Socioeconomic disparities in health behaviour: An evolutionary perspective

Abstract

Socioeconomic disparities in health behaviour are a reliable finding across many societies. Individuals of lower socioeconomic status (SES) more frequently undertake behaviours detrimental to health (e.g. Smoking) than those of higher SES. Despite a large volume of research on the subject, there is still no consensus on the causes of these disparities. In this chapter, we discuss nine categories of explanation which have been put forward in the social science literature. We then outline a complementary behavioural-ecological approach based on the idea that as extrinsic mortality increases, the payoff to investment in preventative health behaviour declines. We discuss how this evolutionary approach alters the interpretation of existing explanations, allowing us to reorganise the nine categories of explanation into three; ultimate, proximate and constraint based. We then discuss how this perspective can help to guide future research in public health.