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November 25, 1998

Socioeconomic Factors and Determinants of Mortality—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;280(20):1744-1745. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-20-jac80013

In Reply.—We agree with Drs Davey Smith and Hart that both early and later socioeconomic influences are important, with their relative impacts likely to vary across populations, time, and specific health outcomes.

We also agree that indicators such as education, income, and occupational status should not be considered as equivalent measures of social class or socioeconomic position, since the mechanisms or paths by which these indicators are related to health may vary substantially.1 The suggestion that education better reflects socioeconomic circumstances of early life is a good one, although this may vary across societies and time, depending on the nature of the educational system and its relation to both antecedent and subsequent socioeconomic position.2

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