The Concept of Fundamental Causes in Explaining Social Inequities in Health

Award Year:
Bruce Link, Jo Phelan,
Poverty and Health, Social Determinants of Health
Drs. Phelan and Link believe that certain social conditions, such as socioeconomic status (SES), may be fundamental social causes of health and disease. Their health and policy relevance which involve access to resources such as money, knowledge, power, prestige and the social connections that determine the extent to which people are able to avoid risks for morbidity and mortality are explored. The project elaborates beyond the initial focus on SES, by incorporating theory on social capital, social class, power, and prestige. It also examines the social patterning of disease by race, ethnicity, gender, age, and marital status. A case study approach is used to assess the validity of the concept, looking at whether fundamental social causes have a persistent effect on health despite changes in risk factors, diseases, and interventions. The issue of whether reducing inequality in resources can be expected to improve overall health in a population or merely to redistribute it, is also explored.