The Relationship Between Social Status and Health: A Conceptual Review

Although “health disparities” have been a long standing interest of public health researchers, the complex relationship between social status and health has only recently captured the attention of sociological students of social inequality. Indeed, the first appearance of a session on health at an RC 28 meeting was in 2003 in Tokyo. However, interest in this topic is expanding rapidly and it clearly is an important direction for future research by our community. The current paper reviews what is known about the relationships between indicators of inequality (primarily social origins, education, occupational status, and income) and health outcomes and also about the effect of health on subsequent socioeconomic status. The evidence regarding many of these relationships is equivocal. But, more important, even when empirical relationships are well established, the social processes that generate them are often under-theorized. In this paper I attempt to lay out the theoretical basis for expecting particular relationships with the intent of encouraging new research.

Research topics I will focus on include the following:
• The effect of trauma experienced in pregnancy on education, adult socioeconomic outcomes, and adult health.
• The effect of childhood illness and injury on education, adult socioeconomic outcomes, and adult health.
• The role of education in affecting health behaviors and health outcomes.
• The effect of social rank on health behaviors and health outcomes.
• The effect of income on health behaviors and health outcomes.
• The role of poverty as an added detriment to health.
• The effect of health on socioeconomic achievement.
• Methodological issues:
   • Getting adequate retrospective data to measure childhood illness and injury in surveys of adults.
   • Improving subjective health assessments through anchoring and other techniques.
   • How useful are biometric measurements, including blood and saliva samples, in general population surveys?