Intended for healthcare professionals

Education And Debate

Socioeconomic determinants of health: Health and the life course: why safety nets matter

BMJ 1997; 314 doi: (Published 19 April 1997) Cite this as: BMJ 1997;314:1194
  1. Mel Bartley, principal research fellowa,
  2. David Blane, senior lecturerb,
  3. Scott Montgomery, research fellowc
  1. a Department of Epidemiology and Public Health, University College London Medical School, London WC1E 6BT
  2. b Academic Department of Psychiatry, Charing Cross and Westminster Medical School, London W6 8RP
  3. c University Department of Medicine, Royal Free Hospital Medical School, London NW3 2QG


    This article argues that a life course approach is necessary to understand social variations in health. This is needed in order to take into account the complex ways in which biological risk interacts with economic, social, and psychological factors in the development of chronic disease. Such an approach reveals biological and social “critical periods” during which social policies that will defend individuals against an accumulation of risk are particularly important. In many ways, the authors of modern welfare states were implicitly addressing these issues, and the contribution of these policies to present day high standards of health in developed countries should not be ignored.

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