Socioeconomic Status and Health: What We Know and What We Don't


Address for correspondence: Nancy E. Adler, Health Psychology Program, Center for Health and Community, University of California San Francisco, 3333 California Street, Suite 465, California 94143-0844, USA. 415-476-7759 (voice); 415-476-7744 (fax). e-mail:


Abstract: In the past 15 years, we have seen a marked increase in research on socioeconomic status (SES) and health. Research in the first part of this era examined the nature of the relationship of SES and health, revealing a graded association; SES is important to health not only for those in poverty, but at all levels of SES. On average, the more advantaged individuals are, the better their health. In this paper we examine the data regarding the SES-health gradient, addressing causal direction, generalizability across populations and diseases, and associations with health for different indicators of SES. In the most recent era, researchers are increasingly exploring the mechanisms by which SES exerts an influence on health. There are multiple pathways by which SES determines health; a comprehensive analysis must include macroeconomic contexts and social factors as well as more immediate social environments, individual psychological and behavioral factors, and biological predispositions and processes.