DALY ET AL. RESPOND

Abstract

Braveman and Cubbin are correct in pointing out that the optimal indicators of socioeconomic status (SES) may vary across health outcomes and health behaviors. Indeed, we alluded to this point when we noted that “various measures of SES may summarize different components of overall health risk.” We also agree that systematic evaluation of the importance of various SES measures is required before an “optimal” set can be recommended. That said, we are more convinced than Braveman and Cubbin about the power of economic measures to predict a wide range of health outcomes and behaviors. Our assessment is based on a growing body of longitudinal research in health studies, economics, and demography evaluating the links between health and income. As in our own empirical work, researchers have found important linkages between income and mortality.1–7 Recently, scholars also have shown economic variables such as income and wealth to be important correlates of self-reported health, functional limitations, and work disability. A great deal of this research is now focused on understanding the causal pathways underlying the correlations between income, wealth, and health. While this is not to say that economic factors are crucial for all health outcomes and behaviors, it does underscore their utility in understanding a wide range of health issues. And, as Braveman and Cubbin point out, if economic variables were regularly collected on health-based surveys, their importance could be evaluated more systematically. Given this evidence and the reliability of survey-based economic measures, we join Braveman and Cubbin in supporting the collection and use of economic variables in understanding health dynamics across various populations and over the life course.