Socioeconomic status and physical health, how are they related? An empirical study based on twins reared apart and twins reared together

This investigation used the powerful combined twin and adoption design to assess the validity of three different hypotheses—social causation, childhood experiences, and health selection—on the origin of the association between socioeconomic status (SES) and health. The sample contains 99 pairs of monozygotic twins reared apart, 166 pairs of monozygotic twins reared together, 238 pairs of dizygotic twins reared apart, and 221 pairs of dizygotic twins reared together, who completed questionnaire items concerning their SES and health status. Genetic effects, environmental effects unique to the individual, as well as environmental effects shared by twins were involved in mediating the associations between SES and health. However, the relative importance of these effects varied for the different associations depending on the measures of health and SES respectively. The results indicate that social causation, childhood experiences, and health selection may all be important for the association between SES and health. It is argued that these hypotheses are not contradictory, rather the relationship between the complex dimensions SES and health may be explained by several different causes.