Social Epidemiology

Abstract

The search of social determinants of health and disease has advanced substantially over the last decade. We present recent theoretical advancements, methodological approaches, and a selection of empirical evidence for the three main research strands: first, social inequalities can explain health differences. Here, we first focus on hierarchical social stratification with regard to socioeconomic and social class differences influencing health, then we extend the view toward nonhierarchical social stratification with regard to ethnocultural differences, lifestyle, and cognitive and noncognitive abilities. We shortly mention social relations and social network as determinants of health. Last, we use the concept of social times to distinguish age, period, and cohort effects in population health. After presenting evidence on contextual social determinants of health, we close with methodological challenges, social policy implications, and translation to practice.

Socioeconomic hierarchy and health gradient in Europe: the role of income inequality and of social origins

“…The pattern of our findings does not obviously point to one of those explanations. It may be possible though that in this sample of respondents from Northern European countries, low levels of income inequality mask large health gaps between lower and higher socioeconomic groups, and may be a result of class-specific attitudes and (health) behaviors [ 3 , 47 ]. Concerning the sample of Southern European countries Portugal, Poland, Italy, and Spain, all with a high rate of members of the Catholic church compared to the other countries in this study, it could be argued – as all countries with this positioning of health gradient and income inequality are known for their familialistic welfare system – that high income inequality is buffered by traditional family systems and may increase especially health of lower socioeconomic groups.…”

“…This health stratification is a result of education, occupation and income producing differences in outcomes of morbidity and mortality, however differing depending on which stratification measure is used [ 1 , 2 ]. Possible mechanisms between socioeconomic position and differences in health involve health behaviors, affordability of healthy life style and health care, absence of physically demanding work and hazardous working conditions or distress, but also reverse causation from bad health into low socioeconomic position [ 1 – 3 ]. Indeed, the associations of socioeconomic position and health are so strong that several researchers have put forward the hypothesis that social standing may indeed by the fundamental cause for health [ 4 , 5 ].…”

La Epidemiología Social en el desarrollo de la investigación en medicina tradicional y complementaria

“…El resurgimiento de la Epidemiología Social reside en la renovada importancia y necesidad de estudios que busquen evaluar las inequidades en salud dentro de las poblaciones, con una perspectiva integral; para con ello plantear políticas de salud que sean sinérgicas con la dinámica de las poblaciones y, por ende, puedan ser aceptadas y lleguen a solucionar los problemas de salud que las afectan (3,4) .…”

“…Dentro de estas cuatro consideraciones, las dos últimas están muy relacionadas con el componente cultural y tradicional que tienen las poblaciones en materia de salud. En el binomio salud-enfermedad, las diferencias étnicas, sociales y culturales no pueden ser evaluadas como meros factores de riesgo, sino como parte del proceso de vida de la población, que lleva a consecuencias en la salud hasta llegar a la enfermedad, discapacidad permanente e, incluso, la muerte (4) .…”

Do Subjects from Different Occupational Groups Experience Dental Fear and Anxiety Equally?

“…A higher socioeconomic status can be linked to less dental fear or dental anxiety, as opposed to individuals who have poor socioeconomic status [15,24,29,30]. This trend can be attributed to level of education since individuals with more years of education are usually at higher socioeconomic levels [31].…”