Social Science & Medicine
Volume 62, Issue 9 , May 2006, Pages 2171-2182

The wealthy get healthy, the poor get poorly? Lay perceptions of health
inequalities

Rosemary Davidsona, , , Jenny Kitzingerb and Kate Huntc

aCentre for Analysis of Social Exclusion, London School of Economics and
Political Science, Houghton Street, London WC2A 2AE, UK
bCardiff School of Journalism, Media and Cultural Studies, Cardiff
University, King Edward VII Avenue, Cardiff CF10 3NB, UK
cMRC Social and Public Health Sciences Unit, University of Glasgow, 4
Lilybank Gardens, Glasgow G12 8RZ, UK

Available online 21 November 2005.

Abstract
Research repeatedly identifies an association between health and
socio-economic status—richer people are healthier than poorer people.
Richard Wilkinson has posited that socio-psychological mechanisms may be
part of the explanation for the fact that socio-economic inequalities run
right across the social spectrum in wealthy societies. He argues that
polarised income distributions within countries have a negative impact on
stress, self-esteem and social relations which, in turn, impact on physical
well-being. How people experience and perceive inequalities is central to
his thesis. However, relatively little empirical work has explored such lay
perceptions. We attempt to address this gap by exploring how people see
inequality, how they theorise its impact on health, and the extent to which
they make personal and social comparisons, by drawing on 14 focus group
discussions in Scotland and the north of England. Contrary to other
research which suggests that people from more deprived backgrounds are more
relucta
nt to acknowledge the effects of socio-economic deprivation, our findings
demonstrate that, in some contexts at least, people from less favourable
circumstances converse in a way to suggest that inequalities deeply affect
their health and well-being. We discuss these findings in the light of the
methodological challenges presented for pursuing such research.

Keywords: Health inequalities; Lay perceptions; Focus groups;
Socio-economic