1. Social Inequalities in Health. 23
Introduction: Background Concepts. 24
Conceptions of Health. 25
Concept Box: Health Capital 26
Population Health. 27
Conceptions of Social Position. 28
Concept Box: Max Weber and Social Class. 29
Concept Box: Health Inequalities and Inequities. 31
Concept Box: Moral Imperatives for Action on Inequalities. 32
Concept Box: Amartya Sen on Health Equity. 32
Concept Box: Gini Coefficient. 34
Scales of Analysis. 35
Social Mobility. 37
Global Patterns of Health (1): Rising Life Expectancy. 38
Historical Perspective: Epidemiologic Transitions. 42
Concept Box: The Evolution of Inequalities. 44
International Patterns of Health (2): Health Contrasts Between Nations. 46
The Uneven Gains in Life Expectancy. 47
Concept Box: Mortality Gini Curves. 48
National Patterns of Health (3): Health Inequalities Within Nations. 48
Social Class and Health. 49
Trends in Social Disparities in Health. 52
Socioeconomic Status and Health: The Whitehall Studies. 54
Income Inequality and Health. 55
Concept Box: Measuring Poverty, Relative and Absolute. 56
Further Investigations of the Income Inequality Hypothesis. 62
Critiques of the Income Inequality Hypothesis. 64
Conclusion. 65
Discussion Points. 66
References. 67
2. Explanation and Causal Models for Social Epidemiology. 78
The Challenge of Explanation. 79
Explanation and Understanding. 82
Concept Box: Erosion as a Metaphor. 83
Theories and Concepts. 84
Scales of Explanation. 86
Concept box: A Critique of Epidemiology. 87
Top-Down and Bottom-Up Explanations. 88
Idiographic and Nomothetic Science. 91
Concept Box: Structuralism.. 92
Systems Thinking. 92
Concept Box: Dissipative Structures. 94
Explanatory Models in Epidemiology. 95
The Epidemiologic Triad. 95
Explanation, Prediction and the Role of Time. 97
Binary Thinking. 99
Causality and Explanation. 100
Conceptions of Cause. 100
Causes and Determinants. 103
Concept Box: Functionalism.. 104
Concept Box: Fundamental Causes. 105
Counterfactuals, Potential Outcomes, and Causal Dilemmas. 105
Quantifying and Graphing Causal Influences. 107
Concept Box: Asymmetry in Causal Perceptions. 108
Concept Box: Determinants and Determinism.. 110
The Limits to Explanation: Entropy. 111
Concept Box: Income Entropy. 112
The Limits to Explanation: the Role of Chance. 112
Traditional Explanatory Approaches in Epidemiology. 114
Causal Chains. 114
Causal Webs. 115
INUS. 115
Rothman's Pies. 116
The Need for a Modified Conceptual Model 117
Potentially Useful Analytic Tools for Social Epidemiology. 118
Complexity and Emergent Phenomena. 118
Emergence. 119
Agent-Based Modeling. 119
Adaptive Systems. 120
Applying Complexity Thinking. 122
Autocatalytic Sets. 122
Chaos Theory. 125
Catastrophe Theory. 125
Sensitivity to Initial Conditions. 127
Fractals. 128
Attractors. 129
Interacting Causes. 130
Conclusion. 133
Discussion Points. 136
References. 137
3. Social and Economic Theories to Explain Patterns of Disease. 146
Explaining Patterns of Health and Longevity. 147
The Main Categories of Explanations for Social Disparities in Health. 149
Concept Box: Hard and Soft Explanations. 150
An Economic Perspective: Concavity and the Absolute Income Hypothesis. 151
Concept Box: Speed. 151
Historical Perspectives on the Interaction Between Wealth and Health. 154
Concept Box: The Origins of Inequalities. 154
The Links to Health. 156
Concept Box: Cumulative Advantage and the Matthew Effect. 157
Concept Box: Demographics and Economic Development. 157
The Scale of Analysis. 157
Social Mobility and Social Selection. 158
Concept Box: Status Passages. 159
Concept Box: Symbolic Violence. 161
Government Policies and Political Influences on Health. 165
Political Ideologies and Health. 165
Concept Box: Historicism.. 167
Neo-Materialism, Neo-Liberalism and Health Inequalities. 168
Concept Box: Post-Materialism.. 169
Neo-Liberalism.. 171
Globalization. 173
Critiques of Neo-Liberalism.. 174
Concept Box: Blaming the Victim.. 176
Poverty and Lack of Material Resources as Explanations for Social Inequalities in Health. 178
Theories of Poverty. 178
Structural Theories of Poverty. 179
