PERINATAL OUTCOME AND THE SOCIAL-CONTRACT - INTERRELATIONSHIPS BETWEEN HEALTH AND SOCIETY

Rates of infant mortality and prematurity or low birthweight serve as indirect measures of the health of a nation. This paper presents curre nt population data documenting the still serious problem of perinatal outcome in the USA as well as in other economically developed countrie s. International comparisons suggest that nations which have the great est inequality of income and social opportunity also have the most adv erse perinatal, child and adult health outcomes. Furthermore, the data assert that these effects are independent of average national wealth or gross national economic productivity. Health status differs by soci al class and race, even among the most affluent sectors of the populat ion. All social classes, even the wealthiest, suffer the health conseq uences of social inequalities. An explanatory socio-psychological theo ry of causality is proposed.