•ANALYZE A RANGE OF PSYCHOLOGICAL FACTORS THAT INFLUENCE HEALTH, ILLNESS AND BEHAVIOUR.
— Psychosocial” factors such as stress, hostility, depression, hopelessness, and job control seem associated with physical health particularly heart disease. Adverse risk profiles in terms of psychosocial factors seem to cluster with general social disadvantage.3,4 Because of this the “psychosocial hypothesis” proposes that psychosocial factors are an important cause of health inequalities.5 Such factors include many mental states, psychological traits, or aspects of the social environment with a negative connotation. In this article we consider “psychosocial factors” to be any exposure that may influence a physical health outcome through a psychological mechanism. We wish to critically examine the evidence that the association between psychosocial factors and physical health is causal. If this association is not causal, interventions targeting psychosocial exposures are unlikely to lead to improvements in population health.
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