Psychosocial factors and public health

acleod and Davey Smith state that the aim of their paper is to critically examine the role of psychosocial factors in health. 1 Unfortunately, what could have been an interesting discussion is compromised by the authors implicit assumption that there is a single pathway linking social position to health. The authors seem to equate parsimonious causal analysis with a narrow, reductionistic perspective, subsequently devoting most of their paper to a discussion of "psychosocial versus material explanation", while ignoring evidence showing multiple pathways linking social position to health. 2 3 This commentary widens the debate by considering three issues