This working paper summarises current knowledge about the biological consequences of social disadvantage in the first decades of life and how these contribute to health inequalities. People’s health varies depending on where they are on the ‘social gradient’. People in more advantaged socioeconomic circumstances live longer – and in better health – than those experiencing less advantage. Understanding why this is the case is an important step in addressing health inequalities. 

Studies have shown that socioeconomic disadvantage is associated with higher allostatic load. In turn, increased allostatic load has been associated with multiple chronic diseases. The relationship between social position and the biological embodiment of physiological responses that results in allostatic load operates through several pathways including the effects of behaviour, psychosocial responses, education and material deprivation. 

There is still much more to understand in this field. The scientific research on the concept of biological embodiment – how we literally incorporate the social world in which we live into our bodies’ cells, organs and systems – is still at an early stage. However, the evidence is consistent across the literature about the impact of socioeconomic disadvantages and stressful life conditions in childhood and adolescence on physiological and biological adaptive responses and the consequences of these for health outcomes. 

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