TY - JOUR AU - Banks,James AU - Marmot,Michael AU - Oldfield,Zoe AU - Smith,James P. TI - The SES Health Gradient on Both Sides of the Atlantic JF - National Bureau of Economic Research Working Paper Series VL - No. 12674 PY - 2006 Y2 - November 2006 UR - http://www.nber.org/papers/w12674 L1 - http://www.nber.org/papers/w12674.pdf N1 - Author contact info: James Banks University College London E-Mail: j.banks@ucl.ac.uk Michael Marmot Department of Epidemiology and Public Health Royal Free and University College London Medical S 1-19 Torrington Place London WC1E6BT, UK E-Mail: m.marmot@public-health.ucl.ac.uk Zoe Oldfield Institute for Fiscal Studies 7 Ridgemount London, WC1 7AE U.K. E-Mail: zoe_o@ifs.org.uk James P. Smith RAND Corporation 1776 Main Street P.O. Box 2138 Santa Monica, CA 90407-2138 Tel: 310-451-6925 E-Mail: smith@rand.org M1 - published as James Banks, Michael Marmot, Zoe Oldfield, James P. Smith. "The SES Health Gradient on Both Sides of the Atlantic," in David A. Wise, editor, "Developments in the Economics of Aging" University of Chicago Press (2009) M3 - presented at "Economics of Aging Conference", May 13-15, 2005 AB - Looking across many diseases, average health among mature men is much worse in America compared to England. Second, there exists a steep negative health gradient for men in both countries where men at the bottom of the economic hierarchy are in much worse health than those at the top. This health gradient exists whether education, income, or financial wealth is used as the marker of one's SES status. These conclusions are maintained even after controlling for a standard set of behavioral risk factors such as smoking, drinking, and obesity and are equally true using either biological measures of disease or individual self-reports. In contrast to these disease based measures, health of American men appears to be superior to the health of English men when self-reported general health status is used. The contradiction most likely stems instead from different thresholds used by Americans and English when evaluating health status on subjective scales. For the same "objective" health status, Americans are much more likely to say that their health is good than are the English. Finally, feedbacks from new health events to household income are one of the reasons that underlie the strength of the income gradient with health in England. ER -