The link between general health and socio-economic status is well established. There is also a body of evidence showing that poor oral health is associated with low socio-economic status or deprivation. In both high and lower income countries around the world, low socio-economic status was significantly associated with increased oral cancer risk, even after adjusting for potential behavioural confounders.
Thus, socio-economic status per se is an important risk factor: social disadvantage causes health disadvantage. SLÁN 2007 reported that long-term illness was more common among the lower social groups.
In addition to being a risk factor in itself, socio-economic status is also an important underlying determinant of other common risk factors. SLÁN 2007 reported that:
- those in the lower social class groups were more likely to smoke,
- those in the higher social class groups were more likely to have tried to quit smoking in the previous year
- excessive alcohol consumption was more common among lower social class groups
- those in the higher social class groups were more likely to consume a greater quantity of fruit and vegetables
25% of those in the (highest) social classes 1–2 reported practicing four positive lifestyle behaviours – i.e., eating 5+ daily servings of fruit and vegetables, being a nonsmoker, being a moderate drinker, being physically active – compared to 21% in the social classes 3–4 and 18% in social classes 5–6. Practicing all four of these positive behaviours confers an additional 14 years in life expectancy relative to practicing none of these behaviours.
Growing Up in Ireland – National Longitudinal Study of Children( http://www.growingup.ie/ ), which commenced in 2007, reports that differences in health across social groups are evident from as early as 3 years of age.
Dalhgren and Whitehead’s pictorial representation of the main determinants of health reproduced below highlights the various influences which impact on the lives we lead.
Acknowledging that personal lifestyle behavioural “choices” may, for certain segments of society, be limited by socioeconomic, cultural, political and other environmental conditions beyond their control is essential for developing effective public health strategies.