For most of us in the developed world, death is so remote we don't even concern ourselves with it. Later in life, it becomes a distant, inevitable reality, but still nothing for immediate concern. Then, as Rudyard Kipling wrote, "Man dies too soon, beside his works half-planned." Health and longevity are based upon factors we can all acknowledge: genetics, lifestyle and luck among them. They are also largely taken for granted. But as Stephen Bezruchka explains, social class has a far more profound effect in the US than we realize, in ways we wouldn't guess, even for the many of us who consider ourselves middle class.

Stephen Bezruchka is a senior lecturer at the University of Washington and works as an emergency room physician in Seattle. His particular areas of research are population health and societal hierarchy and its application to health. He is author of numerous articles and essays. His most recent contribution is to Sickness and Wealth, a collection of essays on the effects of global corporatization on health.