© 2003 American Public Health Association
Susan L. Ettner is with the University of California at Los Angeles. Joseph G. Grzywacz is with the University of Northern Iowa, Cedar Falls. Correspondence: All requests for reprints should be sent to Susan L. Ettner, UCLA School of Medicine, Division of General Internal Medicine and Health Services Research, 911 Broxton Plaza, Box 103, Los Angeles, CA 90095 (e-mail: settner@mednet.ucla.edu).
Health inequalities manifest as a gradient, rather than as a distinction between "haves" and "have nots." Therefore, eliminating health inequalities will require targeting interventions at segments of the entire population, not just particular subgroups at the disadvantaged end of the social hierarchy. Developing such interventions, however, has been stymied by an unclear understanding of how socioeconomic status (SES) influences health. The literature offers 5 fundamental explanations, including 1) selection effects, 2) differences in lifestyle patterns, 3) differential exposure to life stresses, 4) differences in psychosocial resources, and 5) differential access to, and poorer quality health care resources.19 A major limitation
Data and Study Cohort Variables Statistical Analyses
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