Socioeconomic Inequalities in Health
JAMAPublished 23 June 1993
Nancy E. Adler
Citations1,073
SJR quartileQ1
SJR score5.35
SNIP10.71
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
Abstract
Health insurance coverage alone is not likely to reduce significantly SES differences in health. Attention should be paid both in policy decisions and in clinical practice to other SES-related factors that may influence patterns of health and disease.
Keywords
Social SciencesHealth Professions
Psychological BulletinStress, social support, and the buffering hypothesis.
17,063 Citations1985Sheldon Cohen, Thomas A. Wills
There is evidence consistent with both main effect and main effect models for social support, but each represents a different process through which social support may affect well-being.
American Journal of OrthopsychiatryPsychosocial resilience and protective mechanisms.
5,709 Citations1987Michael Rutter
The concept of mechanisms that protect people against the psychological risks associated with adversity is discussed in relation to four main processes: reduction of risk impact, reduction of negative chain reactions, establishment and maintenance of self-esteem and self-efficacy, and opening up of opportunities.
Milbank QuarterlyThe Epidemiologic Transition: A Theory of the Epidemiology of Population Change
3,799 Citations2005Abdel R. Omran
The LancetHealth inequalities among British civil servants: the Whitehall II study
3,605 Citations1991Michael Marmot, S. Stansfeld +8 more
There was an inverse association between employment grade and prevalence of angina, electrocardiogram evidence of ischaemia, and symptoms of chronic bronchitis, and self-perceived health status and symptoms were worse in subjects in lower status jobs.
Psychological BulletinSocioeconomic status and obesity: A review of the literature.
2,307 Citations1989Jeffery Sobal, Albert J. Stunkard
A review of 144 published studies of the relationship between socioeconomic status (SES) and obesity reveals a strong inverse relationship among women in developed societies and values congruent with the distribution of obesity by SES in different societies.
Journal of Personality and Social PsychologyAppraisal, coping, health status, and psychological symptoms.
2,252 Citations1986Susan Folkman, Richard S. Lazarus +2 more
New England Journal of MedicineThe Association of Changes in Physical-Activity Level and Other Lifestyle Characteristics with Mortality among Men
2,002 Citations1993Ralph S. Paffenbarger, Robert T. Hyde +4 more
Starting moderately vigorous sports activity, quitting cigarette smoking, maintaining normal blood pressure, and avoiding obesity were separately associated with lower rates of death from all causes and from coronary heart disease among middle-aged and older men.
New England Journal of MedicinePsychological Stress and Susceptibility to the Common Cold
1,714 Citations1991Sheldon Cohen, D. A. J. Tyrrell +1 more
Psychological stress was associated in a dose-response manner with an increased risk of acute infectious respiratory illness, and this risk was attributable to increased rates of infection rather than to an increased frequency of symptoms after infection.
American PsychologistEstablishing and maintaining healthy environments: Toward a social ecology of health promotion.
1,524 Citations1992Daniel Stokols
The LancetINEQUALITIES IN DEATH—SPECIFIC EXPLANATIONS OF A GENERAL PATTERN?
1,459 Citations1984Michael Marmot, M Shipley +1 more
In the Whitehall study, 17 530 civil servants were classified according to employment grade, and their mortality was recorded over 10 years, showing a steep inverse relation between grade and mortality.
BMJIncome distribution and life expectancy.
1,184 Citations1992Richard G. Wilkinson
There is clear evidence of a strong relation between a societys income distribution and the average life expectancy of its population.
Journal of Epidemiology & Community HealthEmployment grade and coronary heart disease in British civil servants.
1,067 Citations1978Michael Marmot, G Rose +2 more
It is concluded that the higher CHD mortality experienced by working class men can be only partly explained by the established coronary risk factors.
New England Journal of MedicinePsychosocial Influences on Mortality after Myocardial Infarction
984 Citations1984William Ruberman, Eve Weinblatt +2 more
The increase in risk associated with stress and social isolation applied both to total deaths and to sudden cardiac deaths and was noted among men with both high and low levels of ventricular ectopy during hospitalization for the acute infarction.
