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Psychobiological mechanisms of socioeconomic differences in health


  • Kristenson, M.
  • Eriksen, H. R.
  • Sluiter, J. K.
  • Starke, D.
  • Ursin, H.


The association between low socioeconomic status and poor health is well established. Empirical studies suggest that psychosocial factors are important mediators for these effects, and that the effects are mediated by psychobiological mechanisms related to stress physiology. The objective of this paper is to explore these psychobiological mechanisms. Psychobiological responses to environmental challenges depend on acquired expectancies (learning) of the relations between responses and stimuli. The stress response occurs whenever an individual is faced with a challenge. It is an essential element in the total adaptive system of the body, and necessary for adaptation, performance and survival. However, a period of recovery is necessary to rebalance and to manage new demands. Individuals with low social status report more environmental challenges and less psychosocial resources. This may lead to vicious circles of learning to expect negative outcomes, loss of coping ability, strain, hopelessness and chronic stress. This type of learning may interfere with the recovery processes, leading to sustained psychobiological activation and loss of dynamic capacity to respond to new challenges. Psychobiological responses and health effects in humans and animals depend on combinations of demands and expected outcomes (coping, control). In studies of humans with chronic psychosocial stress, and low SES, cortisol baseline levels were raised, and the cortisol response to acute stress attenuated. Low job control was associated with insufficient recovery of catecholamines and cortisol, and a range of negative health effects. Biological effects of choice of lifestyle, which also depends on the acquired outcome expectancies, reinforce these direct psychobiological effects on health. The paper concludes that sustained activation and loss of capacity to respond to a novel stressor could be a cause of the higher risk of illness and disease found among people with lower SES.

Suggested Citation

  • Kristenson, M. & Eriksen, H. R. & Sluiter, J. K. & Starke, D. & Ursin, H., 2004. "Psychobiological mechanisms of socioeconomic differences in health," Social Science & Medicine, Elsevier, vol. 58(8), pages 1511-1522, April.
  • Handle: RePEc:eee:socmed:v:58:y:2004:i:8:p:1511-1522

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    2. Glei, Dana A. & Goldman, Noreen & Shkolnikov, Vladimir M. & Jdanov, Dmitri & Shalnova, Svetlana & Shkolnikova, Maria & Weinstein, Maxine, 2013. "To what extent do biomarkers account for the large social disparities in health in Moscow?," Social Science & Medicine, Elsevier, vol. 77(C), pages 164-172.
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    4. Hjelm, Lisa & Handa, Sudhanshu & de Hoop, Jacobus & Palermo, Tia, 2017. "Poverty and perceived stress: Evidence from two unconditional cash transfer programs in Zambia," Social Science & Medicine, Elsevier, vol. 177(C), pages 110-117.
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    6. Gisselmann, Marit Dahlén, 2006. "The influence of maternal childhood and adulthood social class on the health of the infant," Social Science & Medicine, Elsevier, vol. 63(4), pages 1023-1033, August.
    7. Chaves, Sônia Cristina Lima & Vieira-da-Silva, Lí­gia Maria, 2008. "Inequalities in oral health practices and social space: An exploratory qualitative study," Health Policy, Elsevier, vol. 86(1), pages 119-128, April.
    8. Nicod, Edouard & Stringhini, Silvia & Marques-Vidal, Pedro & Paccaud, Fred & Waeber , Gérard & Lamiraud, Karine & Vollenweider, Peter & Bochud, Muriel, 2014. "Association of education and receiving social transfers with allostatic load in the Swiss population-based CoLaus study," ESSEC Working Papers WP1412, ESSEC Research Center, ESSEC Business School.
    9. Bosma, H. & Van Jaarsveld, C. H. M. & Tuinstra, J. & Sanderman, R. & Ranchor, A. V. & Van Eijk, J. Th. M. & Kempen, G. I. J. M., 2005. "Low control beliefs, classical coronary risk factors, and socio-economic differences in heart disease in older persons," Social Science & Medicine, Elsevier, vol. 60(4), pages 737-745, February.
    10. Johanna Lundberg & Margareta Kristenson, 2008. "Is Subjective Status Influenced by Psychosocial Factors?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 89(3), pages 375-390, December.
    11. Patrick Hamm & David Stuckler & Lawrence King, 2006. "Mass Privatization and the Postcommunist Mortality Crisis," Working Papers wp118, Political Economy Research Institute, University of Massachusetts at Amherst.
    12. Koster, Annemarie & Bosma, Hans & van Lenthe, Frank J. & Kempen, Gertrudis I.J.M. & Mackenbach, Johan P. & van Eijk, Jacques Th.M., 2005. "The role of psychosocial factors in explaining socio-economic differences in mobility decline in a chronically ill population: results from the GLOBE study," Social Science & Medicine, Elsevier, vol. 61(1), pages 123-132, July.
    13. Boyce, W. Thomas & Den Besten, Pamela K. & Stamperdahl, Juliet & Zhan, Ling & Jiang, Yebin & Adler, Nancy E. & Featherstone, John D., 2010. "Social inequalities in childhood dental caries: The convergent roles of stress, bacteria and disadvantage," Social Science & Medicine, Elsevier, vol. 71(9), pages 1644-1652, November.
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    17. Zachary Zimmer & Heidi A. Hanson & Ken R. Smith, 2016. "Offspring Socioeconomic Status and Parent Mortality Within a Historical Population," Demography, Springer;Population Association of America (PAA), vol. 53(5), pages 1583-1603, October.
    18. Goldman, Noreen & Turra, Cassio M. & Rosero-Bixby, Luis & Weir, David & Crimmins, Eileen, 2011. "Do biological measures mediate the relationship between education and health: A comparative study," Social Science & Medicine, Elsevier, vol. 72(2), pages 307-315, January.


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