In the stress paradigm, disadvantaged social position is both a source of adversity and a drain on the capacity to cope. Given these circumstances, smoking, overeating, and inactivity represent forms of pleasure and relaxation that help regulate mood. The coping or self-medicating functions of these behaviors make the costs of giving them up particularly salient and limit the ability of individuals to adopt healthy but challenging behaviors (Lutfey & Freese 2005). 

Those deprived economically and living in disadvantaged neighborhoods face a variety of chronic stressors in daily living: They struggle to make ends meet; have few opportunities to achieve positive goals; experience more negative life events such as unemployment, marital disruption, and financial loss; and must deal with discrimination, marginality, isolation, and powerlessness . 

These stresses trigger a host of compulsive behaviors such as overeating, drinking, and smoking ( Marmot 2004). Studies give indirect support to stress arguments by showing higher smoking among persons in positions of high stress, including unemployed workers , poor single women with child rearing duties, those from disadvantaged backgrounds, and residents of deprived neighborhoods. 

Less educated persons with jobs that offer few opportunities for learning may have limited knowledge of the harm of unhealthy behavior and therefore less motivation to adopt healthy behaviors. They are exposed less often to warnings about smoking, poor diet, and lack of exercise and may not grasp the potential long-term harm of these activities. They instead may be exposed more to advertising that promotes the enjoyment of tobacco and unhealthy food and associates smoking, drinking, and eating with a glamorous lifestyle.

Knowledge about the risks of obesity is less widespread and differs by SES. Only 36% of U.S. adults rate obesity as a very serious health problem—far behind AIDS, even though obesity contributes to more deaths each year (Bleich et al. 2007). Compared to those with less than a high school degree, those with more than a college degree are 3.6 times as likely to report that they pay a lot or a fair amount of attention to nutritional information from scientific experts. Similarly, higher educational attainment is related to an awareness of whether one is overweight (Paeratakul et al. 2002), and knowledge about the risks of obesity can contribute to attempts to control weight (Kan & Tsai 2004). Indeed, the effectiveness of educational programs for promoting proper diet among low-income adults (Howard-Pitney et al. 1997) suggests that poor knowledge about nutrition may partially account for SES differences in weight. 

Schooling increases the efficacy, problem-solving skills, ability to process information, and locus of control needed to overcome obstacles to good health such as nicotine addiction, the inertia of inactivity, the discomfort of exercise, and the desire for unhealthy foods and excess calories. The increase in human capital, effective agency, and a sense of personal control that comes with greater education (Mirowsky & Ross 2007) proves particularly important in dealing with the difficulties of adopting and maintaining healthy lifestyles. In fact, highly educated persons may induce short-term stress as a means for long-term gain (Thoits 2006)— a key to overcoming initial feelings of discomfort and deprivation that come from adopting healthy behaviors. Conversely, less educated persons in positions of powerlessness have more trouble overcoming the obstacles to healthy behavior. Thus, the ability to act on health knowledge rather than the knowledge itself affects health behavior. 

Efficacy and agency include the search for innovative means to help change behavior and relate to a long tradition of research on diffusion of innovations that identifies education as a key to early adoption (Rogers 2003). Consistent with diffusion research, high-SES groups are quickest to use new medical technologies, such as Pap smears and mammography for screening or coronary stents and statins for treatment. High-SES groups not only seek out new health-promoting technologies, but they also are better able to overcome obstacles to using those new technologies effectively to promote health behavior. In relation to health behaviors, then, high-SES groups are open to new smoking cessation methods, diets, and exercise regimens. 

Adopting many healthy behaviors does not require money, but paying for tobacco cessation aids, joining fitness clubs and weight loss programs, and buying more expensive fruits, vegetables, and lean meats can help realize desires for healthy behavior. Income and the ability to pay for these kinds of aids can help overcome low education, efficacy, and agency and thus represent an independent means to healthy behavior. 

For smoking, individual counseling and medications to ease withdrawal symptoms can be costly, and low-SES groups tend to use low-cost and often less effective methods (Lillard et al. 2007). For exercise, since the 1960s the prices of sports equipment, bicycles, and sports club memberships have increased more quickly than the prices of televisions or movie tickets, whereas the income per hour of leisure time has fallen most among those with lower incomes (Berry 2007).  And for weight control, some researchers contend that the obesity epidemic is a relatively simple matter of changing economics—the drastic increase in obese persons in developed countries coincides with dropping prices of refined grains and added sugars and fats, making these cheap, high-calorie foods accessible to low-SES groups (Drewnowski 2004).

Occupational resources overlap with financial ones. Those with good jobs and benefit packages gain access to aids for healthy behavior without having to purchase them. In regard to smoking, workers with better jobs may have employer-provided health insurance and better access to health care, which increasingly emphasizes the treatment of tobacco dependency (Manley et al. 2003). In addition, the worksites of higher prestige professional, managerial, and administrative employees more often have clean indoor air rules that make smoking more difficult, and they sometimes offer smoking cessation programs that help smokers quit (Bauer et al. 2005). Blue-collar and factory workers have less access to these benefits (Sorensen et al. 2004).

Communities shape opportunities to adopt and maintain healthy behaviors. Low-income neighborhoods have more than their share of fast-food restaurants, liquor stores, and places to buy cigarettes and have less than their share of large grocery stores with a wide selection of healthy fresh foods. Some research finds that low-SES neighborhoods have greater or equal access to gyms, parks, or recreation centers than high-SES neighborhoods, although others find that high-SES neighborhoods have more attractive open spaces and free recreation facilities, and greater access to beaches, rivers, golf courses, tennis courts, and bike trails  

Group membership—and the characteristics of individuals within communities—can affect health behavior.  First, networks of health-oriented family members, relatives, friends, and neighbors support healthy behavior, sanction unhealthy behavior, and exchange information on ways to change . Given that high-SES persons adopt healthy behaviors and associate with other high-SES persons, their networks of social support, influence, and engagement promote health and widen disparities.