Population health: challenges for science and society.
The emphasis on risk factor intervention at the individual level has predominated in efforts to reduce mortality and promote health. Interest in social and other nonmedical interventions, particularly socioeconomic status (SES) influences, has increased in recent years. This article focuses on the interaction of social structure and socioeconomic status with other influences in complex pathways to affect health, and their contribution to health disparities. It examines both social class as an explanation of health differences and competing hypotheses concerning prenatal and early nutrition and cognitive capacity. Although education is associated with income, wealth, occupation, and other SES indicators and may not be the most important SES determinant, it influences a variety of pathways to health outcomes and offers strategic leverage for intervention because of social and political consensus on its value beyond health.
Mechanic
David
D
Insitute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ 08901-1293, USA. mechanic@rci.rutgers.edu
D003071:Cognition; D004522:Educational Status; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends; D007231:Infant, Newborn; D009752:Nutritional Status; D011159:Population Surveillance; D012923:Social Class; D012924:Social Conditions; D014481:United States
Health Serv Res. 2003 Jun;38(3):831-65
12822915
J Health Soc Behav. 2004 Sep;45(3):265-85
15595507
Am J Epidemiol. 2005 May 1;161(9):831-9
15840615
Matern Child Health J. 2003 Mar;7(1):13-30
12710797
Milbank Q. 1993;71(1):41-64
8450822
BMJ. 1995 Jul 15;311(6998):171-4
7613432
N Engl J Med. 2005 Oct 27;353(17):1802-9
16251536
BMJ. 2003 Jun 28;326(7404):1419
12829553
Pediatrics. 2002 Apr;109(4):608-14
11927704
JAMA. 1998 Jul 22-29;280(4):373-4
9686557
N Engl J Med. 2006 Aug 31;355(9):920-7
16943404
Inquiry. 1980 Winter;17(4):331-8
6450165
Soc Sci Med. 1999 Jun;48(11):1599-611
10400260
Annu Rev Public Health. 2003;24:341-62
12471271
Health Aff (Millwood). 2002 Mar-Apr;21(2):48-59
11900186
Proc Natl Acad Sci U S A. 2006 Nov 14;103(46):17308-12
17101998
Soc Sci Med. 1996 Jan;42(1):47-57
8745107
Int J Epidemiol. 2006 Aug;35(4):817-24
16931525
JAMA. 1997 Feb 19;277(7):535-42
9032159
J Epidemiol Community Health. 2004 Apr;58(4):327-32
15026449
Sci Am. 1980 Nov;243(5):53-9
7423181
JAMA. 1998 Jul 22-29;280(4):329-35
9686549
BMJ. 2006 Mar 18;332(7542):617-8
16543302
N Engl J Med. 1998 Jul 30;339(5):313-20
9682045
Ann N Y Acad Sci. 2001 Dec;954:118-39
11797854
Am J Public Health. 2007 Apr;97(4):679-83
17329654
Am J Epidemiol. 1998 Feb 1;147(3):213-6
9482494
BMJ. 2006 Mar 18;332(7542):659-62
16543339
N Engl J Med. 2005 Oct 27;353(17):1848-50
16251542
J Epidemiol Community Health. 1998 Mar;52(3):153-60
9616419
BMJ. 2006 Mar 11;332(7541):580-4
16452104
Int J Epidemiol. 1985 Mar;14(1):32-8
3872850
Int J Epidemiol. 2001 Feb;30(1):15-23
11171842
J Health Soc Behav. 1995;Spec No:80-94
7560851
BMJ. 2001 Dec 1;323(7324):1273-6
11731388
JAMA. 2005 Aug 3;294(5):557-62
16077049
Philos Trans R Soc Lond B Biol Sci. 2004 Sep 29;359(1449):1359-66
15347527
J Pers Soc Psychol. 2004 Jan;86(1):174-99
14717635
Demography. 2004 Nov;41(4):773-800
15622954
Am Sociol Rev. 1982 Dec;47(6):752-64
7171158
Proc Natl Acad Sci U S A. 2006 Nov 14;103(46):17071-2
17101997
J Econ Perspect. 1999 Spring;13(2):144-66
15179962
JAMA. 1998 Jul 22-29;280(4):336-40
9686550
Popul Dev Rev. 2010;36(4):655-92
21174865
Rev Am Hist. 2004 Mar;32(1):128-36
15143753
BMJ. 2004 Dec 18;329(7480):1447-50
15604180
BMJ. 2003 Jun 28;326(7404):1407-8
12829526
Int J Epidemiol. 2002 Feb;31(1):34-7
11914289