Poverty Traps. 180
Culture of Poverty. 181
Poverty and Family Structure. 183
Migration. 184
Concept Box: Migration and Concentration of Disadvantage. 184
The Geography of Health. 186
Concept Box: Disease Ecology. 186
Concept Box: City Size. 187
Context and Composition. 189
The Modifiable Area Unit Problem.. 190
Concept Box: Relational Geography. 191
Concepts of Space and Place. 192
Concept Box: Therapeutic Landscapes. 193
Access to Nature. 194
Causal Direction and Interactions Between Health and Place. 195
Concept Box: Broken Windows. 196
Socioeconomic Status and Access to Care. 197
Concept Box: SES and the Differential Diffusion of Innovations. 197
A Health Literacy Gradient. 200
Relative Income and Psychosocial Explanations for Health Inequalities. 201
Concept Box: The Easterlin Paradox. 201
Theories Concerning Community Structures and Health. 202
Social Cohesion. 203
Social Capital 203
Concept Box: Bourdieu's Three Forms of Capital 204
Socioeconomic Status and Social Capital 205
Social Capital and Health. 206
Critiques of Social Capital 207
Concept Box: Membership Theory. 208
Collective Efficacy. 209
Community Empowerment. 210
Concept Box: Opportunity, Agency, and Empowerment. 211
Community Resilience. 212
Theories Relating to Psychosocial Processes Within the Community. 213
Motivation and Self-Determination Theory. 213
Variants of the P-E Fit model 215
Relative Deprivation. 217
Discrimination and Social Dominance Theory. 220
Ethnic Diversity. 221
Racial Inequalities. 223
Critical Race Theory. 224
Social Policy Interventions. 225
How Effective Are Policies that Address Income Inequalities?. 227
Discussion Points. 230
References. 232
4. Biological Pathways Linking Social Determinants to Health. 252
Introduction. 253
Brain Structure. 255
Limbic System.. 255
The Neocortex. 258
The Nervous System.. 259
Polyvagal Theory. 261
The Endocrine System.. 263
Types of Hormones. 264
Steroid Hormones. 264
Peptides and Oxytocin
Hormones and the Brain Reward System.. 267
Endocrine Pathways. 268
The Stress Response. 269
The SAM and HPA Systems. 269
The Immune System.. 271
Inflammation. 274
The Microbiome and Immunity. 274
Psychological States and Immune Function. 275
Socioeconomic Status and Chronic Inflammation. 277
Allostasis and Allostatic Load. 277
Biphasic Reactions and Hormesis. 279
Concept Box: The Yerkes-Dodson Law.. 280
Genetics and Epigenetics. 280
Genes. 281
Epigenetic Influences and Gene Regulation. 283
Concept Box: Fitness Landscapes. 287
Telomere Length. 287
Conceptions of Environmental Influence. 289
Plasticity. 290
Concept Box: Predictive Adaptation. 291
Concept Box: Kauffman's NK Model 293
Multiple, Interacting Systems. 296
Case Study: Differential Male and Female Longevity. 296
Conclusion: Embodiment. 299
Discussion Points. 302
References. 303
5. Health Determinants Cumulate over the Life Course. 318
The Life Course Perspective. 320
Concept Box: Slice of Life Studies. 321
Concept Box: The Exposome. 324
Socioeconomic Status and the Life Course. 326
Barker's Fetal Origins Hypothesis. 328
Developmental Origins of Health and Disease (DOHaD). 331
Programming Mechanisms in Sensitive Periods. 331
Concept Box: Experience Expectancy. 334
Concept Box: The Life Course Health Development Model 335
Adverse Childhood Experiences. 336
Concept Box: Developmental Analysis. 337
Health Effects of Adverse Child Events. 339
Prospective Evidence. 340
Socioeconomic Status and Childhood Adversities. 343
Mechanisms for the Influence of Life Course Experiences on Health. 345
Pathway I: Cognitive Development. 345
Pathway II: Psychological Reactions. 348
Concept Box: Ethnomethodology. 349
Concept Box: Intrinsic Motivation. 351
Personality Reactions. 352
Self-Confidence. 353
Attachment Theory. 353
Resilience. 355
Successful Aging. 356
Concept Box: Primary and Secondary Control 357
Pathway III: Adverse Child Experiences and Social Relationships. 358
The Role of Family Stability. 359
Parenting. 361
Concept Box: Parenting Styles. 361
Delay of Gratification: the Experiments of Walter Mischel 362
Concept Box: Socioeconomic Status and Vocabulary. 365
