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Socioeconomic Status & Health

PROLOGUE

Socioeconomic Status And Health

As a result, evidence supporting discrete, targeted policy interventions to mitigate the effects of SES on health is never easy to produce. Absent such evidence, policymakers bent on reducing disparities may see no alternative but to seek a fundamental redistribution of wealth—a noble but politically overwhelming task.

The two papers that follow attempt to break this analytical problem down to manageable proportions. David Mechanic, who has written frequently on SES and health during his distinguished forty-year career, tackles the complicated relationship between broad interventions to improve population health and targeted efforts to reduce disparities. Infant mortality among African Americans, for example, has fallen dramatically since mid-century but has not kept pace with parallel improvements among whites. The question for policymakers is how the benefits of the interventions that produced these gains could be more equitably distributed.

Nancy Adler and Katherine Newman explore in further detail the multiple pathways by which the primary dimensions of SES—income, education, and occupation—may influence health status. These "powerful yet mysterious determinants" may transmit their effects through a variety of environmental risks, behavior patterns, access to care, or stress factors, Adler and Newman explain. In the face of political resistance and inertia, interventions must be tailored to well-researched "causal pathways" that clearly establish the links between SES and health.

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