Social and economic disparities in health: Thoughts about intervention

It is now well established that inequalities in income lead to high morbidity and mortality races. Certain explanations for this phenomenon are explored: (1) Instead of income inequalities causing disease, the inequalities are determined by powerful cultural forces. (2) The rich get richer and the poor get poorer. (3) Wealthier people can buy the means to protect their health. (4) Poorer people suffer not from poverty, but from relative deprivation. (5) Those with che weakest genes drift into the lower income groups. It is difficult to develop int interventions directed to these possibilities. The concept of "control and destiny" is a possible explanation for the relation between inequalities and disease; unlike the other explanations, this idea is amenable to intervention.