ABSTRACT
This chapter discusses the major pathways by which social hierarchy shapes both physical and mental health. Individuals of lower socioeconomic position (SEP) experience disproportionately higher rates of disease (e.g., rheumatoid arthritis, common cold, Alzheimers's Disease) and poorer mental health (e.g., mental disorders and poor subjective well-being). A number of objective and subjective measures of SEP are used in the literature, with the most common indicators being income, education, and occupation. Stress and negative affect act as primary mechanisms by which SEP contributes to poor health, and a number of psychosocial risks (e.g., social isolation) and resilience (e.g., social support) factors mediate these relationships. Health behaviors (e.g., smoking, diet) act as another primary pathway by which SEP affects health. Our current knowledge of the SEP-health relationship has some limitations. Strong measurement of psychosocial constructs is often missing in population-level research, and changes in SEP throughout the lifecourse have not been assessed in a majority of the literature. Methods for addressing these limitations may include a multidisciplinary approach to future research, as well as an increased focus on longitudinal data.
