Aging, Health Behaviors, and Health Outcomes

By K. Warner Schaie; Dan Blazer et al. | Go to book overview

1

Social Stratification, Age, and Health

James S. House Ronald C. Kessler A. Regula Herzog Richard P. Mero Ann M. Kinney Martha J. Breslow University of Michigan


INTRODUCTION

This chapter integrates and summarizes a line of research developed in somewhat more detail in several other papers ( House et al., 1990a, 1990b, 1991). The research derives from an ongoing program project funded by the National Institute on Aging, entitled "Stress, Health and Productive Activity in Middle and Later Life," which seeks to identify psychosocial factors that maintain and enhance health and effective functioning in middle and later life. The work presented here suggests that such psychosocial factors are both macrosocial and microsocial in nature. At the macrosocial level we focus on the system of social stratification in our society. We then try to show how position in the stratification system shapes exposure to microsocial risk factors that are the more proximate determinants of health over the life course.

In this chapter we argue that our society can neither understand nor deal with the related problems of aging and health without coming to grips with what we have come to term the social stratification of aging and health ( House et al., 1990b, 1991). By this we mean that the way in which health varies by age within and across individuals is heavily influenced by people's socioeconomic status ( House et al., 1990a). People of higher socioeconomic status (SES) generally experience high levels of health until quite late in life, whereas people of lower SES are much more likely to manifest significant declines in health by early middle age. Thus, the relation of age to health varies markedly by SES. Furthermore, the relation of SES to health is very different at different points in the life course: SES differences in health are small in early adulthood, in-

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