Handbook of the Sociology of Health, Illness, and Healing

Part of the series Handbooks of Sociology and Social Research pp 67-81


Fundamental Causality: Challenges of an Animating Concept for Medical Sociology

  • Jeremy FreeseAffiliated withDepartment of Sociology, Northwestern University Email author 
  • , Karen Lutfey

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Arguably, the most important problem at the intersection of sociology and epidemiology is how to understand the pervasive positive relationship between various indicators of social position (hereafter, socioeconomic status or SES) and health. The lower status people are, the sooner they die, and the worse health they have while alive. Negative associations between SES and health overall have been found in almost every place and time for which data permit adequate study, implying that the generalization has held even as the prevalence of particular causes of ill-health and death have varied (see reviews in Marmot 2004; Link and Phelan 1995; Deaton 2002; House et al. 1990). In addition, data suggest that the negative association between at least some indicators of SES and some indicators of health may be increasing in some populations, including the United States (Duncan 1996; Lauderdale 2001; Preston and Elo 1995; Steenland et al. 2004; Krieger et al. 2008). Meara et al. (2008) found that while life expectancy had increased 1.6 years between 1990 and 2000 among those who had attended college, it had not increased at all over this same period among those who had not. While various caveats can be raised, none should detract from appreciating that socioeconomic disparities in health in studied populations overwhelmingly are pervasive and profound.