There is continued discussion regarding socioeconomic status and the role it plays in mortality differentials in the United States (Bond Huie et al. 2003; Elo 2009; Geruso 2012; Link et al. 1995, 2002; Phelan et al. 2010). The role of socioeconomic status on mortality differentials between White and Non-Hispanic Black populations in the United States continues to be a cause of concern for researchers (Bond Huie et al. 2003; Geruso 2012). The purpose of this response paper is to highlight the continued impact of socioeconomic status on mortality. By acknowledging the increasing role that socioeconomic status contributes to mortality, new insight can help to inform future research and aid in reducing mortality effects for low-socioeconomic status groups.
Socioeconomic status influences all aspects of life including mortality (Elo 2009; Link et al. 2002; Phelan et al. 2010). Low socioeconomic status is attributed to higher likelihood of illness and higher mortality rates (Bond Huie et al. 2003; Elo 2009; Geruso 2012). Low socioeconomic status has less of a protective factor for individuals who may already be at risk for certain diseases. While McKeown’s theory asserts that the improvements in health throughout populations were due to changes in economic and social conditions rather than other known causes was discredited (Bruce et al.2002; Geruso 2012), the causes have been proven to be a number of processes which include social conditions (Bruce et al. 2002; Link and Phelan 1995). The inequalities in socioeconomic conditions are exacerbated by widening inequality in public health.
As a result of continued inequality in public health, socioeconomic disparities have been shown to be an issue for numerous populations as early as the nineteenth century (Antonovsky 1967; Bruce et al. 2002; Bond Huie et al. 2003). Looking at the continued widening gaps in socioeconomic conditions today is an indication that more needs to be done in order to create and promote solutions that have the potential to diminish these conditions and would result in better health outcomes across populations. These outcomes have persisted while the conditions have continued to decline throughout the years.
Researchers have also sought to find the underlying causes of socioeconomic disparities (Link and Phelan 1995; Phelan et al. 2010). Elo (2009) mentions that there are still unclear ideas regarding the determination of these underlying causes and the point in which they begin to affect a person’s health outcomes. Looking at the historical research that identifies various factors in early life gives an indication that a person’s socioeconomic status and related health outcomes are influenced by their family and all of the various parts of life that the role of family impacts(where you live, wealth, education, what you eat). These discrepancies continue to be larger for those who fall into the lower socioeconomic status. The continued gap would indicate that those with higher socioeconomic status form a foundation for future generations that will enable them to continue to have higher socioeconomic status (Elo 2009). This also indicates that more intervention will be needed at the early stages of life for those in low socioeconomic status in order to help improve their health outcomes throughout their lifespan. In order for policies and interventions related to health outcomes for low socioeconomic groups to be effective, the stance taken by policymakers has to be from a contextual standpoint instead of the status quo individual lens (Link and Phelan 1995). This is one reason why such disparities in relation to socioeconomic status continue to persist because if the collective view is of issues being a concern for the individual, there will continue to be less preventative measures taken collectively as a result of having a collective idea that it is up to the individual to solve an individual problem.
The areas in which socioeconomic status influences health policy often correlates to those who have higher socioeconomic status. Those with poor socioeconomic status are not necessarily lacking in education about their own health, they are often lacking the resources, like fluid income, to afford the services needed to not only prevent poor health outcomes but also to have needs met for health emergencies that those with higher socioeconomic status often do not have to handle as a result of already having the resources to prevent these issues (Bond-Huie et al. 2003; Krueger et al. 2003). This is particularly true in the case of those populations that are at risk for premature mortality outcomes. This is especially the case for Non-Hispanic Blacks, who have higher rates of premature mortality in both males and females. This is evident when we consider wealth disparities and race when discussing premature mortality outcomes. Non-Hispanic Blacks are found to have higher gaps in wealth compared to Non-Hispanic Whites. These findings are similar to those found by Geruso (2012). Even when noting limitations in their findings, Bond-Huie and colleagues (2003) mention that their findings likely reflect a true relationship to the population.
Even if we hold to the idea that socioeconomic status disparities will always be a factor in the population, there are policies and programs that can be created in order to help eliminate the drastic outcomes that are a result of these discrepancies (Link and Phelan 1995; Phelan et al. 2010; Bond Huie et al. 2003). These policies can be in the areas of education, occupation, nutrition, etc. It may take time in order to see significant changes but the attempt would be an improvement for the population as a whole. These changes would need to apply not only to individuals but to structures as well in order to serve as a buffer to the extreme outcomes that are currently seen. The motivation for health promotion and preventative measures will be required to flow from a collective problem solving framework versus a pathological framework that is often individualistic in nature. Until then we must continue to do the research needed to inform these changes that includes diverse samples and new ways of looking at previous research in order to reduce limitations and get a greater picture of what is required in order to inhibit growth.


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