Socities are structured like ladders. The rungs of the ladder represent the resources that determine whether people can live a good life – prosperous, healthy, and secure – or a life plagued by difficulties – insufficient income, poor health, and vulnerability. People standing on the top rungs are the best educated, have the most respected jobs, ample savings, and comfortable housing. On the bottom rungs are people who are poorly educated, experience long bouts of unemployment or low wage jobs, have nothing to fall back on in the way of savings, and live in substandard homes. The people in the middle have more resources to rely on than do people at the bottom, but far less than people on the top. In reaching for health, every step up makes a difference.

Of all the outcomes determined by your position on the ladder, none is more fundamental than this: it predicts how long you live and how healthy you are during your lifetime. This is a surprising finding because we tend to think of health as something that is fixed by our genetic heritage. But genes are only part of the picture. It turns out that the more advantaged our lives are, the longer we live and the healthier we are from birth to old age. People who grow up on the bottom die younger and are sicker throughout their lifetimes than those who are born to the rungs above them.

This is a very rich document from the MacArthur Foundation investigating the effects of socioeconomic status on health. Of particular interest: pg. 39 shows disease risk by educational level and income.

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