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T he association between socioeconomic status (SES) and health status is so robust and consistent that epidemiologists routinely adjust for it as a potential confounding variable when evaluating the etiologic role of other risk factors for disease. This chapter turns this logic on its head, focusing on SES as a fundamental determinant of disease, specifically cancer incidence and mortality. The association between SES and health status has been recorded throughout history. William Farr, regarded as the intellectual founder of epidemiology, documented the existence of socioeconomic disparities in mortality in nineteenth century Britain and concluded that:“No variation in the health of the states of Europe is the result of chance; it is the direct result of the physical and political conditions in which nations live”(quoted in Beaglehole and Bonita, 1997, p. 93). The apparently persistent and pervasive association between lower socioeconomic position and worse health status accounts for the belief that SES may be a “fundamental” determinant of individual and population health; that is, no matter what the current health threats confronted in any given society, the disadvantaged groups are worse off in terms of their achieved health (Link and Phelan, 1995). However, as this chapter argues, there are important exceptions to these generalizations. For example, the direction of causation does not uniformly run from SES to health. Evidence suggests that socioeconomic attainment and health status exert reciprocal influences on each other. Second, the relation between SES and health is dynamic and may change (or even reverse) over time. Major risk factors for …