The finding that income predicts mortality has a long history. Nineteenth-century studies include Villermé1 on Paris, France, in 1817, Engels2 on Manchester, England, in 1850, and Virchow3 on Upper Silesia in 1847 through 1848. Modern analyses include the Whitehall study of British civil servants, whose status was measured by income,4 as well as similar findings for other European countries.5 Indeed, the mortality gradient by income is found wherever and whenever it is sought. Virchow’s statement3,6 that “medicine is a social science, and politics is nothing but medicine at a larger scale” has lost none of its resonance. By contrast, the medical mainstream, looking back to Koch rather than Virchow, emphasizes biology, genetic factors, specific diseases, individual behavior, health care, and health insurance.
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Deaton A. On Death and Money: History, Facts, and Explanations. JAMA. 2016;315(16):1703–1705. doi:10.1001/jama.2016.4072
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.