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This study tests the first two tenets of the fundamental causes theory – that socioeconomic status influences a variety of risk factors for poor health and that it affects multiple health outcomes – by examining the associations between adverse socioeconomic circumstances and five measures of health.

We employ bivariate and logistic regression analyses of data from the Centers Disease Control and Prevention 2011 Behavioral Risk Factor Surveillance Survey (BRFSS) to test the individual and cumulative associations between three measures of socioeconomic position and five measures of health risk factors and outcomes.

The analysis demonstrates support for the fundamental causes theory, indicating that measures of adverse socioeconomic conditions have independent and cumulative associations with multiple health outcomes and risk factors among U.S. adults aged 18–64.

The findings of this chapter are generalizable to adults aged 18–64 living in the United States and may not apply to individuals living outside the United States, older Americans, and children.

Adverse socioeconomic circumstances are not only associated with self-rated health but are also associated with the two leading causes of death in the United States (cancer and heart disease) and risk factors that contribute to these causes of death (smoking and high blood pressure). Improving access to socioeconomic resources is critical to reducing health disparities in leading causes of death and health risk factors in the United States.

Improving the nutritious quality of diets for individuals and populations is a central goal of many public health advocates and intergovernmental organizations. Yet the outcome of healthy eating has been shown to systematically vary across individual-level socioeconomic lines, and across countries in different locations of the food system. We therefore assess variation in the association between eating nutritionally dense fresh fruits and vegetables and both self-rated health (SRH) and body mass index (BMI) across individual income and country locations in the food system.

We use nationally representative survey data from 31 countries drawn from the International Social Survey Programme’s 2011 Health module. We estimate the effect of the frequency of eating fresh fruits and vegetables using random-intercept, random-coefficient multilevel mixed-effects regression models.

We confirm that eating nutritionally dense fresh fruits and vegetables frequently associates with more positive health outcomes. However, this general conclusion masks substantial individual- and country-level heterogeneity. For both SRH and BMI, the largest beneficial associations are concentrated among the most affluent individuals in the most affluent countries. Moving away from either reduces the positive association of healthy eating.

Our results provide an important wrinkle for policies aimed at changing the nutritional quality of diets. Adjustments to diets without taking into account fundamental causes of socioeconomic status will likely be met with attenuated results.

We compare two important health outcomes across a wide variety of types of countries. We demonstrate that our main conclusions are only detectable when employing a flexible multilevel methodological design.

This chapter provides an introduction both to some major issues and concerns in the area of population health and major health problems, especially chronic health problems, and to the overall volume. The topic of population health is reviewed, beginning with the more public health approach of Kindig and that attempt to define the term and the outcomes of interests. The chapter will then move to an examination of the linkages between population health from a more specifically sociological perspective, and especially to relationships between social structure, including socioeconomic status, and health. The last part of this introductory chapter briefly discusses the other sections in the book and each of the chapters within those sections.

Though it is one of the strongest predictors of vaccine initiation, few studies have examined the social correlates of health care professional (HCP) recommendations of the human papillomavirus (HPV) vaccination. This study employs a “fundamental causes” framework to examine whether family socioeconomic status is associated with parent reports of HPV vaccine uptake and HCP recommendation of the vaccine among female youth aged 12–17.

Using the 2007 National Survey of Children’s Health, a nationally representative sample of parents in the United States, this study documents a clear socioeconomic gradient in HCP recommendation of the HPV vaccine.

Results from a set of logistic regression models demonstrate that lower income families have significantly lower odds of vaccine initiation; however, the effect of household income is mediated by HCP recommendation. Further analyses reveal that lower income and poor families have reduced odds of receiving a HCP recommendation even when other health care related factors such as insurance status, annual preventive care, and a usual source of care are controlled.

The findings suggest that low income and poor families are less likely to receive needed health information regarding the HPV vaccine, thereby reducing the likelihood of vaccine uptake.

