged with reducing health disparities in that country.

[1]  J. Salonen,et al.  Why do poor people behave poorly? Variation in adult health behaviours and psychosocial characteristics by stages of the socioeconomic lifecourse. , 1997, Social science & medicine.

[2]  T. Selden,et al.  Waiting in the wings: eligibility and enrollment in the State Children's Health Insurance Program. , 1999, Health affairs.

[3]  Jeremy N. Morris,et al.  The independent inquiry into inequalities in health , 1998, BMJ.

[4]  Catherine E. Ross,et al.  The links between education and health. , 1995 .

[5]  Sir Donald Acheson Independent inquiry into inequalities in health report , 1998 .

[6]  D. Gregorio,et al.  The effects of occupation-based social position on mortality in a large American cohort. , 1997, American journal of public health.

[7]  K. Emmons,et al.  Coverage of smoking cessation treatment by union health and welfare funds. , 2001, American journal of public health.

[8]  J. Milyo Income distribution, socioeconomic status, and self rated health in US , 1999, BMJ.

[9]  Ichiro Kawachi,et al.  Income distribution and mortality: cross sectional ecological study of the Robin Hood index in the United States , 1996, BMJ.

[10]  S. Cobb,et al.  The experience of losing a job: some effects on cardiovascular functioning. , 1980, Psychotherapy and psychosomatics.

[11]  J. Prochaska,et al.  The association of school environments with youth physical activity. , 2001, American journal of public health.

[12]  D. Baker,et al.  Health insurance and access to care for symptomatic conditions. , 2000, Archives of internal medicine.

[13]  M. Marmot,et al.  Contribution of job control and other risk factors to social variations in coronary heart disease incidence , 1997, The Lancet.

[14]  M. Feinglos,et al.  Relaxation-induced Improvement in Glucose Tolerance Is Associated with Decreased Plasma Cortisol , 1984, Diabetes Care.

[15]  Joseph R. Blasi,et al.  A Working Nation: Workers, Work, and Government in the New Economy , 2000 .

[16]  J. Schwartz,et al.  The impact of anticipation of job loss on psychological distress and worksite blood pressure. , 1992, American journal of industrial medicine.

[17]  Bruce G. Link,et al.  Social conditions as fundamental causes of disease. , 1995, Journal of health and social behavior.

[18]  F. A. Soper The economics of smoking. , 1972, Rehabilitation: Sozialmedizin, physikalische Medizin, Praventivmedizin; internationale Zeitschrift mit Zentralblatt.

[19]  A. Deaton Inequalities in Income and Inequalities in Health , 1999 .

[20]  P. Martikainen,et al.  The effects of differential unemployment rate increases of occupation groups on changes in mortality. , 1998, American journal of public health.

[21]  M. Schechter,et al.  Social inequalities in male mortality amenable to medical intervention in British Columbia. , 1999, Social science & medicine.

[22]  J. Lynch,et al.  Inequality in income and mortality in the United States: analysis of mortality and potential pathways , 1996, BMJ.

[23]  A A Rimm,et al.  Outcome after allogeneic bone marrow transplant for leukemia in older adults. , 1993, JAMA.

[24]  M. Fiore,et al.  Trends in cigarette smoking in the United States. Educational differences are increasing. , 1989 .

[25]  L. Alecxih,et al.  Out-of-pocket health spending by poor and near-poor elderly Medicare beneficiaries. , 1999, Health services research.

[26]  P. Sorlie,et al.  A comparison of the relationships of education and income with mortality: the National Longitudinal Mortality Study. , 1999, Social science & medicine.

[27]  S. Fortmann,et al.  Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. , 1992, American journal of public health.

[28]  P. Watson,et al.  Explaining rising mortality among men in eastern Europe. , 1995, Social science & medicine.

[29]  M. Antoni,et al.  Reductions in Herpes Simplex Virus Type 2 Antibody Titers After Cognitive Behavioral Stress Management and Relationships With Neuroendocrine Function, Relaxation Skills, and Social Support in HIV-Positive Men , 2000, Psychosomatic medicine.

[30]  Clyde Hertzman,et al.  Population health and human development. , 1999 .

[31]  Robert D. Putnam,et al.  Bowling alone: the collapse and revival of American community , 2000, CSCW '00.

[32]  E. Rodriguez,et al.  Keeping the unemployed healthy: the effect of means-tested and entitlement benefits in Britain, Germany, and the United States. , 2001, American journal of public health.

[33]  Alan C. Monheit,et al.  Race/Ethnicity and Health Insurance Status: 1987 and 1996 , 2000 .

