IB Psychology Poverty and Socio-economic Status Notes

Socioeconomic status shapes health outcomes through interconnected material, psychosocial, and behavioural pathways

In health psychology, socioeconomic status (SES)—determined by income, education, and occupation—is the strongest single predictor of health outcomes. The health gradient reveals that health improves continuously with each step up the SES ladder, not just between rich and poor. This is not about material deprivation alone.

1. Material pathways: limited income restricts access to nutritious food, preventive healthcare, safe housing, and medication.
2. Psychosocial pathways: low SES triggers chronic stress from financial insecurity, reduced sense of control, and awareness of social status disadvantage.
3. Behavioural pathways: poverty is associated with higher rates of smoking, poor diet, and reduced exercise, partly through limited access and stress-driven coping.

The Whitehall studies demonstrated the health gradient persists even among employed, secure workers

Marmot's landmark Whitehall studies tracked British civil servants across decades. Even among secure, employed workers, those in lower-grade positions showed dramatically higher rates of heart disease, diabetes, and early mortality than those in senior roles. This proves the health gradient is not explained by material poverty alone—relative social status matters profoundly for health.

Chronic stress from low SES triggers biological pathways that damage health

Low SES activates the stress response system continuously. The hypothalamic-pituitary-adrenal (HPA) axis releases cortisol in response to daily financial and social stressors. Prolonged elevation of cortisol creates allostatic load—wear and tear on the body from chronic activation of stress physiology. This accelerates ageing and increases vulnerability to infection, cardiovascular disease, and metabolic dysfunction.

1. Elevated cortisol damages the immune system, increasing infection risk and slowing healing.