This review integrates and builds linkages among existing theoretical and empirical literature from across disciplines to further broaden our understanding of the relationship between inequality, imprisonment, and health for black men. The review examines the health impact of prisons through an ecological theoretical perspective to understand how factors at multiple levels of the social ecology interact with prisons to potentially contribute to deleterious health effects and the exacerbation of race/ethnic health disparities.

This review finds that there are documented health disparities between inmates and non-inmates, but the casual mechanisms explaining this relationship are not well-understood. Prisons may interact with other societal systems – such as the family (microsystem), education, and healthcare systems (meso/exosystems), and systems of racial oppression (macrosystem) – to influence individual and population health.

The review also finds that research needs to move the discussion of the race effects in health and crime/justice disparities beyond the mere documentation of such differences toward a better understanding of their causes and effects at the level of individuals, communities, and other social ecologies.

Recent national policy adoptions of the social determinants of health approach present enormous challenges to practitioners designing health promotion programs aimed at eliminating health disparities. This chapter provides a framework for understanding the social determinant rationale embedded in Healthy People 2020 and introduces the concept of place as an important consideration.

This chapter presents a conceptual explanation of social determinant thinking and describes the potential impact for traditional health promotion activities that target the at-risk populations.

Two major resources, the Health Impact Assessment Toolkit and the HHS Disparities Action Plan, have emerged as frameworks for developing a health in all policies approach that will enable health practitioners to enhance their social determinant interventions.

Current social determinant approaches and models need to be strategically tailored to interventions aiming to reduce health disparities. Additional research focusing on how these approaches are integrated within the existing health promotion program frameworks is required.

Very few health practitioners have had the opportunity to integrate a social determinant approach that emphasizes the concept of place and explores the consequences of using a health in all policies approach. This chapter serves as a practical introduction and outlines the major challenges.

The tipping point for the inclusion of social determinants of health in addressing health disparities occurred with the publication of Healthy People 2020. As this innovation begins to diffuse throughout the country, health practitioners will benefit by reviews and applications of the new rationale and model.

Research on health care disparities is making important descriptive and analytical strides, and the issue of disparities has gained the attention of policymakers in the United States, other nation-states, and international organizations. Still, disparities research scholarship remains US-centric and too rarely takes a cross-national comparative approach to answering its questions. The US-centricity of disparities research has fostered a fixation on race and ethnicity that, although essential to understanding health disparities in the United States, has truncated the range of questions that researchers investigate. In this chapter, we make a case for comparative research that highlights its ability to identify the institutional factors that may affect disparities.

We discuss the central methodological challenges to comparative research. After describing current solutions to such problems, we use data from the World Values Survey to show the impact of key social fault lines on self-assessed health in Europe and the United States.

The negative impact of socioeconomic status (SES) on health is more generalizable across context, than the impact of race/ethnicity or gender.

Our analysis includes a limited number of countries and relies on one measure of health.

The chapter represents a first step in a research agenda to understand health inequalities within and across societies.

In this chapter, we draw on health lifestyle, human capital, and health commodity theories to examine the effects of educational attainment on a wide range of individual dietary behaviors and dietary lifestyles.

Using data from the 2005-2006 iteration of the National Health and Nutrition Examination Survey (n = 2,135), we employ negative binomial regression and binary logistic regression to model three dietary lifestyle indices and thirteen healthy dietary behaviors.

We find that having a college degree or higher is associated with seven of the thirteen healthy dietary behaviors, including greater attention to nutrition information (general nutrition, serving size, calories, and total fat) and consumption of vegetables, protein, and dairy products. For the most part, education is unrelated to the inspection of cholesterol and sodium information and consumption of fruits/grains/sweets, and daily caloric intake. We observe that having a college degree is associated with healthier dietary lifestyles, the contemporaneous practice of multiple healthy dietary behaviors (label checking and eating behaviors). Remarkably, household income and the poverty-to-income ratio are unrelated to dietary lifestyles and have virtually no impact on the magnitude of the association between education and dietary lifestyles.

Our findings are consistent with predictions derived from health lifestyle and human capital theories. We find no support for health commodity theory, the idea that people who are advantaged in terms of education live healthier lifestyles because they tend to have the financial resources to purchase the elements of a healthy lifestyle.