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This article seeks to elucidate the relationship between socioeconomic position and health by showing how different facets of socioeconomic position (education and income) affect different stages (onset vs. progression) of health problems. The biomedical literature has generally treated socioeconomic position as a unitary construct. Likewise, the social science literature has tended to treat health as a unitary construct. To advance our understanding of the relationship between socioeconomic position and health, and ultimately to foster appropriate policies and practices to improve population health, a more nuanced approach is required—one that differentiates theoretically and empirically among dimensions of both socioeconomic position and health. Using data from the Americans' Changing Lives Study (1986 through 2001/2002), we show that education is more predictive than income of the onset of both functional limitations and chronic conditions, while income is more strongly associated than education with the progression of both.

Previous research has shown that involuntary job loss may have negative health consequences, but existing analyses have not adequately adjusted for health selection or other confounding factors that could reveal the association to be spurious. Using two large, population-based longitudinal samples of U.S. workers from the Americans' Changing Lives Study and the Wisconsin Longitudinal Study, this analysis goes further by using respondents' self-reports of the reasons for job loss and information about the timing of job losses and acute negative health shocks to distinguish health-related job losses from other involuntary job losses. Results suggest that even after adjustment for numerous social background characteristics and baseline health, involuntary job loss is associated with significantly poorer overall self-rated health and more depressive symptoms. More nuanced analyses reveal that among involuntary job losers, those who lose their jobs for health-related reasons have, not surprisingly, the most precipitous declines in health. Job losses for other reasons have substantive and statistically significant effects on depressive symptoms, while effects on self-rated poor health are relatively small.

The development of social epidemiology and medical sociology over the last half of the 20th century, in which Leo Reeder played a central role, transformed scientific and popular understanding of the nature and causes of physical health and illness. Viewed in the early 1950s as shaped almost entirely by biological processes and medical care, physical health and illness are now understood to be as much or more a function of social, psychological, and behavioral factors. Utilizing a stress and adaptation conceptual framework, social epidemiology has identified a broad range of psychosocial risk factors for health, most notably: (1) social relationships and support; (2) acute or event-based stress; (3) chronic stress in work and life; and (4) psychological dispositions such as anger/hostility, lack of self-efficacy/control, and negative affect/hopelessness/pessimism, with new risk factors continuing to be identified. However, proliferation of risk factors must be balanced by conceptual integration and causal understanding of the relationships among them, their causes, and consequences. One source of such integration and understanding has been the rediscovery of large and persistent socioeconomic and racial-ethnic disparities in health. Socioeconomic position and race/ethnicity shape individuals' exposure to and experience of virtually all known psychosocial, and well as many environmental and biomedical, risk factors, and these risk factors help to explain the size and persistence of social disparities in health. Improving the socioeconomic position of a broad range of disadvantaged socioeconomic and racial-ethnic strata constitutes a major avenue for reducing exposure to and experience of deleterious risk factors for health, and hence for improving the health of these groups and the overall population. This in turn requires better understanding of the macrosocial forces that influence the socioeconomic position of individuals.

