Social inequalities in mortality: a problem of cognitive function

This editorial refers to ‘Does IQ explain socio-economic differentials in total and cardiovascular disease mortality? Comparison with the explanatory power of traditional cardiovascular disease risk factors in the Vietnam Experience Study’†, by G.D. Batty et al., on page 1903 Inequalities in health matter. The relationship between measures of socio-economic position and mortality is a strikingly consistent finding. It has been clear for some time that this relationship extends to cardiovascular mortality: a lower position in the social hier-archy is linked to higher mortality.1 It should give us pause. Much of medicine has to do with diagnosis and treatment of disease in individ-uals. This concern with individuals has been extended to prevention: use of the epidemiological data on risk factors as a basis for behaviour change or risk factor modification in individuals. Social inequalities in cardiovascular and other diseases suggest that we need to broade