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What is the evidence that differences in ‘control over destiny’ lead to socioeconomic inequalities in health? A theory-led systematic review of high-quality longitudinal studies on pathways in the living environment

Published version
Peer-reviewed

Type

Article

Change log

Authors

Orton, Lois Catherine 
Pennington, Andy 
Nayak, Shilpa 
Sowden, Amanda 
Petticrew, Mark 

Abstract

jats:secjats:titleBackground</jats:title>jats:pLow control and high demand in the places where people work has been shown to partially explain why those in lower socioeconomic positions experience poorer health than their counterparts in higher socioeconomic positions. It would seem likely then that experiences of control in the wider living environment, beyond people’s places of work, might also play a role in shaping these health inequalities. Our recent review of theory revealed potential pathways by which low control in the living environment might explain the social patterning of health via low control beliefs and low actual control.</jats:p></jats:sec>jats:secjats:titleMethods</jats:title>jats:pBased on the potential pathways identified in our review of theory, we conducted a systematic review of longitudinal studies on the relationship between low control in the living environment and social inequalities in health published by January 2019, in English.</jats:p></jats:sec>jats:secjats:titleResults</jats:title>jats:pSix studies were included in the review. Taken together, they provide evidence that lower social positions are associated with lower control beliefs and poorer health outcomes, in terms of heart disease, anxiety, depression and self-rated health, and that some of the association between low social position and health outcomes is explained by low control beliefs. No studies investigated the pathway from low actual control to poorer health in more disadvantaged groups.</jats:p></jats:sec>jats:secjats:titleConclusion</jats:title>jats:pThere is strong evidence from a small number of high-quality longitudinal studies that low perceived control in the living environment may play an important role in the pathways leading from low social position to poorer health and well-being. Further studies are needed to distinguish between the effects of having low control beliefs and having actual low control.</jats:p></jats:sec>

Description

Keywords

control over destiny, health, inequalities, social determinants, socioeconomic status, systematic review, Female, Health Status Disparities, Humans, Internal-External Control, Longitudinal Studies, Male, Social Class

Journal Title

Journal of Epidemiology and Community Health

Conference Name

Journal ISSN

0143-005X
1470-2738

Volume Title

Publisher

BMJ
Sponsorship
Medical Research Council (MR/K023187/1)
This study was supported by Department of Health and Social Care Policy Research Programme.