Social class refers to individuals’ position within a society’s economic and social hierarchy. Most often, it is measured by looking at individuals’ education, income, or occupational status, with some researchers using only one of these indicators and some combining two or more. Other researchers have argued for additional measures, with wealth perhaps the most important. Wealth refers to the total financial resources an individual or family owns, including cash, houses, pensions, and investments, among other things. For example, imagine two students who work together at Starbucks, earning the same income each week. Now imagine that one girl’s parents can pay her tuition each year from their savings, while the other’s parents took out a second mortgage on their house but could still pay only could pay a quarter of their daughter’s tuition. These students have the same income, education, and occupation but some would say that they differ in social class because they differ in family wealth.

The link between social class and ill health is strong and consistent. For example, the food, shelter, and clothing available to poor Americans 200 years ago differed greatly from that available to poor Americans now, which in turn differs greatly from that available to poor Brazilians these days. Even so, in each place and era and for almost all illnesses, poor persons experience more illness than wealthier persons do. Because of this especially strong link between social class and health across time, place, and disease, some sociologists label social class a “fundamental cause” of disease.

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Fundamental-cause theory argues that even though the common diseases and their causes may change over time and place, in each situation those with greater access to resources will experience better health because those resources help protect their health. For example, Link and Phelan write:

[A] person with many resources can afford to live in a high-status neighborhood where . . . enormous clout is exerted to ensure that crime, noise, violence, pollution, traffic, and vermin have been kept at a minimum and the best health-care facilities, parks, playgrounds, and food stores are conveniently located nearby. Once a person has used [social class-based] resources to locate in an advantaged neighborhood, a host of health enhancing circumstances comes along as a package deal.


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