How social factors affect health: neuroendocrine interactions

Hierarchy is associated with health. Resolving what it is about hierarchy that influences health has important implications for health and social policy. Large gradients in health status and life expectancy by income level, education and occupation were repeatedly observed in various parts of the developed world in the 20th century (Antonovsky 1967; Cassel 1976; Marmot and McDowell 1986; van der Meer and Macenbach 1998). Income, education and occupation indicators are interrelated and, individually and in various combinations, have been used to measure socioeconomic status (SES). That associations between SES and morbidity and mortality are found for each indicator suggests some underlying primary causal process, correlated with relative social position, which expresses itself through pathways of health and disease.