Socioeconomic Position in Population Characteristics: Measures and Data
Which parts of socioeconomic position can influence environmental public health, and why?Within the story of increased life expectancy and shrinking infant mortality, there are still chapters – disparities in health based on circumstances of life that are beyond individual control – that indicate room for improvement. The recent publication CDC Health Disparities and Inequalities Report — United States, 2011 notes a number of “unacceptable and correctable” differences in adverse health outcomes not related to age, sex, or race/ethnicity. Disproportionate pressures on health of poor people include exposure to airborne particulate pollution and ozone, increased preventable hospitalizations, and hypertension.
Based on research from the Center for Social Disparities in Health (see link at right), there is room for investigation of many associations of life circumstances and good health, including the following.
Educational level can influence not only one’s choice of jobs, but also a person’s knowledge about how to stay healthy and his or her social standing and support. These intermediary circumstances are then related to factors like nutritional choices, exercise, use of drugs and alcohol, stress, choice of neighborhoods, and family stability. Chronic stress is thought to be especially damaging in that it affects the body’s immune system and can lessen natural resistance to chronic disease. Lack of education may also prevent a person from escaping a life of poverty or near poverty.
- Adult life expectancy varies proportionally with income.
- Child health varies with income.
- Adults’ perception of their own health varies with income and race/ethnicity.
Why are these particular socioeconomic status measures in use versus others?The three measures currently included in WTN are broadly accepted in research and practice as being central to understanding risks associated with socioeconomic status. Adequate research evidence supports the use of these measures, often along with others. Data are generally available from both federal and state government agencies.
As research questions become more complex, newer measures of socioeconomic status and disparity (for instance, income gradient in a nation) are put forth for testing for predictive value of health outcomes. A longer term goal of WTN is to include more indicators that may add granularity to community research.
Which social-status-based health risks can be mitigated or avoided, and how?Many circumstances that feed social and economic status are not easily changed at the family or individual level. Public health and other policy-making sectors face challenges in adjusting public resources in order to allow a more level playing field for families and communities that are at a disadvantage. Increasing the number of choices for parents who live at or near the poverty level can leverage later choices available to their children.
The Health of Washington State 2007 report (see link at right) mentions many potential public policy strategies, including the following:
- Educating lawmakers and other influential institutions on the downstream costs of neglecting to address adverse conditions in neighborhoods, at work, and at school,
- Implementing community-based projects such as early childhood education and rental vouchers,
- Supporting programs to improve access to nutritious foods, and
- Encouraging partnerships to combat racism and address issues of social justice.