This volume explores the relationship between social inequality and public health. Health in every society is stratified by income, race and class. Rich people enjoy better health than poor people; members of the majority enjoy better health than members of disadvantaged minorities; professionals enjoy better health than workers. It had long been assumed that these social gradients in health resulted from differential access to healthcare or systematically different health behaviours between groups: lower-ranked groups could not get medical care, or smoked more or simply did not trust doctors. Mounting evidence, however, suggests that more is at work. Social scientists and public health researchers are becoming increasingly convinced that the social context in which an individual lives has a powerful direct effect on health, independent of health resources and behaviours. Moreover, entire societies seem to have better health outcomes than others; on this count, the US, the richest country the world has ever known, scores particularly badly. We are only beginning to understand the links between societal inequality and individual health; this volume represents a survey of research on the subject, written by scholars who are actively engaged in pushing forward the state of the art.

The individual chapters collected here emerged out of conversations held at the 2006 Pitt International Conference on Inequality, Health and Society. The organisers – Siddharth Chandra, John Marx, Ravi Sharma, Ken Thompson and myself – brought together leading social science and public health scholars from around the world to discuss ways to improve our understanding of how societal inequality affects broad population health. The chapters represented in this volume emphatically are not reprints of papers presented at the conference. On the contrary, most of the chapters were written expressly for this volume. In fact, several of the contributors did not even attend the conference, but were nonetheless eager to participate in this book project. One reason is that many of us researching the relationship between social inequality and public health see a pressing need to educate health and health policy professionals – not just academics – about the importance of societal context in influencing individual health outcomes. The chapters in this volume, accordingly, take quite sophisticated academic propositions, strip them of their customary statistical argumentation and present them in words and figures in a language that non-specialists can understand. The result is a volume that is rigorous without being arcane.