Control and Health: An Epidemiological Perspective
The problem that first brought me to the concept of control involved a research project on socioeconomic status (SES). I had for several years been interested in the fact that disease rates varied by SES: The lower the
This gradient is not unique to British civil servants. It has been observed in a wide variety of populations in many different countries and it is not confined to a single disease entity or age group. The gradient has been observed for many body systems including the digestive, genitourinary, respiratory, circulatory, nervous, blood, and endocrine systems. It has been observed also for most malignancies, congenital anomalies, infections and parasitic diseases, accidents, poisoning and violence, perinatal mortality, diabetes, and musculo-skeletal impairments (Susser, Watson, & Hooper, 1985). It is very difficult to explain these gradients and, especially, to account for differences between those at the top of the hierarchy and those just one or two steps down.