Table 1

Socioeconomic status and general health

AuthorsYear of publicationFindings
Socioeconomic status and excess risk factors
Dam et alw652008
  •  In a cohort of 77 782 US women, relative risk of five compared with zero lifestyle risk factors prevalent in low socioeconomic status areas was:

    •  4.31 for all-cause mortality.

    •  3.36 (95% CI 2.45 to 4.34) for cancer mortality.

    •  8.17 (95% CI 4.96 to 13.47) for CV mortality.

Meader et alw662016
  • There is a fivefold and fourfold increase in clustering of risk-associated behaviour.

  • Socioeconomic status is the strongest predictor of this.

  • A common cluster in adult populations was that of excessive drinking and smoking.

  • Younger populations demonstrated sexual risk behaviour with smoking, illicit drug use and alcohol misuse.

  • Relative risk of harm from excess drinking was higher in lower socioeconomic groups (HR 10.22, 95% CI 7.73 to 13.53).

  • Low socioeconomic status is an independent risk factor for premature death and ill health.

  • Increased prevalence in risk-associated behaviour.

Socioeconomic status and excess morbidity
Marmot et alw692020
  • The difference in UK DFLE is 17 years between areas of low and high socioeconomic status.

Kivimäki et alw702020
  • 109 246 Finnish adults aged 17–77 years were measured against 56 physical and mental health conditions.

  • 18 of these had higher prevalence in lower socioeconomic status individuals.

  • A cascade of inter-related health issues with an HR >5 was identified: psychiatric disorders and self-harm, which precipitated liver and renal disease, ischaemic heart disease, cerebral infarction, chronic obstructive bronchitis, lung cancer and dementia.

Dugravot et alw712020
  •  Socioeconomic status measured by occupation demonstrated inequalities from health to:

    •  Multimorbidity (HR 1.54, 95% CI 1.37 to 1.73).

    •  Frailty (HR 2.08, 95% CI 1.85 to 2.33).

    •  Disability (HR 1.44, 95% CI 1.18 to 1.74).

Socioeconomic status and excess mortality
Marmot et alw721978
  • A steep inverse association between socioeconomic status, assessed by grade of employment, and mortality from a range of pathology.

Stringhini et alw732017
  •  1.7 million individuals in 48 cohorts demonstrated that low SE status is associated with a 2.1-year reduction in life expectancy.

  •  Other risk factors accounted for the following years of life lost:

    •  0.5 years in excess alcohol consumption.

    •  0.7 years in obesity.

    •  1.6 years in hypertension.

    •  2.4 years in physical inactivity.

    •  3.9 years in diabetes.

  •  4.8 years in current smokers.

Marmot et alw722020
  • Life expectancy among women in the most deprived 10% of areas fell between 2010–2012 and 2016–2018.

Lewer et alw742020
  • One in three premature deaths can be attributed to low socioeconomic status.

  • References w65–74 can be found in online supplemental file 1.

  • CV, cardiovascular; DFLE, disability-free life expectancy; SE, socioeconomic.