Socioeconomic Status (SES)

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Socioeconomic Status Definition

Socioeconomic status (SES) is evaluated as a combination of factors including income, level of education, and occupation. It is a way of looking at how individuals or families fit into society using economic and social measures. These factors have been shown to impact individuals' health and well being.That's why they're used in the calculation of SES. 

Socioeconomic status and health are closely related.

SES can often have profound effects on a person's health. These effects are due to a number of different challenges and opportunities that vary by SES. For example, people with different SES have very different abilities to access healthcare and medical services. They may also have profoundly different dietary options and/or exposure to environmental toxins. There are many health related behaviors and factors that are associated with both finances and education -- two fundamental components of SES.

Socioeconomic status is usually categorized into high SES, middle SES, and low SES.

Socioeconomic Status and STDs

A number of studies have found links between lower socioeconomic status and the risk of acquiring STDs.  Unfortunately, the understanding of the reasons for this link is not without controversy. Research on adolescent sexual health, in particular, suggests that for many people the link has less to do with income and more to do with other factors.

For example, STD risk may have more to do with how many parents are living in the home or parental education levels. The link between adolescent sexual behavior and STD risk and SES is also confounded by the link between SES and race. Young people who are not White generally have higher STD risk for a number of reasons.

Some of them are linked to behavioral choices and others are not. For example, the overall higher prevalence of various STDs in non-White communities puts people living and dating in those communities at inherently higher risk of exposure.

That's one reason why another big risk factor associated with STD risk, and particularly HIV risk, is the SES status of the community in which individuals live.This is a factor that goes above and beyond individual SES. Low SES communities are less likely to have access to doctors, or even STD clinics. This means that there is less access to screening and treatment. That's followed, unsurprisingly, by a higher STD prevalence in the community. That, as mentioned above, means there is a greater risk of exposure and transmission.

A lack of access to regular healthcare is strongly associated with HIV risk. Why? Because people with new infections, who have not yet been diagnosed, are thought to be at the greatest risk of passing on their infection. In addition, recent studies have shown that early HIV treatment is a highly effective form of prevention.

Therefore, a lack of healthcare in the community directly impacts HIV risk for those living there.

Improving universal access to healthcare can have profound effects on leveling the playing field and reducing the impact of SES on health. This means not just better insurance coverage. It also requires that individuals have the ability to access care in their neighborhoods and communities. 

Sources

Centers for Disease Control and Prevention (CDC). Characteristics associated with HIV infection among heterosexuals in urban areas with high AIDS prevalence --- 24 cities, United States, 2006-2007. MMWR Morb Mortal Wkly Rep. 2011 Aug 12;60(31):1045-9.

Dinenno EA, Oster AM, Sionean C, Denning P, Lansky A. Piloting a system for behavioral surveillance among heterosexuals at increased risk of HIV in the United States. Open AIDS J. 2012;6:169-76. doi: 10.2174/1874613601206010169.

McDavid Harrison K, Ling Q, Song R, Hall HI. County-level socioeconomic status and survival after HIV diagnosis, United States. Ann Epidemiol. 2008 Dec;18(12):919-27. doi: 10.1016/j.annepidem.2008.09.003.

Newbern EC, Miller WC, Schoenbach VJ, Kaufman JS. Family socioeconomic status and self-reported sexually transmitted diseases among black and white american adolescents. Sex Transm Dis. 2004 Sep;31(9):533-41.

Santelli JS, Lowry R, Brener ND, Robin L. The association of sexual behaviors with socioeconomic status, family structure, and race/ethnicity among US adolescents. Am J Public Health. 2000 Oct;90(10):1582-8.

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