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What’s the issue? In all countries, it is well-established that poorer people have substantially shorter life expectancies and more illnesses than the rich. This phenomenon has been observed since at least the nineteenth century when Chadwick (1965) investigated the health of the working classes in Victorian England. Two contemporary British studies have been very influential in their documentation of the relationship between socioeconomic factors and health status. The Whitehall civil service study compared the health status of individuals over time with their position in a well-defined job hierarchy. Those lower in the hierarchy experienced three times the risk of death from heart disease, stroke, cancer, gastrointestinal disease, accident and suicide compared with those at the top of the hierarchy. These differences could not be explained by differences in medical care. The Secretary of State for Health in Britain was concerned about why – 30 years after the establishment of the National Health Service (which made health serves available to all, regardless of income) – significant differences in mortality between social classes persisted. The Black Report, released in 1980 (Townsend et al., 1992) concluded that these differences in health status were not the result of individual differences, but rather of structural differences in the way members of these different classes led their lives. This included a wid