SOCIAL EPIDEMIOLOGY AND THE FUNDAMENTAL CAUSE CONCEPT - ON THE STRUCTURING OF EFFECTIVE CANCER SCREENS BY SOCIOECONOMIC-STATUS

Since the early 1800s, studies have consistently demonstrated that peo ple higher in the socioeconomic hierarchy live longer than people of l ower rank. One hypothesis for the persistence of this association is t hat people who are relatively better off are more able to avoid risks by adopting currently available protective strategies. In a partial te st of this idea, the social distributions of two cancer screening test s-Pap smears and mammography-were examined. A review of the literature and an analysis of Behavioral Risk Factor Surveillance System (BRFSS) data showed a consistent association between indicators of socioecono mic status and recent screening. These findings support the theory cha t societies create and shape patterns of disease. Innovations benefici al to health are carried out within the concert of inequalities chat s hape the distribution of the health benefit, thereby affecting pattern s of mortality.