ScienceAging and Health: Effects of the Sense of Control
957 Citations1986Judith Rodin
Mechanisms mediating the control-health relation include feelings of stress, symptom labeling, changes in the neuroendocrine and immune systems, and behavior relevant to health maintenance.
Milbank QuarterlyAge, Socioeconomic Status, and Health
814 Citations1990James S. House, Ronald C. Kessler +1 more
Cross-sectional data from two national surveys of adults aged 25 years and over show that age and socioeconomic status (SES) are significant predictors of self-reported physical health and that the relation of age to health varies with SES features.
American Journal of EpidemiologyPOVERTY AND HEALTH PROSPECTIVE EVIDENCE FROM THE ALAMEDA COUNTY STUDY
712 Citations1987Mary N. Haan, George A. Kaplan +1 more
Psychosomatic MedicineMajor depressive disorder predicts cardiac events in patients with coronary artery disease.
677 Citations1988Robert M. Carney, Michael W. Rich +5 more
It is concluded that major depressive disorder is an important independent risk factor for the occurrence of major cardiac events in patients with CAD.
Journal of Health and Social BehaviorSocioeconomic Status Differences in Vulnerability to Undesirable Life Events
677 Citations1990Jane D. McLeod, Ronald C. Kessler
It is found that lower-SES vulnerability is not confined to income but extends to education and occupational status as well, and it is concluded that differential vulnerability reflects more than a simple economic reality.
Journal of Personality and Social PsychologyLong-term effects of a control-relevant intervention with the institutionalized aged.
593 Citations1977Judith Rodin, Ellen J. Langer
Journal of Health and Social BehaviorA New Perspective on the Relationships Among Race, Social Class, and Psychological Distress
525 Citations1986Ronald C. Kessler, Harold W. Neighbors
It is demonstrated that most prior research has assumed that the effects of race and social class are additive; the analysis shows that they are actually interactive.
Journal of Personality and Social PsychologyNegative life events, perceived stress, negative affect, and susceptibility to the common cold.
490 Citations1993Sheldon Cohen, D. A. J. Tyrrell +1 more
The assumption that perceptions of stress and negative affect are necessary for stressful life events to influence disease risk is challenged, as higher scores on each of the 3 stress scales were associated with greater risk of developing a cold.
American Journal of Public HealthCervical cancer screening: who is not screened and why?
486 Citations1991Linda C. Harlan, Amy B. Bernstein +1 more
In developing screening programs, Hispanics, particularly Spanish speakers, must be targeted in targeting unscreened women who forego the test due to underestimating its importance, procrastination, or because their medical care provider did not suggest the procedure.
Preventive MedicineSocial class disparities in risk factors for disease: Eight-year prevalence patterns by level of education
317 Citations1990Marilyn A. Winkleby, Stephen P. Fortmann +1 more
A highly significant pattern of associations was found between education level and the six risk factors, in the direction of higher risk among those with lower education, which persisted for both sexes and in the younger as well as the older age groups.
American Journal of EpidemiologySOCIOECONOMIC STATUS, JOHN HENRYISM, AND HYPERTENSION IN BLACKS AND WHITES
312 Citations1987Sherman A. James, David Strogatz +2 more
The joint influence of socioeconomic status and John Henryism on risk for elevated blood pressure was examined in a biracial, community sample of 820 adults who resided in Edgecombe County, North Carolina, and were interviewed in 1983.
JAMAThe Effect of Known Risk Factors on the Excess Mortality of Black Adults in the United States
299 Citations1990Mac W. Otten
Broader social and health system changes and research targeted at the causes of the mortality gap, coupled with increased efforts aimed at modifiable risk factors, may all be needed for egalitarian goals in health to be realized.
Archives of Internal MedicineWho Gets Screened for Cervical and Breast Cancer?
267 Citations1988Richard Hayward
It is suggested that women who are older, uninsured, or lower in socioeconomic status are at an increased risk for not receiving preventive care, and that screening mammography, although more common than a decade ago, is still markedly underused.
