About This Network
We all reside somewhere on life’s “luck and accomplishment” ladder. Some have more education, income, and prestigious jobs, while others have little of each. The rung we stand on determines many things about our life, but none is more fundamental than this: it predicts how long we live and how healthy our life is.
Health disparities between those at the extremes of income, or between black and white Americans are today well documented. Yet when the Network on Socioeconomic Status and Healthy Living first began in 1998, these disparities were only then coming to light. The Network set out to both document the health disparities by socioeconomic status (SES) and find the answers to why higher SES leads to better health.
Key Findings
By now it is well known that poverty shaves off several years of a person’s life. But the Network was surprised to discover that the effect of SES on health is seen up and down the economic ladder. Even those in the middle class have shorter lives than those in the upper classes. In fact, compared to those at the top, premature death is more than twice as likely for middle-income Americans and more than three times as likely for those at the bottom.
The Network also found that better health and longer life are not simply a result of what income can buy. It is the blend of fewer threats and more opportunities that higher socioeconomic status allows—the insights and understanding about health and diet, for example, that education tends to enhance; the fewer threats to safety that more affluent neighborhoods afford; the lower levels of stress that knowledge and security can buy. It is also a self-perpetuating loop: good health leads to higher SES and higher SES leads to good health.
Most revolutionary among the Network’s findings was the role of chronic stress in creating disparities in health. The Network developed a new method to capture the “wear and tear” on the body from the kind of chronic stress that accompanies low SES. They found that even small effects cumulated over multiple physiological functions—the same functions that change with aging—predict the onset of disease and risk of death. Such accelerated aging occurred even at the cellular level.
A second important contribution of the Network was its call to expand health policy beyond health care policy. Most discussions of health policy were reflexively and solely about health care. The Network, however, showed that health is more affected by the 99 percent of our life that is not spent in the doctor’s office. Therefore, to improve the health of the nation, we must also improve conditions that are associated with socioeconomic status, such as housing, work, education, and community.
Finally, the Network improved how we measure SES as it relates to health. Researchers typically gauge SES from reports of income, education, and occupation. However, the Network found that people’s overall view of where they stand on the socioeconomic “ladder” has an even stronger association with their health. The MacArthur Subjective Social Status, which they developed to capture this, has since been used worldwide in well over one-hundred studies. In addition, the Network added measures of SES and of biological markers of stress to several existing longitudinal surveys to ensure that this exploration continues on beyond the Network .
Key Research
Publication: Reaching for a Healthier Life, by Nancy Adler and the Research Network on Socioeconomic Status and Health.
This article maps out the essential facts of SES and health in the United States, for policymakers, health professionals, and the general public.
Publication: “Socioeconomic Status and Health in Industrial Nations: Social, Psychosocial, and Biological Pathways,” a special issue by the Network of the Annals of the New York Academy of Sciences (1999).
This article lays the scientific foundation for the study of psychosocial processes linking socioeconomic status to health.
Publication: Biology of Disadvantage: Socioeconomic Status and Health, (Annals of the New York Academy of Sciences, 2010).
This article is a bookend to “Socioeconomic Status and Health in Industrial Nations,” and provides a summary of what the Network learned during its decade of research, including its nuanced understanding of stress, resources, work environments, psychological resilience, neighborhoods, as well as the cumulative risks of all these factors in producing health disparities.