gms | German Medical Science

Kongress Medizin und Gesellschaft 2007

17. bis 21.09.2007, Augsburg

Social inequalities in low control beliefs

Meeting Abstract

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  • Hans Bosma - Maastricht University, Maastricht

Kongress Medizin und Gesellschaft 2007. Augsburg, 17.-21.09.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gmds777

The electronic version of this article is the complete one and can be found online at:

Published: September 6, 2007

© 2007 Bosma.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



The presentation will address the role of low control beliefs (“socialised fatalism”) for the heightened risks of poor health behaviours and, more generally, poor health in lower socioeconomic status groups. First, it is discussed that the prevailing meritocracy and trend towards increased individual responsibility are at the roots of the social inequalities in control beliefs. Further, the influence of both childhood and adulthood socioeconomic adversity on control beliefs is presented, as well as the influence of socioeconomic and socio-cultural characteristics of areas and perhaps even countries. Secondly, it is discussed that low control beliefs can affect health through poor health behaviours and other pathways. Drawing from the presenter’s own work with Dutch and English data, the contribution of control beliefs to socioeconomic inequalities in health and the pathway via health behaviours are quantified. Thirdly, remaining conceptual and methodological issues are discussed: the role of control beliefs in status attainment processes (“indirect selection”, genetics) and control as an “umbrella concept”. Finally, the implications for interventions aimed at the reduction of socioeconomic inequalities in health (behaviour) are discussed. Should the individual or the environment be the target of interventions?

[AG Sozialepidemiologie: Workshop 'Social inequalities in health behaviour - sociological and psychological explanations]


Bosma, H. Socio-economic differences in health. Are control beliefs fundamental mediators? In: Siegrist J, Marmot M, editors. Social inequalities in health. New evidence and policy implications. Oxford: Oxford University Press; 2006.