Political-Economic Context and the ”Challenge of the Gradient”

( a. k. a. my dissertation)

Explaining the persistent social gradient in health is an important theoretical issue in medical sociology and social epidemiology. One line of inquiry focuses on the material resource benefits that social position confers on health, while others emphasize the significance of relative deprivation, social comparisons, and social integration to health.

In my dissertation, Political-Economic Context and the “Challenge of the Gradient”: How Social Structure and Position Shape Health Disparities, I utilize rich variation in political and economic environment to adjudicate this theoretical debate. In particular, I focus on income inequality, economic development, and political power as key structural factors that influence the social gradient in health at multiple levels of analysis.

My first chapter, which appears in the Journal of Health and Social Behavior, examines the pathways through which income inequality is presumed to harm population health. Material mechanisms may be more salient in low- or middle-income countries, while psychosocial mechanisms are more important in high-income countries where the basic needs of life are met. To test these predictions, I utilize economic development as a key moderator in the relationship between income inequality and population health. Findings confirm that inequality has deleterious effects on population health in low- to middle-income countries, with no impact in high-income countries. These findings suggest a global gradient in the effect of inequality on population health that puts poorer countries at a particular population health disadvantage due to a lack of material resources. Please see my publications list for access to a non-gated version.

I am grateful to UC – Riverside Graduate Division, the UC – Riverside Blum Initiative on Global and Regional Poverty, and AIS Mellon for their generous funding in support of my dissertation.