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EDITORIAL: Beyond Health Care -- Socioeconomic Status and Health 

The article by Mackenbach et al. in this issue of the Journal1 documents the extraordinary pervasiveness of socioeconomic inequalities in health as well as the varying magnitude of risks among countries. The compilation of data from western and eastern European countries on mortality, morbidity, smoking, and obesity in relation to socioeconomic status allows the authors to provide the broadest international portrait to date of the association between socioeconomic status and health. The link between socioeconomic disadvantage and poor health has been observed repeatedly,2 but until now we have lacked data that would permit us to make consistent comparisons of these linkages across many countries. Comparisons among countries invite us to examine the features that are shared from country to country that contribute to the overall patterns of disease, as well as to explore the unique features of a nation that contribute to variability in the magnitude of the risks across countries. . . .

Socioeconomic status as it relates to differences in rates of smoking also does not appear to explain differences in mortality from causes generally attributable to smoking (e.g., chronic obstructive pulmonary disease and various cancers). For example, in Hungary, differences in rates of smoking according to socioeconomic status are very small, whereas differences in mortality according to socioeconomic status for conditions related to smoking are large.

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