[34]  M. J. Brown,et al.  The effectiveness of housing policies in reducing children's lead exposure. , 2001, American journal of public health.

[35]  D. Ellwood Anti-Poverty Policy for Families in the Next Century: From Welfare to Work--and Worries , 2000 .

[36]  M. Angell,et al.  Privilege and health--what is the connection? , 1993, The New England journal of medicine.

[37]  J. Atkinson,et al.  Reinventing public health. , 1994, The Journal of the Florida Medical Association.

[38]  S. Wilson,et al.  Unemployment and health: a review. , 1993, Public health.

[39]  McGinnis Jm,et al.  Actual causes of death in the United States. , 1993 .

[40]  S. Gortmaker,et al.  Recent trends in the prevalence and severity of childhood asthma. , 1992, JAMA.

[41]  C. A. Johnson,et al.  Tailoring outdoor tobacco advertising to minorities in Los Angeles County. , 1998, Journal of health communication.

[42]  S. Raudenbush,et al.  Neighborhoods and violent crime: a multilevel study of collective efficacy. , 1997, Science.

[43]  S. Serxner,et al.  The effect of ambient threats to employment on low birthweight. , 1992, Journal of health and social behavior.

[44]  H Labelle,et al.  A new perspective on the health of Canadians. , 1976, AARN news letter.

[45]  A. Tarlov,et al.  Public Policy Frameworks for Improving Population Health , 1999, Annals of the New York Academy of Sciences.

[46]  A. Hoffman American Project : The Rise and Fall of a Modern Ghetto , 2000 .

[47]  E. Brunner,et al.  Socioeconomic determinants of health: Stress and the biology of inequality , 1997 .

[48]  A F Subar,et al.  US adults' fruit and vegetable intakes, 1989 to 1991: a revised baseline for the Healthy People 2000 objective. , 1995, American journal of public health.

[49]  L. Claudio,et al.  Socioeconomic factors and asthma hospitalization rates in New York City. , 1999, The Journal of asthma : official journal of the Association for the Care of Asthma.

[50]  M. Marmot Acting on the evidence to reduce inequalities in health. , 1999, Health affairs.

[51]  G. Smith,et al.  The Black report on socioeconomic inequalities in health 10 years on. , 1990, BMJ.

[52]  David A. Leon,et al.  Educational level and adult mortality in Russia: an analysis of routine data 1979 to 1994. , 1998, Social science & medicine.

[53]  A. Monheit,et al.  Race/ethnicity and health insurance status: 1987 and 1996. , 2000, Medical care research and review : MCRR.

[54]  H. Kraemer,et al.  Pathways by Which SES and Ethnicity Influence Cardiovascular Disease Risk Factors , 1999, Annals of the New York Academy of Sciences.

[55]  S. Folkman,et al.  Socioeconomic inequalities in health. No easy solution. , 1993 .

[56]  W. McIsaac,et al.  Socio-economic status and the utilisation of physicians' services: results from the Canadian National Population Health Survey. , 2000, Social science & medicine.

[57]  S. Lipsitz,et al.  Socioeconomic status and risk for substandard medical care. , 1992, JAMA.

[58]  R. Wilkinson Unhealthy Societies: The Afflictions of Inequality , 1996 .

[59]  S. Saegert,et al.  Residential crowding in the context of inner city poverty. , 2000 .

[60]  J. E. Lincoln Actual Causes of Death in the United States , 1994 .

[61]  Hilleboe He The environment and public health. , 1961 .

[62]  P. Morris,et al.  The Self-Sufficiency Project at 36 Months: Effects on Children of a Program That Increased Parental Employment and Income. , 2000 .

[63]  M. Moffatt,et al.  Asthma--An Epidemic in the Absence of Infection? , 1997, Science.

[64]  P. Blackman Actual causes of death in the United States. , 1994, JAMA.

[65]  B Kennedy,et al.  Income inequality, primary care, and health indicators. , 1999, The Journal of family practice.

[66]  M. Dignan Socioeconomic Status and Health in Industrial Nations: Social, Psychological and Biological Pathways , 2001 .

[67]  C. Hafner-Eaton,et al.  Physician utilization disparities between the uninsured and insured. Comparisons of the chronically ill, acutely ill, and well nonelderly populations. , 1993, JAMA.

[68]  G. Evans,et al.  Conceptual and analytic issues in crowding research. , 1992 .

[69]  M. Katz,et al.  Estimation of health benefits from a local living wage ordinance. , 2001, American journal of public health.

[70]  W. Hadden,et al.  The increasing disparity in mortality between socioeconomic groups in the United States, 1960 and 1986. , 1993, The New England journal of medicine.