Toggle Main Menu Toggle Search

Open Access padlockePrints

Why Are There Social Gradients in Preventative Health Behavior? A Perspective from Behavioral Ecology

Lookup NU author(s): Professor Daniel Nettle



Background: Within affluent populations, there are marked socioeconomic gradients in health behavior, with people of lower socioeconomic position smoking more, exercising less, having poorer diets, complying less well with therapy, using medical services less, ignoring health and safety advice more, and being less health-conscious overall, than their more affluent peers. Whilst the proximate mechanisms underlying these behavioral differences have been investigated, the ultimate causes have not. Methodology/Principal Findings: This paper presents a theoretical model of why socioeconomic gradients in health behavior might be found. I conjecture that lower socioeconomic position is associated with greater exposure to extrinsic mortality risks (that is, risks that cannot be mitigated through behavior), and that health behavior competes for people's time and energy against other activities which contribute to their fitness. Under these two assumptions, the model shows that the optimal amount of health behavior to perform is indeed less for people of lower socioeconomic position. Conclusions/Significance: The model predicts an exacerbatory dynamic of poverty, whereby the greater exposure of poor people to unavoidable harms engenders a disinvestment in health behavior, resulting in a final inequality in health outcomes which is greater than the initial inequality in material conditions. I discuss the assumptions of the model, and its implications for strategies for the reduction of health inequalities.

Publication metadata

Author(s): Nettle D

Publication type: Article

Publication status: Published

Journal: PLoS ONE

Year: 2010

Volume: 5

Issue: 10

Print publication date: 13/10/2010

Date deposited: 26/01/2011

ISSN (electronic): 1932-6203

Publisher: Public Library of Science


DOI: 10.1371/journal.pone.0013371


Altmetrics provided by Altmetric


Find at Newcastle University icon    Link to this publication