Some Observations on Health and Socio economic Status.

Health and socio-economic status are powerfully linked. This association cannot be attributed to social-selection effects, and the unequal distribution of behavioural risk factors, such as smoking, explains only a part of the variance. Differential exposure to physical hazards plays a role, but the persistence of health differentials into the better-off social strata and the significance of relative as well as absolute living standards suggest psychosocial factors also. We outline a conceptual model that regards the clustering of adverse physical and psychosocial factors over the life course as critical. Identifying the salient physical and psychosocial factors is a formidable research mission. In pursuing this mission we should not lose sight of the key fact that socio economic health differentials are intimately bound up with material differentials, and that remediation demands strategies that counter socio-economic disparity.