Intelligence: is it the epidemiologists' elusive "fundamental cause" of social class inequalities in health?

Abstract

Virtually all indicators of physical health and mental competence favor persons of higher socioeconomic status (SES). Conventional theories in the social sciences assume that the material disadvantages of lower SES are primarily responsible for these inequalities, either directly or by inducing psychosocial harm. These theories cannot explain, however, why the relation between SES and health outcomes (knowledge, behavior, morbidity, and mortality) is not only remarkably general across time, place, disease, and kind of health system but also so finely graded up the entire SES continuum. Epidemiologists have therefore posited, but not yet identified, a more general "fundamental cause" of health inequalities. This article concatenates various bodies of evidence to demonstrate that differences in general intelligence (g) may be that fundamental cause.