[EQ] Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us

Socioeconomic Disparities in Health in the United States: What the Patterns Tell Us

Paula A. Braveman and Susan Egerter are with the University of California, San Francisco.
Catherine Cubbin is with the University of Texas, Austin.
David R. Williams is with Harvard University, Boston, MA.
Elsie Pamuk is an independent consultant in Orcas Island, WA.

April 2010, Vol 100, No. S1- | American Journal of Public Health S186-S196

Abstract URL: http://bit.ly/cjCbUM

Objectives.
We aimed to describe socioeconomic disparities in the United States across multiple health indicators and socioeconomic groups.

Methods.
 Using recent national data on 5 child (infant mortality, health status, activity limitation, healthy eating, sedentary adolescents) and 6 adult (life expectancy, health status, activity limitation, heart disease, diabetes, obesity) health indicators, we examined indicator rates across multiple income or education categories, overall and within racial/ethnic groups.

Results.
Those with the lowest income and who were least educated were consistently least healthy, but for most indicators, even groups with intermediate income and education levels were less healthy than the wealthiest and most educated. Gradient patterns were seen often among non-Hispanic Blacks and Whites but less consistently among Hispanics.

Conclusions.
Health in the United States is often, though not invariably, patterned strongly along both socioeconomic and racial/ethnic lines, suggesting links between hierarchies of social advantage and health. Worse health among the most socially disadvantaged argues for policies prioritizing those groups, but pervasive gradient patterns also indicate a need to address a wider socioeconomic spectrum—which may help garner political support. Routine health reporting should examine socioeconomic and racial/ethnic disparity patterns, jointly and separately.

 

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