Exceptions to the rule

I agree with everyone else that higher SES in general translates into better health. But I just wanted to talk about some exceptions to this general rule. In Mexico, for example, Smith and Goldman (2007) found that in urban areas there was a positive association between SES (here measure by income, wealth, and education) and self-reported health but that in rural areas there were few differences. Also, they found that in urban areas education was a protective factor for obesity but was a risk factor in rural areas. Interestingly, there was a positive relationship between income and obesity, smoking, and alcohol consumption; the reverse is found in industrialized countries. In Costa Rica, one study found that for some health indicators, such as mortality, hypertension, obesity, and the metabolic syndrome, individuals with higher SES appear to be worse off (Rosero-Bixby & Dow, 2009). The authors conclude that higher SES may be associated with a more modern lifestyle and subsequently chronic disease. However, there may be selective mortality of poorer individuals as these studies focus on older populations.

So it seems there may be a few instances where there is a reverse SES gradient in some health measures and these have been attributed to lifestyle and health behaviors and to living in rural areas of developing countries where perhaps even if you have money, healthcare may not be available. But overall (and documented in an extensive amount of literature), higher SES is linked to better health.

For an interesting discussion of how (biologically) SES impacts health:

Crimmins EM, Seeman T. Integrating biology into the study of health disparities (in health and socioeconomic status). Population and Development Review. 2004;30:89–107. (Supplement: Aging, Health, and Public Policy).