Education and debate

Socioeconomic determinants of health: Health inequalities: relative or absolute material standards?

^a Trafford Centre for Medical Research University of Sussex Brighton BN1 9RY, R.G.Wilkinson@sussex.ac.uk

	Introduction

That mortality in developed countries is affected more by relative than absolute living standards is shown by three pieces of evidence. Firstly, mortality is related more closely to relative income within countries than to differences in absolute income between them. Secondly, national mortality rates tend to be lowest in countries that have smaller income differences and thus have lower levels of relative deprivation. Thirdly, most of the long term rise in life expectancy seems unrelated to long term economic growth rates. Although both material and social influences contribute to inequalities in health, the importance of relative standards implies that psychosocial pathways may be particularly influential. During the 1980s income differences widened more rapidly in Britain than in other countries; almost a quarter of the population now lives in relative poverty. The effects of higher levels of relative deprivation and lower social cohesion may already . . . [Full text of this article]

	Income within and between societies

	Income distribution

	Epidemiological transition

	A theory of health and social position?

Need for a theory
Pathways

	Relative poverty and mortality

	Acknowledgements

	References

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