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We need to identify the thresholds after which weaker SES effects are observed and to characterize the social, psychological, and material risks and resources that are associated with each level of the SES hierarchy.

In both industrialized and less industrialized countries, persons of higher socioeconomic status (SES) live longer and have lower rates of most diseases than their less favored counterparts (Behm, 1980; Grosse and Auffrey, 1989; Holzer et al., 1986; Department of Health and Social Security, 1980).

In the United States, for example, higher position in the SES hierarchy was associated with greater prevalence of heart disease earlier this century, but SES is currently inversely related to cardiovascular risk (Morgenstern, 1980).

Thus, apparently discrepant findings highlight the importance of attending to broader social and historical contexts.

Although differences between SES groups in access, utilization, and the quality of medical care probably play some role in the widening health inequality (Makenbach et al., 1989), increases in income and wealth inequality in both the United States and Western Europe (Danziger and Gottschalk, 1993) appear to be the driving force behind the widening health disparities (Williams and Collins, 1995).

A high degree of inequality in a given location (e.g., country, state, county, district, city) may itself be a health hazard.

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