Although economic impoverishment has long been recognized as a health risk, it has not generally been targeted as a modifiable risk factor. A number of methodologic and conceptual issues have impeded and obscured explanation of the nature and characteristics of the relationship between socioeconomic status and health. Further investigation is needed to address directional effects, confounding factors, and measurement difficulties. Conceptual representations of the links between economic impoverishment and health need to be clarified and expanded. Until this relationship is better understood, development of effective strategies to improve health for the economically disadvantaged will be problematic.