American Journal of EpidemiologyEDUCATIONAL ATTAINMENT AND BEHAVIORAL AND BIOLOGIC RISK FACTORS FOR CORONARY HEART DISEASE IN MIDDLE-AGED WOMEN
262 Citations1989Karen A. Matthews, Sheryl F. Kelsey +3 more
Many biologic and behavioral factors by which women with little education are at elevated risk for coronary heart disease are suggested.
Journal of Chronic DiseasesSocioecological stressor areas and black-white blood pressure: Detroit
207 Citations1973Ernest Harburg, John C. Erfurt +4 more
For Black males, the younger, overweight High Stress residents had significantly higher Borderline and Hypertensive levels than did a similar Black Low Stress subgroup, and for both groups, being raised in Detroit and not migrating from elsewhere was related to higher readings.
American Heart JournalCoronary heart disease: Epidemiology of smoking and intervention studies of smoking
192 Citations1988Lars Wilhelmsen
Of great importance regarding community risk of smoking are the many light and moderate smokers.
The LancetHEALTH INEQUALITIES IN BRITAIN AND SWEDEN
173 Citations1989Denny Vågerö, Olle Lundberg
Health differences between social classes are greater in Britain than in Sweden, but persist in both countries despite central Government interventions aimed at the reduction of such differences.
CancerEconomic status and survival of cancer patients
167 Citations1977John W. Berg, Ronald K. Ross +1 more
Host differences associated with poverty that could also account for much of the observed Black‐White differences as well as some international differences in cancer survival rates are postulated.
American Journal of Public HealthRace and weight change in US women: the roles of socioeconomic and marital status.
158 Citations1991Henry S. Kahn, D F Williamson +1 more
Amont US women, Black race is independently associated with a reduced likelihood of major weight loss, but not with major weight gain, and women at greatest risk of weight gain are those with education below college level, those entering marriage, and those with very low family income.
Social Science & MedicineMore resources better health? A cross-national perspective
155 Citations1992Kwangkee Kim, Philip M. Moody
Findings from this study suggest that health resources as a whole do not make a significant contribution to accounting for the variance of infant mortality rates over and above the variance accounted for by socioeconomic resources only.
Social Science & MedicineCausal explanations for class inequality in health—An empirical analysis
153 Citations1991Olle Lundberg
A large part of the class differences in physical as well as mental illness can be understood as a result of systematic differences between classes in living conditions, primarily differences in working conditions.
American Journal of EpidemiologySOCIOECONOMIC STATUS, ETHNICITY, AND RISK OF CORONARY HEART DISEASE1
145 Citations1980Jess F. Kraus, Nemat O. Borhani +1 more
An inverse relationship between SES and risk of CHD and the relationship persisted for whites, Asians, and Spanish Americans but not for blacks, and age adjustment did not significantly alter this finding.
PubMedSocioeconomic status differences in health behaviors related to obesity: the Healthy Worker Project.
143 Citations1991Robert W. Jeffery, Simone A. French +2 more
Weaknesses in the methodologies for measuring health behaviors and possible effects of obesity itself on social mobility are suggested as possible explanations for the residual association between obesity and SES.
PubMedAssociation of breast cancer and cervical cancer incidence with income and education among whites and blacks.
140 Citations1980Susan S. Devesa, Earl L. Diamond
Sociology of Health & IllnessIncome distribution and mortality: a‘natural’experiment
138 Citations1990Richard G. Wilkinson
The striking tendency for life expectancy to be highest in those developed countries where income is distributed most equally, rather than in those which are richest, is starts out from the shape of the relationship between income and health which this implies within nations.
Journal of Epidemiology & Community HealthSocioeconomic status and risk of cancer, cerebral stroke, and death due to coronary heart disease and any disease: a longitudinal study in eastern Finland.
115 Citations1982Jukka T. Salonen
Not being married, short education, and low income are associated with an excessive risk of death from ischaemic heart disease and any disease and those with a short education an increased risk of cancer.
JAMAThe Effect of Providing Health Coverage to Poor Uninsured Pregnant Women in Massachusetts
115 Citations1993Jennifer S. Haas
It is suggested that access to prenatal care may have declined for all women in Massachusetts between 1984 and 1987, and the expansion of health coverage to uninsured low-income pregnant women was not associated with an improvement in access to antenatal care or birth outcomes.
