Social Hierarchy and Health

Oscar J. Mujica

Social organization and population health are inextricably linked. Societies organize their affairs in different ways, and these differences, by means of various pathways, have an effect on the production of health and disease among individuals, as well as between and within communities. Although some of these pathways are not yet fully understood, an ever-mounting body of evidence persuasively supports the contention that the social gradient—the hierarchical organization of society's members along the social ladder, as defined by a number of socioeconomic classifications or representations of social position—is intimately mirrored by a corresponding health gradient. Almost invariably, those who rank lower in the socioeconomic scale have worse health status than those above them in the hierarchy—that is, the higher the social standing, the better the health. Central to the notion of this steadily observed social gradient in health —also known as the ‘status syndrome,’ the archetype of the relationship between social ...

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