People and places: contrasting perspectives on the association between social class and health

While a substantial body of evidence demonstrates a strong association between socioeconomic variables and health outcomes, most analyses conceptualize socioeconomic status as an individual characteristic. This article argues for an expanded view that focuses on the relationship between social class and characteristics of the neighborhood and communities in which people live, and illustrates how these characteristics can provide some new directions for research relating class and health. Using the Alameda County Study, the author presents three analyses that support this view. They indicate that socioenvironmental characteristics of areas are importantly related to the mortality experience of individuals, independent of characteristics of the individuals, and that personal and socioenvironmental risk factors cluster together in areas of low income and high mortality. Studying the balance of demands and resources in areas may help to unravel some of the pathways that link social class and health.