Stress Proliferation. 367
Reproductive Strategies. 368
Concept Box: r and K Reproductive Strategies. 369
Pathway IV: Behavioral Mechanisms. 370
Pathway V: Biological Processes. 371
Concept Box: Biological Embedding. 371
Brain Development. 372
Genetics and Epigenetic Processes. 374
Concept Box: Molecular Conduit Model 375
Endocrine Pathways. 376
Immune Pathways. 377
Telomere Length. 378
Potential Life Course Interventions. 378
Discussion Points. 381
References. 384
6. Theoretical Models of Health Behavior. 400
Health and Illness Behaviors. 401
Lifestyle Patterns and Social Class. 401
Risk Attributable to Behaviors. 402
Conceptual Approaches to Explaining Health Behavior. 403
Behavior as Choice. 404
Psychological Models: The Role of Cognition. 404
Subjective Expected Utility Theory. 406
Concept Box: Uncertainty and Belief. 406
Behavioral Economics. 407
Path Dependence and Health Behavior. 408
Concept Box: The Polya Urn Process. 408
Prospect Theory and Risk-Taking Behavior. 409
Behavior as Constrained by Circumstance and Life Chances. 411
Collective Behavior. 412
Cognitive Models of Behavior: Continuum and Stage. 413
Concept Box: Competence-Environment Press. 414
Continuum Models of Health Behavior. 414
Health Belief Model 414
Rogers Protection Motivation Theory. 417
Theory of Reasoned Action. 418
Theory of Planned Behavior. 420
Bandura Social Cognitive Theory and Self-Efficacy. 422
Limitations of the Cognitive Analyses of Behavior and Behavior Change. 424
Concept Box: Cognitive Biases and Health Behaviors. 424
Heuristics and Judging Probabilities. 425
A Dual Processing Behavioral Model 426
Stage Models of Health Behavior. 427
Stages of Change and the Transtheoretical Model 428
Precaution Adoption Process Model 432
Health Action Process Approach (HAPA) model 434
The Precede-Proceed Framework. 435
Taxonomies of Intervention Models: Changing Health Behaviors. 436
Concept Box: Intervention Mapping. 436
The Theoretical Domains Framework (TDF). 437
The Behavior Change Wheel 439
Discussion Points. 440
References. 442
7. Work Environment and Health. 457
Work as a Health Determinant. 458
Evolving Patterns of Work Through Time. 458
Job Security. 459
Concept Box: The Worksome. 459
The Benefits of Work. 460
Work-Life Balance. 461
Job Characteristics and Health. 462
Job Demand and Control Model 463
The Employment Strain Model 466
Effort-Reward Imbalance. 467
Concept Box: Procedural and Relational Injustice. 467
Concept Box: Status Control 469
The Job Demands-Resources Model 470
The RIASEC Theory of Vocational Choice. 473
Unemployment and Health. 475
Who Will Suffer Adverse Effects of Unemployment?. 477
Latent Deprivation Theory. 478
Fryer's Agency Restriction Model of Unemployment. 479
Warr's Vitamin Model of Unemployment. 479
Ezzy's Status Passage Model 482
Unemployment and Socioeconomic Status. 482
Discussion Points. 483
References. 484
8. Stress and Health. 494
Introduction: Stress and Health. 495
The Adverse Health Effects of Stress. 495
Concept Box: Enriched Environments. 497
Conceptual Models of Stress. 497
Stimulus Models: Stressful Life Events. 498
Critiques of the Stimulus Model 499
Response Models. 500
Harold Wolff. 501
Concept Box: Meaning Making. 501
Hans Selye. 502
Antonovsky's Resistance Resources. 503
Critiques of the Response Model 504
Interactional and Systems Models of Stress. 505
Lazarus & Folkman. 505
Toxic Stress. 509
Modeling the Time Dimension. 510
Weathering. 511
Problems with the Interactional Model 511
Measurement Challenges. 512
Concept Box: Measuring Life Events. 513
Applying Interactional Stress Models to Disease Risk. 514
Stress and Socioeconomic Status. 515
Interventions. 517
Discussion Points. 518
References. 521
9. Social Networks, Social Support and Health. 530
Introduction. 531
Concept Box: Social Baseline Theory. 531
Social Networks. 532
Social Support. 532
Evidence for the Impact of Social Relationships on Health. 533
Meta-Analyses. 533
Marriage. 535
Divorce. 535
Bereavement. 535
Paternal Absence. 536
Loneliness and Health. 537
Pets and Health. 537
Mechanisms of Influence: Theories Relating to Social Networks. 538
