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#2005-05: Inter-Cohort Trends in Age-Specific Health Inequalities: A test of the Theory of Fundamental Causes.
Authors: John Robert Warren, Department of Sociology, Minnesota Population Center, University of Minnesota, and Elaine M. Hernandez, Department of Sociology, Life Course Center, University of Minnesota
ABSTRACT: Link and Phelan’s (1995; 1996) “Fundamental Causes” theory posits that social and economic inequalities in morbidity and mortality have persisted over historical time --- and will continue to persist --- because people with access to more social and economic resources are always better able to avoid health risks (even if the nature of those risks change over time). Despite the prominence of this theory and its inherent challenge to mainstream epidemiological, public health, and social science research, the core empirical fact that the theory is designed to explain has not been well established by Link and Phelan or others. Have socioeconomic inequalities in morbidity and mortality remained essentially constant over time? To investigate, we examine inter-cohort trends in age-specific health inequalities using data from the 1972 through 2002 General Social Surveys. Our results reproduce findings of inter-cohort improvements in health outcomes, but we find that socioeconomic differences in health have remained unchanged across the bulk of the 20th century. Although Americans’ health has improved over time, inequalities in health have persisted.