Socioeconomic status and health: The challenge of the gradient

Adler, Nancy E.; Boyce, Thomas; Chesney, Margaret A.; Cohen, Sheldon; Folkman, Susan; Kahn, Robert L.; Syme, S. Leonard

doi:10.1037/0003-066x.49.1.15

Cited by 2,383Health disparities and outcomesPublic Health and Social InequalitiesEmployment and Welfare Studies

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Socioeconomic status and health: The challenge of the gradient

Adler, Nancy E., Boyce, Thomas, Chesney, Margaret A., Cohen, Sheldon, Folkman, Susan, Kahn, Robert L., Syme, S. Leonard·1994·American Psychologist

DOI 10.1037/0003-066x.49.1.15

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Abstract

SES is consistently associated with health outcomes, yet little is known about the psychosocial and behavioral mechanisms that might explain this association. Researchers usually control for SES rather than examine it. When it is studied, only effects of lower, poverty-level SES are generally examined. However, there is evidence of a graded association with health at all levels of SES, an observation that requires new thought about domains through which SES may exert its health effects. Variables are highlighted that show a graded relationship with both SES and health to provide examples of possible pathways between SES and health end points. Examples are also given of new analytic approaches that can better illuminate the complexities of the SES-health gradient.

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Stress is one of several mediating pathways by which lower socioeconomic status raises the risk of poor physical and mental health.
“It is prominent among the several mediating mechanisms through which risk for poor physical and mental health increases in inverse relation to socioeconomic status (SES; Adler et al., 1994).”
From Stress and the development of self-regulation in context (2010) · cites this paper as Adler et al., 1994

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Authors: Adler, N. E., Boyce, T., Chesney, M. A., Cohen, S., Folkman, S., Kahn, R. L., & Syme, S. L.
ORCID: Adler, Nancy E.
Chesney, Margaret A.
Cohen, Sheldon
Kahn, Robert L.
Syme, S. Leonard
Venue: American Psychologist
Publisher: American Psychological Association (APA)
Published: 1994
Volume: 49
Issue: 1
Pages: 15-24
ISSN: 0003-066X (ISSN-L)
1935-990X
DOI: 10.1037/0003-066x.49.1.15
OpenAlex: W4252136409
Cited by: 2,383
References: 10
Citations by year: 2026: 51 · 2025: 109 · 2024: 99 · 2023: 87 · 2022: 118 · 2021: 117 · 2020: 101 · 2019: 101 · 2018: 124 · 2017: 107 · 2016: 101 · 2015: 114 · 2014: 106 · 2013: 99 · 2012: 71
FWCI: 49.72
Type: journal article
Language: en
Open access: closed
Locations: American Psychologist (publishedVersion)
KiltHub Repository (submittedVersion)
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: socioeconomic status, health disparities, social gradient, psychosocial mechanisms, behavioral mechanisms, poverty, health outcomes

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Socioeconomic status and health: The challenge of the gradient

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