The Macarthur ladder is a common approach to assessing subjective socioeconomic status (SES), and many studies have confirmed that living at the bottom of the ladder is associated with poorer health, and a higher chronic disease burden. This is not just a problem of access to care, as the health gradient exists even in countries with good universal healthcare coverage. There is some data that the steepness of the ladder has an impact, as health worsens when there are bigger gaps. An impressive report released today in Lancet documents the magnitude of the SES impact, compared with seven major risk factors that the WHO has targeted for prevention of non-communicable disease. SES ranked higher than all of the other risk factors except for smoking and physical inactivity. Improving opportunities for populations at risk will benefit the health of individuals and the health of the country.
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