In 1999, the New York Academy of Sciences, New York, conducted a conference entitled, "Socioeconomic Status and Health in Industrial Nations: Social, Psychological, and Biological Pathways."

Research from several countries has shown clear and growing evidence that socioeconomic status is associated with health. No one socioeconomic indicator is key; a variety of indicators at the individual and social levels are associated with health status.

Individual indicators include income, education, and occupation; social indicators include neighborhood and community characteristics. It is well established that at each step along the socioeconomic status hierarchy, improvements in social status result in improved health; less is known about how this occurs.

The goals of this conference were to:

• Examine the data on socioeconomic status and health.
• Explore some of the biological pathways by which socioeconomic status may influence health.
• Examine policies that could address the social and health inequalities associated with socioeconomic status.

Key Results

• The conference, which was held May 10–12, 1999, at the National Institutes of Health in Bethesda, Md., was attended by 328 people, including neurobiologists, physicians, epidemiologists, psychologists, economists, educators, community activists, and approximately 100 professionals from the National Institutes of Health.
  
  The conference included five sessions with 21 presentations and two poster sessions with 80 posters.
  
  Sessions included:
  • An introduction to socioeconomic status and health.
  • The developmental influence of socioeconomic status across the life span.
  • The effects of the social environment, including the workplace and the community, and the effects of racism and discrimination.
  • The psychobiological and psychosocial pathways and mechanisms to disease.
  • Aspects of policy implications for health and research.
• Several key conclusions emerged:
  • Early environments are important. Experiences early in life associated with the socioeconomic position of one's family can set the course for later life. Health behaviors and psychological responses that later play a role in health may be shaped by childhood experiences.
  • Work environments are strongly linked to health. There is compelling evidence that conditions in work environments are associated with the occupational component of socioeconomic status. These conditions include physical exposure to toxins and risk of injury, and the social environment, particularly low levels of control.
  • Individuals' experiences are embedded in a social context. A key context for ethnic minorities is a culture of racism. Institutional barriers and discrimination create added burdens that impair health. Communities with great income disparities also have poorer health.
  • Chronic, long-term stress causes changes in the body that lead to disease. The lower people are on the socioeconomic status hierarchy, the more likely they are to be exposed to chronic stress. Socioeconomic-related stress can, for example, affect the body through problems with sleeping and relaxing after work due to shift work and non-restful home environments. Low social status itself may be a stressor.
  • Researchers know a lot about possible mechanisms and pathways whereby socioeconomic status affects the body, but more interdisciplinary, multilevel research is needed on both specific pathways and mechanisms that take account of individual variation and the role of social contexts in this variation, and on the interactions in socioeconomic status among social, psychological, and biological mechanisms.
• Conference proceedings were published in a special issue of Annals of the New York Academy of Sciences. See the Bibliography for details.

After the Grant

The New York Academy of Sciences has no plans to follow-up this conference. The MacArthur Foundation is continuing work in this area.

Funding

The Robert Wood Johnson Foundation (RWJF) provided partial support for this conference with a grant of $40,000 between March 1999 and August 1999.

The conference was also supported by:

• The John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status and Health ($30,000).
• The National Institutes of Health's Office of Behavioral and Social Sciences Research ($10,000).
• The National Institute of Environmental Health Sciences ($10,000).