Socioeconomic Status and Health over the Life Course: Capital as a Unifying Concept

On average, individuals of lower socioeconomic status (SES)—based on education, income, or occupation—have worse health than their higher SES counterparts (Adler, Boyce, Chesney, Folkman, & Syme, 1993; Antonovsky, 1967; Feinstein, 1993; Feldman, Makuc, Kleinman, & Cornoni-Huntley, 1989; House, Kessler, & Herzog, 1990; Kitagawa & Hauser, 1973; Marmot, Shipley, & Rose, 1984; Pappas, Queen, Hadden, & Fisher, 1993; Preston & Taubman, 1994; Townsend & Davidson, 1982). This relationship is best depicted as a gradient in health with a fairly linear trend in better health associated with increasing levels of SES, rather than a threshold effect. Furthermore, this relationship is stratified by age; lower SES individuals begin to experience health problems shortly after adolescence, while higher SES individuals experience little health decline until around retirement age (House et al, 1990, 1994). This life course patterning of SES and health is intriguing since it suggests substantial variation in the ability of each group to sustain good health over the life course.