The contribution of adult experiences, multimorbidity and positive psychological well-being to social inequalities in health

Abstract

Abstract We focus on three aspects of health inequalities. The first is the role of adult adversities such as chronic work stress, breakdown of intimate relationships, social isolation and discrimination, all of which contribute to increased morbidity and to premature mortality. These experiences are more common among less advantaged groups, so promote health inequalities. Second, we emphasize the impact of multimorbidity, the presence of two or more long-term physical and mental health conditions, on health inequalities. Inequalities in mental ill-health early in life are directly linked to later physical health inequalities, highlighting the critical importance of managing multiple conditions effectively. Third, we discuss socio-economic inequalities in protective psychological characteristics, such as purpose in life, optimism and positive well-being. These experiences are graded by education, income and occupational prestige. They are not only health protective but also malleable. Enhancing these factors through psychological and social interventions may contribute to reductions in health inequalities.