ABSTRACT
In the opening chapter of this text, we alluded to the links between health and social and material circumstances. Whether indexed by occupational status or by asset-based measures such as household income (Blaxter, 1990) or housing tenure and car ownership (Whitehead, 1988), those at the top of the social scale enjoy substantially lower rates of mortality than those further down. The mortality differentials contingent on social locus typify women as much as they do men (see, eg. Whitehead, 1988). Further, what is true of mortality also applies to morbidity. All the major killer disease groups now affect the less well off more than the rich (Davey Smith et al., 1990). Long-standing illness measures also favour higher income groups (see, eg. Arber, 1989; Blaxter, 1989). Again these morbidity differentials characterize women as much as men (see, eg. Marmot et al., 1991). What seems to be emerging from recent epidemiological research then, is a gradient of morbidity and mortality that applies to both men and women and persists throughout the social and occupational scale. Accordingly, the implications of social and material circumstances for health appear to extend beyond the very poor in society.
