Research on reducing social disparities in health should also identify the critical targets for intervention and the particular indicators that are likely to maximize potential intervention effects. Schulz and colleagues175 show that income affects risk factors for CVD (such as waist circumference, BMI and cigarette smoking) through a chain of effects to which psychosocial stress and psychological distress contribute. Even in a sample with a relatively restricted range of income, they found that even modest increases in income could lead to a “cascade of effects” that could trigger improvements in CVD risk at the population level. Future research needs to replicate these cross-sectional findings and identify the key leverage points for intervention and the target indicators that are likely to produce cascading effects.
