American Journal of Public Health · 2010 · 1.5K citations · 105 references
Public HealthPopulation Health SciencesHealth EquityPopulation HealthSocial Determinants Of HealthHealth DisparitiesSocial EpidemiologySocioeconomic Determinants Of HealthArea-level Socioeconomic DeprivationHealth Inequalities AnalysisPopulation Health DisparitiesPublic Health IndicatorsSocioeconomic Gradient AnalysisSocioeconomic Health DisparitiesSocioeconomic Health GradientsSocioeconomic Inequalities In Morbidity
OBJECTIVES: We aimed to describe socioeconomic disparities in the United States across multiple health indicators and socioeconomic groups. METHODS: Using recent national data on 5 child (infant mortality, health status, activity limitation, healthy eating, sedentary adolescents) and 6 adult (life expectancy, health status, activity limitation, heart disease, diabetes, obesity) health indicators, we examined indicator rates across multiple income or education categories, overall and within racial/ethnic groups. RESULTS: Those with the lowest income and who were least educated were consistently least healthy, but for most indicators, even groups with intermediate income and education levels were less healthy than the wealthiest and most educated. Gradient patterns were seen often among non-Hispanic Blacks and Whites but less consistently among Hispanics. CONCLUSIONS: Health in the United States is often, though not invariably, patterned strongly along both socioeconomic and racial/ethnic lines, suggesting links between hierarchies of social advantage and health. Worse health among the most socially disadvantaged argues for policies prioritizing those groups, but pervasive gradient patterns also indicate a need to address a wider socioeconomic spectrum-which may help garner political support. Routine health reporting should examine socioeconomic and racial/ethnic disparity patterns, jointly and separately.
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