Cited by 661Health disparities and outcomesPublic Health and Social InequalitiesEmployment and Welfare Studies

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Social inequalities in health: Next questions and converging evidence

Marmot, Michael, Ryff, Carol D., Bumpass, Larry L., Shipley, Martin, Marks, Nadine F.·1997·Social Science & Medicine

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Abstract

Mortality studies show that social inequalities in health include, but are not confined to, worse health among the poor. There is a social gradient: mortality rises with decreasing socio-economic status. Three large sample studies, one British and two American, brought together for their complementarity in samples, measures, and design, all show similar social gradients for adult men and women in physical and mental morbidity and in psychological well-being. These gradients are observed both with educational and occupational status and are not explained by parents' social status or lack of an intact family during childhood. They are also not accounted for by intelligence measured in school. This suggests that indirect selection cannot account for inequalities in health. Possible mediators that link social position to physical and mental health include smoking and features of psycho-social environment at work and outside.

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Authors: Marmot, M., Ryff, C. D., Bumpass, L. L., Shipley, M., & Marks, N. F.
Affiliations: University College London (GB)
University of Wisconsin–Madison (US)
University of Wisconsin System (US)
ORCID: Marmot, Michael
Ryff, Carol D.
Venue: Social Science & Medicine
Publisher: Elsevier BV
Published: 1997-03
Volume: 44
Issue: 6
Pages: 901-910
ISSN: 0277-9536 (ISSN-L)
DOI: 10.1016/s0277-9536(96)00194-3
OpenAlex: W1966184844
Cited by: 661
References: 49
Citations by year: 2026: 2 · 2025: 4 · 2024: 10 · 2023: 11 · 2022: 18 · 2021: 21 · 2020: 21 · 2019: 23 · 2018: 23 · 2017: 18 · 2016: 30 · 2015: 23 · 2014: 25 · 2013: 30 · 2012: 27
FWCI: 23.67
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Social Science & Medicine (publishedVersion)
PubMed (publishedVersion)
RePEc: Research Papers in Economics (submittedVersion)
UCL Discovery (University College London) (submittedVersion)
Funders: Agency for Healthcare Research and Quality (5RO1 HS06516)
National Institute on Aging (AG9775, R01AG009775)
National Heart, Lung, and Blood Institute (2 RO1 HL36310-04, R01HL036310)
Topics: Social Sciences › Health › Health disparities and outcomes
Social Sciences › Health › Public Health and Social Inequalities
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Employment and Welfare Studies
Keywords: health disparities, social gradient, mortality, socioeconomic status, educational attainment, occupational status, psychiatric morbidity, physical morbidity, psychological well-being, indirect selection, parental social status, family structure, intelligence, smoking, work environment, psychosocial environment
MeSH terms: Adult, Female, United Kingdom, Health Status, Humans, Male, Mortality, Social Class, Social Justice, Socioeconomic Factors, United States, Causality, Odds Ratio, Occupational Health

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Social inequalities in health: Next questions and converging evidence

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