Socioeconomic status, fundamental cause theory, and prescription opioid use behaviors: a theoretical examination

Abstract I applied Phelan et al.'s fundamental cause theory (FCT) framework to examine the association between socioeconomic status (SES) and prescription opioid use behaviors among a nationally representative sample of US adults. I also explored the mediating roles of health status and the deployment of flexible resources. Consistent with FCT, the results showed that higher SES was associated with significantly lower odds of prescription opioid use behaviors. Two flexible resources—health care access and social support—and various indicators of poor health helped explain this relationship. Inconsistent with FCT, knowledge of heroin use as being a “great risk” was not a mediator of the SES-prescription opioid use behaviors association. Based on these findings, efforts to reduce SES disparities in prescription opioid use behaviors should emphasize reducing SES disparities overall as well as in health and access to important health-enhancing resources. Limitations of this study are discussed.