Socioeconomic Disparities in Health Behaviors

Abstract

The inverse relationships between socioeconomic status (SES) and unhealthy behaviors such as tobacco use, physical inactivity, and poor nutrition have been well demonstrated empirically but encompass diverse underlying causal mechanisms. These mechanisms have special theoretical importance because disparities in health behaviors, unlike disparities in many other components of health, involve something more than the ability to use income to purchase good health. Based on a review of broad literatures in sociology, economics, and public health, we classify explanations of higher smoking, lower exercise, poorer diet, and excess weight among low-SES persons into nine broad groups that specify related but conceptually distinct mechanisms. The lack of clear support for any one explanation suggests that the literature on SES disparities in health and health behaviors can do more to design studies that better test for the importance of the varied mechanisms.

The association between personal income and smoking among adolescents: a study in six European cities

“…As addiction increases, it is more difficult to stop smoking or decrease the cigarette consumption following a negative income shock or a rise in prices. Fifthly, the reasons for the inverse gradient in smoking among adults are related to causes that may not prevail among adolescents, such as chronic stress caused by deprivation and living in disadvantaged neighbourhoods or low access to smoking cessation services 34. Finally, the literature indicates that while there is an inverse relationship among adults between income and smoking, a short‐term increase in income may lead to higher cigarette consumption 35.…”

Mental health problems among 4–17-year-olds with hearing problems: results from a nationally representative study

“…These included family structure, equivalised household income, highest level of caregiver education, whether or not the child's household had at least one parent in employment, residential remoteness, financial strain (where the parent indicated they had experienced difficulties such as not being able to pay bills on time), and the smoking status of the primary carer, which can proxy for other poor health-related behaviours [37]. The mental health of the primary carer was indexed on the Kessler Psychological Distress Scale (K10) [38] a measure of non-specific psychological distress in the last four weeks.…”

Colon cancer surgery following emergency presentation: effects on admission and stage-adjusted outcomes

“…Aside from intrinsically adding even more risk and disease burden, these characteristics are also associated with low socioeconomic status, 27,28 low health literacy, 29 and poor access to health care, 30 which may explain in part why emergency presentations come with more serious disease: for these underprivileged patients, often reluctant to seek medical attention until their symptoms become too severe to ignore, the ED is often the primary presentation site. In that sense, it is hardly a surprise to see these patients with both more advanced and more aggressive disease.…”