For over 50 years I have been, and remain, an interdisciplinary social scientist seeking to develop and apply social science to improve the well-being of human individuals and social life. Sociology has been my disciplinary home for 48 of these years. As a researcher scholar, teacher, administrator, and member of review panels in both sociology and interdisciplinary organizations that include and or intersect with sociology, I have sought to improve the quality and quantity of sociolog ists and sociolog y . This article offers my assessment as a participant observer of what (largely American) sociology has been over the course of my lifetime, which is virtually coterminous with the history of modern (post-World War II) sociology, and what it might become. I supplement my participant observations with those of others with similarly broad perspectives, and with broader literature and quantitative indicators on the state of sociology, social science, and society over this period. I entered sociology and social science at a time (the 1960s and early 1970s) when they were arguably their most dynamic and impactful, both within themselves and also with respect to intersections with other disciplines and the larger society. Whereas the third quarter of the twentieth century was a golden age of growth and development for sociology and the social sciences, the last quarter of that century saw sociology and much of social science-excepting economics and, to some extent, psychology-decline in size, coherence, and extradisciplinary connections and impact, not returning until the beginning of the twenty-first century, if at all, to levels reached in the early 1970s. Over this latter period, I and numerous other observers have bemoaned sociology's lack of intellectual unity (i.e., coherence and cohesion), along with attendant dissension and problems within the discipline and in its relation to the other social sciences and public policy. The twenty-first century has seen much of the discipline, and its American Sociological Association (ASA), turn toward public and critical sociology, yet this shift has come with no clear indicators of improvement of the state of the discipline and some suggestions of further decline. The reasons for and implications of all of this are complex, reflecting changes within the discipline and in its academic, scientific, and societal environments. This article can only offer initial thoughts and directions for future discussion, research, and action. I do, however, believe that sociology's problems are serious, arguably a crisis, and have been going on for almost a half-century, at the outset of which the future looked much brighter. It is unclear whether the discipline as now constituted can effectively confront, much less resolve, these problems. Sociolog ists continue to do excellent work, arguably in spite of rather than because of their location within the current discipline of sociolog y . They might realize the brighter future that appeared in the offing as of the early 1970s for sociology and its impact on other disciplines and society if they assumed new organizational and or disciplinary forms, as has been increasingly occurring in other social sciences, the natural sciences, and even the humanities. Society needs more and better sociology. The question is how can we deliver it.

Health care spending in the United States today is approaching 20 percent of GDP, yet levels of U.S. population health have been declining for decades relative to other wealthy and even some developing nations. How is it possible that the United States, which spends more than any other nation on health care and insurance, now has a population markedly less healthy than those of many other nations? Sociologist and public health expert James S. House analyzes this paradoxical crisis, offering surprising new explanations for how and why the United States has fallen into this trap. InBeyond Obamacare, House shows that health care reforms, including the Affordable Care Act, cannot resolve this crisis because they do not focus on the underlying causes for the nation's poor health outcomes, which are largely social, economic, environmental, psychological, and behavioral. House demonstrates that the problems of our broken health care and insurance system are interconnected with our large and growing social disparities in education, income, and other conditions of life and work, and calls for a complete reorientation of how we think about health. He concludes that we need to move away from our misguided and almost exclusive focus on biomedical determinants of health, and to place more emphasis on addressing social, economic, and other inequalities. House's review of the evidence suggests that the landmark Affordable Care Act of 2010, and even universal access to health care, are likely to yield only marginal improvements in population health or in reducing health care expenditures. In order to rein in spending and improve population health, we need to refocus health policy from the supply side-which makes more and presumably better health care available to more citizens-to the demand side-which would improve population health though means other than health care and insurance, thereby reducing need and spending for health care. House shows how policies that provide expanded educational opportunities, more and better jobs and income, reduced racial-ethnic discrimination and segregation, and improved neighborhood quality enhance population health and quality of life as well as help curb health spending. He recommends redirecting funds from inefficient supply-side health care measures toward broader social initiatives focused on education, income support, civil rights, housing and neighborhoods, and other reforms, which can be paid for from savings in expenditures for health care and insurance. A provocative reconceptualization of health in America,Beyond Obamacarelooks past partisan debates to show how cost-efficient and effective health policies begin with more comprehensive social policy reforms.

Objectives. We investigated the association between anticipatory stress, also known as racism-related vigilance, and hypertension prevalence in Black, Hispanic, and White adults. Methods. We used data from the Chicago Community Adult Health Study, a population-representative sample of adults (n = 3105) surveyed in 2001 to 2003, to regress hypertension prevalence on the interaction between race/ethnicity and vigilance in logit models. Results. Blacks reported the highest vigilance levels. For Blacks, each unit increase in vigilance (range = 0–12) was associated with a 4% increase in the odds of hypertension (odds ratio [OR] = 1.04; 95% confidence interval [CI] = 1.00, 1.09). Hispanics showed a similar but nonsignificant association (OR = 1.05; 95% CI = 0.99, 1.12), and Whites showed no association (OR = 0.95; 95% CI = 0.87, 1.03). Conclusions. Vigilance may represent an important and unique source of chronic stress that contributes to the well-documented higher prevalence of hypertension among Blacks than Whites; it is a possible contributor to hypertension among Hispanics but not Whites.

