Social Epidemiology and the Fundamental Cause Concept: On the Structuring of Effective Cancer Screens by Socioeconomic Status

Since the early 1800s, studies have consistently demonstrated that people higher in the socioeconomic hierarchy live longer than people of lower rank. One hypothesis for the persistence of this association is that people who are relatively better off are more able to avoid risks by adopting currentl...

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Bibliographic Details
Published in:The Milbank quarterly 1998-01, Vol.76 (3), p.375-402
Main Authors: Link, Bruce G., Northridge, Mary E., Phelan, Jo C., Ganz, Michael L.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Breast cancer
Breast Neoplasms - epidemiology
Breast Neoplasms - prevention & control
Cancer
Cancer screening
Class Differences
Diagnostic Tests, Routine - economics
Diagnostic Tests, Routine - standards
Diagnostic Tests, Routine - utilization
Epidemiology
Factors
Female
France
Geographical surveys
Health
Health Care Utilization
Health policy
Heart diseases
Humans
Income - statistics & numerical data
Mammography
Mammography - economics
Mammography - utilization
Medical screening
Middle Aged
Mortality
Original
Papanicolaou Test
Population Surveillance
Poverty - statistics & numerical data
Predisposing factors
Program Development
Public health
Risk-Taking
Screening
Screening tests
Social Class
Social conditions
Social Constructionism
Social Inequality
Socioeconomic Factors
Socioeconomic Status
Standard of living
United States - epidemiology
USA
Uterine Cervical Neoplasms - epidemiology
Uterine Cervical Neoplasms - prevention & control
Vaginal Smears - economics
Vaginal Smears - utilization
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Description
Summary:Since the early 1800s, studies have consistently demonstrated that people higher in the socioeconomic hierarchy live longer than people of lower rank. One hypothesis for the persistence of this association is that people who are relatively better off are more able to avoid risks by adopting currently available protective strategies. In a partial test of this idea, the social distributions of two cancer screening tests-Pap smears and mammography-were examined. A review of the literature and an analysis of Behavioral Risk Factor Surveillance System (BRFSS) data showed a consistent association between indicators of socioeconomic status and recent screening. These findings support the theory that societies create and shape patterns of disease. Innovations beneficial to health are carried out within the context of inequalities that shape the distribution of the health benefit, thereby affecting patterns of mortality.
ISSN:0887-378X
1468-0009
DOI:10.1111/1468-0009.00096