Definition of ‘socioeconomic inequalities in health’

Socioeconomic inequalities in health can be defined as systematic differences in the prevalence or incidence of health problems between people of higher and lower socioeconomic status (distinguished by level of education, occupational class, or income) (Kunst & Mackenbach, 1994). For most health problems, a higher prevalence or incidence is observed in the lower socioeconomic groups.

Explanations of socioeconomic inequalities in health

Several explanations of socioeconomic inequalities in health are entry-points for policies and interventions to reduce these inequalities. A reduction of socioeconomic inequalities in health may be achieved by (a combination of) the following entry-points:

• a reduction of inequalities in education, income, occupation
• to diminish the negative effects of health problems on the educational level, occupational level and income of people
• to diminish the negative health effects of exposure to unhealthy living and working conditions and of an unhealthy life style; the prevalence of these unhealthy factors is often higher in the lower socioeconomic groups (see: Inequalities in smoking and lung cancer)
• to improve access to health care facilities and the quality of health care for people with a low socioeconomic status.

Inequalities in health are strongly connected to inequalities in other areas of society, such as inequalities in socioeconomic status and living and working conditions. It is a problem with many causes, that cannot be tackled by the health care sector alone. An integrated approach based on integrated policy is needed (Wilkinson & Marmot, 2003; De Hollander et al., 2006).