Inequalities in women's health may be better understood outside the strait-jacket of class by using indicators which more sensitively measure women's structural position. This chapter argues that the dominance of structural/materialist explanations of inequalities in women's health has blinded researchers to the ways in which women's roles intersect and amplify structural inequalities. For a married woman there may be some direct effect of her own paid employment on her health, but the major effect of material conditions is likely to be better captured by a household-based measure. Occupational class has dominated analyses of men's health, but role analysis has been the predominant framework used for analyzing women's health. The Black Report found little evidence that poor health selects people out of higher classes resulting in their 'drift' down the class structure. To help understand inequalities in women's health it is essential to have a clear model of the relationships between relevant variables.