Adherence

The extent to which health behaviors (smoking, diet, physical activity, alcohol) explain socioeconomic differences in mortality is contingent on the strength of the social patterning of those behaviors; in contexts where unhealthy behaviors are strongly concentrated in lower socioeconomic groups, they act as major mediators of mortality inequality, whereas in contexts with weaker social patterning, they explain a minor proportion of the inequality.

If you are designing public health policy to reduce health inequalities, do not assume that promoting healthy behaviors (like quitting smoking or eating well) will automatically close the gap between rich and poor. The effectiveness of these behaviors in reducing inequality depends on how strongly those behaviors are linked to social status in your specific community. In places where unhealthy behaviors are concentrated among the poor, promoting them is a high-leverage strategy. In places where these behaviors are more evenly distributed, other structural factors may be more important.