Network Analysis. 538
Scale-Free Networks. 540
Network Density and Redundancy. 540
Concept Box: Homophily. 541
Information Networks. 542
Network Reciprocity. 542
Concept Box: The Helper-Therapy Principle. 543
Concept Box: Identity Accumulation. 543
Network Pressure. 543
Concept Box: Social Control Theory. 544
Space, Place and Networks. 544
Social Networks, and Social Support. 545
Social Supports: Conceptual Approaches. 545
Mechanisms of Influence: Theories Relating to Social Supports. 546
Perceived Versus Received Support. 546
Concept Box: What Makes an Interaction Supportive?. 548
Attachment Theory. 548
Disordered Attachment. 548
Unconditional Benefits of Support. 549
Interpersonal Theory. 549
Appraisal Function of Support. 550
Measuring Supportiveness. 550
The Potential for Negative Influences of Social Relationships. 550
Disrespect. 551
Rejection. 552
Mechanisms of Influence: Biological Mediators. 552
Summary: The Benefits of Social Connections. 554
Discussion Points. 556
References. 557
10. Positive Influences on Health: Coping and Control 566
Conceptions of Coping. 567
Physiological Responses and Allostasis. 569
Taxonomies of Coping Responses. 570
Coping Repertoires. 573
Concept Box: Ashby and the Variety of Responses. 573
A Conceptual Model of the Coping Process. 574
Two Major Coping Strategies and their Effectiveness. 578
Sense of Humor and Laughter. 578
Physiological Effects of Laughter and Humor. 580
Aphorisms. 582
Concept Box: Empiricism and Transcendentalism.. 583
The Impact of Religion on Health. 584
Mechanisms of Influence. 587
Concept Box: Uncertainty-Identity Theory. 588
Theories to Explain Coping Capacity. 590
Psychosocial Resources. 590
Mastery and the Sense of Control 591
Conservation of Resources Theory. 592
Salutogenesis and the Sense of Coherence. 593
Positive Emotions: the Broaden and Build Theory. 595
Community Coping and Resiliency. 596
Discussion Points. 597
References. 599
11. Mental Processes and Health: the Mind-Body Connection. 614
Introduction. 615
Conceptions of Mind and the Mind-Body Connection. 615
Cognition and the Mind. 617
Concept Box: Groundlessness. 617
Embodiment in Epidemiology. 618
Cognitive Embodiment. 618
Emotional Embodiment. 619
Social Embodiment. 620
The Placebo Response. 620
How May Placebos Work?. 622
How Powerful Is the Placebo Response?. 623
Which Types of People Respond to a Placebo?. 624
Other Theoretical Perspectives on the Mind-Body Link. 625
Psychoneuroimmunology. 625
Psychosomatics. 625
Psychoanalysts. 626
Concept Box: Meaning in Life. 626
Intelligence. 627
Discussion Points. 628
References. 630
12. The Relationship Between Personality and Health. 636
Personality. 637
Personality and Health. 637
Fundamental Attribution Error. 638
Theories of Personality. 639
The Big Five Model 639
Concept Box: The Healthy Adherer Effect. 641
Two and Three Trait Models. 641
The HEXACO Personality Model 641
The Hot and Cool Framework of Emotions. 642
The Alphabet Soup of Personality: Types A, B, C, and D.. 643
Type A Personality and Behavior. 643
Anger, Hostility and Aggression. 644
Type C, or Cancer-Prone Personality. 646
The Type D, Distressed Personality. 647
Culture, the Personality of Groups. 647
Conceptual Links Between Personality and Health. 650
Positive Personality Traits and Health. 650
Happiness and Positive Well-Being. 650
Hopefulness and Optimism.. 651
Personality and Coping Styles. 652
Locus of Control 653
Mastery. 654
Resilience and Vulnerability. 654
Concept Box: Emotional and Social Intelligence. 655
Concept Box: Stress Inoculation. 655
Hardiness. 656
Mental Toughness. 657
Reserve Capacity. 657
Negative Personality Concepts Linked to Health. 658
Powerlessness and Learned Helplessness. 658
Denial 659
Personality and Socioeconomic Status. 660
Discussion Points. 662
References. 665
13. Overall Model for Social Determinants and Health. 677
Models. 679
Income Inequalities. 679
Political Influences. 680
The Work Environment. 681
The Role of Education. 683
Intergenerational Transmission of Adversity. 684
Life Course Influences. 687
Conclusion. 689
References 692