A Telescope on Society seeks to convey the development of social science in the twentieth century through its interaction with a major new instrument for gathering data about society-survey research. The story of survey research and social science is largely told by social scientists affiliated with the Survey Research Center (SRC) and Institute for Social Research (IRS) at the University of Michigan about work done there. But the book also places this story in the broader context of survey-based social science in the United States and the world, to which many individuals and institutions beyond SRC, ISR, and Michigan have also contributed. The chapters of this volume illustrate the impact that developments in survey research have had and continue to have on a broad range of social science disciplines and interdisciplinary areas ranging from political behavior and electoral systems to macroeconomics and individual income dynamics, mental and physical health, human development and aging, and racial/ethnic diversity and relationships. The volume will speak to a wide audience of social science and survey research professionals and students interested in learning more about the broad history of survey-based social science and its contributions to understanding ourselves as social beings. It also seeks to convey how crucial institutional and public support are to the development of social science and survey research, as they have been to development in the natural, biomedical, and life sciences. The five editors of this book are longtime research professors and colleagues in the Survey Research Center of the Institute for Social Research at the University of Michigan. James S. House is also Professor in the Department of Sociology; F. Thomas Juster is Professor Emeritus in the Department of Economics; Robert L. Kahn is Professor Emeritus in the Department of Psychology and Department of Health Management and Policy; and Howard Schuman is Professor Emeritus in the Department of Sociology; Eleanor Singer is Research Professor in the Survey Research Center, all at the University of Michigan. Professors House (1991-2001), Kahn (1970-76), and Schuman (1982-90) have each served as Director of the Survey Research Center; Professor Juster served (1976-86) as Director of the Institute for Social Research; and Professor Singer served (1999-2002) as Associate Director of the Survey Research Center.

Objectives. We investigated whether the conventional Spanish translation of the self-rated health survey question helps explain why Latinos' self-rated health is worse than Whites' despite more objective health measures showing them to be as healthy as or healthier than are Whites. Methods. We analyzed the relationship between language of interview and self-rated health in the Chicago Community Adult Health Study (2001–2003) and the 2003 Behavioral Risk Factor Surveillance System. Results. Being interviewed in Spanish was associated with significantly higher odds of rating health as fair or poor in both data sets. Moreover, adjusting for language of interview substantially reduced the gap between Whites and Latinos. Spanish-language interviewees were more likely to rate their health as fair (regular in Spanish) than as any other choice, and this preference was strongest when compared with categories representing better health (good, very good, and excellent). Conclusions. Our findings suggest that translation of the English word “fair” to regular induces Spanish-language respondents to report poorer health than they would in English. Self-rated health should be interpreted with caution, especially in racial/ethnic comparisons, and research should explore alternative translations.

Objectives. We sought to demonstrate the advantages of using individual-level survey data in quantitative environmental justice analyses and to provide new evidence regarding racial and socioeconomic disparities in the distribution of polluting industrial facilities. Methods. Addresses of respondents in the baseline sample of the Americans' Changing Lives Study and polluting industrial facilities in the Environmental Protection Agency's Toxic Release Inventory were geocoded, allowing assessments of distances between respondents' homes and polluting facilities. The associations between race and other sociodemographic characteristics and living within 1 mile (1.6 km) of a polluting facility were estimated via logistic regression. Results. Blacks and respondents at lower educational levels and, to a lesser degree, lower income levels were significantly more likely to live within a mile of a polluting facility. Racial disparities were especially pronounced in metropolitan areas of the Midwest and West and in suburban areas of the South. Conclusions. Our results add to the historical record demonstrating significant disparities in exposures to environmental hazards in the US population and provide a paradigm for studying changes over time in links to health.