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Research has consistently shown that groups that are disadvantaged in terms of their income, occupational position or level of education tend to have poorer health and a shorter life expectancy. The distribution of health follows a distinctive pattern, with those at the bottom of the socioeconomic spectrum being in the worst health, those at the top enjoying the best health, and those in the middle having better health than those at the bottom but less good health compared with those at the top. This pattern has come to be known as the social gradient in health. The gradient is apparent in early infancy and extends through childhood and adolescence into adulthood (Chen, 2004) and old age (Huisman et al., 2003, 2004). Gradients are found irrespective of whether education, income, social class, race, ethnicity or a large number of other socioeconomic indicators are examined, and are evident even in countries where universal healthcare coverage exists (Adler & Newman, 2002). Indeed, so ubiquitous is the association between social position and health that it has been referred to as a ‘fundamental’cause of disease (Adler & Newman, 2002; Link & Phelan, 1995) in the sense that, almost irrespective of the cause of disease or death over time and place,