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Social and Economic Disparities in Health: Thoughts about Intervention

S. Leonard Syme
The Milbank Quarterly
Vol. 76, No. 3, Socioeconomic Differences in Health (1998), pp. 493-505
Published by: Wiley on behalf of Milbank Memorial Fund
Stable URL: http://www.jstor.org/stable/3350473
Page Count: 13
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Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Social and Economic Disparities in Health: Thoughts about Intervention
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Abstract

It is now well established that inequalities in income lead to high morbidity and mortality rates. Certain explanations for this phenomenon are explored: (1) Instead of income inequalities causing disease, the inequalities are determined by powerful cultural forces. (2) The rich get richer and the poor get poorer. (3) Wealthier people can buy the means to protect their health. (4) Poorer people suffer not from poverty, but from relative deprivation. (5) Those with the weakest genes drift into the lower income groups. It is difficult to develop interventions directed to these possibilities. The concept of "control and destiny" is a possible explanation for the relation between inequalities and disease; unlike the other explanations, this idea is amenable to intervention.

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