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In this chapter, I review recent evidence on the developmental origins of health inequality. I discuss the origins of the education-health gradient, the long-term costs caused by early life adversity, and how early life experiences affect the biology of the body. Additionally, I provide complementary evidence on enrichment interventions which can at least partially compensate for these gaps. I highlight emerging lines of scientific inquiry which are likely to have a significant impact on the field. I argue that, while the evidence that early life conditions have long-term effects is now uncontroversial, the literature needs to be expanded both in a theoretical and empirical direction. On the one hand, a model linking early life origins to ageing needs to be developed; on the other hand, a better understanding of the mechanisms – both biological and socioeconomic – is required, in order to design more effective interventions.

This paper was written as part of a suite to inform the Big Lottery Better Start programme and as such has focused on the outcomes that are of interest to that programme. The authors have also focused on outcomes for younger children and the zero to three years age group where data are available. There is a social gradient such that the lower a family's socio-economic status (SES) the greater the likelihood that they have children who are obese, have impaired social and emotional skills, or have impaired language acquisition. These statistics are clear and undisputed. The purpose of this paper is to explore some of the reasons for the social gradient in these outcomes. The paper provides some suggestions for actions that might be taken to redress the inequalities. It follows broader work presented in, for example, the Marmot (2010) review, Fair Society Healthy Lives.

Rapid review of the literature building on the work of the Marmot (2010) review.

Poor SES is linked with increased stress and a higher likelihood of being unable to afford to live a healthy life. These factors can have a negative impact on children's outcomes. The paper presents some examples of what can be done.

This should be a useful paper for local authorities trying to reduce inequalities and improve outcomes.

The purpose of this chapter is to use sociological theory and research to develop an explanation for how chronic illnesses are managed at home and to thereby suggest some ways in which a sociological perspective can be applied to improve health care for persons with chronic illnesses. Self-care illness management is crucial to the prevention of and reduction of morbidity and mortality from chronic illness.

Review and synthesis of research literature.

Sociological research and theory suggest two important insights that should inform health care services aimed at improving self-care; chronic illness care occurs in the context of the household, neighborhood, and community and, therefore, the “patient” (i.e., the object of health services) is really the caregiving social network around the patient, and because the risk of chronic illness and the resources available to deal with it are socially (and unequally) distributed, “health care” interventions need to take account of disparities in risks and resources that will affect the patient’s ability to successfully comply with self-care regimens.

The review does not include an examination of the clinical research literature. It does, however, suggest that sociologists need to explicitly study chronic illness and health care related to it.

The chapter links the long history of research on family caregiving to the concern with the success of self-management of chronic illness. It also links concerns about that success to social disparities in the distribution of social resources and hence to morbidity and mortality disparities.

Over the years, many upstream health policies have sought to reduce smoking across populations. While smoking has been substantially reduced, the effects of these policies on education-smoking gradient remain unclear. The present paper compares the education-smoking gradient among the Generation X and the millennials, who grew up with different types of upstream policies.

The study relies on regression analysis. The data are from the Canadian Tobacco, Alcohol and Drugs Survey of 2017, with the sample restricted to those born between 1965 and 1995.

At the zero-order, the education-smoking gradient has not significantly flattened from Generation X to millennials. And, accounting for the channels of impact of education on smoking does not substantially change this pattern.

The implications for health inequalities associated with socioeconomic status, and tobacco consumption reduction policies, are discussed.

This paper is the first study of the kind using Canadian data.

The purpose of this paper is to shed some light on the large differences between poor and rich Brazilian households regarding children's outcomes; that is, understanding inequality in health outcomes in the childhood in Brazil, examining the link between the health of Brazilian children and a variety of socioeconomic factors.

Logit models for some measures of child health (poor health, chronic diseases, hospitalization and visits to doctors and dentists). Individuals are grouped according to their income decile. Independent variables comprise indicators of socioeconomic status and demographic variables, primarily related to the family structure.

Results suggest that the true effect of family structure is more complex than the biological relationship of parents to children. There are large effects of family income distribution on child health indicators. When control variables are included, the magnitude of these effects changes. The addition of mothers' educational attainment to the set of controls reduces the estimated income effects. Also, the gradient in the health‐income relationship is a little steeper for older children.

Although there are numerous studies investigating the impact of family resources on health outcomes, whether income and family structure truly matters is still a debated issue. Brazil presents a huge level of income and until recently there has been little data with which to assess the nature and magnitude of the role, which socioeconomic factors play in the incidence and severity of health problems. The authors originally attempt to understand what it means to talk about inequality in health, and whether health inequality in Brazil is linked to income inequality.

Studies repeatedly have found social disparities of health at many levels of spatial aggregation. A second body of empirical research, demonstrating relationships between an area's racial and class composition and its environmental conditions, has led to the rise of an environmental justice movement. However, few studies have connected these two sets of findings to ask whether social disparities in health outcomes are due to local environmental disparities. This chapter investigates whether the association between racial and socioeconomic composition and multiple health conditions across New York City zip codes is partly mediated by neighborhood physical, built, and social environments.

The prevalence and stability of marriage has declined in the United States as the economic lives of men and women have converged. Family change has not been uniform, however, and the widening gaps in marital status, relationship stability, and childbearing between socioeconomic groups raise concerns about child well-being in poor families and future inequality. This paper uses data from a recent cohort of young adults – Wave IV of the National Longitudinal Study of Adolescent Health – to investigate whether disparities in cognitive ability and non-cognitive skills contribute to this gap. Blinder–Oaxaca decompositions of differences in key family outcomes across education groups show that, though individual non-cognitive traits are significantly associated with union status, relationship instability, and single motherhood, they collectively make no significant contribution to the explanation of educational gaps for almost all of these outcomes. Measured skills can explain as much as 25 percent of differences in these outcomes by family background (measured by mother’s education), but this effect disappears when own education is added to the model. Both cognitive and non-cognitive skills are strongly predictive of educational attainment but, conditional on education, explain very little of the socioeconomic gaps in family outcomes for young adults.

There are clear links between health, housing and social care. The homeless live much shorter lives as do those people living in poorer quality accommodation and areas of deprivation. Life expectancy and the quality of life in later years are both drastically affected by Marmot's (2010) social gradient, with people from poorer backgrounds often doing worse. A decent home is fundamental to a healthy and a good life. The paper aims to discuss these issues.

The research approach reviewed existing articles, examples from the housing sector and analysis of a range of data from organisations including the NHS.

Good housing helps to support better health but it is not the only answer – joined up working between agencies and Marmot's proposal of proportionate universalism are significant factors in finding solutions to this long-standing issue.

Costs to the government, health services and local authorities and other agencies could be reduced by wider thinking around the link between housing, health and other support.

This paper focuses on the existing links between health, housing and social care.

We explore what health-capital theory has to offer in terms of informing and directing research into health inequality. We argue that economic theory can help in identifying mechanisms through which specific socioeconomic indicators and health interact. Our reading of the literature, and our own work, leads us to conclude that non-degenerate versions of the Grossman (1972a, 1972b) model and its extensions can explain many salient stylized facts on health inequalities. Yet, further development is required in at least two directions. First, a childhood phase needs to be incorporated, in recognition of the importance of childhood endowments and investments in the determination of later-life socioeconomic and health outcomes. Second, a unified theory of joint investment in skill (or human) capital and in health capital could provide a basis for a theory of the relationship between education and health.