American Journal of Public HealthHealth and the environment in the 1990s.
109 Citations1992Richard Doll
It is concluded that the principal environmental hazards worldwide are those associated with poverty of individuals within the market economies and of communities in the developing countries and that in the future, they will be the effects of overpopulation and the production of greenhouse gases.
Pediatric Clinics of North AmericaPoverty and Child Health
85 Citations1988Paul H. Wise, Alan Meyers
This discussion reviews the clinical expression of poverty in childhood and assesses the clinical and political capacity to reduce its tragic impact.
PEDIATRICSSocioeconomic Status and Low Birth Weight: A Racial Comparison
79 Citations1988Jeffrey B. Gould, Susan LeRoy
There were marked racial differences in the relative risks imposed by one's residential median family income, age, prenatal care, and pattern of interactions, and at the individual level.
The American Journal of CardiologyComparison of long-term outcome after acute myocardial infarction in patients never graduated from high school with that in more educated patients
68 Citations1993Geoffrey H. Tofler, James E. Muller +4 more
The clinical course of 363 patients with acute myocardial infarction who did not complete high school education was compared with that of 453 who completed at least high school, suggesting unidentified causes of mortality, such as lack of compliance with therapy and possible social isolation.
American journal of public healthDEATHS AMONG TAXPAYERS AND NON-TAXPAYERS INCOME TAX, PROVIDENCE, 1865
61 Citations1924Charles V. Chapin
Social Science & MedicineInequality in health—Some theoretical and empirical problems
60 Citations1991Denny Vågerö
It seems clear that a theoretical over-simplification in analysing class and health will prove to be counter-productive and should be taken seriously.
PubMedPhysical activity by socioeconomic status in two population based cohorts.
60 Citations1991Jane A. Cauley, Sharyne Donfield +2 more
Psychosomatic MedicineLife Events and Myocardial Infarction Revisited: The Role of Measures of Individual Impact
55 Citations1980D. G. Byrne, H. M. Whyte
It is suggested that due regard for the experiential uniqueness of life event data has strengthened the relationship between life events and MI, which would not have become apparent with the application of a more conservative research strategy.
American Journal of EpidemiologyFACTORS ASSOCIATED WITH SURVIVAL DIFFERENCES BETWEEN BLACK WOMEN AND WHITE WOMEN WITH CANCER OF THE UTERINE CORPUS1
50 Citations1986Sandra C. Steinhorn, Max H. Myers +2 more
It is suggested that, even when controlling for known markers of racial differences, there remain other underlying prognostic factors associated with survival of black women and white women with adenocarcinomas of the uterine corpus that have yet to be determined.
Family ProcessThe contribution of socioeconomic position to minority health
43 Citations1985Mary N. Haan, G. A. Kaplan
Journal of Toxicology and Environmental HealthLife‐style in occupational cancer
30 Citations1980A M Adelstein
Using data derived from the census report of 1970-1972 concerning occupational mortality in England and Wales, it can be calculated that social class accounts for about 88% of the variation in cancer mortality.
JAMABeyond Universal Health Insurance to Effective Health Care
22 Citations1991Eli Ginzberg, Miriam Ostow
The history of the U.S. governmental health care reform indicates that efforts toward universal health insurance cannot be expected from a financially strapped federal government, and Ginzberg presents interim targets for the expansion of access to health care.
Public Health Reports (1896-1970)Mortality and Economic Level in an Urban Area
12 Citations1960Mary Ellen Patno
This study contains no evidence that an invers,e relationship no longer exists between economic level and mortality, but it does suggest a possible association of mortality with changes in the relative economic levels of residential areas.
JAMAMedical Care Is Not Health Care
6 Citations1993Warren Winkelstein
Was President Bush and are President Clinton and the editors of JAMA really talking about health care or are they talking about "disease" or "medical care"?
Archives of Internal MedicineInsuring the Uninsured Is Not Enough
3 Citations1991James E. Dalen
The May 15, 1991, issue of the Journal of the American Medical Association and the May editions of theAMA's specialty journals focus on another critical defect in the health care system—more than 30 million Americans have no health insurance; additional millions are underinsured.