Why do societies experience higher rates of mortality after economic recession? What accounts for the persistent social class differences in mortality rates? How do we explain the health status differences between men and women, blacks and whites, and different communities or cultures? How do some families create more healthful environments for their children? How is stress generated in the workplace? Such fundamental questions about the social determinants of health are discussed in depth in this wide-ranging and authoritative book. Well-known contributors from North America and Europe gather and assess the evidence for the diverse pathways by which society influences health and provides conceptual frameworks for understanding these relationships. The book opens with a broad review of research on the social environment's contribution to health status and then addresses particular social factors: the family, the community, culture, class, race and gender, the economy, and the workplace. The concluding two chapters examine the contribution of medicine to the improved health of Americans and recast the health policy debate in a broad social policy context.